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Urolab - Urovision System V Operators Manual Rev C

Operators Manual

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Urolab /Urovision System V ®

OPERATOR’S MANUAL Galen, Maximus, Janus, Primus, Opus and Novus Configurations

Life-Tech® Inc. 4235 Greenbriar Dr. Stafford, TX 77477-3995 M1036 Rev C

800-231-9841 281-491-6600 www.life-tech.com

Contents

Contents Contents...i Before You Begin ...1 Product Introduction...2 Features...3 Equipment Identification ...4 Important Computer Advice ...5 This Manual’s Organization ...6 Chapter Description ...7 Frequently Asked Questions ...8 Index ...8 This Manual’s Formatting Conventions ...9 Frequently Asked Questions...10 Assembly, Care & Maintenance of System V Hardware...13 Precautions ...14 Meaning of Symbols ...14 Safety...15 Environment...15 Placement...15 Service ...16 Safety Configuration Note ...16 Maintenance ...16 System Specifications...17 Introduction ...17 Computer Hardware Minimum Requirements ...17 Printer ...17 Measurements ...17 Recording Capabilities...18 Certifications ...18 Declaration of Conformity ...19 Setting Up Computer Hardware...20 Connecting Computer Hardware ...20 Setting Up the Keyboard & Trackball ...21 Patient Interface/Unit ...22 Interface Cables...23 Connecting the Patient Unit...24 Power Cords ...25 Assembling System V Accessories ...27 Overview of M22J Patient Unit Bottom Panel...27 Overview of M20/22 Patient Unit Bottom Panel ...28 Overview of M42 Patient Unit Bottom Panel ...29 Overview of 2012/2012A/M33 Computer Interface Board...31 Computer Drives ...32 3.5" Floppy Disk Drive ...32 CD/DVD Drive...32 Jaz Drive...33 Urolab/Urovision System V Manual M1036 Rev C

Contents Troubleshooting Equipment ...34 Troubleshooting Monitors ...34 Troubleshooting Keyboards...34 Troubleshooting Printers...34 Cleaning & Disinfection...35 Cleaning & Disinfection Procedure...35 Frequently Asked Questions...38 Getting Started with System V Software...41 Starting and Exiting System V ...42 Starting the Computer...42 Starting System V Software...42 Exiting the System V Software ...44 Restoring Logon Access after Losing Password(s)...45 Installing System V Software ...47 Obtaining an Activation Key...49 Running a Remote Database Migration on a Network Server ...56 Maximizing Video Quality...59 Adjusting Video Display Quality...59 Optimizing Printed Images...63 Frequently Asked Questions...65 Setting Preferences to Customize System V...41 Introduction ...67 About Setting Preferences...68 Acquisition Preferences ...69 Description of Acquisition Preferences...69 Accessing Acquisition Preferences ...69 Setting Acquisition Preferences...70 Display Preferences...74 Description of Display Preferences ...74 Accessing Display Preferences ...74 Setting Display Preferences ...75 Hardware Preferences ...82 Description of Hardware Preferences...82 Accessing Hardware Preferences ...82 Setting Hardware ...82 Preferences ...82 System Preferences...87 Description of System Preferences ...87 Accessing System Preferences ...87 Setting System Preferences ...88 Description of Reports Preferences...99 Accessing Reports Preferences ...99 Setting Reports Preferences...99 User Preferences ...102 Description of User Preferences...102 Accessing User Preferences ...102 Setting User Preferences...102 Video Preferences ...115 ii

