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Getting started with PhysioTrak

Application Tip
Geerts, Liesbeth Philips Healthcare Philips Global

Introduction

The PhysioTrak is an MR compatible patient trolley with integrated monitoring equipment, providing a nurse call (NC), respiration (RESP), peripheral pulse (PPU), oxygen saturation (SpO2), electrocardiogram (ECG), non-invasive blood pressure (NIBP) and temperature (T)monitoring signals. The PhysioTrak is intended for monitoring patients at the MR system and during transportation within the hospital. This system runs on DC (battery) power supplies.


This document provides information on how to get started with your PhysioTrak. For more detailed information, please refer to the Application Guide for PhysioTrak.

PhysioTrak System Overview

The PhysioTrak monitoring system is MR-compatible and consists of four major component parts: the sensor set, the Monitoring Connector Box (A; MCB), the Monitoring Display and Control Unit (C; MDCU), and the Monitoring Electronics Box (D; MEB) installed on the PhysioTrak Trolley. Cables are automatically guided through the cable slab (B), allowing easy patient manipulation. The PhysioTrak docks semi-automatically to the system, with the docking connector (E). Optionally, a remote display is available which allows medical staff to remotely monitor the patient as if they were in the MRI room.

 

Click on a photo to enlarge it:

 A: Monitoring Connector Box (MCB) <br>
B: Cable slab <br>
C: Monitoring Display and Control Unit (MDCU) D: Monitoring Electronic Box (MEB) E: Docking connector
A: Monitoring Connector Box (MCB)
B: Cable slab
C: Monitoring Display and Control Unit (MDCU)
D: Monitoring Electronic Box (MEB)
E: Docking connector

How to get started

  1. Position the patient on the PhysioTrak trolley with all necessary sensors connected. Disable the alarms for the sensors that are not in use. The same sensors as for the Achieva can be used. Use of the knee-support cushion is recommended. For feet-first scanning, make sure the patient's head is about 10 cm away from the MCB.

  2. Dock the PhysioTrak by moving the PhysioTrak sideways towards the patient support (as you do with a normal system trolley). The PhysioTrak docks semi-automatically to the system, with the docking connector (E).

  3. The PhysioTrak is connected to the scanner via several connections. The quality of the connections can be inspected:
    - When the PhysioTrak is docked, a docking icon should appear in the top right
    corner of the Physiology display, indicating proper transmission of triggering signals. In case of bad connection of the docking connector, the icon will flicker.
    - When the PhysioTrak is docked it is connected to the mains power supply via the docking connector. This is indicated by a green LED on the MDCU (F) (operation on batteries is indicated by an orange LED). 

  4. When all connections are in place, triggering signals will be derived from the PhysioTrak sensors. Engage the brakes of the trolley to ensure signal stability during scanning.

  5. You can now start scanning.
 Docking icon in the top right 
corner of the Physiology display.  F: LED indicating operation on batteries (orange) or mains power supply (green). <br>
G: ON/OFF button.
Docking icon in the top right corner of the Physiology display.
F: LED indicating operation on batteries (orange) or mains power supply (green).
G: ON/OFF button.

Important notes

By default, all available signals are displayed at the PhysioTrak monitor.

 

The Remote Monitor display duplicates the information displayed on the MDCU that is connected to the PhysioTrak trolley. The Remote Monitor is a slave monitor and does not allow for user interaction.

 

It is possible to initiate a non-invasive blood pressure (NIBP) reading remotely from the scanner control console. Via the "NIBP" button on the Physiology Properties display a measurement can be started/stopped (see figure). The resulting NIBP reading will be visible at the PhysioTrak monitor and at the Remote Monitor.

 

Upon docking of the PhysioTrak, the physiology triggering signals are derived from the PhysioTrak. This implies that any triggering sensor that is connected to the PICU, except for the nurse call, will no longer be active.

 

The nurse call that is connected to the PhysioTrak will only be audible in the operator room via the Remote Monitor. When no Remote Monitor is available, the Achieva nurse call must be
connected to the connection panel on the patient support for proper patient communication during scanning. We recommend to always use the Achieva nurse call during scanning.

