BRM3 Quick Guide Ver 1 Aug 2007

Performing an assessment

Note : Full operating instructions are available in the BRM3 Onscreen Help System. 1.

Set up the BRM3 Brain Monitor close to the patient and check that the connections are OK (see Figure 1).

2.

Hang the DAU from a convenient hook or handle on the incubator or cot.

3.

Switch on the power switch (see Figure 1) and log in, using NICU as the user name and password.

4.

Touch Assess Patient and enter the details of the patient, then push OK.

5.

Apply a Neonatal Sensor Set (see page 3) or connect a Sensor Adaptor Set (see page 4). Check the signal quality of the first two sensors before you apply and check the remaining sensors.

6.

Start the assessment (see page 5).

7.

During or after an assessment, you can:

Equipotential terminal

Figure 1: Brm3 Brain Monitor Connections

- mark an event ( see page 8) - archive data files and snapshots onto a USB memory stick (see page 9) - print aspects of an assessment (see page 10) - take a snapshot of the screen (see page 11)

Power switch

Equipotential terminal

Power supply cable

DAU USB 2.0 cable



Applying a Neonatal Sensor Set

Warning: Do not apply the Neonatal Sensor Set to a patient until you have read the instruction sheet supplied with the Neonatal Sensor Set, or received specific training in this procedure. 1

2

Keep the Positioning Aid vertical and parallel to the face. Align it so that the letter at the ear tragus is the same as the letter at the sagittal suture. The forward edge of the Positioning Aid should touch the tragus.

Lay out all the materials, including the Sensor Set and Positioning Aid (in the Sensor Pouch). Place the wrap hat under the head, aligning the head with the body.

4

3

5

Part the hair vertically at the first mark with a damp gauze pad, so that a small ‘bald’ spot is created at the site.

7

6

Pat the site and the surrounding hair dry, keeping the hair parted. DO NOT RUB. Note: Keeping a finger next to the bald spot will help as the pen mark washes off.

8

Remove the NuPrep™ with a damp gauze pad, working outwards from the center to keep the hair parted.

10

With a little NuPrep™, clean the exposed scalp, working up and down the length of the parting. Hold the skin taut as you clean.

9

Pat the site and the surrounding hair dry, as before, maintaining the bald spot.

11

Repeat the previous steps for the second sensor site. In a similar way, prepare a site for the Reference sensor on the shoulder, neck or behind the ear (choose a site with no hair).

Mark the two sensor sites, one on each side of the Positioning Aid, at the ends of the arrow.

Apply the first sensor directly over the clean bald spot with the sensor wire upwards. Check the Left or Right label on the cable and remember: “Black is Back”.

12

Connect the Neonatal Sensor Set to the DAU (Data Acquisition Unit) and check the contact quality of the sensors. When OK, use the wrap hat to secure the sensors then turn the head.

Prepare the sites and apply the sensors to the second side, as before. When the contact quality is OK for all the sensors, fold the wrap hat around the head and secure it with tape.

3

Applying a Sensor Adaptor Set

Warning: Do not apply the Sensor Adaptor Set to a patient until you have read the instruction sheet supplied with the Sensor Adaptor Set, or received specific training in this procedure.

1

2

Keep the Positioning Aid vertical and parallel to the face. Align it so that the letter at the ear tragus is the same as the letter at the sagittal suture. The forward edge of the Positioning Aid should touch the tragus.

Lay out all the materials, including the Sensor Adaptor Set and Positioning Aid (in the Sensor Pouch). Place the wrap hat under the head, aligning the head with the body.

4

3

5

Use a cleansing solution to clean the site where the first sub-dermal needle electrode will be inserted.

7

6

Insert the first sub-dermal needle electrode with the sensor wire upwards. Ensure that all of the metal is under the dermal layer. Check the Left or Right label on the cable.

8

Prepare a site for the Reference sensor on the shoulder, neck or behind the ear (choose a site with no hair). Refer to page 3 for site preparation instructions.

Mark the two sensor sites, one on each side of the Positioning Aid, at the ends of the arrow.

Secure the sub-dermal needle electrode in place. Repeat the previous steps for the second sub-dermal needle electrode.

9

Connect the Sensor Adaptor Set to the DAU (Data Acquisition Unit) and check the contact quality of the sub-dermal needle electrodes. When OK, turn the head.

Prepare the sites and insert the sub-dermal needle electrodes to the second side, as before. When the contact quality is OK for all the sub-dermal needle electrodes, fold the wrap hat around the head and secure it with tape.

4

Checking signal quality and starting the assessment

1.

The Signal Status screen is displayed after the patient’s details are entered. (To check the signal quality during an assessment, touch Check Signal to display the Signal Status screen.)

2.

Note the colors of the four EEG sensor electrodes represented on the “head” graphic, and the values shown for impedance. The meaning of the indicator colors is explained in the following table. Green

Electrode contact is good (< 7.5 kΩ)

Yellow

Electrode contact is marginal (7.5 - 10 kΩ)

Red

Electrode contact is poor (> 10 kΩ)

4.

If the indicator for any electrode is yellow or red, check the text display area at the bottom of the Signal Status screen for a suggested course of action.

5.

If the suggested action does not result in either a yellow or green indication, it may be necessary to reapply the electrode.

6.