Contents Video & Urovision Definitions ...115 Description of Video Preferences ...115 Accessing Video Preferences...116 Setting Video Preferences ...116 Urovision Preferences...121 Description of Urovision Preferences ...121 Accessing Urovision Preferences...121 Setting Urovision Preferences ...122 Creating Patient Records ...129 About Entering Patient Data ...131 Overview of Patient Data Applications...133 The Patient Management Database...133 The Advanced Management Database ...134 The Galen Database...136 Creating Patient Records...140 Creating a New Patient Record ...140 Editing Patient Records ...143 Selecting an Existing Patient Record ...143 Using the Fast Find Feature ...146 Working In Database Applications...148 Accessing Data Entry Applications...148 Using Visit Dates ...149 Patient-Use Database Forms ...150 Entering General Patient Information ...151 Entering Patient History ...153 Entering Patient Complaints ...155 Entering Patient Plans ...158 Entering a Survey ...164 Entering a Pelvic Organ Prolapse Exam ...168 Entering a Bladder Diary/Pad Test ...176 Printing the Bladder Diary/ Pad Test Report ...186 Creating and Storing Procedures for Future Use ...193 In This Section ...193 Introduction ...194 Creating Procedures ...195 Creating a Procedure...195 Reassigning Pressure Inputs...202 Urodynamic Channel Type Explanations ...203 DICC Procedure Channel Type Explanations ...205 GI Procedure Channel Type Explanations ...206 Modifying the Specific Gravity List...206 Automating a Procedure ...208 CMG Procedure Setups...213 Pressure / Flow Procedure Setups...214 CMG / Pressure-Flow Procedure Setups ...215 Uroflow Procedure Setups...217 UPP Procedure Setups...218 UP Procedure Setups ...219 Urolab/Urovision System V Manual M1036 Rev C

iii

Contents DICC Procedure Setups ...220 GI Procedure Setups ...221 Undesignated Procedure Setups...222 Editing Stored Procedures ...223 Editing a Procedure ...223 Renaming a Procedure...225 Deleting a Procedure ...226 Setting a Procedure as the Default Procedure ...227 Copying Procedures from Another User Logon Name...227 Creating Linked Studies...228 Creating a Linked Study ...228 Editing Linked Studies ...231 Renaming a Linked Study...231 Deleting a Linked Study...232 Setting a Linked Study as the Default Study ...233 Frequently Asked Questions...234 Acquiring Data During Urodynamic Procedures ...237 In This Section ...237 Before You Begin...238 Overview of the Acquisition Window...239 Mode Descriptions ...239 Tour of Acquisition Windows ...240 Description of Title Bar ...242 Description of Acquisition Toolbar 1 ...243 Description of Acquisition Toolbar 2 ...248 Description of the Channel Display ...252 Description of the Event Toolbar ...254 Description of the Multi-media Toolbar...257 Description of the Scroll Toolbar ...258 Description of the Status Toolbar ...260 Making Adjustments During Procedures ...261 Troubleshooting Pressures...261 Pausing Data Acquisition...264 Re-zeroing Individual Channels...265 Returning to Atmospheric Referenced Zero Baselines ...267 Changing EMG Channel Scale...267 Changing the Infusion Medium Bag or Bottle During a Procedure...268 Changing the GUB During a Procedure ...269 Changing the Video/Channel Display...270 Using Event Markers...273 Placing Event Markers at the Current Point of the Study ...274 Placing Event Markers in the History of the Study ...275 Removing an Event Marker ...277 Creating and Placing User-Defined Event Markers...279 Editing the User-Defined Event Marker List ...281 Acquiring Urodynamic Procedures ...286 Using Stored Procedures...286 Selecting a Stored Procedure...288 Acquiring a Uroflow...289 iv

Contents Acquiring a CMG-PF...293 Acquiring a UPP ...302 Using a Stored Linked Study ...308 Using a Hand Held Remote Control During Acquisition ...310 Description of Remote Control Buttons ...311 Using Voice Commands During Acquisition ...314 Frequently Asked Questions...315 Analyzing Completed Procedures and Studies ...319 In This Section ...319 Before You Begin...321 Overview of Analysis Window...322 Tour of Analysis Windows ...322 Description of Title Bar ...325 Description of Analysis Toolbar 1 ...325 Description of Analysis Toolbar 2 ...330 Description of the Event Toolbar ...333 Description of the Status Toolbar ...335 Analyzing Completed Procedures ...336 Analyzing a <manual> Procedure ...337 Analyzing an <auto> Procedure ...340 Completing a Uroflow Analysis...344 Completing a CMG Analysis...349 Completing a CMG-P/F Analysis...357 Completing a Pressure Flow Analysis ...362 Completing a UPP Analysis...371 Completing a UP Analysis ...386 Completing a VLPP Analysis...394 Optional Analysis Tools ...398 Printing Waveforms From the Analysis Window ...398 Moving Between Linked Procedures in Analysis...399 Using Playback ...399 Editing Event Markers in Analysis ...400 Creating and Placing User-Defined Event Markers...402 Zooming a Waveform ...404 Removing Artifact from Procedure Waveforms ...408 Viewing Compliance Values ...411 Reconfiguring Channels ...412 Creating an X-Y Plot ...415 Using Slide Capture...416 Using the Siroky Flow Nomogram ...419 Using the Liverpool (Haylen, et al) Flow Nomogram...420 Using the ICS P/F Nomogram ...422 Using the Werner Schäfer P/F Nomogram...424 Using the Chess Classification Plot...426 Using the Watt Factor Plot...428 Using the Compliance Nomogram...430 Using the Leak Point Pressure Plot...433 Using the Transmission Ratio Plot ...434 Viewing a Saved Report ...437 Urolab/Urovision System V Manual M1036 Rev C

