Sensis VIBE Turnover Workbook

Resp EtCO2 SIEMENS BO O Healthineers /PWed LV+PCW 2 PM Pressure Calculation PCW LV. 200 200 180 180 160 160 laVL 140 140 LV 200 B 120 120 PCW 200 M 100 100 80 80 60 60 40 40 20 20 M Condition: 1.Rest Cardiac Output: Valve/Site Difference Gradient Area Education Services www.usa.siemens.com/education SENSIS VIBE Turnover Workbook Answers for life. User Services. Driven by More. More: Our philosophy for a lifelong improvement through continuing education and consulting. Working closely with you, we develop your personalized education and consulting strategy and support you and your staff with our comprehensive User Services to help gain: • More: Routine Confidence • More: Clinical Expertise • More: Superior Performance More: Personalized training, education, and consulting services from Siemens Healthcare Customer Services. For your leading edge in medical care. User Services. Driven by More. More: Personalized More: More: Superior Clinical Performance More: Routine Expertise Confidence 2 I Contact Information Summary Welcome to Siemens Healthineers Clinical Education Offerings: Siemens Healthcare is dedicated to helping you Call 1-888-221-8010 (follow the prompts) • get the most out of your investment throughout Classroom Training the entire product life cycle and beyond. Our goal (Offerings, Registration & Scheduling) • is to enable you to take technology further, Educational Symposia • profitability higher, and patient care to the next On-site Training • level. Find the information, resources, and tools Printed Self-studies • you need to get the most out of your recent Virtual Education (Offerings & Registration) • investment and stay up-to-date. Visit Workshops & Fellowships www.usa.siemens.com/Welcome2Healthcare. Visit www.usa.siemens.com/education for more information regarding the current Clinical Training and Siemens Clinical Training and Continuing Continuing Education Education portfolio. Siemens Customer Care Center: Call 1-800-888-7436 Siemens Training Centers • Troubleshooting assistance Immediate assistance for software Siemens Clinical Education • applications and workflow issues Training Center – TDC2 • For Tech Support press option 2 / for 110 MacAlyson Court applications support, press option 3 Cary, NC 27511 • Press the * key or enter the last six digits of your Functional Location Number Functional Location Number ____________________ Serial Number ________________________________ IP Address System _____________________________ IP Address PACS _______________________________ 3 II Contents I Contact Information Summary ............................................................................................... 3 II Contents .............................................................................................................................. 4 III Course Agenda .................................................................................................................... 5 Session 1 (4 hours) ............................................................................................................ 5 Session 2 (8 hours)............................................................................................................. 5 Session 3 (8 hours)............................................................................................................. 5 Session 4 (4 hours)............................................................................................................. 6 1. Session One – System Overview ........................................................................................... 7 1.1 Objectives .................................................................................................................... 7 1.2 Hardware ..................................................................................................................... 7 1.3 Shutdown Procedure .................................................................................................. 13 1.4 Software Navigation ................................................................................................... 14 2. Procedure Workflow........................................................................................................... 29 2.1 Objectives .................................................................................................................. 29 2.2 Procedure Workflow.................................................................................................... 29 3. Databases.......................................................................................................................... 50 3.1 Objectives .................................................................................................................. 50 3.2 Patient Browser Database............................................................................................ 50 3.3 Patient Explorer Database ........................................................................................... 55 4. Administrative Functions.................................................................................................... 61 4.1 Objectives .................................................................................................................. 61 4.2 Setting your Defaults .................................................................................................. 61 4.3 Channel Calibration .................................................................................................... 68 4.4 Points of Interest ........................................................................................................ 71 4.5 Optional Software and Hardware................................................................................. 71 4.6 Review Checklist......................................................................................................... 73 4 20 20 SAL Pressure Calculations Event Properties - 3:53:41 PM HR (LV) 80 bpm Reset Signa Site SIA DIV E/M dP/dt P/dt/P P1 LV Condition: 1.Rest Cardiac Output: 120 2231 55 Events Results 2 14 P2 PCW 15 13 12 Site S/A E/M 02 Sat Valve/Site Difference Gradient Area Signals Valves/Sites Diff Gradient Area P1:P2 Mitral 6 Print Pleth Modify OK Cancel Storage: 262:58 3:53:45 PM - Snapshot 3:54:45 PMVIBE Sensis , 97198075198 III Course Agenda Session 1 (4 hours) Operator’s Manuals and Quick Guides Hardware • Control Room • Procedure Room • Shut down and Reboot Procedure Software Navigation Session 2 (8 hours) Procedure Workflow Calculations • Pressure • Cardiac Output Test Cases – Emergency Cases Correct Patient Demographics Session 3 (8 hours) Patient Studies Patient Browser and Maintenance Load into Post Processing When to and When NOT to use “Continue Exam” Patient Explorer 5 Session 4 (4 hours) Setting your Defaults Channel Calibration Points of Interest Optional Software and Hardware Review Checklists Questions and Answers NOTE: Patient procedures may be performed after completion of Session 2. 6 Turnover Workbook | Sensis VIBE 1. Session One – System Overview 1.1 Objectives Notes After completion of this session, you will be able to: • Correctly identify and describe the uses of the Sensis Vibe Hardware in both the Control Booth and Procedure Room. • Appropriately shut down and restart the Sensis Vibe system for weekly maintenance. • Recognize and describe the User Interface icons and their functions. 1.2 Hardware 1.2.1 Control Room Hardware 1. Real Time and Dialog Monitor 2. Sensis Vibe keyboard and Mouse 3. Computer 7 Turnover Workbook | Sensis VIBE 1.2.2 Procedure Room Hardware Notes Hemo Intelligent Signal Input Box – HiSIB P1/P2 ECG P3/P4 Sp02 CO NBP T1/T2 A EtCO2 Microstream® P1/P2 and P3/P4 - Invasive blood pressure input channels • Each input accepts the connection of a bifurcated IBP interface cable (total of 4 invasive pressure inputs) CO - Thermodilution Cardiac Output (CO) input channel • Connects to a thermodilution CO trunk cable, which subsequently connects to a catheter and an injectate thermistor T1/T2 - Temperature input channels • Connects to a single (for one channel) or bifurcated (for two channels) temperature probe interface cable ECG - ECG input • Connects to a ECG Cable. Possible to connect the patient for a 12 lead ECG or just the limb lead ECG with V4. The electrodes of which are applied to the patient’s limbs chest. 8 Turnover Workbook | Sensis VIBE SpO2 - SpO2 input (pulse oximetry) Notes • Connects to an SpO2 sensor (applied to the patient’s finger NBP - Connects to an NBP hose and cuff (usually applied to the patient’s arm) EtCO2 Microstream - Carbon Dioxide (CO2) monitoring input • Connects to an external CO2 OEM module (the Oridion MicroPod), connects to a sampling line (applied in line with the patient’s airway) Hemo Intelligent Signal Input Box – HiSIB – Front and top functions >0€ (1) (2) (3) (4) (1) Alarm Silence/Reset (2) Thermal Dilution Cardiac Output Start (3) NIBP Start/Stop (4) Zero Balance ALL IBP channels connected with Transducer Hemo Intelligent Signal Input Box – HiSIB – Bottom Connectors IP XA Artis ....... . .... Analog Out At the bottom of the HemoBox (HiSIB), are the connections to: • Artis X-Ray system • Analog Output (for signals out to other medical devices that need Vibe signals i.e. ECG or Pressure. • Ethernet connection to connect HiSIB to Vibe PC in the Control Room 9 Turnover Workbook | Sensis VIBE Notes ECG Trunk Cable Standard Limb Lead - Non Radiotranslucent 5-Lead Cable (Limbs + V4) ` Standard Chest Lead - Non Radiotranslucent V1>V3 and V5 + V6 to complete 12 lead ECG Limb Lead - Radiotranslucent 5 Lead Cable (Limbs +V4) (Option) 10 Turnover Workbook | Sensis VIBE Notes Chest Lead - Radiotranslucent V1 > V3 and V5 + V6 to complete 12 lead ECG (Option) NIBP Cuff Nonin Fingertip SpO2 Sensor Transducer Connection Cables • ECG Cables – Radiotranslucent leads are am option • Cuff for non-invasive blood pressure measurement (NIBP) • Nonin SpO2 fingertip sensor 11 Turnover Workbook | Sensis VIBE Notes Microcap Capnograph • Respiration and EtCO2 measurement cannula (optional purchase) • Respirations - EtCO2 display on the Vibe Monitor 12 Turnover Workbook | Sensis VIBE 1.3 Shutdown Procedure Notes • Weekly shut down Process 1. Top toolbar > Options > End Session Calculate [Pressure 80 Vital Signs TA Hemo Calculation Check Electrodes ! V2 Check Electrodes !V3 Check Electrodes V4 ! V5 Check Electrodes IV6 Check Electrodes 307:39 PNP Device Mounted - Drive(CH). Total Spa . U 15:42:58 PM 3:42:57 PM 2. This Window will then appear End Session X This will end your session Normal Forced Logoff Shut down Reset HemoBox Cancel • You have two options here – to do the Shut down or to Reset your HiSib (Signal input box). Weekly Shut Down, hit the Shut Down! hp 3. When both of your monitor screens are completely black – you will notice that the Green Light on your PC is flickering. Hit the Power button (just above the green lights) to turn your Sensis Vibe back on. 13 Turnover Workbook | Sensis VIBE 1.4 Software Navigation Notes 1.4.1 Real Time and Review Patient Applications Edit View Acquire Input `Tools Review Real Time Calculate Pressures Setup Workflow Support mody nam ... Resp EICO2 HR 80 AO PA C.O. LVEWed LV.PCW PW>PA PA>RV 3:53:42 PM Pressure Calculation 120 / 0 LV 45 Current Condition 1. Rest 15 / 10 Vital Signs WW200 PCW 12 132 / 87 NBP X 102 REC 98 Hemo Calculation LVI BO DE 2 14 2231 55 2 Wcw 128 2 12 223 Everts Results PIP2 Mitral 0 6 Storage: 262:58 14 Turnover Workbook | Sensis VIBE 1.4.2 Results Function Notes ient Applications Resp 21 E1002 29 HR 81 n VIBE Sensis Review 9719807519876 Female 02/26/1 958 TRV 25 mm's 120 / 0 Setup . Worklow Support RTSLT - P16P2 A LV 45 Current Condition 1. Rest 15 / 10 New PCW LV TaVE 200 200 LV 200 PCW LV 12 PCW 200 180 180 PCW 160 160 laVL 132 / 87 140 140 200 200 120 120 LV 200 B PCW 200 NBP 102 100 100 180 180 Sp02 % Hemo Calculation 80 80 160 160 60 60 40 40 140 140 FICO 4.0 20 20 120 120 0 M SA 100 100 O Everts FREsund Cardiose Output TRcomo- - --- Pre Cath Data Performing Physicians Personnel Case Times Patient/Procedure Status Procedure Checklist Lab Values Pre Procedure Pulses LOC Score Pre age: 262:58 3:57:01 PM - Vital Sign Alarm 3:57:25 PMVIBE Sensis . 