 

The ECG source is set to 'auto' (see image below). In this case, when the PhysioTrak is docked to the MR scanner and reliable communication is established, the displayed ECG signal is automatically routed via the scanner. This ensures that the ECG signal is compensated for disturbances that might be introduced by the MR scan (ie gradient influences). When the ECG signal is routed via the scanner, the word '(scanner)' is visible in the ECG display.

 

The PhysioTrak can be used as a stand alone, which will guarantee monitoring functionality during patient preparation and/or transport. During this time the system will operate on batteries. The time that the system operates on batteries should be limited to 2 hours or less. In the preparation room a Charging Unit connected to the mains power supply is available. It is advised to connect the system to the mains power whenever the system is operated in the preparation room. During stand-alone operation the monitor can be switched ON/OFF using the switch on the display (G).

 

 

  The ECG signal is derived from the scanner, the word '(scanner)' is visible in the ECG display.
"NIBP" button on the Physiology Properties display.
The ECG signal is derived from the scanner, the word '(scanner)' is visible in the ECG display.

MDCU User interface

The MDCU front panel consists of one Rotary Knob, six Direct Control Keys, four Menu-Select keys, five Operational keys, one Alarm Silence key and the Power On/Off switch. The following is a general description of the front panel controls.
 MDCU Control panel.
MDCU Control panel.

Rotary Knob

The Rotary Knob is located to the right of the Display Screen. The function of the Rotary Knob is menu specific. In general, however, the Rotary Knob operates as described below:


As the Rotary Knob is rotated, either clockwise or counterclockwise, the monitor display "scrolls" through the various screen items (screen icons, menu options and patient parameters) which are available for selection. When the appropriate item is "highlighted," it may be selected by pressing and releasing the Rotary Knob. All menus have a RETURN option which will return the monitor to the previous menu selection.

 

During normal operation each active parameter has a Menu-Select icon on the screen. When the Rotary Knob is rotated, the Menu-Select icon which is being pointed at becomes "highlighted." Rotating the Rotary Knob will cause the monitor to "scroll through" the available menu selections. Once the appropriate Menu-Select icon is highlighted, pressing the Rotary Knob completes the selection and brings up the required menu. Once the menu is selected, the Rotary Knob is used to scroll through the available choices and make adjustments to the selected parameter.

 

The following Menu-Select Icons may be available on the Normal Screen (depending on which parameters are available, enabled and turned on): ECG, NIBP, Temperature, Respiration and SpO2.

The Direct Control Keys

 The Direct Control keys. Top row: ZERO, NIBP START/STOP and NIBP STAT. Bottom row: EVENT MARK, FREEZE and RECORD.
The Direct Control keys. Top row: ZERO, NIBP START/STOP and NIBP STAT. Bottom row: EVENT MARK, FREEZE and RECORD.

 

There are six Direct Control keys (from left to right and top to bottom): ZERO, NIBP START/STOP, NIBP STAT, EVENT MARK, FREEZE and RECORD. These keys provide the operator with direct control of the following features: Starting/stopping NIBP Readings, Starting/Stopping the NIBP STAT Mode, and Freezing all Traces. The ZERO key, Starting the Recorder and Adding a Marker to the Recorder are inactive. 
 

NIBP Start/Stop Key
This key starts a new NIBP measurement, or stops a measurement that is
already in progress.

 

NIBP STAT Key
This key starts the NIBP STAT Mode measurements. This mode may be terminated by pressing the NIBP START/STOP key. The STAT Mode performs up to five (5) NIBP measurements in rapid succession (with a short pause between readings) within a maximum time frame of five (5) minutes.

 

Freeze Key
The ECG waveform from Trace A may be frozen for closer examination upon user demand. When the ECG trace is active, pressing the FREEZE key will freeze it into the Trace B location while Trace A remains active. When the trace is frozen, pressing the FREEZE key will release it. A "Blue Box" appears around the frozen waveform as a visual indication that the waveform is not active. While the Freeze feature is active, the monitor will not allow any changes to the Parameter Setups or Recall Setups; if the operator attempts to access the PARAMETER SELECTION or RECALL SETUP menus, a WARNING Box alerts the operator that entry to the selected menu
is not allowed while FREEZE is enabled.

