Android ECG device L12. Manual without copyright 2014 MCT Ganseman Steenweg 278 9470 Denderleeuw Belgium email: [email protected] web: http://www.ganseman.com Android is a trademark of Google Inc. 2 Contents Installation p3 Main menu p 5 Setup p7 Recording p8 View p 10 PQRST- reference points p 12 Protocol p 14 Motivation p 16 Actions – Delete, Copy or Export ecg p17 3 Preface Since we launched our first ecg apparatus connected to a PC a quarter of a century is already passed. Both the personal computer and our software changed a lot since then. Recent years showed the coming of smartphones and tablets. AndroidTM is now the tablet market leader. We are glad to announce that all our ecg apparatuses, released after 1/7/2004 are able to function with Android tablets without any hardware modification. More then ever your device is now portable. New recordings are ported very easy to your Windows PC for integration in your patient database, further processing, printing, pdf generation etc. The technical specifications of the ecg apparatus are located in the EcgL12En.pdf manual. These Android manual supposes that you are used to work with an ecg apparatus. Minimal configuration of Android device Dual core processor, CPU 1 ghz or more. Operating system 3.2 ( Honeycomb ) or higher USB port with OTG (on the go) capability Minimal screen resolution of 480*800 Minimal dimension of the screen is only 4 inch. Transfer of new recordings to your PC is possible by means of various ways Home wifi network: very easy to use Micro SD card ( not all tablets are equipped with it ) Connection to an USB stick When your device has so called root access several other possibilities for file transfer exists. The name of a binary ecg files is: Year_month_day_hour_minute_second.F12 2014_01_12_11_30_10.F12 means that the recording has been done on 12 january 2014 at 11 hr 30 min 10 sec With a file explorer the file can be found back in the following directory : /Android/data/com.ganseman.ecg/files/ User requirements: A minimal knowledge of the Ecg signal, Windows and Android is already a good starting point. 4 Installation Software installation The software can be obtained for our website. However it's also possible to download it from the Android Play Store. Search for medical - ecg - MCT Installation from the playstore has the adventage that no particular permissions like superuser are necessary. The installation directory is in Android File.DirDefaultExternal The *.f12 ecg files are located in Android/data/com.ganseman.ecg/files In the same directory are also located the configuration file in ConfigEcg.xml and the configuration file for the automatic protocol in EcgProtocol.xml. Delete the software By means of Apps . Uninstall it is possible to uninstall the software. Attention: all recordings will also be deleted Hardware installation = Connection to the micro USB port. The ecg software has to be installed first! It's not necessary to turn off Android. Most tablets are equipped with a micro USB female connector. You need a USB OTG cable : – One one side it has a micro usb male connector. Pin 4 and Pin 5 are connected together – On the other side it has an usb A' female connector. Plug the USB serial converter in a free USB port and wait a few moments. Android will give a message when the installation is ready. Select ok. 5 Main menu After launching Ecg.exe the following menu appears: Most option are easy to understand. New record. (A) View. (B) PQRST (C) Protocol (D) Setup. Do this once before first recording ! (E) Actions (F) Delete, Copy or exportthe selected file to an other location (6) Quit. (G) 1 2 3 4 5 6 Above the grid from left to right are: Name First name Date of birth. Birth year then month and day ID number Path name and file name Counter for the *.f12 ecg files 6 Remark The data in the grid are sorted alphabetic When a patient has several recordings these become sorted with the last recordings downward. Select a patient and his recording. Up and down scrolling in the list is easy. Tap once on a record to select it. Execute at first now option E: setup Before starting a new record, execute once 'Setup' . 7 E - Setup You see the following screen. Please select the correct options Language Select. Hardware Select USB ! Username Replace 'username' with your own name. He then becomes visible in protocol and printout. 8 Colours of the signal, grid and buttons. Background of signal and screen. All have three colour bars for selection of the amount of red, green and blue. Signal thickness ( at left ) With the buttons + and – the signal thickness can be adjusted. 9 Recording. Put the patient on a comfortable examination table. Apply gel or cream on the electrodes. Turn the apparatus ON and tap on the main screen left above the button “Record” The first record on a new android device will once popup a message : Click on 'Ok' below On the left of the screen, a small part of the ECG is displayed. If a pre cordiallead is missing, attach the electrode again. X : clear patientdate Select leads Mon = longtime recording Start = start recording. The personal data, name, first name of the previous patient are shown. This is handy if you want a new recording of the same patient. 