Contents After an Analysis...437 Optional Video Analysis Tools ...440 Using the Image File Locator...441 Selecting Video Images on the Analysis Waveform...444 Changing the Video/Channel Display...446 Changing the Location of Video Images on the Analysis Waveform...449 Viewing Images Without a Waveform...449 Changing the Appearance of Video Images...450 Deleting Video Images on the Analysis Waveform ...453 Viewing a Video Image Gallery ...455 Deleting Images in a Gallery...458 Frequently Asked Questions...460 Printed Urodynamic Reports...465 Procedure Specific Report Formats...467 Printed Reports for Uroflow Procedures...467 Printed Reports for CMG Procedures...477 Printed Reports for P/F Procedures ...488 Printed Reports for VLPP Procedure Analysis ...504 Printed Reports for UPP Procedures...512 Printed Reports for UP Procedures ...519 Linked Study Report Formats ...524 Link Summary Printouts...524 Video Image Printouts...528 Printing a Video Image ...528 Using Optional Report Formats ...535 Using the MSWord Report Writer ...535 Printing Adobe® PDF® Files...537 Using Advanced System V Features...539 File Management ...541 Directories & File Structure...542 Creating Database Backups ...548 Archiving Video Images ...549 Editing Patient Records ...550 Deleting Patient Records ...550 Undeleting Patient Records ...552 Emptying the Recycle Bin...553 Moving Procedures from One Patient Record to Another ...555 Deleting a Procedure from a Patient’s Record ...559 Undeleting a Procedure ...561 Exporting Patient Records ...564 Importing Patient Records ...569 Copying System III Report Text...574 Using the Appointment Scheduler ...577 Scheduling Appointments ...577 Changing or Canceling an Appointment...579 Viewing Today’s Appointments ...580 Viewing the Next Patient Record...581 Creating Consultation Reports...582 vi

Contents Creating a Consultation Report ...582 Creating a Limited Consultation Report...586 Saving Reports as Text Files...590 Saving Reports as MS Word Documents ...591 Creating Follow-Up Notes...592 Creating Follow-Up Notes...592 Customizing Database Applications ...594 Modifying Drop-Down Lists...595 Modifying Physician Drop-Down Lists ...602 Modifying Medication Drop-Down Lists ...605 Modifying User Defined Fields...609 Creating a Customized History.txt Template ...611 Creating a Customized Plans.txt Template ...613 Using Database Profiles ...616 Creating Custom Database Profiles ...617 Using Database Searches and Reports ...622 Overview of the Search Criteria Window...622 Overview of the Report Layout Window ...626 Using a Database Search & Report ...629 Creating a Database Search ...635 Editing Database Search Criteria ...644 Creating Search Report Layouts ...647 Editing Report Layouts ...652 Frequently Asked Questions...655 Appendices ...659 Appendix A: Windows Tutorial ...661 Windows Basics...661 Overview of Windows ...661 Shutting Down Windows...661 Desktop Description...662 Taskbar and Start Button Descriptions...663 Starting a Program...664 Commonality Among Windows-Based Computer Programs...665 Minimizing the Size of a Window...665 Maximizing the Size of a Window...666 Reducing the Size of a Window...666 Customizing the Size of a Window ...666 Moving a Window ...666 Opening and Viewing Multiple Windows ...667 Scrolling a Window ...667 Learning How to Use Windows ...667 Closing a Window ...668 Unlocking Windows ...668 Running Scandisk...669 Running Defrag...670 Using Windows Explorer...671 Windows Explorer Description...671 Navigating Windows Explorer...672 Urolab/Urovision System V Manual M1036 Rev C