9719807519876 Pressure Calculation is accepted • The Results tab gives the user a “quick look” location of previously sampled pressure calculations, cardiac output results, valve gradient calculations and O2 saturations that have been logged into the Sensis Vibe. • S/A = Systolic or A wave • D/V = Diastolic or V wave • E/M = EDP or Mean 15 Turnover Workbook | Sensis VIBE 1.4.3 Events Tab Notes Patient Applications Edit View Acquire Input Tools Options Help VIBE Sensis Review 9719807519876 Female 02/26/1 958 RV PA PCW AO-PA LVPWed V+PCW PW>PA PA>RV 25 mm/s Setup . Workflow Support RT< - P1&P2 Pressure Calculation Hemodynam ... Current Condition 1. Rest New -- A- PCW LV Vital Signs 200 200 B SSTOP 180 160 160 Post Proces ... Recording 140 140 120 120 Hemo Calculation 100 100 80 80 60 60 40 40 20 20 SAI O Tools Pleth (5) ·0+ Q Add / Edit Event (2) Events Results Event - (4) Cardiac Flowsheet Time Summary 3:31:24 PM Equipment | 6F Sheath Pinnacle MP 45 View Equipment 3:32:55 PM Pre LAC & en 1 10 Sheath Access 3:33:15 PM Aller (3) lown Allergies | Type of Reaction: Procedure Note 3:33:23 PM Vital Rate (bpm) : 80 | Rhythm : Sinus Rhythm | Blood Pressure (Sys/Dia) : 134/78 | 02 Sa ... Documentation Medication (1) 3:34:59 PM Sheath Access | Entry Site: Femoral artery right | Sheath: 6F PIG / 125cm Expo DX Cath 3:50:22 PM New Condition | Name : Rest ACT 3:35:35 PM Equipment | 6F FL 4 / 100cm Expo DX Cath Devices 3:50:22 PM Condition Changed Inflation Data 3:52:56 PM Vital Signs | SpO2 : 95 [ % ] | Heart Rate : 80 [ bpm ] | NBP : 132 / 87 / 102 [ mmHg ] | IBP : 0 / 0 / 0 [ mmHg ] 3:53:45 PM * Pressure Calculations | Pressures : LV : ( 120 / 2 / 14 ), PCW : ( 15 / 13 / 12 ) | Differences : MITRAL : 0 Procedure 3:56:01 PM CO Thermo Average | CO : 4 [ I/min ]| CI : 2.5 [ I/min/m2 ]| Stroke volume : 50 [ ml/beat ]| Injection site : RA Storage: 262:58 PNP Device Mounted - Drive(G:): Total Spa ... (x 5:37:54 PM (1) Flash Doc (2) Quick Add (3) Case Log (4) Filter Events in the Caselog (5) Print Case Log 16 Turnover Workbook | Sensis VIBE Medication Notes X Event Time 12:57:14 PM Include In Report Medication Amount Route Versed (Midazolam) (mg) IV Reason Given Given By Sedation George Comments (2) (1) n Summary Create a Kit Time Medication Amount Route Reason Given Given By Comments 12:57:14 PM Versed (Midazolam) (mg) 2 Sedation George Hide Medication Summary Save Cancel Add / Edit Event Event - Time Summary 12:59:00 PM Procedure Medications Medication Versed (Midazolam) (mg) Amount 2 12:57:14 PM Medication | Versed (Midazolam) (mg) | Amount: 2 | Route : IV | For. Sedation | Given By: George 11:43:05 AM Pre LOC Score | 7 11:43:03 AM Pre LOC Score | 7 11:43:01 AM Pre LOC Score| 7 11:42:59 AM Pre LOC Score | 8 (1) Select Med with the checkbox (2) Choose “Create a Kit” 1. Chronological Log of the Procedure 2. Documentation of the Procedure – Groups can be filtered out of the Summary area. Kits can be made for specific items that will be documented multiple times. It is recommended that the Kits be discarded after each procedure. 3. Select items of interest in the Event: dropdown. You have the ability to print the selected items – or the entire case log. Q Add / Edit Even Events Results Event: - Cardiac Flowsheet - Time Summary Equipment 3:31:24 PM Equipment | 6F Sheath Pinnacle MP 45 3:32:55 PM Sheath Access Pre LOC Score | 10 3:33:15 PM Allergies | No Known Allergies | Type of Reaction: Procedure Note 3:33:23 PM Vital Signs Pre | Rate (bpm) : 80 | Rhythm : Sinus Rhythm | Blood Pressure (Sys/Dia) : 13 Medication 3:34:59 PM Sheath Access | Entry Site: Femoral artery right | Sheath: 6F PIG / 125cm Expo DX Cat 3:50:22 PM New Condition | Name : Rest ACT 3:35:35 PM Equipment | 6F FL 4 / 100cm Expo DX Cath Devices 3:50:22 PM Condition Changed Inflation Data 3:52:56 PM Vital Signs | SpO2 : 95 [ % ] | Heart Rate : 80 [ bpm ] | NBP : 132 / 87 / 102 [ mmHg ] | IBP : 0 3:53:45 PM Pressure Calculations | Pressures : LV : ( 120 / 2 / 14 ), PCW : ( 15 / 13 / 12 ) | Differences Procedure 3:56:01 PM CO Thermo Average | CO : 4 [ I/min ]| CI : 2.5 [ l/min/m2 ]| Stroke volume : 50 [ ml/beat ]| Inje PNP Device Mounted - Drive(G:): Total Spa ... (x 4. Select an appropriate size of the case log for the work you need to do. • NOTE: Each staff member should take the responsibility to learn the documentation of your procedures. Your applications person will show you how the documentation tool functions, but they cannot make you comfortable with it. Only you can do that by taking the time to familiarizing yourself with the documentation tool and all its functions and variations! 17 Turnover Workbook | Sensis VIBE 1.4.4 Setups and Workflow Support Programs Notes Applications Edit View Acquire Tools Options Help MIBE Sensis Review Real Time 9719807519876 02/26/1958 LUmb Lead E. 25 mm/s Female Setup @Worklow Support 1 Pressure Hemody nam .. Zero RA RV PA PCW AO-PA C.O. LVPWed LV+PCW 1 • Customized for your facility to display desired pressure and ECG for a particular procedure type. Change the sweep speed or View. Views are customized per your specifications within a Setup. The parameters on the RTC are also programmed through the Setups or Workflow Support Programs. Tracings 0 EtCO2 HR 80 120 / 0 Setup .Workflow Support RT<- P16P2 LV 45 Current Condition 1. Rest 15 / 10 Ney PCW 200 V PCW 12 PCW 200 200 200 NB 180 180 REC Hemo Calculation 140 140 120 12 SA Tool Q. Add / Edit Event Cardiac Flowsheet Equipment Sheath Access Procedure Note Medication ACT :262:58 PNP Device Mount 6:36:59 PM • Move tracing: Hover your mouse over a particular tracing label, left click and drag that trace to a new location on the screen. • To put the screen back to normal right click anywhere on your screen and select “Autospace” - or – you could manually drag it back LV ., 200 PCW 200 rave Save Setup As. Autospace Display Waveforms. Manage View ... 18 Turnover Workbook | Sensis VIBE Notes • Hide tracing: Right click the site label of the tracing you wish to hide and select “Hide”. mody Past P Sensitivity Up Sensitivity Down Hide Show Sensitivity Show Grid Sensitivity Properties • To bring tracing back to the screen, Right click anywhere on the screen and select “Display Waveform” Display Hidden Waveforms X Save Setup As. Waveforms Autospace MaVL Display Waveforms Manage view. Select all OK Cancel Time 10:35:08 AM Summary Condition Changed 19 Turnover Workbook | Sensis VIBE Workflow Support Programs Notes Patient Applications Edit View Acquire MIBE Sensis Review Zero RA RV PA PCW AO-PA C.O. LVPWed v+pcw 9719807519876 Female 02/26/1958 Pressure Calculation Setup .Workflow Support RT< - P18P2 Hemodynam ... • Customized to prompt a user through an entire procedure. It is always possible to step outside the Workflow Program and perform any task. 1.4.5 Change Conditions Change Conditions when you have done something to change the patient condition. The Drop-down here will show a list of previous conditions. To change the current condition – click the NEW icon. M VIBE SENSIS 9875537534 Female 02/26/1 958 Setup .Workflow Support RT< - P1&P2 Current Condition 1. Rest New If you have previously performed a cardiac output – most likely you will want to “Inherit Cardiac Output” by selecting that option in the Change of condition window. If you forget, it can be easily brought forward using the Hemodynamic Worksheet. New Condition Event Properties General | Specific Name 3. Post Angio Intervention Amount Intervention Amount Intervention Amount Intervention Amount Fient Card a Quipu] Put a Checkmark to Inherit Cardiac Output OK Cancel 20 Turnover Workbook | Sensis VIBE 1.4.6 Change Mode Notes Change Mode X This will end the Setup and instead the selected Workflow Support Program will be loaded Select Workflow Support Program Workflow Support Adult Catheterization Left Heart Cath Right Heart Cath-P1 Rt and Lt Heart Cath-P1 and P2 OK Cancel MIBE Sensis Review Zero RA RV PA PCW AO-PA C.O. LVPWed LV+PCW 9719807519876 Female 02/26/1958 Pressure Calculation Setup . Workflow Support RT< - P18P2 THA Hemody nam ... Current Condition 1. Rest New PCW LV LaVL Vital Signs 200 200 Pcw 200 180 18 STOP 160 160 Post Proces ... Recording 140 1 Change Mode x 120 1 Hemo Calculation This wil end the Workflow Support Program and instead the selected Setup 100 1,00 will be loaded. 80 BO 60 60 elect Setup 40 40 20 20 1 Pressure 2 Pressure O Tools Pleth 3 Pressure 4 Pressure FFR P2 Only Q Add / Edit Event Events Results Event - Cardiac Flowsheet - Time Summary 1:28:11 PM Procedure Checklist | ID Band Correct: Yes | PL ID Verbally Verified: Yes | Allergy Band: Yes | H & P ... View Equipment 1:31:18 PM Lab Values | Lab Values Verified: Lab Values verified, within normal limits Sheath Access 3:31:24 PM Equipment| 6F Sheath Pinnacle MP 45 Procedure Nole 3:32.55 PM Pre LOC Score| 10 Documentation Medication 3:33:15 PM Allergies | No Known Allergies _ | Type of Reaction._ 3:33:23 PM Vital Signs Pre | Rate (bpm) : 80 | Rhythm : Sinus Rhythen | Blood Pressure (Sys/Dia) : 134/78 1 02 Sa. ACT 3:34:59 PM Sheath Access | Entry Site: Femoral artery right | Sheath: 6F PIG / 125cm Expo DX Cath E Devices 3:35:33 PM Equipment| 6F Sheath Pinnacle MP 45 21 Turnover Workbook | Sensis VIBE • Use the radio button to bring up the list of custom Workflow Support Programs. Notes MIBE Sensis Review Zero RA RV PA PCW AO-PA c.O. LVEWed LV.PCW 9719807519876 Female 02/26/1958 Pressure Calculation Setup .Workflow Support RT< - P18P2 Hemodynam Current Condition 1. Rest New PCW TaVL Vital Signs 200 200 180 1 STOP 160 1 Post Proces ... Recording 140 1 Change Mode 120 1 RIC 4-12 100 Hemo Calculation This will end the Workflow Support Program and instead the selected Setup will be loaded. 