10 Clicking on the button “ X ” clears name, first name, birth date and Id.. Enter the new name, first name , birth date and Id number of the patient. However, as the recording has already been started, it's not always easy to enter the patient data. This depends of the cpu speed and number of cores of your Android tablet. Don't worry, there is still plenty of time to enter the patient data later in the protocol. If you don't like to use the Android keyboard, it's not necessary to enter any data : after transfer of the recording(s) to Windows, you can enter them there: date and time are stamped into the *.f12 names. If you did several recordings and did not enter the personal data, just note the time when you did them. Other options on the recording screen are: Checkbox 'Pause' Reattach a loosed electrode and uncheck pause to continue. Checkbox 'Save' Long time recording has a cost of 360 kb/minute. When turned on before a 10 sec screen is finished, only that screen will be saved. Checkbox 'Mon' ( red circle above) for a longtime recording. Selection of the leads that will be displayed is possible. More explication about long time recording is located in the file \Addenda_EN_Ecg.pdf These file is located on our site or on the CD-Rom in the directory \Manuel\English Ecg. Click 'Start' will start recording. Elapsed time in seconds and cardiac frequency are displayed at right. The ecg recording will end after 10 seconds. The button 'Quit' makes termination of a monitoring possible. Recording seems not possible : Do not panic ! There are no mechanical parts inside the apparatus. A hardware failure is very unlikely. Consider the following. Apparatus is not turned ON. Cables are not connected properly. Press 'Cancel' on the recording screen and then again 'Record' After a new installation, always test the apparatus first once without a patient. Of course you see only disturbed signals. However if the Ecg recording is finished in exactly 10 seconds, it will also be fine with a patient. 11 View A B C D E F G H I J K A B and C: positioning. A Sec 0-5 / 10 means that the first 5 seconds of the 12 leads of a classic 10 seconds recording are displayed. B moves one position at left or at right. If the 12 leads are selected the view jumps by 5 seconds. If the 6 peripheral (F) or 6 pre cordials (G) are selected, then the view jumps by 10 seconds. If a detailed view is selected then the view jumps by 2,5 seconds. C scrollbar, has the same effect as B and C. Intended for long time recordings. D 5 seconds of the 12 leads. E I..AVF 10 seconds of I at AVF. F V1..V6 10 seconds of V1 at V6. G T test signal 2,5 seconds. H Also previous signal becomes visible. This button becomes only visible when at least two recordings has been displayed. I Filter – 50 Hertz - on if checked J Drift filter on if checked. Stabilisation of the baseline. K Quit Tap on a particular lead to view a detail of it : 12 Example of a detailed view Remark, in the red circle are also 6 vertical lines. These lines correspond with the reference points. The 4 (auricular fibrillation ) or 6 reference points of the PQRST complex are : Beginning and end of the P wave ( if present ) - pink Beginning and end of the QRS complex. - green Beginning and end of the T wave.- blue The software tries to place those points correctly. However if the placing is not ok, failure of the automatic protocol is likely. You can help the tablet to indicate e.g. the beginning of a P wave with a low voltage. Click once the Quit button below on the screen to return to the main menu. In the main menu, select the button PQRST 13 PQRST Click the Cancel button when you agree with the automatic placing of the reference points. If you disagree and prefers to place the reference points by yourself, this can be done in 5 simple steps. A Make at first the decision that the recording has a P wave or not. As most recordings have a P wave, this has been selected by default. B Select the period of the recording where to place the reference points. A 10 seconds recording is divided in to 4 pieces. C Lead I and II are displayed. If necessary select two other leads to place the reference points. Sometimes e.g. a P wave is better visible in V1 then in lead I or II. Most often, the firsts 3 steps A B and C require no action of the user. 14 D Selection of the reference point to place It's best to start with the beginning of the QRS complex ! The other reference points will be places nearby their expected positioning and only small adjustments will be necessary As a qrs complex is always present, “QRS beginning” is selected by default. When QRS beginning is selected, then E >, >> and >>> will move all the reference lines to the right with increasing speed <, << and <<< will move the reference lines to the left with increasing speed When another reference point then QRS beginning is selected, then E >, >> and >>> will move only the selected reference line to the right. <, << and <<< will move only the selected reference line to the left. F displays the newly calculated values. In case of a retrograde P wave the PQ time will be calculated negative. After adjustments, click 'Quit' to save them. 15 Protocol At left : Name (1) and first name (2) Birth date (3) – year, month, day and Id number (4) When you did not enter these data, it's also possible here. Secondary changes are also here possible. 