J Three Holding BU2073J Bluetooth Adaptor User Manual M Turbo Ultrasound System User Guide
J-Three International Holding Co., Ltd Bluetooth Adaptor M Turbo Ultrasound System User Guide
Contents
- 1. Users Manual
- 2. User Guide Supplement
- 3. User Manual M Turbo
- 4. User Manual S Series
- 5. Setup Instructions
User Manual M Turbo
M-Turbo
Ultrasound System
User Guide
TM
M-Turbo
Ultrasound System
User Guide
TM
ii
SonoSite,Inc.
2191930thDriveSE
Bothell,WA98021
USA
T:1‐888‐482‐9449or1‐425‐951‐1200
F:1‐425‐951‐1201
SonoSiteLtd
AlexanderHouse
40AWilburyWay
Hitchin
HertsSG40AP
UK
T:+44‐1462‐444800
F:+44‐1462‐444801
M-Turbo, SiteLink, SonoCalc, SonoHD, SonoSite, and the SonoSite logo are registered trademarks or trademarks of SonoSite, Inc.
DICOM is the registered trademark of the National Electrical Manufacturers Association for its standards publications relating to digital
communications of medical information.
Non-SonoSite product names may be trademarks or registered trademarks of their respective owners.
The SonoSite product(s) referenced in this document may be covered by one or more of the following US patents: 5722412, 5817024,
5893363, 6135961, 6203498, 6364839, 6371918, 6383139, 6416475, 6447451, 6471651, 6569101, 6648826, 6575908, 6604630, 6817982,
6835177, 6962566, 7169108, D456509, D461895, D509900, D538432, D544962, D558351, D559390, and by the following counterpart
foreign patents: AU727381, AU730822, CA2373065, CN98106133.8, CN98108973.9, DE60021552.0, DE60029777.2, DE60034670.6,
DE69730563.5, DE6980539.6, DE69831698.3, FR0875203, FR0881492, FR0815793, FR1180970, FR1175713, GB0875203, GB0881492,
GB0815793, GB1180970, GB1180971, GB1175713, IT0881492, IT0815793, IT1175713, KR532359, KR528102, NZ542968,
RCD000897368-0001, SP0881492, SP0815793. Patents pending.
Caution: Federal (United States) law restricts this device to sale by or on the order of a
physician.
P07662‐02 10/2008
Copyright2008bySonoSite,Inc.
Allrightsreserved
iii
Contents
Introduction
Conventions, symbols, and terms ......................................................................... vii
Customer comments .................................................................................................. vii
Chapter 1: Getting Started
About the system .......................................................................................................... 1
Preparing the system ................................................................................................... 1
Installing or removing the battery ................................................................. 1
Using AC power and charging the battery ................................................. 2
Turning the system on or off ............................................................................ 3
Connecting transducers .................................................................................... 3
Inserting and removing USB storage devices ............................................ 4
System controls .............................................................................................................. 5
Screen layout ..................................................................................................................7
General interaction ....................................................................................................... 8
Touchpad and cursor .......................................................................................... 8
On-screen options ............................................................................................... 8
Annotation and text ............................................................................................ 9
Preparing transducers ...............................................................................................10
Training videos .............................................................................................................11
Intended uses ...............................................................................................................11
Chapter 2: System Setup
Displaying the setup pages .....................................................................................15
Restoring default settings ........................................................................................15
A & B Key, Footswitch setup ....................................................................................15
Administration setup .................................................................................................15
Security settings .................................................................................................16
User setup .............................................................................................................16
Exporting or importing user accounts .......................................................17
Exporting and clearing the Event log .........................................................17
Logging in as user ..............................................................................................18
Choosing a secure password .........................................................................18
Annotations setup ......................................................................................................18
Audio, Battery setup ...................................................................................................19
Cardiac Calculations setup ......................................................................................19
Connectivity setup ......................................................................................................19
Date and Time setup ..................................................................................................20
Display Information setup ........................................................................................20
IMT Calculations setup ..............................................................................................20
Network Status setup .................................................................................................20
iv
OB Calculations setup ................................................................................................20
OB Custom Measurements setup .......................................................................... 21
OB Custom Tables setup ...........................................................................................22
Presets setup ................................................................................................................. 22
System Information setup ........................................................................................23
USB Devices setup ...................................................................................................... 23
Limitations of JPEG format ............................................................................. 23
Chapter 3: Imaging
Imaging modes ............................................................................................................ 25
2D imaging ...........................................................................................................25
M Mode imaging ................................................................................................ 26
CPD and color Doppler imaging ...................................................................27
PW and CW Doppler imaging ........................................................................ 28
Adjusting depth and gain ........................................................................................30
Freezing, viewing frames, and zooming ............................................................. 30
Imaging modes and exams available by transducer ...................................... 31
Annotating images ..................................................................................................... 32
Patient information form .......................................................................................... 33
Images and clips .......................................................................................................... 35
Saving images and clips .................................................................................. 35
Reviewing patient exams ...............................................................................36
Printing, exporting, and deleting images and clips ...............................37
ECG Monitoring ............................................................................................................ 38
Chapter 4: Measurements and Calculations
Measurements .............................................................................................................. 41
Working with calipers .......................................................................................41
2D measurements ..............................................................................................42
M Mode measurements ................................................................................... 43
Doppler measurements ................................................................................... 43
General calculations ...................................................................................................45
Calculations menu ............................................................................................. 45
Performing and saving measurements
in calculations ......................................................................................................45
Displaying, repeating, and deleting
saved measurements in calculations .......................................................... 46
EMED calculations ..............................................................................................46
Percent reduction calculations ......................................................................46
Volume calculations ..........................................................................................48
Volume flow calculations ................................................................................ 48
Exam-based calculations ..........................................................................................50
Cardiac calculations .......................................................................................... 50
Gynecology (Gyn) calculations ...................................................................... 58
IMT calculations .................................................................................................. 59
OB calculations ...................................................................................................61
v
Small Parts calculations ....................................................................................64
Transcranial Doppler and Orbital calculations ........................................65
Vascular calculations .........................................................................................67
Patient report ................................................................................................................68
Vascular and cardiac patient reports ...........................................................69
TCD patient report .............................................................................................69
OB patient report ...............................................................................................69
EMED worksheets ...............................................................................................70
Chapter 5: Troubleshooting and Maintenance
Troubleshooting ..........................................................................................................71
Software licensing .......................................................................................................71