80 60 Select Setup 40 20 1 Pressure 2 Pressure O Tools Pleth 3 Pressure 4 Pressure FFR ·0+ P2 Only Q Add / Edit Event ents Results Event: - Cardiac Flowsheet Time View Equipment 1:28:11 PM Procedure Checklist | ID Band Correct: Yes | Pt ID Verbally Verified: Yes | Allergy Band: Yes | H & P ... 1:31:18 PM Lab Values | Lab Values Verified: Lab Values verified, within normal limits Sheath Access 3:31:24 PM Equipment| 6F Sheath Pinnacle MP 45 Procedure Note 3:32:55 PM Pre LOC Score| 10 Documentation Medication 3:33:15 PM Allergies | No Known Allergies _ | Type of Reaction 3:33:23 PM Vital Signs Pre | Rate (bom) : 80 | Rhythm : Sinus Rhythen | Blood Pressure (Sys/Dia) : 134/78 1 02 Sa. ACT 3:34:59 PM Sheath Access | Entry Site: Femoral artery right | Sheath: 6F PIG / 125cm Expo DX Cath Devices 3:35:33 PM Equipment | 6F Sheath Pinnacle MP 45 • “Change Mode” back to a Setup if desired by hitting the button next to the Setups – the Setup Window is displayed for selection. 22 Turnover Workbook | Sensis VIBE 1.4.7 Dialog Monitor Icons Notes Vital Signs STOP Recording RIC F-12 Hemo Calculation SAI Tools +0+ View Documentation E • Additional Icons are seen when some options are purchased 23 Turnover Workbook | Sensis VIBE • Vital Signs Notes Vital Signs STOP • Stat Single Cuff Pressure (Right Click for more options) • Stop Cuff inflations • Alarms • Recording Recording RIC F-12 • Recorder ON/Off • Snapshot – Does no calculations – Is a “picture” of that moment in time. You can visualize the other 5 “VIEWS” for that moment in that have been customized for your facility. • If you attach all the ECG electrodes to the patient, it is possible to do a 12 lead ECG 24 Turnover Workbook | Sensis VIBE Calculations Notes • Hemo Calculation • Pressure Calculation • Mean Pressure • Pullbacks • Cardiac Output • Saturations • Hemodynamic Worksheet (See more detail below) Patient Applicati Heart 2 Transducers Hemadynam Review R RA RV PCW PA co LVPCW LVAO NG COND PLLBK Hemodynamic Worksheet X Show only representative pressures Save Revert Show/hide measurement units BSA 1.75 1 : Rest 2: Post Ventricular Angio @ 3:Post Angio Pressures Pressures Pressures RA (A/V/M) 10:42 7,5,3 0 10:07 7,5,3 RV (S/D/E) 17,2,3 17,2,3 PA (S/D/M) O 10:07 17,2,3 10:42 17,7,10 O 10:42 17,7,10 O10:21 17,7,10 PCW ( A/V/M ) O 10:08 17,7.10 10:07 10,9,8 O10:42 10,9,8 LV (5/D/E) O 10:07 10,9.8 10:47 81,1,9 10:55 81,2,9 10.47 81 19 AO (S/D/M) 81.2.10 80,54,64 10:55 17,7,10 ART R.Fe (S/D/M ) 80,54,64 80,54,64 Ventricular Assessments RV Pressures (S/D/E) 17/2/3 31/2/9 Max dp/dt Max dp/dt/P SW 0.04 0.30 SWi 0.02 0,17 SP 0.16 1.56 SPi SER 0.09 0.89 20.00 15.20 250 190 26.20 DFP 30.40 28.80 DFD 380 360 Cardiac Flows Thermo CO 10:16 2.70 Ci 1.54 HR SV 33.75 19.28 Paste SVi Oximetry Assessments Revert Events Results Storage: 668:15 10:16:49 - CO Thermo Average DEREC 10:59:52 • The Hemodynamic Worksheet is a valuable tool for both the monitor person and the physician. If you forget to inherit the cardiac output(s) when changing conditions, you can easily copy and paste them from one condition to the next. Always use the “Source” C.O. when copying. If more than one pressure is sampled in a chamber, in the same condition, the physician can decide which pressure to use in the calculations by 25 Turnover Workbook | Sensis VIBE selecting it here in the Hemodynamic worksheet. If changes are made, Notes remember to Save your changes before exiting. • Tools Tools • Zero Pressure • Export Waveform • Timers • Print • Annotate • NOTE: Items 2, 4 and 5 are only available on REVIEW Screen • View View • Duplicate Waveform Area (Display DMC on the RTC minus the icons) • Split Screen 26 Turnover Workbook | Sensis VIBE Notes • Documentation Documentation Reports Generate Now Reports 'View Previous Reports Select Report Template : Hemodynamics (1) Hemodynamics (2) Hemodynamics (3) Waveform HeartPicture Flowsheet (C) ACC Report Biling Report OK Cancel • Select and print Catheterization reports • Other software icons are displayed in this area if your facility has purchased those options (CHP-CTI) 27 Turnover Workbook | Sensis VIBE • Screen Spanning Notes L 60 L. 127 / 69 --- L 94 % 50:00:00 • Windows can be moved over from the Dialog Monitor to the Real-Time Monitor “drag and drop”. 28 Turnover Workbook | Sensis VIBE 2. Procedure Workflow 2.1 Objectives Notes At the completion of this session, the participant will: • Understand the workflow of utilizing the Sensis Vibe during patient procedures. • Be able to obtain pressure samples from various heart chambers. • Modify pressure samples. • Perform Cardiac output using both Thermodilution and Fick Methods. • Perform Shunt Calculations • Complete corrections to the Patient Demographics • Utilize Post Processing 2.2 Procedure Workflow • Patient registration process will be specified by your facility • If automatic, the patient information is received via the Hospital Information System or Cardiology Data Management System. Also, Patient registration can received automatically via Radiology Scheduler (DICOM Modality Worklist) • If Manual, Patient registered in Sensis Vibe in another area prior to Cath Lab arrival (e.g., Prep/Holding area) or directly into the Sensis Vibe Acquisition unit. Patient Applications Edt View Acquire haput Jools Opacas Help Register Nim 0 Emergency ... Read Tane Browser Nim. Print Waveforms Cakulite Pressures Close Study abient Registration PATIENT PROCEDURE Last name Accession No Her Current Conézien First name Request ID Title Requested Vital Signs Patient ID procedure(s) Date of birth · Male Female Other Study Post Proces ... Recording Sex Age Years -J study commore Height Hemo Calculation Weight: bs oz I Metric Address Patient position INSTITUTION Adational info Institution name Dotals 1. Performing physician Tools 2. Performing physician HOSPITAL -0. Rofoning physician Admitting diagnosis 1. Operator 2. Operator View Ward Preregister Exam Search Cancel Emergency Help Documentation SO_IR 100 • NOTE: The BOLD Fields are mandatory. It is always advised that if you know the patient’s height and weight to enter that information. The height and weight is used in many Cardiac Calculations. • If you do not have any information on the patient, and must get started, you need only to select a Study type (which will bring up the appropriate documentation for that type of Study. You have the option to hit the Emergency button at the bottom of the Registration window and then change the information later. 29 Turnover Workbook | Sensis VIBE • Select a Setup or Workflow Support Program Notes VIBE Serais Review C.O. LVPWed LV+PCW 9719807519876 Zero RA RV PCW Female 02/26/1998 Pressure Calculation Setup . Workflow Support RTSLT - P18P2 Current Condition 1. Rest New PCW LV Vital Signs 200 200 Pcw200 180 180 STOP 160 160 Post Proces ... |Hemodynam ... 140 140 Change Mode 120 120 RIC -12 This will end the Workflow Support Program and instead the selected Setup 100 100 Hemo Calculation M AA ill be loaded. 80 BO 60 60 Select Setup 40 40 20 20 1 Pressure 2 Pressure O O Tools Pleth 3 Pressure 4 Pressure FFR P2 Only Q. Add / Edit Event Events Results Event Cardiac Flowsheet - Time Summary Equipment 1:28:11 PM View Procedure Checklist | ID Band Correct: Yes | Pt ID Verbally Verified: Yes | Allergy Band: Yes | H & P ... 1:31:18 PM Sheath Access Lab Values | Lab Values Verified: Lab Values verified, within normal limits 3:31:24 PM Equipment| 6F Sheath Pinnacle MP 45 Procedure Nole 3:32:55 PM Pre LOC Score| 10 Medication 3:33:15 PM Allergies | No Known Allergies _ | Type of Reaction:_ Documentation 3:33:23 PM Vital Signs Pre| Rate (bom) : 80 | Rhythm : Sinus Rhythen | Blood Pressure (Sys/Dia) : 134/78 | 02 Sa. ACT 3:34:59 PM Sheath Access | Entry Site: Femoral artery right | Sheath: 6F PIG / 125cm Expo DX Cath Devices 3:35:33 PM Equipment| 6F Sheath Pinnacle MP 45 Change Mode X This will end the Setup and instead the selected Workflow Support Program will be loaded. Select Workflow Support Program Workflow Support B Adult Catheterization Left Heart Cath Right Heart Cath-P1 Rt and Lt Heart Cath-P1 and P2 OK Cancel • Document the patient’s ECG prior to your study by using either a snapshot or 12 ECG. Recording REC 30 Turnover Workbook | Sensis VIBE Notes • Initiate the NIBP cycle. Right click the cuff icon and select” Repeated” to start your default settings. Vital Signs STOP • Select “Settings” in order to change the parameters for this particular patient. Sensis Vibe will default back to the pre-defined defaults when this study is closed. Vital Signs Settings Vital Signs Alarms Setting for current examination Effective directly when pressing OK. Logging Parameters HR (averaged) Sp02 NBP Respiration rate IBP EtCO2 IBP Channel- · P1 .P3 When Vital Signs Event is created, prompt for Consciousness Muscle Function Pain Score Respiration Circulation Skin Color Total Aldrete Score Log interval (min) 5 min NBP For the current examination, use: O NBP neonatal mode O NBP adult mode Note that you should not use NBP adult mode on neonates or patients who weigh less than 8.2 kg (18 pounds). Respiration Rate Source License to use for calculating respiration rate CO2 Module ECG Respiration @ CO2 Module O Lead I O Lead Il OK Cancel 31 Turnover Workbook | Sensis VIBE • Aldrete score will populate each time a NIBP is acquired if set as default. It is Notes also possible to use the Aldrete Score for select patients only. Sedation Assessment X Time 7:00:52 PM Aldrete Score Consciousness 2: Fully awake Respiration 2: Deep breath or cough freely Skin Color 2: Pink Muscle Function 2: Moves 4 extremities Circulation 2: BP +/- 20 mmHg Total Aldrete Score 10 Pain Score 0 of 10: No Pain OK Cancel • A Pain Scale will also populate each time a NIBP is acquired if set as default. It is also possible to use the Pain scale for select patients only. • Balance your transducers once they have been flushed and opened to air. Tools +0+ • Turn on the case recorder (full disclosure) Recording RIC • The REC icon will be highlighted when the Recorder is on. Also, a Bright Yellow bar is visible on both the DMC and RTC. Storage: 668:15 10:16:49 - CO Thermo Average OFREC 32 Turnover Workbook | Sensis VIBE Notes • Utilize the Flash Doc and Quick Add to generate your case log in order to document the procedure. TaVR YaVR Lavi QUICK ADD JARi Q Add / Edit Event Events Results Event: - Cardiac Flowsheet -Time Summary Equipment 1:28:11 PM Procedure Checklist | ID Band Correct: Yes | Pt. ID Verbally Verified: Yes | Allergy Band; Yes | H & P ... 