NorthEast Monitoring LX Event Recorders User Manual
- June 4, 2024
- NorthEast Monitoring
Table of Contents
LX Event
User’s Manual
for use with
NorthEast Monitoring’s
Event Recorders
Version 3.1.1
NorthEast Monitoring is an FDA Registered Facility, number 1224919, that
follows all FDA CGMP Manufacturing Practices.
LX Event has been developed by NorthEast Monitoring, Inc.
LX Event has FDA 510(k) Market Approval Number K070014.
This product, like all Holter monitoring products, should be used only under
the direct supervision of a licensed physician.
Microsoft Windows 10 is a registered trademark of Microsoft Corp.
Technical Support
In addition to the information in this manual, more information and help is
available on our website: www.nemon.com or
Toll-Free USA: 866-346-5837 option 1
Phone: [+1] 978-461-3992 option 1
Fax: [+1] 978-461-5991
e-mail: support@nemon.com
The “Technical Support” page on the website includes
Frequently Asked Questions.
The current version of this manual can be found on our website on the
“Downloads & Documents” page.
INTRODUCTION
Welcome to NorthEast Monitoring’s LX Event. With LX Event, you can receive
ECG-recorded events, review the events, save particular ECG strips of
interest, and create event or procedure summary reports.
System Requirements
LX Event can be used with NorthEast Monitoring DR400 recorders. To run LX
Event, your PC should include:
- dedicated PC for LX Event, Event Decoder and Etel, not to be used for other purposes
- Microsoft Windows 10 Operating System
- processor with a speed of 3 GHz or faster
- at least 16 GB of working memory
- monitor with a resolution of at least 1280 x 1024
- the disk drive of at least 1 TB HDD or SSD
- laser printer
- Internet connection with permissions to make FTP transfers
Operator Knowledge
To use NorthEast Monitoring LX Event, you must have extensive ECG knowledge
that allows you to properly identify sinus and paced rhythms, abnormal
rhythms, upraventricular and ventricular arrhythmias, artifacts, ST segment
changes, and pacemaker failures. In addition, all instructions assume a
working knowledge of computers and, specifically, Microsoft Windows
operating systems.
User Specifications
LX Event is designed to be used by a trained operator under the supervision of
a licensed clinician for the purpose of evaluating the ECG captured as part of
an automatic or manually saved recording event. LX Event can only be used with
a NorthEast Monitoring, Inc. DR400 recorder in Event mode.
Essential Requirements:
Display capability:
- Display ECG data as individual events.
- Label recordings made from the NorthEast Monitoring recorders with time, date, and event type.
- Display in full disclosure on a scale of from 0.25 to 4x normal with from 3.75 to 60 seconds of data per line of the display.
- Measure PR, QRS, QT, ST, and HR values using cursors that can be positioned on the ECG data.
Recorder capability:
- Data from recorders can be displayed with all time, date, and event labels.
- The data transmission method is wireless using the NorthEast Monitoring Gateway.
- Maximum recording length: No maximum
Intended Use
The LX Event utility is a data management pro- gram intended and designed to be used with the DR400 recorders for diagnostic evaluation of transient symptoms such as dizziness, palpitations, syncope, and chest pain. The system provides single-lead or multiple-lead ECG morphology, which may be used to visualize arrhythmias, ST segment changes, SVT, heart block, re-entrant phenomena, and p-waves. The system may be used with pacemaker patients to assess pacemaker activity. The LX Event Software is to be used only on the order of a physician.
Indications For Use
The LX Event utility is intended to be used with the DR400 recorders. LX Event
does not analyze data
Utilities
Physician Edit
You will want to create physician files before you start adding patients to LX
Event. By setting up physicians, you will able to more easily enter patients
when the time comes. In order to do this, go to Utilities > Physician Edit
from the toolbar.
PROCEDURE INFORMATION
When the NorthEast Monitoring Event recorder is given to a patient, a new
Procedure should be set up in LX Event.
Because a recorder number can only exist on one procedure at a time, be sure
that the previous procedure for that recorder number has been closed before
starting a new procedure with the same recorder number.
When the LX Event utility first opens, it displays a blank screen with a
standard toolbar. To create or to work with an existing procedure, select
Procedures from the toolbar and choose an option.
Find a Procedure/Patient
Go to Procedures > Find. Use the Search box at the top of the screen to search
any of the visible items to find your patient. To view Closed Procedures,
click on the box at the bottom of the screen. Click on any column to sort that
column.
Select a patient by clicking on that line. You can then open that procedure by
clicking OK or by double-clicking on the line. From this screen, you can also
Delete a selected patient. The system will ask you to confirm deleting by
typing DELETE to ensure that you are sure you want to delete the selected
patient.