Maintenance .................................................................................................................72
Cleaning and disinfecting the ultrasound system .................................73
Cleaning and disinfecting transducers .......................................................74
Cleaning and disinfecting the battery .......................................................75
Cleaning the footswitch ...................................................................................75
Cleaning and disinfecting ECG cables ........................................................76
Recommended disinfectants ..................................................................................77
Chapter 6: Safety
Ergonomic safety .........................................................................................................85
Position the system ...........................................................................................86
Position yourself .................................................................................................86
Take breaks, exercise, and vary activities ...................................................87
Electrical safety classification ..................................................................................87
Electrical safety .............................................................................................................88
Equipment safety ........................................................................................................90
Battery safety ................................................................................................................90
Clinical safety ................................................................................................................92
Hazardous materials ...................................................................................................93
Electromagnetic compatibility ...............................................................................93
Manufacturer’s declaration .............................................................................94
ALARA principle ...........................................................................................................97
Applying ALARA .................................................................................................98
Direct controls .....................................................................................................98
Indirect controls ..................................................................................................99
Receiver controls ................................................................................................99
Acoustic artifacts .........................................................................................................99
Guidelines for reducing MI and TI .........................................................................99
Output display ........................................................................................................... 102
MI and TI output display accuracy ............................................................ 103
Factors that contribute to display uncertainty ..................................... 103
Related guidance documents ..................................................................... 104
Transducer surface temperature rise ................................................................ 104
Acoustic output measurement ............................................................................ 105
vi
In Situ, derated, and water value intensities ...........................................105
Tissue models and equipment survey ......................................................106
Acoustic output tables ............................................................................................107
Terms used in the acoustic output tables ...............................................132
Acoustic measurement precision and uncertainty ..............................133
Labeling symbols ......................................................................................................134
Chapter 7: References
Measurement accuracy ...........................................................................................139
Sources of measurement errors ...........................................................................140
Measurement publications and terminology .................................................141
Cardiac references ............................................................................................141
Obstetrical references .....................................................................................145
Gestational age tables ....................................................................................146
Growth analysis tables ...................................................................................148
Ratio calculations .............................................................................................149
General references ...........................................................................................149
Chapter 8: Specifications
Dimensions ..................................................................................................................153
System ..................................................................................................................153
Display ..................................................................................................................153
Supported transducers ...........................................................................................153
Imaging modes ..........................................................................................................153
Image and clip storage ............................................................................................153
Accessories ..................................................................................................................153
Peripherals ..........................................................................................................154
Temperature and humidity limits ........................................................................154
Operating ............................................................................................................154
Shipping and storage .....................................................................................154
Electrical .......................................................................................................................154
Battery ...........................................................................................................................154
Electromechanical safety standards ...................................................................154
EMC standards classification .................................................................................155
Airborne equipment standards ............................................................................155
DICOM standard ........................................................................................................155
HIPAA standard ..........................................................................................................155
Glossary
Terms .............................................................................................................................157
Abbreviations .............................................................................................................159
Index ...........................................................................................................................169
vii
Introduction
Introduction
ThisM‐TurboUltrasoundSystemUserGuide
providesinformationonpreparingandusingthe
M‐Turbo™ultrasoundsystemandoncleaning
anddisinfectingthesystemandtransducers.It
alsoprovidesreferencesforcalculations,system
specifications,andsafetyandacousticoutput
information.
Theuserguideisforareaderfamiliarwith
ultrasoundtechniques.Itdoesnotprovide
traininginsonographyorclinicalpractices.
Beforeusingthesystem,youmusthave
ultrasoundtraining.
SeetheapplicableSonoSiteaccessoryuserguide
forinformationonusingaccessoriesand
peripherals.Seethemanufacturer’sinstructions
forspecificinformationaboutperipherals.
Conventions, symbols, and
terms
Theuserguidefollowstheseconventions:
•AWARNINGdescribesprecautionsnecessary
topreventinjuryorlossoflife.
•ACautiondescribesprecautionsnecessaryto
protecttheproducts.
•Numberedstepsinproceduresmustbe
performedinorder.
•Itemsinbulletedlistsdonotrequirea
sequence.
•Single‐stepproceduresbeginwith.
Symbolsandtermsusedonthesystemand
transducerareexplainedinChapter 1,Chapter 5,
Chapter 6,andGlossary.
Customer comments
Questionsandcommentsareencouraged.
SonoSiteisinterestedinyourfeedbackregarding
thesystemandtheuserguide.Pleasecall
SonoSiteat888‐482‐9449intheUS.Outsidethe
US,callthenearestSonoSiterepresentative.You
canalsoe‐mailSonoSite
at comments@sonosite.com.
Fortechnicalsupport,pleasecontactSonoSiteas
follows:
SonoSite Technical Support
Phone (US or
Canada):
877-657-8118
Phone (Outside
US and Canada):
425-951-1330
Or call your local
representative.
Fax: 425-951-6700
E-mail: service@sonosite.com
Web site: www.sonosite.com
Click Support & Service.
Europe
Service
Center:
+44-(0)1462-444-800
uk.service@sonosite.com
viii Customer comments
Chapter 1: Getting Started 1
Getting Started
Chapter 1: Getting Started
About the system
TheM‐Turboultrasoundsystemisaportable,
software‐controlleddeviceusingall‐digital
architecture.Thesystemhasmultiple
configurationsandfeaturesetsusedtoacquire
anddisplayhigh‐resolution,real‐time
ultrasoundimages.Featuresavailableonyour
systemdependonsystemconfiguration,
transducer,andexamtype.
Alicensekeyisrequiredtoactivatethesoftware.
See“Softwarelicensing”onpage 71.On
occasion,asoftwareupgrademayberequired.
SonoSiteprovidesaUSBdevicecontainingthe
software.OneUSBdevicecanbeusedtoupgrade
multiplesystems.
Figure 1 System Front Features:
(1) Control panel, (2) Handle, (3) Display, (4) USB
ports for storage, updates, importing, and exporting
Figure 2 System Back Connectors:
(1) DC input connector, (2) I/O connector, (3) Battery,
and (4) ECG connector
To use the ultrasound system
1Attachatransducer.
2Turnthesystemon.(Forpowerswitch
location,see“Systemcontrols”onpage 5.)
3PressthePATIENTkey,andcompletethe
patientinformationform.
4Pressanimagingmodekey:2D,MMODE,
COLOR,orDOPPLER
Preparing the system
Installing or removing the battery
4
3
2
1
WARNING: To avoid injury to the operator and
to prevent damage to the
ultrasound system, inspect the
battery for leaks prior to installing.
To avoid data loss and to conduct a
safe system shutdown, always keep
a battery in the system.
23 4
1
2 Preparing the system
Figure 3 Install the Battery
To install the battery
1Disconnectthepowersupplyfromthe
ultrasoundsystem.
2Removethesystemfromthemini‐dock(if
present)andturnitupsidedown.
3Placethebatteryintothebattery
compartment,ataslightangle.SeeFigure 3.
4Slidethebatteryforwarduntilitlocksinto
place.
5Pushdownonthetwolockingleverstosecure
thebattery.
To remove the battery
1Disconnectthepowersupplyfromthe
ultrasoundsystem.
2Removethesystemfromthemini‐dock(if
present)andturnitupsidedown.
3Pullupthetwolockinglevers.
4Slidethebatteryback.
5Liftthebatteryfromthecompartment.
Using AC power and charging the
battery
Thebatterychargeswhenthesystemis
connectedtotheACpowersupply.Afully
dischargedbatteryrechargesinlessthanfive
hours.
ThesystemcanrunonACpowerandchargethe
batteryifACpowerisconnectedtothesystem
directly,toamini‐dock,ortoadockingsystem.
Thesystemcanrunonbatterypowerforupto
twohours,dependingontheimagingmodeand
thedisplaybrightness.Whenrunningonbattery
power,thesystemmaynotrestartifthebatteryis
low.Tocontinue,connectthesystemtoAC
power.