1:31:18 PM Lab Values | Lab Values Verifed. Lab Values verified, within normal limits Sheath Access 3:31:24 PM Equipment| 6F Sheath Pinnacle MP 45 Procedure Note 3:32:55 PM Pre LOC Score | 10 Medication 3:33:15 PM Allergies | No Known Allergies _ | Type of Reaction: FLASH DOC 3:33:23 PM Vital Signs Pre | Rate (bpm) : 30 | Rhythm : Sinus Rhythm | Blood Pressure (Sys/Dia) : 134/78 102 Sa. ACT 3:34:59 PM Sheath Access | Entry Sito: Femoral artery right | Sheath: 6F PIG / 125cm Expo DX Cath Devices 3:35:33 PM Equipment| 6F Sheath Pinnacle MP 45 Inflation Data 3:35:35 PM Equipment| 6F FL 4 / 100cm Expo DX Cath 3:35:37 PM Equipment| 6F FR 4.0 Expo DX Cath Procedure 3:50:22 PM New Condition | Name : Rest • Use the Workflow Support Program or Right click on the Pressure label to make adjustments ravi Site Set Pullback Set Pullback Sequence Range Up Range Down Range Hide Hide Range Hide Grid Properties Set as Analog Output 33 Turnover Workbook | Sensis VIBE • Choose standard site label Notes Site x B- Normal VEN - Vein VEN Inno - Vein Innominate VEN Femo - Vein Femoral SVC - Superior Vena Cava + IVC - Inferior Vena Cava RA - Right Atrium RV - Right Ventricle PA - Pulmonary Artery Main # PCW - Pulmonary Capillary Wedge · PV - Pulmonary Vein LA - Left Atrium - LV - Left Ventricle · AO - Aorta ART - Artery ART Brac - Artery Brachial ART Femo - Artery Femoral · Congenital Coronary @- Peripheral Not Defined OK Cancel • Additional sites in Congenital subtree Site x . Congenital VEN - Vein VEN Inno - Vein Innominate - VEN Jugu - Vein Jugular VEN Subc - Vein Subclavian VEN Hep - Vein Hephatic VEN Umb - Vein Umbilical VEN Femo - Vein Femoral - VEN Cor - Vein Coronary Sinus SVC - Superior Vena Cava IVC - Inferior Vena Cava RA - Right Atrium RA Infl - Right Atrium Inflow (=Mixed Venc RA High - Right Atrium High RA Low - Right Atrium Low RA Pulm - Right Atrium Pulmonary Return RA Comm - Common (Single) Atrium of I RV - Right Ventricle PA - Pulmonary Artery Main PCW - Pulmonary Capillary Wedge PVW - Pulmonary Venous Wedge - PV - Pulmonary Vein - LA - Left Atrium OK Cancel 34 Turnover Workbook | Sensis VIBE Notes • Peripheral sites in Peripheral subtree. Also open up the Coronary section for list of Coronary Sites. Site X ART Brac - Artery Brachial ... ART Umb - Artery Umbilical B. ART Femo - Artery Femoral · Coronary B- Peripheral VEN - Vein VEN Inno - Vein Innominate ............. VEN Jugu - Vein Jugular VEN Subc - Vein Subclavian VEN Hep - Vein Hephatic VEN Umb - Vein Umbilical AO - Aorta .... ART - Artery B. ART Inno - Artery Innominate B- ART Caro - Artery Common Carotid BART Subc - Artery Subclavian ART Axil - Artery Axillary ART Brac - Artery Brachial ART Ulna - Artery Ulnar ART Radi - Artery Radial ART Rena - Artery Renal ART llia - Artery lliac ART Femo - Artery Femoral Not Defined OK Cancel • Pressure signal Properties Waveform Properties X Signal P1:AO Previous Waveform Next Waveform Display Acquisition Amplification Position Clip Waveform Colors- T .. . . . T ..... .. . ..... ......... 60.0 10.0 100 Range Grid Scales (mmHg) 200 mmHg 10 % Sensitivity OK Cance • Amplification set at 60 • Position set at 10 • The above settings are to ensure proper Scaling and Presentation on the Printed Waveform 35 Turnover Workbook | Sensis VIBE • ECG signal Properties Notes Waveform Properties X Signa Previous Waveform Display Acquisition Next Waveform Amplification Position Clip Waveform Colors ........ ...... ....... 95.0 100 M Range Grid Scales (mmHg) 50 % Sensitivity 10 mm/mV OK Cancel • PLETH signal Properties Waveform Properties X Signal Pleth Previous Waveform Next Waveform Display Acquisition Amplification Position Clip Waveform Colors ........... 10.0 5.0 100 Range M Grid M Scales (mmHg) Sensitivity OK Cance • Acquisition Tab for changing filter settings 36 Turnover Workbook | Sensis VIBE Notes • Pressure Calculations • If the Pressure Calculation icon is Ghosted – you have not yet Balanced (Zero) your transducer. Hemo Calculation M AL • If the Pressure Calculation icon is Ghosted – AND – your ZERO icon is ghosted, you have not yet Balanced (Zero) your transducer AND your recorder is ON. Remember, you cannot be recording during the ZERO process. You will not be able to calculate the pressure off of the recording because the transducer was never BALANCED ! Recording REC -12 Hemo Calcul ation SAI Tools Pleth Q, Add / Edit Event Pre Cath Data View Case Times Patient/Procedure Sitatus Procedure Checklist Documentation Lab Values Pre Procedure Pulses LOC Score Pre Allergies Vital Signs Pre age: 259:08 37 Turnover Workbook | Sensis VIBE • If modifications are necessary, click modify on the Calculation window Notes Pressure Calculations Event Properties - 2:04:45 PM × HR (LV) 60 bpm Reset Signal Site S/A D/V E/M dP/d dP/dt/P P1 LV 120 1 14 1880 48 Signals Valves/Sites Diff Gradient Area CLICK TO MODIFY PRESSURES Print Modify OK Cancel • This window becomes available. Modify x Change Analysis Window] Move Pressure Markers Adjust Time Shift Recalculate Cancel 38 Turnover Workbook | Sensis VIBE Notes • From the Modify window, you can Change the Analysis Window (any beats behind the grey screen are ignored) or Move the Pressure markers. On the rare occasion that you may need to Adjust the Time Shift, you are able to do that from the Modify window. Applications Edit View Acquire hout Tools Options Help MEE Sensis Review Real Time 0175543 Female 02/26/1958 200 Exac 25men's O Setup @Worktow Support ZU32 2:04:45 PM 3512 Paasaure Current Condition 1. Rest NEW htal Signs V 200 B Recording REC 1-12 Hemo Celculation Tools Pieth lodity Q Add / Edit Event Events Results Event Pressure Coltusoces Pro Cat Data · Time Summary Case Tres 2:04:49 PM Pressure Calculations | Proccuros : LY : ( 120 / 1/14 ) | Contracsitios : LV : 1830 ) 43 Change Analysis Window Patient Procedure Statuay 2:04:09 PM Pressure Calculations | Pressures : AD : ( 120/31 /93) Procedure Checklist Lab Values Pro Procedure Pukos 6dust Time Shift LOC Score Pre Recelculate Cancel Vital Signs Pre MEE Sensis Review Real Tarne 0175543 Female 02/26/1958 200 Scale 25 mm's Setup Workfew Suppon 2:04:45 PM Current Condition New Vital Signs LV 20 [119] B Post Proces ... |Hemody nam ... Recording Hemo Celculation M AL m Tool leth Modity Q Add / Edit Event Evenes Result Condition 1.Post Cardiac Output Pro Cath Data 02 Sat Valve/Site |Difference Gradient Area Case Tres 180g: Analysis Window Patient Procedure Stata Procedure Checklist Move Pressure Markers Lab Values Pro Procedure Pukos Agust Time Shift LOC Score Pre Allergies Recolculate Cancel Vital Signs Pre 39 Turnover Workbook | Sensis VIBE • Thermodilution Cardiac Output Notes Hemo Calculation M AA CO Thermo Input Catheter Injection Site RA Enter Site Comp Constant Sample Site PA Dist Enter Site Manual CO CO V/min Accept Thermo CO Measurements Include Time CO(l/min) HR(bpm) SV(ml/bt) Inj. T.( C). Comp. C Average CO Values CO Vmin SV CI Vmin/m2 OK • First you select the Cardiac Output Icon and then the proper catheter from the Dropdown List. Selecting the correct catheter ensures the correct Computation Constants for that catheter. If the catheter you are using is not in the dropdown, see below. • Display if RED Cap port is not connected. CO Thermo x Input Catheter Edwards 141HF7 7.0 F 10 ml Injection Site RA Enter Site Inj. Voll(ml) Comp. Constant Accept Sample Site PA Dist Enter Site 40 Turnover Workbook | Sensis VIBE Notes • Display if Temperature cable unplugged CO Thermo X Input Catheter Edwards 141HF7 7.0 F 10 ml Injection Site RA Enter Site Inj. Yol.(mi) Comp Constant Accept Sample Site PA Dist Enter Site Manual CO co Vmin Accept Note: The injectate thermistor is not connected 0ºC will be used as the injectate temperature • Display when ready for injection CO Thermo x Input Cathete Edwards 141HF7 7.0F 10 ml Injection Site RA Enter Site j Vol.(m Comp Constant Accept Sample Site PA Dist Enter Site Manual CO Ready for First Injection - Syringe icon CO V/min Accept CO Thermo Input Cafeter Edwards 141HF7 70F 10 ml Injection Site RA Enter Sito Comp. Conscant Accept Sample Site PADis! Enter Site Comp. C. = 0.578 4.00 Manual CO 35.0 CO Vmin Accept 26.0 ................................ Wait for catheter temperature to 37.0 .......................................... normalize - hourglass icon Thermo CO Measurements Include Time Collmin) HR(bpm) SV[m/b:) hj. T.(C) Comp. C 51 3:57:24 PM 3.00 80 37.50 17,40 0.578 3:58:06 PM 2.90 80 36.25 17.40 3:58:41 PM 4.00 80 50.00 10.578 • The syringe icon will appear again when the system is ready for subsequent injections. 41 Turnover Workbook | Sensis VIBE • Result will be added to the measurements, and to the average C.O. The Notes measurements can be included or excluded for the final average by simply removing the checkmark associated with the unwanted value. CO Thermo x Input Catheter Edwards 141HF7 7.0F 10 ml Injection Site RA Enter Site Inj Vol (mb) Comp Constant Accept Sample Site PA Dist Enter Site Comp. C. = 0.578 4.00 Manual CO 35.0 ................................ CO Vmin Accep 36.0 .................................. 37.0 ........................................ Thermo Co asurements Include Time 01 2:57.24 COMmin) HR(bpm) SV(m//bt) Inj. T.(*C) Comp. C. 3:57:24 PM 3.00 80 37.50 17.40 0,578 2.90 80 36.25 0,578 03 3:58:06 PM 3:58:41 PM 4.00 80 17.40 50.00 Average CO Values CO 2.95 Umin SV 36.88 ml/beat CI 1.72 1.72 Vmin/m2 OK • If the catheter being used is not in your dropdown, you can select “Other” and enter the Injection Volume and Computation Constant manually. Also, as seen in this image, if you have a set of Cardiac Outputs from another source (as a C.O. may have been performed in the unit) you may enter a Cardiac Out put manually to be used in future cardiac calculations. CO Thermo X Input Catheter Other Injection Site RA Enter Site nj. Vol.(ml) 10 Comp. Constant .682 Accept Sample Site PA Dist Enter Site Manual CO co I/min Accept 42 Turnover Workbook | Sensis VIBE Notes • You can also filter the Events in the Case log by C.O. Thermal for later examination. PCW LV 200 200 180 180 160 160 CO Thermo 140 140 The na CO Measurements Ready STICI 120 120 100 100 50.00 60 CD Average CO values CO 3.73 Mmin Stroke Volume 46 67 m/best 20 20 CI 2.17 Vminim2 Cancel Events Resulta Event CO Themo . Time Summary 4:00:53 PM CO Thermo Average | CO : 3.73 | Prin ]| Ca : 2,17 | Umin/2 ]| Stroke volume : 46.67 [ mi beat ]| Injection site : ... 