Click on the “Show Closed Procedures” box at the bottom to only view Closed
Procedures. Scroll to the right to see additional items on the Procedure
List.
New and Patient Info screen
To create a new patient, go to Procedures > New. The Patient Information
window will open and enter the new procedure information at this
time.
If a procedure is already opened, view the current patient information by
going to Procedures > Patient Info. You can update that information at any
time.
LX Event requires a Patient to have a Name, an Enrolled Date, and a Recorder
ID, but we recommend that you also enter the Patient DOB, Phone, and Referring
Physician at a minimum. Once you are finished entering a new patient, press OK
to accept/save or Cancel to exit without saving.
Patient Dates
Enter a date by manually typing or using the calendar.
If you know the patient’s Date of Birth – DOB – you can enter it and the
age will automatically be calculated. You can just enter the age if the date
of birth is unknown.
The Enrolled Date is the start date of the procedure – when the patient is
instructed to begin wearing the event recorder.
The Due Back Date is entered when the procedure has started. It is the date
that you expect the procedure to end.
The Procedure Closed Date is filled in once the recorder has been returned.
Once a procedure has a Closed Date, you can no longer save new events for the
procedure. The Technician field should be filled in at this time.
Indications and Medications
Each field has a drop-down box where you can select one or more entries. You
can also edit the field directly and add or modify what you have entered.
The Recorder ID
Enter the SN number that is found on your recorder.
Status
At the bottom of the Patient Information window, you can update the patient’s
status by clicking on the Edited, Reported, or Verified buttons. The status
fields are visible from the Patient Found List.
Summary
View the Summary Screen for the currently opened Procedure.
Exit Procedure
Close the current procedure by going to Procedures > Exit Procedure.
Network Installations
The lxevent.ini file located in your installation points to members,
providers, and other directories. You can customize this file for your
purposes as follows:
IncomingFilesDirectory=c:\nm\ftp. Tells the Incoming Files window where
the “Event” folder is located. This is where the wireless files should be
saved.
PatientDataDirectory=c:\nm\patients\. The default is on the c: drive,
but you can denote a shared directory for network installations.
PhysiciansDataDirectory
=c:\nm\lxevent\Physicians\ The default is on the c: drive, but users can
share a single directory for network installations.
Customizing Lists
Lists for medications, indications, diaries, and strip labels can be found in
the c:\nm\lxevent directory in a typical installation.
To share these lists, you will need to copy them to each PC. If you customize
these lists, you may want to make a copy and save it elsewhere as when and if
you update LX Event, your updated lists may get replaced.
Back-up Procedure Data
It is highly recommended that you back-up and save your procedure files
separately from your computer on a regular basis. On a typical installation,
the Patients directory is found in c:\nm\patients.
Archiving Procedure Data
Data for each procedure is stored in a folder that can be found in the folder
name of the year, month and day that the procedure was created. Additionally
there is a MPatients.csv file in the patients folder that acts as the
directory for the Patient List in LX Event.
When LX Event is not running, you can archive patient data, by copying and
then deleting any year and/or month folder from the Patients folder. To
correct the directory file, you will then need to delete the
NMPatients.csvfile so that it can be rebuilt the next time LX Event is
started.
SAVING EVENTS AND CREATING STRIPS
A patient must have an open Procedure – a record with no Procedure Closed Date
– in order to receive a new event. A procedure may consist of one or more
events and you can ontinue receiving new events for a patient until a
Procedure Closed Date is entered onto the Procedure.
If a procedure is closed and a new event has arrived, you can either:
- Open a new Procedure for the patient, or
- Remove the Procedure Closed Date from the patient’s last record in order to re-open it.
(This should only be done if the last procedure should not have been closed.)
The DR400 recorders have the capability to send files via the cellphone
network using a Gateway. In order to receive these files you must have
NorthEast Monitoring’s Event ecoder utility installed in your facility.
Information on how to set up and receive files wirelessly can be found in the
DR400 manual. Refer to Chapter 5 for more information on using the Incoming
Files window.
The Event Screen
A procedure is composed of one or more events. An event is when the patient
experienced a cardiac symptom and either pressed the button or the event was
sensed utomatically. Settings that you can adjust are on the top row of the
screen:
Gain
High Pass Filter
To adjust the High Pass filter, click on the drop-down box labeled HP. This
filter will allow you to reduce baseline wander.
Low Pass Filter To adjust the Low Pass filter, click on the drop-down box
labeled LP. This filter will allow you to reduce muscle noise and electrical
artifact.
Invert ECG: To invert the ECG signal, check or uncheck the Inverted box.