Locking levers
Chapter 1: Getting Started 3
Getting Started
To operate the system using AC power
1ConnecttheDCpowercablefromthepower
supplytotheconnectoronthesystem.See
Figure 2onpage 1.
2ConnecttheACpowercordtothepower
supplyandtoahospital‐gradeelectrical
outlet.
Turning the system on or off
To turn the system on or off
Pressthepowerswitch.(See“System
controls”onpage 5.)
To wake up the system
Toconservebatterylifewhilethesystemison,
thesystemgoesintosleepmodeifthelidisclosed
orifthesystemisuntouchedforapresettime.To
adjustthetimeforsleepdelay,see“A u d i o ,
Batterysetup”onpage 19.
Pressakey,touchthetouchpad,oropenthe
lid.
Connecting transducers
Figure 4 Connect the Transducer
WARNING: The equipment shall be connected
to a center-tapped single phase
supply circuit when users in the
United States connect the
equipment to a 240V supply
system.
Caution: Verify that the hospital supply
voltage corresponds to the power
supply voltage range. See
“Electrical” on page 154.
Caution: Do not use the system if an error
message appears on the display.
Note the error code and turn off the
system. Call SonoSite or your local
representative.
WARNING: To avoid injury to the patient, do
not place the connector on the
patient. Operate the ultrasound
system in a docking system or on a
flat hard surface to allow air flow
past the connector.
Caution: To avoid damaging the transducer
connector, do not allow foreign
material in the connector.
4 Preparing the system
To connect a transducer
1Removethesystemfromthemini‐dock(if
present),andturnitupsidedown.
2Pullthetransducerlatchup,androtateit
clockwise.
3Alignthetransducerconnectorwiththe
connectoronthebottomofthesystem.
4Insertthetransducerconnectorintothe
systemconnector.
5Turnthelatchcounterclockwise.
6Pressthelatchdown,securingthetransducer
connectortothesystem.
To remove a transducer
1Pullthetransducerlatchup,androtateit
clockwise.
2Pullthetransducerconnectorawayfromthe
system.
Inserting and removing USB storage
devices
Imagesandclipsaresavedtointernalstorageand
areorganizedinasortablepatientlist.Youcan
archivetheimagesandclipsfromtheultrasound
systemtoaPCusingaUSBstoragedeviceor
Ethernetconnection.Althoughtheimagesand
clipscannotbeviewedfromaUSBstoragedevice
ontheultrasoundsystem,youcanremovethe
deviceandviewthemonyourPC.
TherearetwoUSBportsonthesystem,andone
onthemini‐dock.ForadditionalUSBports,you
canconnectaUSBhubintoanyUSBport.
Note: Thesystemdoesnotsupportpassword‐
protectedUSBstoragedevices.Makesurethatthe
USBstoragedeviceyouusedoesnothavepassword
protectionenabled.
To insert a USB storage device
InserttheUSBstoragedeviceintoanyUSB
portonthesystemormini‐dock.SeeFigure 1
onpage 1.
TheUSBstoragedeviceisreadywhenthe
USBiconappears.
Toviewinformationaboutthedevice,see
“USBDevicessetup”onpage 23.
To remove a USB storage device
RemovingtheUSBstoragedevicewhilethe
systemisexportingtoitmaycausetheexported
filestobecorruptedorincomplete.
1WaitfivesecondsaftertheUSBanimation
stops.
2RemovetheUSBstoragedevicefromtheport.
WARNING: To avoid damaging the USB storage
device and losing patient data from
it, observe the following:
• Do not remove the USB storage
device or turn off the ultrasound
system while the system is
exporting.
• Do not bump or otherwise apply
pressure to the USB storage
device while it is in a USB port on
the ultrasound system. The
connector could break.
Caution: If the USB icon does not appear in
the system status area on-screen,
the USB storage device may be
defective or password-protected.
Turn the system off and replace the
device.
Chapter 1: Getting Started 5
Getting Started
System controls
1 Power switch Turns system on and off.
2 Alphanumeric keys Use to enter text and numbers.
3 Annotation keys See “Alphanumeric keyboard” on page 9.
4 ZOOM Magnifies the image 100%.
5DEPTH UP,
DEPTH DOWN
Decreases and increases imaging depth.
6 AUTO GAIN Adjusts gain automatically.
7Gain
Near Adjusts the gain applied to the near field of the image.
Far Adjusts the gain applied to the far field of the image.
Gain/
Cine Buffer
In live imaging, adjusts the overall gain applied to the entire image. On a
frozen image, moves the cine buffer.
1
2
3
4
6
7
8 9 11 12 13
14
15
17
16
18
19
20
5
10
6 System controls
8 AC power indicator A steady light indicates that AC power is connected. A flashing light
indicates that the system is asleep.
9 CALIPER
CALCS
Displays calipers on-screen for measuring.
Turns the calculations menu on and off.
10 Touchpad Selects, adjusts, and moves items on-screen.
11 FREEZE Stops live imaging and displays a frozen image.
12 SAVE Saves an image to internal storage. If configured, also saves calculations to
the report. See “Presets setup” on page 22.
13 CLIP Saves a clip to internal storage.
14 Control keys Control on-screen options.
15 Forms
SETUP Displays the system settings.
REPORT Accesses the patient report and EMED worksheets.
REVIEW Accesses the patient list, saved images, and archiving functions.
PATIENT Accesses patient information.
16 EXAM Opens exam menu.
17 A & B shortcut keys Keys that you can program to perform common tasks.
18 SET Sets a trace measurement.
SELECT Used with the touchpad to select items on-screen. Also switches between
Color and Doppler options, calipers for measurement, pictograph-marker
position and angle, frozen images in duplex and dual screens, and arrow
position and orientation.
SAVE CALC Saves calculations and their measurements to the patient report.
19 UPDATE Toggles between dual and duplex screens and imaging modes in M Mode
and Doppler (for example, between D-line and Doppler spectral trace).
20 Imaging Modes
M MODE Turns M Mode on, toggles between M-line and M Mode trace.
DOPPLER Turns Doppler on, toggles between D-line and Doppler trace.
COLOR Turns CPD/Color on and off.
2D Turns 2D on.
Chapter 1: Getting Started 7
Getting Started
Screen layout
Figure 1 Screen Layout
1 Mode Data Area Current imaging mode information (for example, Gen, Res, THI, and PW).
2 Orientation Marker Provides indication for image orientation. In dual and duplex images, the
orientation marker is green on the active screen.
3 Text Text entered using keyboard.
4 Pictograph Pictograph to indicate anatomy and transducer position. You can select
anatomy and screen location.
5 Calculations Menu Contains available measurements.
6 Image Ultrasound image.
7Measurement and
Calculations Data Area
Current data on measurements and calculations.
8 On-screen Options Options available in the current context.
9 Patient Header Includes current patient name, ID number, institution, user, and date/time.
10 System Status Information on system status (for example, exam type, transducer, AC
connected, battery charging, and USB).
11 Depth Marker Marks in .5 cm, 1 cm, and 5 cm increments depending on depth.
1
5
4
6
11
10
9
7
3
8
2
8 General interaction
General interaction
Touchpad and cursor
Usethetouchpadtoadjustandmoveobjects
on‐screen.Thetouchpadcontrolscaliper
position,CPDorColorboxpositionandsize,the
cursor,andmore.Thearrowkeyscontrolmuch
ofthesamefunctionalityasthetouchpad.