43 Turnover Workbook | Sensis VIBE • Fick Cardiac Output Notes • Enter the saturations from AO and PA. If you have previously entered the “Sample Site”, they will be listed in the dropdown. If not, use the O2 Sample Site Button to bring up the site list. m MIBE SENSIS RA RV PA PCW NO-PA C.O. LYEWed LV+PCW PW>PA 9:375537534 Famala 02/26/1958 Enter 02 Set Result Setup @Worknow Support RT< - P1 6PZ Enter 02 Sat Results Current Condition 1. Rast NEW ces ... Hemody nam .. Vital Signs Lavi Sample Site AO 22 Sat Sample Site 32.400 B Time 3:50:23 PM STOP 2 Sat [%] Recording REC 202 [18] Hemo Calculation nclude Average for AO 02 S& PO2 kPa Adjust Shunt Tools +0+ Close Add / Edit Event Sample Site AO Q2 Sat Sample Site Time 7:05:20 PM Site 02 Sat (%) B- Normal -VEN - Vein EVEN Inno - Vein Innominate PO2 (mmHg) - VEN Femo - Vein Femoral SVC - Superior Vena Cava Include IVC - Inferior Vena Cava RA - Right Atrium -RV - Right Ventricle PA - Main Pulmonary Artery Average for AO PCW - Pulmonary Capillary Wedge -PV - Pulmonary Vein 02 Sat % B- LA - Left Atrium -LV - Left Ventricle PO2 mmHg Adjust Shunt AO - Aorta ART - Artery BART Brac - Artery Brachial Close BART Femo - Artery Femoral Congenital Coronary Peripheral Not Defined • Enter a Hemoglobin value Pedent Applications Edit View MBE SENSIS RA RV PA PCW NO-PA C.o. WEWed LV 9375537534 Famala Enter 02 Set Result Setup Worknow Support HB RT< - P1 6P2 Current Condition 1. Fast NOW Vital Signs ravi PAZ t Proces ... Hemodynam ... HB Event Properties General Specific HB 11.8 0'100m 44 Turnover Workbook | Sensis VIBE Notes • Note if the “Calculate CO” selection is ghosted. This is due to the lack of Hemoglobin data or Registration data (patient height and weight needed to calculate a “Predicted O2 Consumption). • Click the Enter button to enter a Hgb Value. The dropdown is for selection of a particular Hgb value to be used in the FICK calculation (if more than one has been entered). Once this is complete, the “Calculate CO” is available. All fields in this window must have viable data in order to calculate a Fick. CO Fick X The Heart Rate is taken from Heart Rate when this window is opened. HR 80 bpm You should ensure that it is close to what the HR was at Hemoglobin the time the samples were HB 11.80 g/100ml drawn. Enter Click this ENTER button to enter HgB value 02 Consumption Predicted @ 170.42 ml/min Measured ml/min Enter If you are missing an 02 Consumption - most likely missing height and weight when the patient was registered for the study 02 Saturations Venous PA 75.00% Enter Arteria AO 98.00% If all necessary data is entered, the Calculate CO button available. If not, Calculate CO Close you are missing a data point for the calculation. • Shunt Calculations Shunt Fick X Heart Rate HR 80 bpm Hemoglobin HB 11.80 g/100ml Enter 02 Consumption Predicted @ 248.52 ml/min Measured @ ml/min Enter 02 Saturations Mixed Venous (IVC:SVC) 75.00% Pulmonary Artery PA 65.00% Pulmonary Vein AO 98.00% Systemic Artery AO 98.00% Shunt Ratios Right to Left Ratio Left to Right Ratio 0.42 Pulm/Sys Flow Ratio 0.70 Calculate Flows Close 45 Turnover Workbook | Sensis VIBE • If the Saturations entered have any STEP – the Sensis Vibe will automatically Notes calculate a SHUNT. This box is displayed If all necessary information is entered, (Hgb for example), the Calculate Flows will be available. Press that to have the Sensis Vibe calculate more detail about the shunt. Shunt Fick Event Properties General | Specific Heart Rate 80 bpm Systemic Blood Flow 6.39 I/min Pulmonary Blood Flow 4.50 I/mir Systemic Stroke Volume 79.84 ml/b Pulmonary Stroke Volume 56.22 ml/b L-R Shunt Flow 1.89 I/min R-L Shunt Flow Pulm/Sys Flow Ratio 0.70 Left to Right Ratio 0.42 Right to Left Ratio 02 Consumption 248.52 ml/min HB 11.80 g/100ml Systemic AV O2 diff 38.91 ml/l Pulmonary AV O2 diff 55.26 ml/l Site 02 Sat 02 (%) (ml/l) Mixed Venous IVC;SVC 75.00 121.66 Pulmonary Artery PA 65.00 105.31 Pulmonary Vein AO 98.00 160.57 Systemic Artery AO 98.00 160.57 OK Cancel • Correct Patient Demographics • First and Foremost, you should always correct the patient demographics as soon as you realize there is a problem. You should always double check the Patient information before closing the study. 1. Open the Patient Browser and highlight the Patient demographic folder. Patient Browser Patient Applications Transfer Edit View Eilter Sort Private Applications Options Help Ox Local Database VIBE, SENSIS Coronary Diag Waveform Series Scheduler VIBE, SENSIS /com/// / / / 1] Waveform Series VIBE, SENSIS, 986 [1] Presentation Series /com/ / / / / / VIBE, Sensis /com/// // / VIBE, Sensis /com/ // / / / VIBE, Sensis /com///// / VIRE SENSIS Patient name VIBE, SENSIS Date of birth 2/26/1958 Patient ID 9875537534 Work Status Mark Status| Requesting Physici ... |Study Descri ... |Study Date and ... |Series 1/11/1 Coronary Diagnos 2/6/2017 3:43:43 PM 3 Current Filter: Off 46 Turnover Workbook | Sensis VIBE 2. Find the EDIT option on the patient browser window Notes 3. Select correct -OR- Patient Browser Patient Applica Transfer Edit View Filter Sort Private Applications Options Help 2 Cut Ctrl+X Paste Ctrl+V Delete Del Auto Delete Restore Clear Scheduler. Local Database Empty RecycleBin pronary Diag [1] Waveform Series Protect Scheduler Remoye Protection [1] Event Series Correct [1] Presentation Series History Mark Num 3 Unmark Set State Eind Ctrl+S VIRE SENSIS Patient name VIBE, SENSIS Date of birth 2/26/1958 Patient ID 9875537534 Work Status |Mark Status | Requesting Physici ... | Study Descri ... |Study Date and ... |Series Coronary Diagnos 2/6/2017 3:43:43 PMV 3 4. Find the Edit Icon on the Browser Toolbar 5. Edit the patient name, correct spelling, add height and weight, etc. Correct "VIBE SENSIS" on "Local" 1 Patient selected Specific Character Set ISO_IR 100 Modifier's name Sensis2 Last name VIBE First name SENSIS PatientID 9875537534 Middle name Tide Patient Suffix Referring physician Other patients name(s) Admission ID Other patient ID(s) Ethnic group Military rank Hospital Date of birth 2/26/195 Accession No Sex Male Ocher Study ID 1 . Female Not set Height 5'6" Weight 140 Series description Series date 2/6/2017 Additional info Number Comment Instance Cancel Help Enter Date of birth in format "Mesyyy" 47 Turnover Workbook | Sensis VIBE • If the patient has been closed – you must go to the Patient Explorer database Notes to correct the patient information. You must have a username and password to open Patient Explorer. Hit the Flying window key on your keyboard to select Patient explorer and enter your username and password. Adobe Reader M Camtasia Studio Microsof Ofice Sinais Notwork mais Information System Client Devices and Printers Statistico Manager Configuration Statistics Manager Configuration Server Stadup Back Shut down • Find the patient level folder and then highlight that folder. Top toolbar, find “Edit” then “Patient/Study” Sensis Patient Explorer Application _Edit Search Patient/Study Report Help Patient/Study SIEMENS Study date Cancel Save Ctrl+S 2/6/2017, State is one of (Pre Cath, During cath, Post cath, Frozen, Pending approval, -Patients Delete VIBE, SENSIS PATIENT DO 2/6/2017 Last name VIBE VIBE, SENSIS 9: 2/6/2017 First name SENSIS Preregistered patients Title Patient ID 0966536543 Date of birth 2/26/1958 Sex O Male Female O Other Age 38 |Years Address Additional info Studies Study type Study date Study state Accessi Request Ref. 1. 99 Coronary.Diagn 2/6/2017 Post cath Johi 48 Turnover Workbook | Sensis VIBE Notes • You will now have the window available to make your corrections. When finished you must hit the Save icon on the top toolbar. You will be asked to confirm these changes. Sensis Patient Explorer Application Edit earch Patient/Study Report Help SIEMENS Study date >= 2/6/2017, Study date <= 2/6/2017, State is one of (Pre Cath, During cath, Post cath, Frozen, Pending approval, -Patients VIBE, SENSIS PATIENT Do 2/6/2017 Last name VIBE VIBE, SENSIS 2/6/2017 First name SENSIS % Preregistered patients Title Patient ID 0966536543 Date of birth 2/26/1958 Sex O Male Female O Other Age 5 Years Address Additional info Studies Study type Study date Study State Accessi Request Ref 1. ao Coronary Diagn 2/6/2017 Post cath Joh • You must also then recreate the report that was created at the time of the study with the wrong patient information on it. Find the study level folder and highlight it. Find the “Create Report” icon on the toolbar for Patient Explorer. 1. Create the report that was created at the time of the study. Sensis Patient Explorer Application Edit Search Patient/Study Report Help SIEMENS Study date >= 2/6/2017, Study date <= 2/6/2017, State is one of (Pre Cath, During cath, Post cath, Frozen, Pending approval, New report ... Patients VIBE SENSIS STUDY HOSPITAL 33 2/6/2017 Study type Coronary. Diagnostic Coronary Catheterization Referring physicia VIBE, SENSIS Do 2/6/2017 Study comment Admitting diagnos % Preregistered patients Wa INSTITUTION Institution nan 2. You will be prompted if that report already exists. You must select YES in order to create a new report. AXIOM Sensis X The report already exists. Refresh and override latest editing? Yes No Cancel 49 Turnover Workbook | Sensis VIBE 3. Databases 3.1 Objectives Notes Upon completion of this session, the learner will be able to: • Complete patient studies either by performing actual patient studies or by simulated pressures and calculations. • Describe the uses and functions of the Patient Browser Database • Describe the uses and functions of the Patient Explorer Database 3.2 Patient Browser Database • Patient Browser database holds the patient data and the recordings from the patients that were performed on that Sensis Vibe Acquisition unit, in that particular lab. So, if you have more than one Cathlab in you department, each patient explorer database will be different. Patient browser database is most often used to bring up a patient that was previously done in order to look at those recordings or recalculate some pressures. To bring up a patient that was previously performed, open up the patient browser. It may be easier to find your patient if the “Local” database is sorted by “Patient Name”. Patient Browser Patient Applications Transfer Edit View Filter Sort Private Applications lons Help Patient Name DB Date and Time Patient ID Patient Latest Exam Date Work Status Local Database_ VIBE, SENSIS Reverse Order [1] Waveform Series Scheduler VIBE, SENSIS [1] Event Series VIBE, SENSIS, 986 1] Presentation Series VIBE, Sensis VIBE, Sensis VIBE, Sensis VIRE SENSIS Work Status | Mark Status | Patient Name Patie ... Date of Birth Additional Info|Studies /com///// VIBE, SENSIS 98755375 2/26/1958 1 /com/ //11 VIBE, SENSIS 09665365 2/26/1958 1 - 50 Turnover Workbook | Sensis VIBE Notes • Once you find your patient, highlight the study that was performed on that patient, then go to the Patient Browser toolbar and select “Patient” > “Load into Post Processing”. Patient Browser Patient Applications Transfer Edit View Filter Sort Private Applications Options Help Continue Examination X Load into Post Processing Register ... Num 0 Emergency ... Import patient from Sensis Information System .. Search for patient in Sensis Information System .. Show MPPS Coronary Dia [1] Waveform Series Print Preview Print List [1] Event Series Print .. Search [1] Presentation Series Search Selected Close Browser Alt+F4 VIBE, Sensis VIRE SENSIS Patient name VIBE, SENSIS Date of birth 2/26/1958 Patient ID 9875537534 Study description Coronary Diagnostic Coronary Catheterization Study date 2/6/2017 TOTT TOOT TOTT TOOT • You can look at the recordings, find specific samplings, perhaps even make edits. If you do change something in that patient record, you will also need to re-create the report for that study as now the two things don’t match! • It is also possible to continue a study that has been closed. Keep in mind that if you continue a study, it will reflect the study duration change. So, you would not want to “Continue Exam” on a patient that was done 4 days ago! A better example of why you would use “Continue Exam” would be: if you are monitoring and finish the procedure and close the study on Sensis Vibe. Suddenly, the patient begins to have crushing chest pain. The physician wants to just take a few more pictures. Your course of action would be to open Patient Browser. Find the patient and click on the study level. Top toolbar of the Patient Browser select “Patient” > “Continue Exam”. You would need to restart the NIBP, zero the transducers and turn on the case recorder. Again, if you add anything at all to the patient record, you will need to re-create the report for the study. • Patients must occasionally be deleted from the patient browser. The recordings for each patient take up a good deal of space. When you delete the patients from Patient Browser, remember, you are deleting the recordings. All the patient data and reports are stored within the Patient Explorer Database. The waveforms may be archived to another system, or embedded in your report (which is stored in the Patient Explorer Database). In order for those waveforms to be in a report, stored on Patient Explorer, the report has to be created to hold the waveforms. The deletion of patients from the Patient Browser can be done manually or in the background with set criteria. Reboot of the system (after your studies have successfully been deleted,) is the only way to make the freed disk space available for new studies. Always delete an entire study or patient. Never delete individual series only, as the study will become invalid. Never delete data objects that belong to an open examination as this can result in data loss and unpredictable system behavior. 