5 6 Frequency, axis P,QRS and T. PQ, QRS, QT and Qtc time. Tab (7) CONC-HINT-PERS : conclusions, hints or personal.txt Conclusion(s) : Proposal(s) of the PC for the final diagnosis. Hints: Suggestions of the pc. Everything that is valuable to be mentioned. Pers contents of a file 'Personal.txt' . This is an ASCII file that can be edited with a text writer to add your own desired personal conclusions in advance. 8 Click to select. 9: Without the use of the red arrow your own personal conclusion (10) stays empty ! 11 + en 12- Diminishes or enlarges vecto cardiogram and displayed lead(13). 14: If tab (7) 'Conclusion is selected, with 14 it's possible to display a part of any of the 12 leads. 15: Motivation of the conclusions of the PC. cfr page 18 16 HINTS – Suggestions of the PC. In the protocol screen: Click the HINT tab, red circle. Possible abnormalities are displayed. By clicking on a hint, the corresponding signal is displayed on the left side of the screen and marked with a blue arrow. It is also possible to add a hint to your own personal conclusion with the red arrow. PERS – Personal.txt In the multi view screen: Click the PERS tab. The contents of a file 'Personal.txt' are displayed. 'Personal.txt' is an ordinary txt file that you can edit to place your preference comments ready. With the red arrow left from 'Personal conclusion', it is also possible to place a part of the file in your personal conclusion when you agree with it. Cancel Quits the protocolscreen without saving your personal data. Quit Quits the protocolscreens and saves you personal conclusion. 17 Motivation of the conclusions of the tablet Why of why not a particular diagnosis is established ? On the protocol screen click on the button motivation (15) page 15 1 : click, select the pathology for examination 2: examined properties. In the formula, below are OR conditions and AND conditions. OR : 1 condition is already ok AND: all conditions must be true. 3 lowest normal value for a certain pathology 4 highest normal value for a certain pathology 5 value of the patient 6 result of 5 compared with 3 and 4 : green ok, red not ok. If all results are green, a certain diagnosis is applicable. Often, even more important is to see why a particular diagnosis is not withdrawn. 18 F - Actions A: Name of the file and name of the patient. B : Button Delete Tap on the button at left 'Delete' and confirm. Deletes this file and quits this screen. Attention: Deleted is deleted ! C : Copy to microSDCARD The names of the directories in Android are somewhat misleading. sdcard doesn't mean external secure digital card but the internal memory and program. The pathname and name of the accessory memory are not part of an Android standard and manufacturer dependent. Some tablets do not have a MicroSD and others have two. The pathname can be found back with a File Explorer and entered in the setup. A file explorer is not delivered standard with Android. However several good file explorers are available as freeware on the play store. 19 Examples : an usb stick connected by means of an otg cable can obtain different names like /storage/udisk , USB Storage 0 , /mnt/usbhost1 etc. If you tablet is equipped with a micro SD card, the button at right “MicroSD card” will try to show the name of its location: Enter this name in D The MicroSD disk can then be put in a SD holder. A PC can read it. Other possibilities for file copying between PC and Android exists with a direct USB connection. Remember that the ecg *.F12 files are located in the directory Android/data/com.ganseman.ecg/files and that the names of the recordings are Year_Month_Day_Time_of_recording.F12 Some file explorers offer several other possibilities for file transfer, via network, bluetooth, ftp, Dropbox.. E: Export When a home wifi network is in range between Android and Windows, it's very easy to transfer files from Android to Windows in 3 simple steps ( A, B, C ) Desktop side : A recent version of the ecg software after 1/1/2014 is necessary. Java should be installed. Check it from the commandprompt with Java -version Verify also in C:\EcgF12\ecg.exe in Setup – Screen that the option 'Import from Android' is checked : 20 PC : Start the batchfile. C:\EcgF12\Bridge.bat ( Step A ) It's possible to make a short cut on the desktop to it. Minimalism is allowed Android : Select a trace to export, tap 'Export' at left and confirm. ( Step B ) You may do this with different recordings. Desktop : Click on the icon at right 'Import from Android' ( Step C ) Positioning on the last incorporated ecg is done automatically Ready ! You may stop Bridge.bat. This seems to be magical, but how does it work ? In a home network, direct talks between two connected apparatus are impossible. The firewall blocks incoming connection. However the batch file launches an initiator on our remote server. Most often this overcomes the blocking of your firewall for incoming connections. 9 Quit Quits the program.
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