Thecursorappearsinthesetuppages,thepatient
informationform,andpatientreport.Youcontrol
thecursorthroughthetouchpad.Forexample,in
thepatientinformationform,placethecursor
overthelastnamefieldandpresstheSELECT
keytoactivatethatfield.Additionally,youcan
usethecursortoselectcheckboxesanditemsin
lists.
On-screen options
Theon‐screenoptionsletyoumakeadjustments
andselectsettings.Theoptionsavailabledepend
oncontext.
Eachoptioniscontrolledbythepairofkeys
belowit.Dependingontheoption,thecontrol
keysfunctioninoneoffourways:
Cycle Movesthroughalistofsettings
continuously.Theuppercontrolkeycycles
upward.Thelowercontrolkeycyclesdownward.
Up-Down Movesthroughalistofsettings,
stoppingatthetoporbottom.Theuppercontrol
keymovesupward.Thelowercontrolkeymoves
downward.Bydefault,abeepsoundswhenyou
reacheitherendoftherange.(See“A u d i o , Battery
setup”onpage 19.)
On-Off Turnsafeatureonoroff.Youcanpress
eithercontrolkey.Informs,youcaninsteadselect
theoptionbyusingthetouchpadandthe
SELECTkey.
Action Performsanaction.Youcanpresseither
controlkey.Oryoucaninsteadselecttheoption
byusingthetouchpadandtheSELECTkey.
Figure 5 On-screen options (2D imaging shown)
Chapter 1: Getting Started 9
Getting Started
1TAB Moves cursor among fields
in the forms, and tabs
between text position in
dual screens.
2 CAPS LOCK Sets the keyboard to
capital letters.
3 SHIFT Allows entry of capitalized
characters and
international characters.
4 TEXT Turns the keyboard on and
off for text entry.
5 PICTO Turns pictographs on and
off.
6 ARROW Displays an arrow graphic
that can be moved and
rotated within the image
area.
7 SPACEBAR Turns the keyboard on for
text entry. In text entry,
adds a space.
8 DELETE Removes all text from the
screen during text entry
and when not measuring.
9 Arrow Keys Move highlighted selection
in calculations menu, move
cursor one space when
entering text, move caliper
position, move cine buffer
forward and backward, and
move among pages in
image review and reports.
10 BACKSPACE Removes the character left
of the cursor in text-entry
mode.
11 ENTER Moves cursor among fields
in forms and saves
calculations to report.
Annotation and text
Alphanumeric keyboard
2
3
4
11
10
1
56 8 97
10 Preparing transducers
Symbols
Youcanentersymbolsandspecialcharactersin
selectfieldsandforms.Thesymbolsandspecial
charactersavailabledependoncontext.
Patient information form: Last,First,Middle,
PatientID,Accession,Indications,ProcedureID,
User,ReadingDr.,ReferringDr.,andInstitution
fields
DICOM or SiteLink configuration page: Aliasand
AETitlefields
A & B Key, Footswitch setup page: Textfield
Text mode (imaging): Annotationfield
Figure 6 Symbols Dialog Box
To enter symbols or special characters
1Selectthefield,andthenselectSymbols.
2Selectthedesiredsymbolorcharacter.
Youcanalsopressthekeysonthekeyboard.
3SelectOK.
Preparing transducers
Acousticcouplinggelmustbeusedduring
exams.Althoughmostgelsprovidesuitable
acousticcoupling,somegelsareincompatible
withsometransducermaterials.SonoSite
recommendsAquasonic®gelandprovidesa
samplewiththesystem.
Forgeneraluse,applyaliberalamountofgel
betweenthetransducerandthebody.For
invasiveorsurgicaluse,applyatransducer
sheath.
WARNING: Some transducer sheaths contain
natural rubber latex and talc, which
can cause allergic reactions in some
individuals. Refer to 21 CFR 801.437,
User labeling for devices that
contain natural rubber.
Some gels and sterilants can cause
an allergic reaction on some
individuals.
Caution: To avoid damage to the transducer,
use only gels recommended by
SonoSite. Using gels other than the
one recommended by SonoSite can
damage the transducer and void
the warranty. If you have questions
about gel compatibility, contact
SonoSite or your local
representative.
SonoSite recommends that you
clean transducers after each use.
See “Cleaning and disinfecting
transducers” on page 74.
Chapter 1: Getting Started 11
Getting Started
To apply a transducer sheath
SonoSiterecommendstheuseofmarket‐cleared,
transducersheathsforintracavitaryorsurgical
applications.Tolessentheriskofcontamination,
applythesheathonlywhenyouarereadyto
performtheprocedure.
1Placegelinsidethesheath.
2Insertthetransducerintothesheath.
3Pullthesheathoverthetransducerandcable
untilthesheathisfullyextended.
4Securethesheathusingthebandssupplied
withthesheath.
5Checkforandeliminatebubblesbetweenthe
faceofthetransducerandthesheath.
Bubblesbetweenthefaceofthetransducer
andthesheathmayaffecttheultrasound
image.
6Inspectthesheathtoensurethatthereareno
holesortears.
Training videos
TheSonoSite®EducationKey™trainingvideos
areanoptionalfeature.
To display the list of videos
1InserttheEducationKeyUSBdeviceintoa
USBportonthesystem.
2PresstheREVIEWkey.
3Ifthereisanactiveexam,selectListon‐screen.
4SelecttheVideostab.
5Ifthelistdoesnotappear,selectthecorrect
USBdevice:
aSelectSelect USB.
bIntheSelect USB device for media
playback dialog box,selecttheEducation
KeyUSBdevice(“Training”appearsunder
Type),andthenselectSelect.
Note: ImageGalleryisanunsupportedfeature.
To view a video
1Displaythelistofvideos.
2Selectthevideo.
3SelectViewon‐screen.
Thevideobeginsplaying.
4Selectanyofthefollowing,asneeded:
•Adjuststhevolume.Thehigherthe
number,thelouderthesound.Zerois
mute.
•BackRewindsthevideo10seconds.
•Pause Pausesthevideo.
•PlayResumesplayingofapausedvideo.
•ForwardAdvancesthevideo10seconds.
To exit a video
Selectoneofthefollowing:
•Listtoreturntothevideolist.
•Donetoreturnto2Dimaging.
Intended uses
Thissystemtransmitsultrasoundenergyinto
variouspartsofthepatient’sbodytoobtain
ultrasoundimages,asfollows.
Fortheintendedtransducerandimagingmodes
foreachexamtype,see“Imagingmodesand
examsavailablebytransducer”onpage 31.
WARNING: To prevent contamination, the use
of sterile transducer sheaths and
sterile coupling gel is
recommended for clinical
applications of an invasive or
surgical nature. Do not apply the
transducer sheath and gel until you
are ready to perform the procedure.
12 Intended uses
Abdominal Imaging Applications Youcanassess
theliver,kidneys,pancreas,spleen,gallbladder,
bileducts,transplantedorgans,abdominal
vessels,andsurroundinganatomicalstructures
forthepresenceorabsenceofpathology
transabdominally.