vii

Contents Selecting Multiple Files ...673 Copying Files ...673 Pasting Files ...673 Deleting Files ...673 Creating a New Folder...674 Appendix B: Computer Tips...675 Using the Keyboard ...675 Overview of the Keyboard ...675 Important Keys on the Keyboard ...676 Using the Trackball or Mouse ...677 Mouse Description ...677 Using the Mouse to Click ...677 Using the Mouse to Double-Click ...677 Using the Mouse to Click-and-Drag an Object ...678 Appendix C: Computer System Settings ...679 Setting the Display Resolution...679 Screen Saver ...680 Power Settings...681 Setting the Time and Date Format ...683 Setting IRQs and I/O Addresses ...685 Changing the Taskbar Properties...689 Computer MB Bios Settings...689 Appendix D: Networking...691 Introduction ...691 Setting Up a Computer for Networking ...692 Setting Up a Computer for Networking...692 Sharing the System V Directory...702 Sharing the System V Directory ...702 Appendix E: Urethral Pressure Profilometry...705 Introduction ...705 Catheter Selection ...705 Using a Single-lumen UPP Catheter ...707 Using a Dual-lumen UPP Catheter...708 Using a Triple-lumen UPP Catheter ...709 Accessory Equipment for UPP Procedures ...710 Accessory Equipment & Supplies...710 Perfusing with a Uropump ...710 Perfusing with a Pressure Bag ...711 Using a Profilometer ...711 UP and UPP Analysis ...712 Computing Transmission Ratios...712 Recommended Reading ...712 Appendix F: Wireless Voice Dictation...705 Creating a User Profile ...716 Using Wireless Voice Dictation in System V ...716 Installing ScanSoft Dragon Naturally Speaking...717 viii

Contents Installing Voice Dictation...718 Appendix G: Using Zip and Jaz Drives ...725 Installing Optional IomegaWare...725 Setting Jaz Auto Sleep Time ...728 Setting Jaz Auto Backup Utility...735 Appendix H: CD-ROM Database Backups ...739 Using NeroExpress Software...739 Recording a Database Backup on CD-R...743 Restoring a Database from a Backup CD ...750 Changing File Attributes ...751 Index ...755

Urolab/Urovision System V Manual M1036 Rev C

Contents

Before You Begin

Before You Begin Introduction In This Section

The following topics are covered in this section.

Topic

Page

Product Introduction

Important Computer Advice

This Manual’s Organization

This Manual’s Formatting Conventions

Urolab/Urovision System V Manual M1036 Rev C

Before You Begin

Product Introduction Overview

Urolab® is a software program designed to record and report data collected during urodynamic procedures. The current “generation” (or version) Urolab is System V. Urovision® adds video image storage capabilities (when used in conjunction with a fluoroscope or endoscope) to the Urolab System V functionality.

Note In this manual we refer to the software program generically as System V, which includes all five Urolab configuration packages as well as Urovision and the Galen Electronic Medical Record (EMR) System with Comprehensive Clinical Database. System V is available in five base levels (referred to as configurations). The operating system configuration determines the level of automation available for acquisition and analysis of urodynamic procedures, as well as the type of patient database and reporting capabilities in the system. The five configurations are: More Features

• Maximus • Janus • Primus • Opus

Fewer Features

• Novus

After the basic operating system is selected, all other system components and features (hardware and software) are purchased to meet your specific procedural requirements; from basic requirements of the maximum number of display channels and the parameters used for procedures (pressures, EMG, flow, volumes) to more advanced additions, like the Galen Comprehensive Clinical Database or the ability to scan survey forms (AutoRead) or send the urodynamic ® ® ® ® reports to Microsoft Word or Adobe Acrobat instead of a printer. We identify optional features throughout this manual when they are described.