Sec/Row:
To adjust the amount of time in each row of the ECG, click on the drop-down
box labeled Sec/Row and choose the amount of seconds in each row.
R-Wave Markers and HR
LX Event attempts to label each R-wave with a red dot and then calculates the
HR based on the RRintervals. The HR calculation has a limit of 180 HR.
Time Date
The time at the beginning of the event.
Event Type
The Event Type initially shows the type of event that was captured by the
recorder. You can update the event type to be more accurate once the event is
reviewed by you.
The drop-down list includes MCT (Mobile Cardiac Telemetry) which is assigned
to ECG data that was not necessarily part of an event, but requested via the
ETel utility.
Diary Symptoms
If your patient kept a diary, you may want to enter any symptoms they were
experiencing or what they were doing at the time of the Event. You can either
select from the drop-down box or add one of your own.
Saving Strips
When an event is open, click on the ECG to identify strips. The blue
bull’s-eye shows where strips have already been saved. A red bull’s-eye
appears when the corresponding strip appears at the bottom of the screen.
Once the strip appears on the bottom of the screen, you can place cursors,
label and save the strip. Once saved, the bull’s-eye will be blue. Use the
Previous and Next Strip buttons to switch between and view or edit saved
strips.
Cursors
The Default Cursors button at the top-left of the strip allows you to place
all of the cursors at once in a location determined by LX Event. After press-
ing Default Cursors, you can move any of the single cursors by pressing the
button for the that cursor and then clicking on the screen where you want it
to go. Apply single cursors by first clicking on he ppropriate cursor
button. LX Event will then place the cursor in the default location, and you
are able to move it by clicking elsewhere on the screen. Once the cursor is
where you want it, select another button to continue. In order to remove a
cursor, click on the button and then click on the Delete Cursor button.
Strip Measurements
The second row of boxes shows the resulting measurements from cursor
placement:
PR: Time difference between Q and P.
QRS: Time difference between S and Q.
QT: Time difference between Q and T.
ST: The vertical difference between the values of the I and ST cursors.
HR: The heart rate is calculated based on R1 and R2 being 2 RR intervals
apart.
XY: X and Y allow you to measure between any two points on a strip. For
screen use only and will not appear on the strip when reporting.
Saving and managing strips
If an event is not significant, you can check the Event Reviewed button to
show that it has been reviewed, without saving any strips.
Strip Label. Every strip must have a label to be saved. You can use the
pre-formatted labels supplied with LX Event and/or add a label of your own.
Save Strip. Once you assign all of the cursors, you can enter a Strip
Label and save the strip by pressing the Save Strip button.
Delete Strip. Delete the strip that you are currently on.
Strip Notes. Once a strip is saved, a gray Notes button will appear.
Notes entered here will not be printed on any reports. When Notes exist for a
strip, the button will appear green.
Save Event as Strips. If you would like an entire event to be saved as
strips, use the Save Event as Strips button. First click on the Event, then
add a Strip Label and then click on Save Event as Strips. The label will be
applied to all of the strips. You can then go back and edit each strip if
desired.
To edit a Strip. To select a previously saved strip, use the Previous and
Next Strip buttons till the strip you want to edit appears on the bottom of
the screen. Once the strip appears, you can edit it and the changes will e
automatically applied to the strip.
The Summary Screen
The Summary Screen allows you to see a summary list of all events and strips
for a procedure in one location. Events appear in gray, and Strips will appear
on white lines. You can go to any event or strip by double clicking on that
line.
Include in Report (Strips)
This box can be used for Strips only. The “Include in report” check box on the
very right is turned on automatically when you Save or edit an existing strip.
When one Strip for a given event is selected, either manually or by creating
a new strip, all strips within that Event will be included in the report. You
can use the Select/Unselect button at the ottom of the screen to turnon/off
all of the Include in report buttons for all events for a procedure.
When an Event report is generated, the report process will then turn off the
check boxes and insert the report name that the event was last included on and
the Printed box will be populated for that event.
Check boxes:
There are several additional check boxes on the Summary Screen that you can
use to manage the procedure as you choose. They are:
Reviewed: This check box is turned on automatically when the Event
Reviewed box is checked at the bottom of the screen. This is useful if you
decide not to save strips, but ant to show that the Event has been seen by a
technician.
Printed: Once an Event report is created by the report process, this
check box will be populated for the Event.
Verified: Manually check this box after a report is verified and finalized.
Event Report#
This is the file name of the last report that the strip was included on. Click
on the Manage Reports button at the bottom of the screen to see a list of all
reports that have been created for the procedure. The reports all end in
“.odt”. You can also create Event or Procedure reports from the screen. More
on that in the next chapter.