When all four indicators display as green or yellow, touch Start to start the assessment. Increased or unstable impedance for a sensor suggests that the sensor is drying out or that skin preparation at the site was inadequate. AC Supply Noise greater than 5 microvolts, or unstable, may indicate that the Reference sensor is making poor contact (re-hydrate or re-prepare the skin under the Reference sensor). 

Troubleshooting

Key to background colors displayed in the trace. Technical deficiencies in the trace are indicated by a red or yellow background tint. Background Tint

Deficiency

Action

Yellow Red

- Minor problem - Major problem

- Watch carefully - Take immediate action

If tinting occurs: 1. Touch Check Signal to display the Signal Status screen. 2. Follow instructions in the text display area at the bottom of the screen. Other problems: • Check for normal operation using the Test Plug (see Reference Manual or Onscreen Help). • Check the BrainZ website, www.brainz.com for additional support information. • If you still need help, contact an Authorized Service Center.

Test Plug



During an assessment you can :

• Check the signal quality (see pg 5)

• Mark an event (see pg 8)

Ending an assessment : 1. 2. 3. 4. 5. 6. 7.

• Change the main display screen

• Review the current assessment

• Edit patient details • Log in/out • Archive data (see pg 9) • Print (see pg 10) • Take a screen snapshot (see pg 11) • Activate the screen saver

• End or suspend the assessment (see pg 11)

Touch Stop to display the Main Menu screen. Remove all of the sensors and perform any aftercare. Touch Manage Data to display the Patient Data File Manager screen. Archive the patient data files you have created to a USB memory stick for offline storage and analysis. Shut down the BRM3 Brain Monitor. Touch Close in the Patient Data File Manager screen. Touch Shutdown and confirm. Turn off the power switch. 

Marking an event

1. 2. 3. 4. 5. 6.

Touch Mark Event to display the Event dialog. The event number is shown in the header of the dialog, with the current date and time. Touch Description to display the Add Comment dialog. Touch Quick Comments and select an option from the list, or Touch the comments area to display the Onscreen Keypad. Enter brief details of the event and touch Enter. Enter your initials and touch Enter. Touch OK to close the Add Comment dialog. Touch OK to save the details of the event. After a short time, the event mark will appear as a thin vertical line on all compatible screens.

If two or more comments are spaced very close together, a thick vertical line will be displayed.

(Optional) You can skip Steps 2 - 4 to create a blank event mark. You can add event details later.



Archiving data files and snapshots

During, or after an assessment, you can archive data files and snapshots onto a USB memory stick. 1.

2. 3. 4. 5. 6.

7.

Touch either: - Manage Data on the Main Menu screen (when assessment is complete), or - Tools to display the Tools menu, then touch File Manager to display the Patient Data File Manager screen (while assessment is in progress). Do not disconnect the USB memory stick while Connect a USB memory stick to one of the USB ports (at the rear of the copying is in progress, as loss of data or damage Touchscreen Monitor). to the USB memory stick may result. Wait 5 seconds, then touch the Refresh button to update the file lists. Select the assessment or snapshot you want to archive in the Internal Suffix _SUM _CLN _RAW Storage file list. One-minute median values of all measured a a a Check there is sufficient free space on the removable media (displayed parameters above the Removable Media file list). aEEG waveforms (XC and BiL) a a To archive the assessment or snapshot: EEG waveforms (1-25 Hz) a a - at the default level (“Clinical”), touch Archive. EEG waveforms (1-123 Hz) - at the “Raw” or “Summary” levels, touch the arrow section of the a Archive button, then select the appropriate level from the 6 Clinical pop-up menu. Raw Result: The Progress bar shows the status of the copying. Summary Touch Close to close the Patient Data File Manager screen. 

Printing

During, or after an assessment, you can print: - a summary of the assessment - the current screen - aEEG traces - a list of events. The BRM3 Brain Monitor must be connected to a BrainZ-recommended printer (HP450cbi, HP460cb or HP460wbt). 1. 2. 3. 4.

Connect the printer to the BRM3 Brain Monitor’s USB port. If necessary, select the display you want to print (either in “record” or “review” mode). Touch Tools to display the Tools menu. Touch one of the following: - Print Summary to print a summary of the current assessment. The summary will include details of the patient, Integrated Amplitude graphs, Spectral Edge graphs and Impedance. - Print Screen to print the current screen, including event details. - Print aEEG to print the cross-cerebral and bilateral aEEG traces for the assessment. - Print Events to print a list of events in the current assessment.

10

Taking a screen snapshot

Record

Review

Touch Tools Touch either: • Snapshot for web - to take an anonymous web resolution snapshot • Snapshot (Advanced) – to choose between: – Anonymous snapshot – Web or print resolution snapshot

Touch Snapshot - to take an anonymous web resolution snapshot OR Touch the arrow to choose between: – Anonymous snapshot – Web or print resolution snapshot

Suspending and resuming an assessment During an assessment you can suspend the current recording. 1. 2. 3. 4.

Touch Stop. Touch Suspend. The screen will display details of the currently suspended recording. (It is possible to shutdown the monitor, restart it and resume the same assessment). To restart the assessment touch Resume Assessment. Touch OK in the Signal Status screen to view assessment. 11

Subject : BRM3 Quick Guide Part No : CZD00068; GE M1119315 Version : 1 Issued : 08/2007 © 2007 BrainZ Instruments Ltd

For contact details refer to :

brainz .com