Cardiac Imaging Applications Youcanassessthe
heart,cardiacvalves,greatvessels,surrounding
anatomicalstructures,overallcardiac
performance,andheartsizeforthepresenceor
absenceofpathology.
Youcanobtainthepatient’selectrocardiogram
(ECG).TheECGisusedfortimingofcardiac
events.
Gynecology and Infertility Imaging Applications
Youcanassesstheuterus,ovaries,adnexa,and
surroundinganatomicalstructuresforthe
presenceorabsenceofpathology
transabdominallyortransvaginally.
Interventional Imaging Applications Youcanuse
thesystemforultrasoundguidanceinbiopsyand
drainageprocedures,vascularlineplacement,
peripheralnerveblocks,spinalnerveblocksand
taps,ovaharvesting,amniocentesisandother
obstetricalprocedures,andprovideassistance
duringabdominal,breast,andneurological
surgery.
Obstetrical Imaging Applications Youcanassess
thefetalanatomy,viability,estimatedfetal
weight,gestationalage,amnioticfluid,and
surroundinganatomicalstructuresforthe
presenceorabsenceofpathology
transabdominallyortransvaginally.CPDand
Colorimagingareintendedforhigh‐risk
pregnantwomen.High‐riskpregnancy
indicationsinclude,butarenotlimitedto,
multiplepregnancy,fetalhydrops,placental
abnormalities,aswellasmaternalhypertension,
diabetes,andlupus.
Pediatric and Neonatal Imaging Applications
Youcanassessthepediatricandneonatal
abdominal,pelvicandcardiacanatomy,pediatric
hips,neonatalhead,andsurroundinganatomical
structuresforthepresenceorabsenceof
pathology.
Superficial Imaging Applications Youcanassess
thebreast,thyroid,testicle,lymphnodes,
hernias,musculoskeletalstructures,softtissue
structures,ophthalmicstructures,and
surroundinganatomicalstructuresforthe
presenceorabsenceofpathology.Youcanusethe
systemforultrasoundguidanceinbiopsyand
drainageprocedures,vascularlineplacement,
peripheralnerveblocks,andspinalnerveblocks
andtaps.
WARNING: The ECG is not used to diagnose
cardiac arrhythmias and is not
designed for long term cardiac
rhythm monitoring.
WARNING: To prevent injury or misdiagnosis,
do not use this system for
Percutaneous Umbilical Blood
Sampling (PUBS) or in vitro
Fertilization (IVF) The system has
not been validated to be proven
effective for these two uses.
CPD or Color images can be used as
an adjunctive method, not as a
screening tool, for the detection of
structural anomalies of the fetal
heart and as an adjunctive method,
not as a screening tool for the
diagnosis of Intrauterine Growth
Retardation (IUGR).
Chapter 1: Getting Started 13
Getting Started
Transcranial Imaging Applications Youcan
assesstheanatomicalstructuresandvascular
anatomyofthebrainforpresenceorabsenceof
pathology.Youcanuseimagingtemporally,
trans‐occipitally,ortrans‐orbitally.
Vascular Imaging Applications Youcanassessthe
carotidarteries,deepveins,andarteriesinthe
armsandlegs,superficialveinsinthearmsand
legs,greatvesselsintheabdomen,andvarious
smallvesselsfeedingorgansforthepresenceor
absenceofpathology.
WARNING: To avoid injury to the patient, use
only an Orbital (Orb) or
Ophthalmic (Oph) exam type when
performing imaging through the
eye. The FDA has established lower
acoustic energy limits for
ophthalmic use. The system will
not exceed these limits only if the
Orb or Oph exam type is selected.
WARNING: To avoid injury to the patient, use
only an Orbital (Orb) or
Ophthalmic (Oph) exam type when
performing imaging through the
eye. The FDA has established lower
acoustic energy limits for
opthalmic use. The system will not
exceed these limits only if the Orb
or Oph exam type is selected.
14 Intended uses
Chapter 2: System Setup 15
Setup
Chapter 2: System Setup
Thesystemsetuppagesletyoucustomizethe
systemandsetpreferences.
Displaying the setup pages
To display a setup page
1PresstheSETUPkey.
2SelectthesetuppageunderSetup Pages.
Toreturntoimagingfromasetuppage,select
Doneon‐screen.
Restoring default settings
To restore default settings for a setup page
Onthesetuppage,select Reseton‐screen.
To restore all default settings
1Turnthesystemoff.
2ConnectthesystemtoACpower.(See“To
operatethesystemusingACpower”on
page 3.)
3Simultaneouslypress1andthepowerkey.
Thesystembeepsseveraltimes.
A & B Key, Footswitch setup
OntheA&BKey,Footswitchsetuppage,youcan
programtheshortcutkeysandfootswitchto
performcommontasks.Selectfromthefollowing
lists:
A Key, B Key Thefunctionoftheshortcutkeys.By
default,theAshortcutkeyissettoPrintandthe
BshortcutkeyissettoRecord.Theshortcutkeys
arebelowthealphanumerickeypad.
Footswitch (L),Footswitch (R) Thefunctionofthe
leftandrightfootswitches:Save Clip,Record,
Freeze,Save Image,orPrint.Seealso“Toconnect
thefootswitch.”
To connect the footswitch
TheSonoSitefootswitchallowshands‐free
operationwithacustomizabletwo‐pedal
footswitch.Thefootswitchisanoptionalfeature.
1Connectthecables:
•YadaptercabletotheECGconnectoron
themini‐dockordockingsystem
•FootswitchcabletoYadaptercable
2OntheA&BKey,Footswitchsetuppage,
selectafunctionfortheleftandright
footswitches.
Administration setup
OntheAdministrationsetuppage,youcan
configurethesystemtorequireuserstologin
andenterpasswords.Requiredloginhelps
protectpatientdata.Youcanalsoaddanddelete
users,changepasswords,importandexportuser
accounts,andviewtheeventlog.
WARNING: To avoid contamination, do not use
the footswitch in a sterile
environment. The footswitch is not
sterilized.
16 Administration setup
Security settings
Securitysettingsonthesystemallowyoutomeet
theapplicablesecurityrequirementslistedinthe
HIPAAstandard.Usersareultimately
responsibleforensuringthesecurityand
protectionofallelectronicprotectedhealth
informationcollected,stored,reviewed,and
transmittedonthesystem.
To log in as Administrator
1OntheAdministrationsetuppage,type
AdministratorintheNamebox.
2Typetheadministratorpasswordinthe
Passwordbox.
Ifyoudon’thavetheadministratorpassword,
contactSonoSite.(See“SonoSiteTechnical
Support”onpage vii.)
3SelectLogin.
To log out as Administrator
Turnofforrestartthesystem.
To require user login
YoucansetthesystemtodisplaytheUserLogin
screenatstartup.
1LoginasAdministrator.
2IntheUser Loginlist,selectOn.
•Onrequiresausernameandpasswordat
startup.
•Offallowsaccesstothesystemwithouta
usernameandpassword.
To change the administrator password or let
users change passwords
1LoginasAdministrator.
2UnderUser List,selectAdministrator.