REPORTING
Once strips are saved for one or more events, you can create a report. There
are two types of reports: Event and Procedure. An Event report will include
any strips that you saved since the last report you created for this
procedure. Procedure report will include all strips that exist for the
patient. Findings for each report can be created and saved in the respective
Report windows that can be found on the Summary Screen or Report from the
toolbar. Once a report created, Libre Office will open and at this point you
can edit and save the report.
To Create a Report
Reports can be produced or reviewed at any time. In order to create a report:
- Open the procedure.
- Review Events and save strips.
- Go to Report on the toolbar or the Summary Screen and choose either Event or Procedure Report.
- Enter and/or edit findings.
- Save & Print the report.
- The report will now open for editing and/or printing.
Findings
You can enter and save Findings for either the Event of Procedure report at
any time. Just enter the findings and Save until you are ready to create a
report.
Include Strips
This check box is turned on by default. Uncheck the box to create a one page
report with findings only.
Procedure Report Trend
The Procedure Report will include an HR rend of all strips that were saved
during the procedure. The trend will vary in size based upon the duration and
can be 1, 3, 7, 14, 21 or 30 days in length. The Max, Min and Mean HR are
based upon the strips that have been saved and the %strip values are based
upon all saved strips.
Manage Reports
All reports that you created previously have been saved in a directory for
that procedure. All reports are saved with the “.odt” suffix. From here you
can open and edit reports, but not the strips. If you like you can also delete
reports from this screen, but keep in mind that the Summary screen will not
update automatically.
Note: As of release 3.0.3, all reports are stored in a directory labeled
“reports” off of the main patient directory. Previously created reports will
still be found in the patients main directory.
Libre Office
Libre Office is word processor that is included with the LX Event install. You
can use Libre office, and possibly other word processor, to edit your reports
after they have been created by LX Event. You will want to save your report as
a PDF file before sending it to its final destination.
Customizing Reports
Two files in the Programs Directory can be updated so that your reports can
include your company’s logo, name and address.
Report Logo
You can include your organizations’s logo on the report. Do this by saving a
jpg file, named logo.jpg, of your company logo in c:/nm/ Lxevent/ directory.
Report Name and Address
Your organization’s name and address and/or phone can also be added to the
report. In order to do this, you will need to edit a file that comes with LX
Event with the information that should appear with the report. The file is
limited to five lines of text. You should edit the file with Notepad only.
Notepad can be found under All Programs->
Accessories. The file you need to edit is
c:/nm/Lxevent/ServiceAddressHeader.ini.
If for some reason you do not want to your organization’s name to appear at
the top of the
WIRELESS FILES
The Incoming Files window allows you to view all event files that have been
received wirelessly via the Event Decoder utility.
Incoming Files Window
Upon installation, LX Event will look for incoming files in c:\nm\ftp\event.
To change this location, you can change the IncomingFilesDirectory in the
lxevent.ini file to look to a folder in another location where it can find
“Event”.
The Incoming Files window automatically matches new event files to open
procedures. The matching logic requires that you input the Serial Number from
the recorder into the Recorder ID on the Patient Information window. ..
When the Recorder SN on the incoming file matches and open procedure Recorder
ID, the Patient Name, Patient ID and DOB will appear columns to the right of
the Recorder SN.
Assign Incoming files
When matched, you can select one or more incoming files, and assign them to the Procedure. The system will ask you to confirm the assignment as once assigned the file will be automatically deleted from the incoming files. If an incoming file is not matching to a patient, you will need to find the Procedure to identify the problem. Most likely the Recorder ID and SN do not match and/or the Procedure has an end date and needs to be reopened for matching to take place.
KNOWN ISSUES
The following is a list of issues that have been identified in this or a previous version of LX Event:
Release| Bug #
| Description| Plans to resolve
---|---|---|---
3.0.1| 1480| Patient DOB on Incoming File Screen wrong date
format| This may be fixed in a future release
3.0.1| 1519| Invert does not work if ECG not clicked on.
Always click on the event before saving strips or updating the event.| This
may be fixed in a future release
3.0.1| 1521| Strip values are currently affected if the user changes the
gain.| This may be fixed in a future release
141 Parker Street, Suite 200
Maynard, MA 01754 USA
www.nemon.com
phone: [+1]978-461-3992
fax: [+1]978-461-5991
toll free USA:866-346-5837
email:info@nemon.com
Part number: NEMM016_Rev_R
Last updated: December 8, 2021
Copyright 2007 – 2021
All rights reserved
Documents / Resources
|
NorthEast Monitoring LX Event
Recorders
[pdf] User Manual
LX Event Recorders, LX, Event Recorders, Recorders
---|---
References
Read User Manual Online (PDF format)
Read User Manual Online (PDF format) >>