51 Turnover Workbook | Sensis VIBE • The storage number on your screen is only truly accurate when a case is open Notes and the recorder is ON. You can also hover your mouse over the timer wheel icon to see a percentage of the storage space used. Storage: 349:28 BROWSER 16:39:11 - Rec on OTREC 16:39:19 • There are two means in which to delete the patients from your patient browser database. Manually or Automatically. • Manual deletion of patients 1. First sort the patients in the browser LOCAL DATABASE by date the study was performed. 2. The patients can be sorted by date or in reverse order. Select a the patients either by holding the shift key down and selecting the top and bottom patient of that group or by holding the CTRL key while clicking specific patients. Patient Browser Patient Applications Transfer Edit View Filter Sort Private Applications ons Help do Patient Name DB Date and Time 17,77 Patient ID Patient Latest Exam Date Work Status Local Database_ VIBE, SENSIS Reverse Order [1] Waveform Series Scheduler VIBE, SENSIS [1] Event Series VIBE, SENSIS, 986 [1] Presentation Series VIBE, Sensis VIBE, Sensis VIBE, Sensis VIRE SENSIS Work Status | Mark Status |Patient Name Patie ... = Date of Birth Additional Info |Studies /com///// VIBE, SENSIS 98755375 2/26/1958 1 /com/ / /11 VIBE, SENSIS 09665365 2/26/1958 1 3. Find the delete key (looks like a paper shredder) on the top toolbar of Patient Browser. Patient Browser Patient Applications Transfer Edit View Filter Sort Private Applications Options Help ? X TEST, Wednesday Delete Coronary Diag [1] Waveform Series TEST, Thursday [1] Event Series TEST, RL 1 Duce [1] Presentation Series com/ 1188 1 Test, Mark TEST, TUESDAY Local Database _ VIBE, SENSIS Scheduler VIBE, Sensis VIBE, Sensis multi selection Work Status | Mark Status |Requesting Physici ... Study Descri ... = Study Date and . Series Coronary Diagnos 1/25/2017 3:21:18 PI 3 /com/ // // Coronary Diagnos 1/26/2017 4:16:28 PI 3 /com///// Coronary Diagnos 1/26/2017 5:07:24 PI 3 Caronas Diannne 1/21/2017 2:51.07 Pl 52 Turnover Workbook | Sensis VIBE 4. You will be asked for confirmation of this action. The second Delete Notes Confirm Window is to let you know that this patient has not been archived otherwise. Say “YES” or “YES to All” if you do mean to delete the ALL selected patients. Delete Confirmation X Do you really want to delete the selected object(s)? Yes No Help Delete Confirmation X Delete permission is not fulfilled for Patient TEST, Wednesday Study Series Instance Missing states: Archived Would you like to delete anyway? Yes Yes to All No Cancel Help 53 Turnover Workbook | Sensis VIBE • Automatic deletion of patients Notes 1. Your applications specialist will work with your facility to set up a scheduled deletion if that is chosen. In order to do this most effectively, you should have an idea of the volume for your Cathlab. Open the Configuration panel on Sensis Vibe – Top toolbar > Options > Configuration. Sensis Vibe - Configuration Panel X File Auto Delete Patient Browser Transfer Patient Software Image Text Registration Distribution Editor Regional and EP Catheter Setups Events Ablation Pressure Language . Connections Configuration Configuration Signals == 1 12 M2 G Transfer Setups Parameters Print 12 Lead ECG Stimulation Mapping and Programs Configuration Snapshot Configuration System C. E= Workflow Support C. Predefined Study Type Pullback ... Settings Patient Registration NUM 2. In the Configuration Panel, you will see the icon for Auto Delete. 3. You will want to discuss with your applications specialist what would be the best schedule for your lab. AutoDelete Configuration x Local Automatic deletion is performed at following timepoints for following data i Deletion can also be started manually via the menu (Edit > Auto Delete) Timepoints for deletion If database fillstate has reached ] 90 % or 108:00 Monthly G Day 2 of every =month(s) The Sunday of every 1 month(s) Data to be deleted Delete all series with following flags [ Archived F Archived + Committed Sent F Sent + Committed or Delete all studies which are older than [14 day(s) Ask confirmation before deletion OK Cancel Help 54 Turnover Workbook | Sensis VIBE 3.3 Patient Explorer Database Notes • Patient Explorer Database is where all the patients reside from all the labs that are connected to that server. In each “Patient Level” folder, a “Study Level” folder is visualized for each study the patient has had performed in your facility. In the you will find the data documented during a study “Study Level” folder you will find any and all reports that were created at the time of that study. Use Patient explorer when you want to: • Print a report from a previous study. • Just add a catheter (for example) to a patient record. • Perform some documentation to a patient who has been pre-registered for a procedure. • In order to gain access to the Patient Explorer database, you must have privileges assigned by your manager. • Hit the flying window key > Sensis Information System > Client > Patient Explorer > Adobe Reader MI Accessories Camtasia Studio Microson Ofice Serais Network Sensis Information System Client Devices and Printers Patient Explorer Statistics Manager Coniguration Sialistics Manager Configuration Server ESErtup Back Shut down • Enter Username and Password > Application is Launched. AXIOM Sensis Patient Naviga AXIOM Sensis Patient Navigator Application Edit Search Patient Study Report Help Application Edit Search Patien SIEMENS State is one offPre Cath, During Cath, Post Cath, Frozen, Pending Approval, Approved) Patents . Smith, Robert STUDY Karlsson, Peter Study type Electrophysiology Electrophysiology Redening Physician |Karlsson Peter Rev. B.A.M.Div. -00 2002-07-03 State is one of(Pre Cath, During OC Flowsheet (T) Study comment Random string Requesting Physician - Karlsson, Peter Admitting Diagnosis |Random string Adamsson, John Robert Q 2 Preregistered Patients Ward Patients Study date 2002-07-03 Patient Level Folder_ Karlsson, Kale Admission ID Smith, Robert Soudy Start Time 16-33:20 INSTITUTION Study Level Folder cmKarlsson, Peter Study State During Cath Institution Name -89 2002-07-03 Height [cm] 17000 ·OC Flowsheet (T) Weight [a] 70 1. Performing Physician Body Surface Area DeBodySurface Area Karlsson, Peter 2. Performing Physician Pre-HB Adamsson, John Robert QI Pre-Medication 1. Operator -2 Preregistered Patients Contrast Allergies 2. Operator Karlsson, Kalle Smoking Status Last Menstrual Date Patient State Patent Position Random string Accession No. Random string Requested Procedures 55 Turnover Workbook | Sensis VIBE • You are logged into Patient Explorer under your username and password. If for Notes some reason, another person is coming in to take over, you can use the Change User key to have that person sign in. AXIOM Sensis Patient Navigator Application Edt Search Patient/Study Report Help • To configure what is shown in each of the patient views (either Patient Level, Study Level folders or Pre Registered Patients) you will use the “Configure Patient Explorer” Icon. AcionM Semais Patient Navigator Configure Patient Explorer Corngure Palors Explorer Configure Patient Explorer Configure Patient Explorer Cools Us Shady Pre. Register · Patient a Study · Pre. Register · Patient · Study Pre. Register Details |List | Details |List Patient Details Configuration Study Details Configuration Pre-Register Detail Configuration Display Display Display Display Display Study type O Pain State B Referring Physician El First Name Study comment O Patent Poation E First Name El Requesting Ptysicion DI Middle Name E Study date E Accession No. O Midde Name E Admizing Diagnosis Study Start Time 5 Requested Procedures E Tide DI Ward E Study Total Time O Admission ID DI Other Patent Name D Ofer Patient Name Study State Referring Physician O Oner Patient D(s) El Height It] [ Requesting Physician [ Other Parent ID(s) B Requested Procedures Weight [b] Admitting Diagnosis O Emc Group O Etric Group E Study type O Misay Rank E Body Surface Ares El Ward D Mitry Rank B Study comment O Pre-HB O Admission ID Pre-Medication El lesttoon Name O Requested Contrast Apies B Insais.zion Name 1. Performing Physician O Contrast Allergies 1. Performing Physician El 2 Perloening Physician B Adscon info O Smoking Status B 2. Performing Physician E Address 3 1. Operator O Special Needs 3 1. Operator E Additional into El 2 Operator O Medical Alons E1 2. Operator O Pregnancy Status Weight [b] O Last Menstrual Date Defout Sore Stose Dotout Soin Deco • The “Edit” icon is used to correct patient information. • The “Save” icon is used to save corrected patient information. • The “Delete” icon is to delete patients from the Patient Explorer database. • Your username and password will determine if you have permissions to perform this task. Normally, you would not ever delete patients from the Patient Explorer database. However, before you run any statistics on your patient population, you will want to remove any test patients (for example). AXIOM Semis Patient Navigator Application Edit Search Patient/Study Beport Help E X Edit - Opens Study, Hospital and Institution data for current patient to modify Save - saves modified Study, Hospital or Institution data for current patient. Delete - Current patient is deleted. Must enter username and password to delete a patient. Patients can only be deleted one at a time. SUGGEST to people learning how to use the Sensis system that they ALWAYS register their test patients with the last name of TEST - this so that when you need to clear those test patients from the database before doing any queries you can easily find the TEST patients. 