Before You Begin

Product Introduction, Continued Features

Depending on the type of configuration and optional features you purchased, the System V software program enables you to:

1. Choose whether or not you want to secure the system by using the logon feature.

2. Assign different logon names and passwords to the people using the software.

3. Store general patient information (such as addresses and phone numbers) as well as urodynamic studies.

4. Store patient complaints, diagnoses, impressions and plans, etc. on a visitby-visit basis.

5. Create and store the following surveys: the Urogenital Distress Inventory (UDI), the Incontinence Impact Questionnaire (IIQ), the International Prostate Symptom Score (IPSS) and the International Index of Erectile Function Questionnaire (IIEFQ).

6. Set appointments for patients. 7. Search for patients by name, physician, appointment date, etc. 8. Create custom physician and referring physician lists. 9. Customize many different system preferences according to how you want the software to perform at your facility.

10. Create and store various types of procedures (CMGs, Pressure Flows, Uroflows, Valsalva Leak Point Pressures, etc.) so that they are performed quickly and easily on a consistent basis.

11. Link various procedures together to create linked studies (which save you time and ensure consistency).

12. Automate the analysis tasks in several different ways depending on your needs.

13. Easily edit patient study waveforms and add your own comments to the study data.

14. Print several types of reports and nomograms in many different layouts. 15. Create consultation reports that summarize the patient’s urodynamic procedures.

16. Perform custom database searches and create custom reports. 17. Capture, review, and print video images (when using a fluoroscope or endoscope-if you have Urovision).

18. Choose to use a wireless hand held remote control or touchscreen while performing urodynamic procedures on patients⎯in addition to using the computer keyboard and trackball, which are standard.

19. Network the System V software on multiple computers at your facility. 20. Use Life-Link to obtain online clinical and technical support as well as regular computer maintenance.

Urolab/Urovision System V Manual M1036 Rev C

Before You Begin

Product Introduction, Continued Equipment Identification

Generally, your System V software works in conjunction with the accessory equipment shown below (depending upon the configuration you purchased.

Figure 1.1: System V Components 4

Before You Begin

Important Computer Advice Advice Regarding Using System V

The following items are the most important things you need to know (overall) about using the System V computer and software. 1.

Turn the computer off and unplug it from its power source before you disconnect, reconnect, or jiggle the cables that connect the different parts of the computer.

Exit the System V software before turning off the computer.

Utilize the Windows software shut-down process to turn the computer off.

Note This may not be possible if your computer locks up; however, under normal circumstances it is possible and highly recommended. 4.

Plug your computer peripherals (printer, Uropump, etc.) into a surge protector to protect them from line power surges.

Plug your computer and monitor into a Universal Power Supply (UPS) to protect them from line power failures and surges.

Note In case of a power failure, this will give you enough time to properly save anything that you are working on, shut down Windows, and turn the computer off.

The Technical Service Department is available @ 800-231-9841 or 281-491-6600.

Do not force disks into disk drives or you will damage them both.

Never install “shareware” programs on your System V computer or your computer may get a virus that damages the software, computer, or both.

Learn how to use Windows. There is a tutorial in the appendix of this manual and there are tutorials in Windows’ online Help.

Keep a supply of extra paper and ink cartridges on hand for your printer.

10.

Call the Life-Tech Technical Service Department (800-231-9841) whenever you need help - preferably before you get exasperated.

Urolab/Urovision System V Manual M1036 Rev C

Before You Begin

This Manual’s Organization Manual Overview

This is an example of a feature availability box: The video Loop feature is available in these configurations: Maximus

(4-6)

Janus

(4-6)

Primus

(4-6)

Opus

(4-6)

Novus

(4-6)

This manual provides information and instructions for use of the features and functions available in: • Urolab Maximus, Janus, Primus, Opus and Novus • Urovision Maximus, Janus, Primus, Opus and Novus • The Galen EMR with Comprehensive Clinical Database When limited to specific system configurations, you will see a Feature Availability box to the left of the instruction that lists the configuration(s) or option(s) to which the instructions apply. The symbols shown below are added to the basic configuration nomenclature for clarification:

This symbol… (1-6)

Represents…

And is used when…

If Urovision (specific levels)

The described feature/function is only available in Urovision configurations of the specified level(s) (1-6).

plus Galen Database

The described feature/function is only available in configurations that include the optional Galen EMR with Comprehensive Clinical Database.

In addition to this printed copy of the manual, your System V computer has a digital, color version in .pdf format available directly on the Windows Desktop.

To view the online System V Operator’s Manual: ¾

Double-click the Operator’s Manual icon on the Windows Desktop.

