Natus Olympic BrainZ Quick Start Guide

Table of Contents Monitoring a Patient ... 3 Applying a Neonatal Sensor Set ... 4 Applying a Neonatal Sensor Set (cont.)... 5 Start Recording ... 6 Checking Signal Quality ... 7 Troubleshooting ... 8 During a Session You Can ... 9 Pausing and Ending a Session ... 10 Marking Events ... 11 Creating Snapshots ... 12 Archiving Sessions ... 13 Powering Down the CFM ... 14 Icons ... 15 Icons ... 16

Monitoring a Patient The Olympic Brainz Monitor is an infant Cerebral Function Monitor (CFM). Full operating instructions are available in the Olympic Brainz Monitor online Help. 1. 2. 3. 4.

Set up the CFM close to the patient and check that the connections are correct. Hang the data acquisition box (DAB) from a convenient hook or handle on the incubator or cot. Switch on the power switch and wait for the system to power up to the main display. Touch the record button, enter patient details (optional), and then press Next. • Select either the 3-electrode or 5-electrode configuration (according to the number of sensors you are using). • Press Start Recording. The CFM starts live monitoring mode. 5. Apply the neonatal sensor set. Use the Electrode impedance view to check impedance levels of the individual sensors. When using a 5-electrode configuration, check the impedance levels of the first two sensors before applying the remaining sensors. 6. Enter a marker to indicate when preparations are complete (optional).

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Applying a Neonatal Sensor Set 1

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Lay out the sensor application materials, including the sensor set and positioning aid. Place the wrap hat under the head, aligning the head with the body.

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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.

Mark the two sensor sites, one on each side of the positioning aid, at the ends of the arrow.

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Pat the site and the surrounding hair dry, keeping the hair parted. DO NOT RUB. Note: Keeping a finger next to the bald spot helps. (Hint: The pen mark washes off.)

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

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

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

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

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Applying a Neonatal Sensor Set (cont.) 9

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Apply the first sensor directly over the clean bald spot with the sensor wire upwards. Repeat the previous steps for all the sensor sites.

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Connect the neonatal sensor set to the DAB (data acquisition box) and check the contact quality of the sensors by starting a new monitoring session. Check the impedance level of each sensor by using the Electrode Impedance View. (An impedance reading under 5 KΩ indicates good contact quality.) Note: When applying a 3-lead configuration, you can perform the impedance level check only after you have applied all leads. In this case, skip to step 13.

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Carefully gather the lead wires emerging from the wrap hat and guide them out of the way (securing the amplifier to the bed sheet using the supplied clip).

In a similar way, prepare the site for the Reference sensor on the shoulder, neck, or behind the ear. (Choose a site with no hair so that it is unlikely to be dislodged.)

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When the contact quality for all the sensors is OK, fold the wrap hat around the head and secure with tape.

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Prepare the sites and apply the sensors to the second side, as before.

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Start Recording To begin live monitoring of the patient: 1. Press the record button. 2. Optionally, enter patient information, and press Next. 3. Select the electrode configuration. If you select a 3-electrode configuration, do not attach the other two electrodes to the DAB. Otherwise excessive electrical interference might result. The electrode configuration you select must agree with the number of electrode sensors you applied to the patient. 4. Press Start Recording.

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Checking Signal Quality During live monitoring, ensure the Electrode Impedance View is selected. Note: Keep an eye on the Electrode Impedance View while securing the wrap hat, making sure contact quality is maintained. To start Electrode Impedance View: •

Press the impedance selector button.

The Electrode Impedance View displays the individual impedance values of each electrode measured in kΩ. • • •

OK (Green) = Values below 10 kΩ. Marginal (Amber) = Values above 10-20 kΩ (generating a Signal Quality Alert). Extremely Poor (Red) = Values above 20 kΩ (generating a Signal Quality Alert).

Note: You can configure the threshold for signal quality alerts and the snooze time (length of time before system repeats alert) for these warnings using the system maintenance utility. 7

Troubleshooting For information about troubleshooting poor impedance and signal quality, see Diagnosing poor electrode sensor contact in the online HELP guide. Sources of noise affect the energy levels of the EEG and are likely to result in an upward shift in the margins of the corresponding aEEG display, limiting the diagnostic value of the device. Observe these tips when diagnosing and correcting poor electrode sensor contact: Periodically check the Electrode Impedance View, taking note of the individual impedance values.

Green Yellow Red

< 10 kΩ > 10-20 kΩ > 20 kΩ

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If the outer ring is no longer green, use the electrode images and their corresponding impedance values to determine which electrode is at fault. Values that read ‘***’ may indicate an electrode that has fallen off.

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If impedance values rise above 20 kΩ (including the case where a sensor has fallen off), the ‘Signal’ alert is triggered and a visual cue appears in the Status bar. The Status bar is always visible.

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The contact quality of the reference (common) electrode is not represented on the Electrode Impedance View. If contact quality deteriorates for this electrode, the CFM becomes more susceptible to electrical and mechanical disturbances. This situation can lead to an elevation in the aEEG base line, depending on the frequency of such disturbances. Examine the EEG view to observing electrical or mechanical noise superimposed on brain activity.

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The techniques used to correct poor electrode sensor contact depend on the type of sensors you use (that is, hyrdogels or needles).