56 Turnover Workbook | Sensis VIBE Notes • When opening Patient Explorer, it will by default, show you the patients that have been done today. To search for a specific patient, hit CLEAR to clear out today’s date, and type some identifying information in the Search Criteria. It is also possible to use the asterisk (*) as a wildcard in the search if you are not sure of a name spelling (Example: John* would return all the patients where their last name started with John). Search for patients and studies X Use a predefined search Delete Set as default Select study states Pre Cath E Frozen During cath M Pending approval Post cath Approved Enter patient criteria Patient ID First name Last name Birth date from Birth date to Conflict date from Enter study criteria Accession no. Study date from 6/5/2008 Study date to 6/5/2008 Physician Save Reset Clear Search Close • To Pre-Register a patient manually, you can use either of the next two icons. If there is a patient in the database that has had a previous study, and is coming back for another, you can highlight their “Patient Level” folder and hit the “Pre- Register Selected” icon. This will populate all the redundant information into a new patient study. If a patient is coming to your lab for the first time, and you want to Pre-Register them (perhaps to accomplish some pre-cath documentation) you could use the “Pre-Register New” icon and that will open a blank registration window for you. 57 Turnover Workbook | Sensis VIBE • Sensis Vibe is designed to allow you to approve and write protect a patient Notes record. If this manual process is not performed, Sensis Vibe itself will write protect a patient study after a designated period of time. E AXIOM Sensis Patient Navigator Backcation Edk Search Patient /Study Report Help Pending Approval - used to lock Documentation Tool and Reports prior to Approval selection. Password protected Approved -All information considered accurate, Documentation Tool and all Reports locked. Password protected • If your system is set up to Export data to another system on your network, there may be occasions where you may want to manually export a study. The next Icon on the toolbar will allow you to do that. AXIOM Sensis Patient Navigator Application Edit Search Patient/Study Report Help X Export Study - Will export the study data in a number of different type of file formats which are configured through Communication Manager 58 Turnover Workbook | Sensis VIBE Notes • If two or more studies on one patient are performed at your facility, the patient should have only one “Patient Level” folder within patient explorer. If on one of the registrations, some piece of data is incorrect (Patient name spelling, DOB, Patient ID, Sex) two Patient Level folders would be created for the one patient. This next icon allows you to merge the studies. This function is only accessible if your username and password allows you permissions. AXIOM Sensis Patient Navigator Application Edt Search Patient/Study Beport Help Rearrange Study - Used to merge two studies together. Correct Patient Name: Tom Smith Procedure Date: IDNR: 54780-1 6/23/2000 DOB: 01/18/1937 Sex: M Name: Tom Smith IDNR: 54780-1 DOB: 01/18/1937 Name: Tom Smyth Sex: M IDNR: 54780-1 DOB: 01/18/1937 Procedure Date: Procedure Date: Sex: M 12/4/2002 6/23/2000 Incorrect Patient Procedure Date: 12/4/2002 • The documentation tool is accessible through Patient Explorer. To access the Documentation Tool, highlight the study level folder within Patient Explorer and select the Documentation tool icon. AXIOM Sensis Patient Navigator Application Ede Search Patient / Study Report Halb Documentation Tool - Opens report groups for entering or updating data. • It is possible to create a new report on a patient through patient explorer. In order to do so, highlight the study level folder and hit the “New Report” icon. AXIOM Sensis Patient Navigator Application Edt Search Patient/Study Boport Help X Report Generator 59 Turnover Workbook | Sensis VIBE • Find out if your facility will have the patient Waveforms built into the report! Notes This is an excellent way to archive your waveforms in the word document report. The Export of the Waveforms is Automatic with Sensis Vibe ! Table Tools Sensis Report Generator: 9875537534 VIBE, SENSIS - Waveform [Compatibility Mode] -1 - " Report Design Layout New Save Refresh Print E-mail Transter Report Sensis Report Generato ----- MENCHEALT-CAN SIEMENS Page 1 of 3|Words: 0 • The next two icons will only be available if you have purchased the options they represent CHP and CTI. • The next icon following that is to print a patient report. • The last two icons are rarely used for hospital and patient information security reasons. They are to setup email and fax of patient reports. Sensis Patient Navigator Application Edt Search Patient/Study Beport Help Opens Heart Picture Illustrator for current patient's Study Opens Coronary Tree Illustrator for current patient's Study AXIOM Sensi Patient Navigator Application Edit Search Patient Study Boport Help Prints report (s) for current patient 60 Turnover Workbook | Sensis VIBE 4. Administrative Functions 4.1 Objectives Notes During patient procedures, Sensis Vibe is acquiring non-invasive blood pressures, and a number of other automatic functions are happening “behind the scenes”. This session will help you to know what is happening and how to change something that isn’t flowing the way you would like it to. Upon completion of this session, the learner will: • Know their facilities pre-set defaults • Know how to change their defaults • Assist in the creation of Setups and Workflow Support Programs • Be able to calibrate their Sensis Vibe system • Identify the optional programs that are available for their Sensis Vibe System. 4.2 Setting your Defaults • Each Sensis Vibe Unit can be set differently according to the types of studies to be performed in that room. • From the top toolbar on the Sensis Vibe, choose Options > Configuration. These changes should be made with NO CASE OPEN. Settings must be performed on each acquisition system individually. Patient Applications Edit View Input Tools Options Help Maintenance. End Session Calculate Configuration Service Hemodynam. Post Proces. #f. Sensis Vibe - Configuration Panel X File * Auto Delete Patient Browser Transfer Patient Software ImageText Registration Distribution Editor Regional and EP Catheter Setup Events Ablation Pressure Language . Connections Configuration Configuration Signals Transfer Setups Parameters Print 12 Lead ECG Stimulation and Programs Mapping Configuration Snapshot Configuration System C ... ES Workflow Predefined Support C ... Pullback ... Study Type Settings Patient Registration NUM 61 Turnover Workbook | Sensis VIBE • The configuration panel has many functions that you will not use. We will cover Notes only the most used functions for Sensis Vibe. • Auto Delete: This function allows you to set up a delete schedule for your Patient Browser Database. ----------- D O Carneesoes --- 12 Lead Eco E Carngrazen et Ce * Auto Delete ----- OK • Patient Registration: The Sensis Vibe can be set to maintain certain data upon patient registration. But, for instance, you most likely do not want to maintain a certain physician for every cath performed in your lab – you would set that to “No Default”. Contguration Connectors aca Srvow MD Correries 12 Lead Eco Sepet ce ONta/al Patient Registration OK 62 Turnover Workbook | Sensis VIBE Notes • Regional and Language: Most often, this icon is accessed to change the measurement system from Metric (m and kg) to US (ft’ and in” and lbs) or visa versa. --- = Connecsons Setos LIJ 12 Laat Eco -- ------------- Mwrong Configuration Workflow Sepet Ce anges the language of the application Regional and Language ... • Setups and Workflow Support Programs: The way in which your screen is displayed during procedures is configured here in the Control Panel. There are 3 icons in the control panel that are accessed in order to create or amend your Setups and WFSP’s. The first is the Pressure Signals. Once the Pressure signals are configured to cover the possibilities for this lab, the Setups are created next based on your Pressure Signal configurations. Then finally, the Workflow – Support Programs are created – based on your Setups. in Sensis - Configuration Panel X File X Auto Delete Patient Transfer Patient Software Image Text Browser Registration Distribution Editor Regional and Multi Monitor EP Cathet Language. Setups Events Ablation Configuration Connection Configuration Configuration Pressure ransfer Parameters Dictionary Print 12 Lead ECG Signals ftups a Configuration Import Snapshot Stimulation Mapping Workflow Predefined Study Type Configuration System Co Support Co. Pullback ... Settings Auto Delete NUM |SCRL • Your applications specialist will install some standard Setups and WFSP’s that will enable him/her to begin training sessions. Work with the applications specialist to ensure that your setups and WFSP’s are indeed what is needed. 63 Turnover Workbook | Sensis VIBE • Events Configuration: Notes • Tachycardia setting for a tachy arrhythmia Events Configuration X Tachycardia Bradycardia | Vital Signs |Vital Signs Al ... Mark Events Configuration Triggers for tachycardia HR >= 150 Duration (beats) 4 When a tachycardia appears . Log as an event and start recording Log as an event if recording is active Do not log as an event Settings for recording of tachycardia Retro-recording time before onset (s) 20 Recording length after onset (s) Until tachycardia termination OK Cancel • Bradycardia setting for a brady arrhythmia Events Configuration X Tachycardia Bradycardia | Vital Signs |Vital Signs Al ... Mark Events Configuration Triggers for bradycardia HR <= 50 Duration (beats) 4 When a bradycardia appears Log as an event and start recording Log as an event if recording is active @ Do not log as an event Settings for recording of bradycardia Retro-recording time before onset (s) 5 Recording length after onset (s) Until bradycardia termination OK Cancel 64 Turnover Workbook | Sensis VIBE Notes • Vital signs setting for your Vital Signs acquisition Events Configuration X Tachycardia Bradycardia Vital Signs |Vital Signs AL Mark Events Parameters Configuration HR (averaged) SpO2 NBP Respiration Rate + EtCO2 IBP IBP Channel P1 P2 P3 P4 When Vital Signs Event is created, prompt for. Consciousness v Muscle Function Pain Score Respiration Circulation View Narrative Values Skin Color Total Aldrete Score Measure vital signs: Repeatedly Log interval (min) 10 Display dialog on Nurse Workstation NBP By default,only use neonatal mode NBP Neonatal Mode NBP Adult Mode NBP initial inflation pressure (mmHg) NBP initial inflation pressure (mmHg) 90 140 Min age to use adult mode (months) 24 Note that you should not use NBP adult mode on neonates or patients who weigh less than 8.2 kg (18 pounds). When examining emergency patient, use: NBP neonatal mode NBP adult mode OK Cancel • With each acquisition of a NIBP, Sensis Vibe is able to display an Aldrete Score and/or Pain Scale. Pain Score Edit Control X Returito Defaut Edit Narrative Values Events Score Associated Narrative Configuration No Pain No Pein Mild Pain Mild Pain Discomfort - Moderate Pain Discomfort - Moderate Pain Distress - Severe Pain Distress - Severe Pain Intense Distress - Very Severe Pain Dimness- Very Severe Pain OK Cancel • Alarms If you have the “Alarms” option, you can set the defaults here (you must have the administrative password to do so). 