Before You Begin

This Manual’s Organization, Continued Chapter Description

This manual consists of the following chapters:

Chapter

Description

Before You Begin

Provides an overview of the System V software and the urodynamic equipment with which it operates. Also explains the organization and formatting techniques used in this manual.

Assembly, Care & Maintenance of System V Hardware

Explains the computer equipment used with System V and how to connect all of it together.

Getting Started with System V Software

Explains how to install System V software, how to open and close the System V program and how to optimize the quality of video images (for Urovision).

Setting Preferences to Customize System V

Explains how to customize System V by changing Preference settings.

Creating Patient Records

Explains the three database configurations, how to create patient records and use database applications.

Creating and Storing Procedures for Future Use

Explains how to create procedures and store them for future use.

Acquiring Data During Urodynamic Procedures

Explains how to utilize System V software to display and store urodynamic procedure data.

Analyzing Completed Procedures and Studies

Explains how to analyze completed urodynamic procedures and studies and then print reports.

Printed Urodynamic Reports

Provides examples of the reports and nomograms available with System V and tells you how to configure the software in order to print them.

Using Advanced System V Features

Explains how to use the advanced features including: consultation reports, database searches, file management, setting appointments, editing patient records, etc. Continued on next page...

Urolab/Urovision System V Manual M1036 Rev C

Before You Begin

This Manual’s Organization, Continued Appendices Description

This manual consists of the following appendices:

Appendix

Description

Appendix A: Windows Tutorial

Explains how to use Microsoft Windows (for beginners).

Appendix B: Computer Tips

Explains how to use a computer keyboard and mouse (for beginners).

Appendix C: Computer System Settings

Explains how to set the most common computer settings in order for System V to run properly.

Appendix D: Networking

Explains how to network several System V computers.

Appendix E: Urethral Pressure Profilometry

Explains anatomic, physiologic and equipment/supply considerations when performing and urethral pressure profilometry.

Appendix F: Wireless Voice Dictation

Explains how to set up the wireless voice dictation feature (if you purchased it).

Appendix G: Using Zip and Jaz Drives

Explains how to install and use Jaz and Zip drives for backing up System V data.

Appendix H: CD-ROM Database Backups

Explains how to install, setup and record database backups on CD.

Frequently Asked Questions

Answers to the most commonly asked questions regarding System V are located at the end of each Chapter. The questions and answers are categorized for easy access.

Index

This manual also contains a comprehensive index located at the end of the manual in Section 12.

Before You Begin

This Manual’s Formatting Conventions Formatting Conventions

You will be directed to press keys on the keyboard as opposed to being told to click buttons on the screen.

Whenever you are told to click something, it always refers to pressing the left mouse (trackball) button. The only time you will press the right mouse button is when you are told to right-click something.

Other Conventions

In order to best understand the information provided in this manual, you should be familiar with the following formatting conventions used.

Object

Formatting Convention

Keys on the keyboard that you press.

Bolded, as in press the Esc key on the keyboard.

Items that you click on a screen (such as buttons, tabs, menus, fields, and field options).

Bolded, as in click Analyze.

Combination of keys on the keyboard that you press at the same time.

Bolded, as in press Shift+F1.

Text that you are supposed to type on the screen.

Bolded, as in type administrator in the Logon field.

Fields on a screen (sometimes referred to as boxes).

Bolded, as in type administrator in the Logon field.

Terms introduced for the first time.

Italicized, as in dimmed refers to a button that has been “grayed out.”

Titles of manuals or chapters.

Italicized, as in refer to the Getting Started with System V Software chapter.

Non-standard uses of a word or phrase.

Surrounded with quotation marks, as in dimmed refers to a button that has been “grayed out.”

Words that need to be emphasized (rarely used).

Underlined, as in you must turn the computer on first.

To perform these combination keystrokes, press and hold (do not release) the Shift key on the keyboard, then press the F1 key, and then release the Shift key.

In this manual, pay close attention to: Warnings-Something that can result in death or serious injury to the patient or user. Cautions-Something that can result in damage to the equipment. Notes-Something that is important to understand. Readily identified as:

Note - Or -

; IMPORTANT

Urolab/Urovision System V Manual M1036 Rev C

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