If the P3 or P4 electrodes dislodge in a 5-electrode configuration, the system cannot accurately calculate the impedance for the C3 or C4 counterparts. In this case, both impedance values read ‘***’ in the Electrode Impedance View. 8

During a Session You Can... General

Tools

Maintenance Utility

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Change display modes between biparietal and bilateral views Select supplemental data displays (Impedance, EEG, IBI) Review previously recorded data for the current session Use the live impedance view to monitor sensor contact quality Pause or resume session recording

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Manage session archiving Import and export sessions Configure clinical configuration settings (for example, customize one-touch markers) Close the current session to launch the maintenance utility (system configuration tools)

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Select language preference Set system date/time Configure storage locations Prepare archive media Update the CFM software Calibrate the screen Save and restore system settings to/ from a USB storage device Connect the bedside unit to a network View the diagnostic event log Configure group access to maintenance utility features

Patient

Reports

Markers

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Edit patient details Review and send stored snapshots to USB End the session Open previously recorded session for Review

Create snapshots Send snapshots to a printer Send the session to a CSV ASCII file

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Mark and edit marked event Navigate through the session using the marker list Use of the manual scoring tools to mark regions of interest (for background patterns or suspected seizure activity)

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Pausing and Ending a Session To pause a session: 1. Press the Record button to stop recording. 2. Press Stop Recording. The session is paused (live monitoring and recording of data is suspended). To resume live monitoring and recording:

To end a session: 1. Press the Record button to stop recording, and press Stop Recording. 2. Open the Patient/Close overlay, and press Close Session. The session unloads from system memory and a watermark appears in the aEEG display.

1. Press the Record button. 2. Press Resume Recording.

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Marking Events To mark an event: Open the Markers/Add overlay, and press one of the preset markers. A marker is inserted at the timeline cursor position (the red vertical line in the aEEG display). 1. To add a marker at a different place in the session, use the navigation controls to move back and forth through the session, or touch the aEEG display to reposition the timeline cursor at the new location. 2. To add a custom marker, touch the custom marker field on the Markers/Add overlay. Use the on-screen keyboard to type the custom marker Event name, and press Add. Editing markers You can edit markers by adding a description or changing the event name. To add a marker description: 1. Press the marker in the area above the aEEG display to open the Markers/Edit overlay. 2. Press the Description field to display the on-screen keyboard. 3. Enter the description and press Apply. To edit the marker event name (identity): 1. Press the marker in the area above the aEEG display to open the Markers/Edit overlay. 2. Press the Event field to display the on-screen keyboard. 3. Enter the identity (Event name) and press Apply. 11

Creating Snapshots To create a snapshot: In the Reports/Snapshots overlay, press the elements that you want to include in the snapshot. You can see which components you selected and a preview of the resulting snapshot in the lower part of the overlay. 1. Add a description (recommended) by pressing the description field. In the on-screen keyboard, type the description. 2. Press the snapshot configuration somewhere outside the description field to return the snapshot preview. 3. Press Save to store a copy of the snapshot as part of the session data. You can view or copy the snapshot to a storage location later. To copy the snapshot: 1. Press Copy to open the Copy snapshots dialog. 2. Select a copy destination in the Location pane, and select Deidentify to remove patient identifying information. 3. Press Copy. The snapshot is copied to the specified destination in a folder called CfmSnapshots. For more information, see Reports/Snapshots in the online HELP. To view snapshots saved as session data: 1. Open the Patient/Info/Snapshots overlay. 2. Select one of the snapshots in the list, and press Preview. You can also print reports to a network printer. See Reports/Print in the online HELP. 12

Archiving Sessions To archive a previously recorded session: 1. Open the Tools/Files/Active overlay to display a list of sessions. 2. Press the multi-selection mode button to select multiple sessions to archive or select single session. 3. Press one or more sessions in the list, and then press Archive. The selected sessions are added to the archive queue to be processed in the background while you continue to use the CFM for other tasks. Archiving is complete when the Tools/Archive/Queue overlay is empty. To check the status of an archive job: •

Open the Tools/Archive/Progress overlay.

To view a list of sessions stored in the archive location: •

Open the Tools/Archive/Content overlay.

To remove sessions from the archive queue: 1. Open the Tools/Archive/Queue overlay. 2. Press the sessions you want to remove and press Remove. You configure the archive location (the destination for archived sessions) by using the system maintenance utility. 13

Powering Down the CFM Before you power down the CFM, you must stop recording and close the current session. To power down the CFM: • •

In the Tools/System/Exit overlay, press Shutdown. Confirm Shutdown.

The system powers down within 15-20 seconds.

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Icons Open sessions, Create new sessions

Create Snapshots

Add markers, Score regions

Home

Online help

Manage data, Configure display

Navigation Controls Timeline cursor

Marker paging

Scroll through session

Auto-scroll

Switch to live 15

Icons Archive State

aEEG selector (1 channel)

Impedance

Scoring view active

New Session

aEEG selector (2 channel)

Impedance selected

Scoring view inactive

Session copy pending

Alert dismissed

Inactive

Session filter disabled

Session copying

Alert snoozed

Initializing

Session filter enabled

Audible alert-mute/unmute

Live monitoring

Session filter settings

EEG amplitude

Live playback

Signal alert

EEG selector

Marker mode active

Signal alert

EEG time based

Marker mode inactive

Standby

File multi-select

Marker navigation

Success

Export connection

File single-select

Play

Time mark

No medium

Go to previous

Recording off

Type BF, defibrillator-proof

Prohibited combination

Go to top

Recording on

USB

Review connection

Home

Refresh

Viewer location selector

Writer connection

Home

Review mode

Warning

Session modified Session successfully archived Connection State Archive connection Disconnected

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