65 Turnover Workbook | Sensis VIBE • Mark Assign the F keys on your keyboard to mark events during a procedure. Notes Events Configuration Edit Comment Tachycardia | Bradycardia | Vital Signs | Vital Signs AL Mark Comment Arrhythmia start Events Configuration Comment Function Key Mark Event Add Tachycardia Arrhythmia start 133 Arrhythmia termination Edit Cardioversion Delete Function Key F10 F11 cel Display "Select Comment" dialog OK Cancel • Transfer Setups and Workflow Support Programs • Any time changes are made to your setups and workflow support programs, you should ALWAYS “Export” them once the changes are complete. This will make a fresh copy of those programs (in case you ever need to reload them). • If you are bringing in a new set of Setups and Workflow Support Programs (for example from one Sensis Vibe to another) there is a specific protocol to follow in transferring Setups and Workflow Support Programs. You will need to Export from the Source system before you copy them, then use the “Import” in order to make them active on the Destination Sensis Vibe. Export or Import Setups and Workflow Support Programs X Transfer In case of Import, Please make sure that setup and workflow files are of same pair: Setups a ... Setups Workflow Support Programs Import Export Close • Print and 12 Lead ECG Snapshot setting for printing ECG and Waveforms Ariz Print Configuration X 12 Lead ECG Snapshot Configuration x Print 2 Lead ECG Raster Print and Display Snapshot 12 Lead ECG Printouts @ On Print c Off Display Other Waveform Printouts Sweep Speed 25 c On @ Off OK Cancel OK Cancel 66 Turnover Workbook | Sensis VIBE Notes • Predefined Pullback • To create predefined pullbacks for use during procedures. Edit Predefined Pullback Sequence x Edit the settings below to update the predefined pullback Predefined sequence. Pullback ... Sweep Speed 25 mm/s Available Sites .RA - Right Atrium -RV - Right Ventricle PA - Pulmonary Artery Main -PCW - Pulmonary Capillary Wedge -PV - Pulmonary Vein -LA - Left Atrium LV - Left Ventricle AO - Aorta · AO Asc - Aorta Ascending AO Arch - Aorta Arch AO Desc - Aorta Descending ART - Artery BART Brac - Artery Brachial Predefined Pullback Sequences x Calculate overall gradient IV . AO LV - AO - ART Femo Selected Sites PCW-PA-RV - RA Add. LV AO Move Up Edt AO Arch Remove Move Down OK Cancel OK Cancel • Study Type Settings • To set the Sensis Vibe to load a specific Setup or Workflow support program based on the Study Type selected at the time of patient registration. Study Type Settings X Study Type Select Study Type Associate Study Type to Settings Coronary Default Setup LDiagnostic Coronary Catheterization Setup Electrophysiology Workflow Support Program LElectrophysiology study Pediatric Pediatric Cardiac Catheterization 1 Pressure Pediatric Cardiac Intervention 2 Pressure 3 Pressure 4 Pressure 1 Pressure Rt Heart P2 Only FFR Apply Close 67 Turnover Workbook | Sensis VIBE 4.3 Channel Calibration Notes • Calibration for the Sensis Vibe pressure channels needs be done • after system re-installation but not necessary after installing patches • after changing a re-usable pressure transducer types • after changing the batch, type or vendor of disposable pressure transducers • at “Regular Intervals” • Regular interval” is defined as calibration every 1-3 months or more depending on your standard of use. • A pressure transducer falling down or after received a mechanical shock need to be replaced • Switching between different pressure transducer types (also between different disposable types) requires re-calibration after EVERY switch. It is not necessary if you are using disposable pressure transducers from the same type/vendor and same batch. • It is much easier to perform calibrations with two people. • It is a good idea to keep a log for reference of dates calibrated. • CALIBRATION PROCESS • AT TABLE SIDE • Attach a new transducer to your Sensis Vibe in port A (P1) and the pressure induction system (i.e. Verical) • DO NOT flush with liquid solution • Open the Transducer to air • AT THE SENSIS VIBE • Open a Test Patient • Select a 4 pressure program • Put all 4 Channels on a 100 Scale. tient Applications Edit View Acquire Input Tools Options Help VIBE SENSIS Review Real Time 0988536543 200 Scale 25 mm/s Female 02/26/1958 Setup Workflow Support ITA 4 Pressure Current Condition 1. Rest New P4 P3 P2 P1 TavL Vital Signs 200 200 200 200 P1 200 -P3 200 180 180 200 180 P4 200 160 160 160 160 Post Proces ... |Hemodynam. Recording 140 140 1 140 Error X 120 120 120 120 12 100 100 100 100 Hemo Calculation Detected disconnected pressure transducers. The transducers must be 80 80 80 X connected, or their correponding signals removed from the pressure scheme. The 60 60 60 transducers are: P3 P4 40 40 40 20 20 20 O O O OK Tools Pleth 68 Turnover Workbook | Sensis VIBE Notes • Hit the -0- balance button and deselect the channels that do not have a transducer connected at the moment. Balance Pressure Transducers X Signals Balancing pressure mmHg P1:P1 o P2:P2 o P3:P3 1 P4:P4 -1 Balance Close • The Sensis Vibe will detect that not all 4 ports have transducers attached – just press OK to move on past that warning. Error Detected disconnected pressure transducers. The transducers must be connected, or their correponding signals removed from the pressure scheme, The transducers are: P3 P4 OK • The balance message close when it is properly balanced. If the balance box stays open, and there is a red area next to the channel you are working with, the transducer is not open to air, not connected to the proper cable for that pressure channel, or there is something wrong with that transducer. • Top toolbar “Tools” > “Calibrate Pressure” Applications Edit View Acquire Input Tools Options Help Change Mode MIBE SENSIS Real 0968536543 Timer Female 02/26/1958 Retrospective Event 100 Scale 25 mm/s Setup Workflow Support Update Event Report Generator 4 Pressure Export Waveform Image Current Condition Mean Pressure 1. Rest New Pressure Calculation Settings ... P4 P3 P2 P1 Vital Signs TavL Balance Pressure 100 Calbrate Pressure 100 100 100 100 22 100 B P3 100 FFR: Equelize Pressures 90 90 90 90 STOP P4 100 1mV - ECG Calibration 80 80 80 Post Proces ... Hemodynam ... Recording Restore Baseline 70 CO2 Pump Control 60 REC 12 Start Heart Picture Illustrator 50 Hemo Calculation Start Coronary Tree Illustrator 40 30 30 69 Turnover Workbook | Sensis VIBE • Select the button next to the transducer you are calibrating, and then type Notes the number “100” into the box. Calibrate Pressure X Signals Correction Factor ·P1:P1 1.00 . P2P2 · P3:P3 · P4:P4 Pressure (mmHg) 100 Calibrate Close • Now, tell your partner to put exactly 100mmHg pressure on the transducer. Wait for the pressure to be stable and not drifting. When the pressure is stable – hit Calibrate. 1.00 100 B 133 100 188 Calibrate Pressure 90 80 Signals Correction Factor 70 . P1:P1 00 60 . P2P2 50 . P3:P3 40 . P4:P4 30 Pressure (mmHg) 20 100 10 O Calibrate Close • You are done calibrating Channel 1 – repeat the steps for channels 2, 3 and 4. Calibrate all channels on all Sensis Vibe units. 70 Turnover Workbook | Sensis VIBE 4.4 Points of Interest Notes • Functional Location Number • Every piece of Siemens equipment is “tagged” with a Functional Location Number (FLN). It is important that you know where to locate the FLN if you call for service. • This is extremely important when calling for assistance to the Customer Care Center. • Dial 1-800-888-7436 You will be prompted to enter your Functional Location Number. • Application Support – 3 • Vascular and Cardiovascular Imaging – 3 • Sensis – 2 4.5 Optional Software and Hardware • Depending on your Sensis Vibe configuration, your applications person will need to discuss any optional software purchased with your Sensis Vibe. • Statistics Manager • Statistics Manager allows you to pull data from the Sensis Information System for reporting purposes. Any data that is documented during a procedure can be pulled out using Statistics Manager! -- --- --- 71 Turnover Workbook | Sensis VIBE • Fractional Flow Reserve Notes • The FFR license will allow you to perform FFR measurements on the Sensis Vibe during interventional studies. Thesp 1E1002 80 20 / 81 Pa 95 25 / 10 LEX AO, LEX 15 0.16 FER Q.10 Cx 200 P.P. 0.16 00.26 Tiver 00:28 LEX ------ 5:0147 PM-FFR 101:59 PMVIBE SENSIS . 6900536549 • Systolic Area Index (Option) for diagnosis of Constrictive Pericarditis • Use the SAI icon when both the LV and RV pressures are visualized. • Select the Expiration Waveform • Select the Inspiration Waveform • Click O.K. to calculate the Systolic Area Index. Heart Normal Inflamed pericardium Pericardium Diagnose of constrictive pericarditis with new option SAI Sensis now enables unique and efficient way to diagnose constrictive pericarditis through calculation of systolic area index SAI =- [RV systolic Area / LV systolic Area] during inspiration [RV systolic Area / LV systolic Area] during expiration 72 Turnover Workbook | Sensis VIBE Notes • Congenital heart picture and Coronary Tree • These two individual software programs allow the user to annotate heart chambers and coronary arteries. - AMOM SEN515 STEVENS. Ride Sensirant LAD: Lape calber. 90%+ pela passinal (12/2014) gratinal nd mid The cwas IM: The Lot Man, Antmor Deseroding and Left Cirondles insieme I&D: The Lel Antefor Descending artery, which aries son Be 134, in a large calber vend. There be a 90% Be presina The Cu The Chromdes at lange calber vessel. There is an Seus X Ton bare nvol RCA: The Ride Convary Anax, stid aises righe cup. is a torpe caliber ves The Righe Pormobiemal Arvary. fon The Righe Posterior Droom POSTERIOR Saturations| Pressures| Reset to Normal 4.6 Review Checklist • It is now time to review your checklist and ensure that all your questions have been answered. 73 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 40 Liberty Blvd. present in individual cases. Malvern, PA 19355-9998 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. A91SVC-17930-P1-4A00 Germany Printed in USA 04-2017 | All rights reserved Telephone: +49 9191 18-0 © 2017 Siemens Medical Solutions USA, Inc. www.siemens.com/healthcare Global Siemens Headquarters Global Siemens Healthcare Siemens AG Headquarters Wittelsbacherplatz 2 Siemens AG 80333 Muenchen Healthcare Sector Germany Henkestrasse 127 91052 Erlangen Germany Telephone: +49 9131 84-0 www.siemens.com/healthcare 74 www.siemens.com/healthcare