3Doanyofthefollowing:
• Changetheadministratorpassword:
UnderUser Information,typethenew
passwordinthePasswordboxand
Confirmbox.(See“Choosingasecure
password”onpage 18.)
•Letuserschangetheirpasswords:Select
thePassword changescheckbox.
4SelectSave.
User setup
To add a new user
1LoginasAdministrator.
2SelectNew.
3UnderUser Information,fillintheName,
Password,andConfirmboxes.(See“Choosing
asecurepassword”onpage 18.)
4(Optional)IntheUser box,typetheuser’s
initialstodisplaytheminthepatientheader
andtheUserfieldinthepatientinformation
form.
5(Optional)SelecttheAdministration Access
checkboxtoallowaccesstoalladministration
privileges.
6SelectSave.
To modify user information
1LoginasAdministrator.
WARNING: Health care providers who maintain
or transmit health information are
required by the Health Insurance
Portability and Accountability Act
(HIPAA) of 1996 and the European
Union Data Protection Directive
(95/46/EC) to implement
appropriate procedures: to ensure
the integrity and confidentiality of
information; to protect against any
reasonably anticipated threats or
hazards to the security or integrity
of the information or unauthorized
uses or disclosures of the
information.
Chapter 2: System Setup 17
Setup
2UnderUser List,selecttheuser.
3UnderUser Information,makechangesas
desired.
4SelectSave.
Anychangetotheusernamereplacesthe
previousname.
To delete a user
1LoginasAdministrator.
2UnderUser List,selecttheuser.
3SelectDelete.
4SelectYes .
To change a user password
1LoginasAdministrator.
2IntheUser List,selecttheuser.
3TypethenewpasswordinthePasswordbox
andConfirmbox.
4SelectSave.
Exporting or importing user accounts
Theexportandimportcommandsletyou
configuremultiplesystemsandbackupuser
accountinformation.
To export user accounts
1InsertaUSBstoragedevice.
2LoginasAdministrator.
3SelectExporton‐screen.AlistofUSBdevices
appears.
4SelecttheUSBstoragedevice,andselect
Export.
Allusernamesandpasswordsarecopiedto
theUSBstoragedevice.
To import user accounts
1InserttheUSBstoragedevicethatcontainsthe
accounts.
2LoginasAdministrator.
3SelectImporton‐screen.
4SelecttheUSBstoragedevice,andselect
Import.
5Restartthesystem.
Allusernamesandpasswordsonthesystem
arereplacedwiththeimporteddata.
Exporting and clearing the Event log
TheEventlogcollectserrorsandeventsandcan
beexportedtoaUSBstoragedeviceandreadon
aPC.
To display the Event log
1LoginasAdministrator.
2SelectLogon‐screen.
TheEventlogappears.
Toreturntothepreviousscreen,selectBack.
To export the Event log
TheEventlogandtheDICOMnetworkloghave
thesamefilename(log.txt).Exportingeitherone
toaUSBstoragedeviceoverwritesanyexisting
log.txtfile.
1InsertaUSBstoragedevice.
2SelectLogandthenselectExport on‐screen.
AlistofUSBdevicesappears.
3SelecttheUSBstoragedevice,andselect
Export.
TheEventlogisatextfilethatyoucanopenina
text‐editingapplication(forexample,Microsoft
WordorNotepad).
To clear the Event log
1DisplaytheEventlog.
2SelectClearon‐screen.
3SelectYes .
18 Annotations setup
Logging in as user
Ifuserloginisrequired,theUserLoginscreen
appearswhenyouturnonthesystem.(See“To
requireuserlogin”onpage 16.)
To log in as user
1Turnonthesystem.
2IntheUser Loginscreen,typeyournameand
password,andselectOK.
To log in as guest
Guestscanscanbutcan’taccesssystemsetupand
patientinformation.
1Turnonthesystem.
2IntheUser Loginscreen,selectGuest.
To change your password
1Turnonthesystem.
2IntheUser Loginscreen,selectPassword.
3Typeyouroldandnewpasswords,confirm
thenewpassword,andthenselectOK.
Choosing a secure password
Toensuresecurity,chooseapasswordthat
containsuppercasecharacters(A‐Z),lowercase
characters(a‐z),andnumbers(0‐9).Passwords
arecase‐sensitive.
Annotations setup
OntheAnnotationssetuppage,youcan
customizepredefinedlabelsandsetthe
preferenceformanagingtextwhenunfreezing
images.
Forinstructionstoannotateimages,see
“Annotatingimages”onpage 32.
To predefine a label group
Youcanspecifywhichlabelsareavailableforan
examtypewhenannotatinganimage.(See“To
placetextonanimage”onpage 32.)
1IntheExamlistontheAnnotationssetup
page,selecttheexamtypewhoselabelsyou
wanttospecify.
2ForGroup,select A, B, or Cforthelabelgroup
youwantassociatedwiththatexam.
Thepresetlabelsappearfortheselectedgroup.
3Doanyofthefollowing:
•Addacustomlabeltothegroup:Typethe
labelintheTextbox,andselectAdd.
• Renamealabel:Selectthelabel,typethe
newnameintheTextbox,andselect
Rename.
•Movealabelwithinthegroup:Selectthe
label,andthenselecttheon‐screenupor
downarrow.
• Deletealabelfromagroup:Selectthe
label,andselectDelete.
Youcanusesymbolsinlabels.See“Symbols”
onpage 10.
To specify text retention when unfreezing
Youcanspecifywhichtexttokeepwhenyou
unfreezeanimageorchangetheimaginglayout.
IntheUnfreezelistontheAnnotationssetup
page,selectKeep All Text,Keep Home Text,or
Clear All Text.
ThedefaultsettingisKeep All Text.For
informationonsettingthehomeposition,see
“Toresetthehomeposition”onpage 33.
To export predefined label groups
1InsertaUSBstoragedevice.
2OntheAnnotationssetuppage,selectExport.
AlistofUSBdevicesappears.
3SelecttheUSBstoragedevice,andselect
Export.
Acopyofallpredefinedlabelgroupsforall
examssavestotheUSBstoragedevice.
Chapter 2: System Setup 19
Setup
To import predefined label groups
1InserttheUSBstoragedevicethatcontainsthe
labelgroups.
2OntheAnnotationssetuppage,selectImport
on‐screen.
3SelecttheUSBstoragedevice,andthenselect
Import.
4SelectDoneinthedialogboxthatappears.
Allpredefinedlabelgroupsforallexamsare
replacedwiththosefromtheUSBstorage
device.
Audio, Battery setup
OntheAudio,Batterysetuppage,youcanselect
optionsinthefollowinglists:
Key clickSelectOnorOffforkeystoclickwhen
pressed.
Beep alert SelectOnorOffforthesystemtobeep
whensaving,warning,starting,orshutting
down.
Sleep delaySelectOff,or5or10minutesto
specifytheperiodofinactivitybeforethesystem
goesintosleepmode.
Power delaySelectOff,or15or30minutesto
specifytheperiodofinactivitybeforethesystem
automaticallyturnsoff.
Cardiac Calculations setup
OntheCardiacCalculationssetuppage,youcan
specifymeasurementnamesthatappearinthe
TissueDopplerImaging(TDI)calculationsmenu
andonthereportpage.