Menu-Select Keys

 The Menu Select keys. Top row: SETUP and ALARMS SCREEN. Bottom row:  RECORDER FUNCTIONS and TRENDS.
The Menu Select keys. Top row: SETUP and ALARMS SCREEN. Bottom row: RECORDER FUNCTIONS and TRENDS.

 

The Menu-Select keys allow the operator to specialize the operation of the PhysioTrak to suit specific procedures and/or situations. Pressing a Menu-Select key will activate the "pop-up" menu for the selected feature which is then controlled by the Rotary Knob so that the associated parameters may be adjusted. The four Menu-Select keys are (left to right and top to bottom) SETUP, ALARMS SCREEN, RECORDER FUNCTIONS and TRENDS.


Setup Key
The SETUP key allows the operator to access the various available setup options.


Alarms Screen Key
The ALARMS SCREEN key allows the operator to setup the Alarms monitoring feature.


Trends Key
The TRENDS key allows the operator to setup the Trend monitoring feature. The exact operation of the TRENDS key is based on whether or not a feature is highlighted. If a feature is highlighted, pressing the TRENDS key will bring up a Trend which is specific to the highlighted feature; if no feature is highlighted, pressing the TRENDS key will bring up the HISTORY Menu and Tabular Display.


Recorder Functions Key
This feature is not available on the MDCU. Pressing this key brings up a box that alerts the operator that the Recorder is not available.

Operational Keys

 Help key Standby key
Help key
Standby key
 Normal screen key Alarm silence key
Normal screen key
Alarm silence key

The are four Operational keys: HELP, STANDBY, NORMAL SCREEN and ALARM SILENCE.


Help Key
Pressing the HELP key provides information about the software version of the MDCU.


Standby Key
Pressing the STANDBY key places the PhysioTrak into the Standby Mode. The monitor stays in Standby Mode until the STANDBY key is pressed a second time. Except for the features given below, the monitor operates normally by continuing to provide current patient information on the Display Screen.

 

Disabled while in Standby Mode:
- All audible alarms are disabled. The disabled alarms are indicated on the screen by the "X" through the bell shaped Alarm Status Symbol.
- Active NIBP automatic measurements are suspended.


Normal Screen Key
Pressing the NORMAL SCREEN key returns the MDCU from any menu to the normal screen.


Alarm Silence Key
Pressing the ALARM SILENCE key will silence any active alarm. The letter "S" appears in the Alarm Bell and an "Alarm Silenced" message appears in the center of the screen as visual indications that an alarm has been silenced. The details of this key's function depend on the monitor's settings:


Unlatched Alarms. If the alarm system has been set to UNLATCHED in the ALARMS Menu and an Alarm Limit is violated, pressing the ALARM SILENCE key will silence the Alarm Tone when an active Alarm Limit has been violated. While the parameter continues to violate its limits, the
numerics of the violating parameter continue to flash on the screen.

 

Latched Alarms. If the alarm system has been set to LATCHED in the ALARMS Menu and an Alarm Limit is violated, while the parameter continues to violate its limits, pressing ALARM SILENCE key stops the Alarm Tone, but the numerics remain red and continue to flash, even after the parameter returns to within its Alarm Limits.


ALARM HOLD. If the ALARM SILENCE key is pressed when the Alarm Tone is enabled but no alarm condition currently exists, a "SOUND ON HOLD" message appears in the upper center of the screen with a count down timer starting at 180 (counting down at a 1 second rate) denoting that the Alarm Tone is being temporarily held silent. In addition, an "H" will appear in the Alarm Status Symbol to further alert the operator that the Alarm System is on Hold.
If the Alarm Tone is sounding, the first pressing of the ALARM SILENCE key stops the Alarm Tone and puts the letter "S" in the Alarm Bell, and a second pressing enables Alarm Hold.



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