Seealso“Cardiaccalculations”onpage 50.
To specify cardiac measurement names
UnderTDI WallsontheCardiacCalculations
setuppage,selectanameforeachwall.
Connectivity setup
OntheConnectivitysetuppage,youspecify
optionsforusingnon‐USBdevicesandforalerts
wheninternalstorageisfull.Youalsoimport
wirelesscertificatesandspecifysettings
(includingTransferModeandLocation)for
SiteLinkandDICOM,whichareoptional
features.RefertotheSiteLinkandDICOM
documentation.
To configure the system for a printer
1Setuptheprinterhardware.(Seeinstructions
includedwiththeprinterordockingsystem.)
2InthePrinterlistontheConnectivitysetup
page,selecttheprinter.
To configure the system for a DVD recorder,
PC, or serial bar code scanner
1OntheConnectivitysetuppage,dothe
following:
•(DVDrecorder)IntheVideo Modelist,
selectthevideostandard:NTSCorPAL.
•IntheSerial Portlist,selecttheperipheral.
Computer (PC) allowspatientreportdata
tobesentasASCIItextfromthesystemto
aPC.ThePCmusthavethird‐party
softwaretoacquire,view,orformatthe
dataintoareport.Checkthecompatibility
ofyoursoftwarewithSonoSiteTechnical
Support.(Seealso“Tosendapatient
reporttoaPC”onpage 69.)
Note: Becausetheseperipheralsusethesame
RS‐232connectoronthemini‐dock,youcan
connectonlyoneofthematatime.
2Restartthesystem.
3Attachaserialcable(RS‐232)fromtheserial
portonthemini‐dockordockingsystemto
theperipheral.
20 Date and Time setup
To receive storage alerts
OntheConnectivitysetuppage,select
Internal Storage Capacity Alert.
Thesystemdisplaysamessageifinternal
storageisnearcapacitywhenyouendan
exam.Thesystemthendeletesarchived
patientexamsifspecifiedinDICOM.
Date and Time setup
To set the date and time
OntheDateandTimesetuppage,dothe
following:
•IntheDate box,typethecurrentdate.
•IntheTime box,typethecurrenttimein
24 hourformat(hoursandminutes).
Display Information setup
OntheDisplayInformationsetuppage,youcan
specifywhichdetailsappearon‐screenduring
imaging.Youcanselectsettingsinthefollowing
sections:
Patient HeaderInformationthatappearsinthe
patientheader.
Mode DataImaginginformation.
System StatusSystemstatusinformation.
IMT Calculations setup
OntheIMTCalculationssetuppage,youcan
customizetheIMTcalculationsmenu.Youcan
specifyuptoeightmeasurementnamesforboth
rightsideandleftsidecalculations.The
measurementnamesalsoappearinthepatient
report.
Seealso“IMTcalculations”onpage 59.
To customize the IMT calculations menu
OntheIMTCalculationssetuppage,dothe
following:
•UnderIMT Calculations,select
measurementnamesfromthelists,or
selectNone.
Theselectednamesappearinthe
calculationsmenuandinthepatient
report.
•Typethedesiredwidthinthe
Region width (mm)box.
Network Status setup
TheNetworkStatussetuppagedisplays
informationonsystemIPaddress,Location,
EthernetMACaddress,andthewireless
connectionifany.
OB Calculations setup
OntheOBCalculationssetuppage,youselect
authorsforOBcalculationtables.Youcanalso
importorexportadditionalOBcalculationtables.
Seealso“OBcalculations”onpage 61.
WARNING: To obtain accurate obstetrics
calculations, an accurate date and
time are critical. Verify that the date
and time are accurate before each
use of the system. The system does
not automatically adjust for
daylight saving time changes.
Chapter 2: System Setup 21
Setup
Figure 1 OB Calculations Setup Page
To specify gestational age and growth
analysis
1OntheOBCalculationssetuppage,selectthe
desiredOBauthors(orselectNone)inthe
measurementlistsunderGestational Ageand
Growth Analysis.
Selectinganauthorplacestheassociated
measurementonthecalculationsmenu.
2(Optional)SelectMoretodisplaythelistof
user‐definedcustommeasurementsandto
associateacustomtableforthecustom
measurement.
Thisoptionisavailableonlywhena
user‐definedcustomtablehasbeencreated
forthecustommeasurement.
To export OB calculation tables
1InsertaUSBstoragedevice.
2OntheOBCalculationssetuppage,select
Export.AlistofUSBdevicesappears.
3SelecttheUSBstoragedevice,andselect
Export.
Alluser‐definedtablesandmeasurementsare
copiedtotheUSBstoragedevice.
To import OB calculationtables
Tablesthatyouimportareaddedtothosealready
onthesystem.
1InserttheUSBstoragedevicethatcontainsthe
tables.
2OntheOBCalculationssetuppage,select
Importon‐screen.
3SelecttheUSBstoragedevice,andthenselect
Import.
4SelectOKinthedialogboxthatappears.
Thesystemrestarts.
OB Custom Measurements
setup
OntheOBCustomMeasurementssetuppage,
youcandefinemeasurementsthatappearinthe
OBcalculationsmenuandOBreport.OBCustom
Measurementsisanoptionalfeature.
Seealso“OBcalculations”onpage 61.
To set up OB custom measurements
Youcansaveuptofivecustommeasurements
thatappearintheOBcalculationsmenuandOB
report.
1OntheOBCustomMeasurementssetuppage,
selectNew.
2IntheNamebox,typeauniquename.
3IntheTypelist,selectthedesired
measurementtype.
4SelectSave.
To delete an OB custom measurement
IfyoudeleteanOBcustommeasurementduring
anexam,theexamends.
1OntheOBCustomMeasurementssetuppage,
highlightthemeasurementintheCustom
Measurementslist.
2SelectDelete Last.
22 OB Custom Tables setup
3SelectYes .
Theexamends,andanytablesandreport
dataassociatedwiththemeasurementare
removedfromthesystem.
OB Custom Tables setup
OntheOBCustomTablessetuppages,youcan
customizegrowthtablesthatappearinthe
calculationsmenuandpatientreport.
Gestational Age Table Measurements Thesystem
providesgestationalagemeasurementsby
selectedauthorsforCRL,GS,BPD,OFD,HC,AC,
FL,APTD,TTD,FTA,and5 additionalcustom
measurementlabels.
Growth Analysis Table MeasurementsThe
systemprovidesgrowthgraphsorcurvesfor
BPD,HC,AC,FL,EFW,andHC/AC.
To view OB tables
1OntheOBCalculationsorOBCustom
Measurementssetuppage,selectTables
on‐screen.
2Selectthedesiredtableand
measurement/author.
To create a new OB custom table
YoucancreatetwocustomtablesforeachOB
measurement.
1OntheOBCalculationsorOBCustom
Measurementssetuppage,selectTables
on‐screen.
2Selectthedesiredtable(GestationalAgeor
Growth Analysis).
3IntheMeasurementlist,selectthe
measurementforthecustomtable.
4SelectNewon‐screen.
5IntheAuthorbox,typeauniquename.
6Enterthedata.
7SelectSaveon‐screen.
Todisplaythemeasurementforthecustomtable
inthecalculationsmenu,see“Tospecify
gestationalageandgrowthanalysis”onpage 21.
To edit or delete an OB custom table
1OntheOBCalculationsorOBCustom
Measurementssetuppage,selectTables
on‐screen.
2SelecttheOBcustomtable.
3Selectoneofthefollowingon‐screen:
•EditEnterdata,andthenselectSave
on‐screen.
•Deletetoremovethecustomtable.Select
Yes.
Presets setup
ThePresetssetuppagehassettingsforgeneral
preferences.Youcanselectfromthefollowing
lists:
Doppler ScaleSelectcm/sorkHz.
Duplex ThelayoutfordisplayingMModetrace
andDopplerspectraltrace:1/3 2D, 2/3 Trace;1/2
2D, 1/2 Trace;orFull 2D, Full Trace.
Live TraceSelectPeakorMean.
Thermal Index YoucanselectTIS,TIB,orTIC.The
defaultsettingisbasedonexamtype:OBisTIB,
TCDisTIC,andallothersareTIS.
Save KeyBehavioroftheSAVEkey.Image Only
savestheimagetointernalstorage.Image/Calcs
savestheimagetointernalstorageandsavesthe
currentcalculationtothepatientreport.
Dynamic RangeSettingsinclude-3,-2,-1,0,+1,
+2,or+3.Negativenumbersshowhigher
WARNING: Prior to use, verify that custom table
data entries are correct. The system
does not confirm the accuracy of
the custom table data entered by
the user.
Chapter 2: System Setup 23
Setup
contrastimages,andpositivenumbersshow
lowercontrastimages.
UnitsUnitsforpatientheightandweightin
cardiacexams:in/ft/lbsorcm/m/kg.
LanguageThesystemlanguage.Changingthe
languagerequiresrestartingthesystem.
Color SchemeThebackgroundcolorofthe
display.
Auto save Pat. FormAutomaticallysavesthe
patientinformationformasanimageinthe
patient’sfile.
System Information setup
TheSystemInformationsetuppagedisplays
systemhardwareandsoftwareversions,and
licenseinformation.
Seealso“Toenteralicensekey”onpage 72.
USB Devices setup
OntheUSBDevicessetuppage,youcanview
informationaboutconnectedUSBdevices,
includingspaceavailability.Youcanalsospecify
afileformatforimagesandclipsinpatientexams
thatyouexporttoaUSBstoragedevice.(See“To
exportpatientexamstoaUSBstoragedevice”on
page 38.)
To specify a file format for exported images
1OntheUSBDevicessetuppage,selectExport.
2UnderUSB Export,selectanexporttype:
•SiteLinkorganizesfilesinaSiteLink‐style
folderstructure.ClipsexportinH.264
videosavedasMP4files.Toviewthem,
SonoSiterecommendsQuickTime7.0or
later.
•DICOMcreatesfilesreadablebyaDICOM
reader.DICOMisanoptionalfeature.
3Selectanimageformatforyourexporttype.
ForJPEGimageformat,alsoselectaJPEG
compression.(Seealso“LimitationsofJPEG
format.”)
Ahighcompressionhasasmallerfilesizebut
lessdetail.
ForSiteLinkexporttype,theimageformat
affectsonlystillimages.ForDICOMexport
type,theimageformataffectsbothstill
imagesandclips.
4ForSiteLinkexporttype,selectasortorder
underSort By.
Toreturntothepreviousscreen,selectDevices.
Limitations of JPEG format
WhentransferringorexportingimagesinJPEG
format,thesystemuseslossycompression.Lossy
compressionmaycreateimagesthathaveless
absolutedetailthanBMPformatandthatdon’t
renderidenticallytotheoriginalimages.
Insomecircumstances,lossy‐compressedimages
maybeinappropriateforclinicaluse.For
example,ifyouuseimagesinSonoCalcIMT
software,youshouldtransferorexportthem
usingBMPformat.SonoCalcIMTsoftwareusesa
sophisticatedalgorithmtomeasureimages,and
lossycompressionmaycauseerrors.
Formoreinformationonusinglossy‐compressed
images,consulttheindustryliterature,including
thefollowingreferences:
“PhysicsinMedicineandBiology,Quality
AssessmentofDSA,UltrasoundandCT
DigitalImagesCompressedwiththeJPEG
Protocol,”DOkkalidesetal1994PhysMed
Biol391407‐1421doi:
10.1088/0031‐9155/39/9/008
www.iop.org/EJ/abstract/0031‐9155/39/9/008
“CanadianAssociationofRadiologists,CAR
StandardsforIrreversibleCompressionin
DigitalDiagnosticImagingwithin
Radiology,”Approved:June2008.
www.car.ca/Files/%5CLossy_Compression.
pdf
24 USB Devices setup
Chapter 3: Imaging 25
Imaging
Chapter 3: Imaging
Imaging modes
Thesystemhasahigh‐performancedisplayand
advancedimage‐optimizationtechnologythat
significantlysimplifiesusercontrols.Imaging
modesavailabledependonthetransducerand
examtype.See“Imagingmodesandexams
availablebytransducer”onpage 31.
2D imaging
2Disthesystemʹsdefaultimagingmode.The
systemdisplaysechoesintwodimensionsby
assigningabrightnesslevelbasedontheecho
signalamplitude.Toachievethebestpossible
imagequality,properlyadjustthedisplay
brightness,gain,depthsettings,viewingangle,
andexamtype.Also,selectanoptimization
settingthatbestmatchesyourneeds.
To display the 2D image
1Doanyofthefollowing:
•Turnonthesystem.
•Pressthe2Dkey.
2Setoptionsasdesired.See“2Doptions.”
2D options
In2Dimaging,youcanselectthefollowing
on‐screenoptions.
Optimize Settings are as follows:
•Res provides the best possible
resolution.
•Gen provides a balance between
resolution and penetration.
•Pen provides the best possible
penetration.
Some of the parameters optimized
to provide the best image include
focal zones, aperture size, frequency
(center and bandwidth), and
waveform. They cannot be adjusted
by the user.
Dynamic
Range
Adjusts the grayscale range: -3, -2,
-1, 0, +1, +2, +3.
The positive range increases the
number of grays displayed, and the
negative range decreases the
number of grays displayed.
Dual Displays side-by-side 2D images.
Select Dual, and then press the
UPDATE key to display the second
screen and to toggle between the
screens. With both images frozen,
press the UPDATE key to toggle
between the images.
To return to full-screen 2D imaging,
select Dual or press the 2D key.
26 Imaging modes
M Mode imaging
Motionmode(M Mode)isanextensionof2D.It
providesatraceofthe2Dimagedisplayedover
time.Asinglebeamofultrasoundistransmitted,
andreflectedsignalsaredisplayedasdotsof
varyingintensities,whichcreatelinesacrossthe
screen.
To display the M-line
1PresstheMMODEkey.
Note: IftheM‐linedoesnotappear,makesurethat
theimageisn’tfrozen.
2UsethetouchpadtopositiontheM‐linewhere
desired.
LVO On,
LVO Off
LVO On turns on Left Ventricular
Opacification. LVO Off turns off this
option.
Use LVO for cardiac exams in 2D
imaging mode when using an
imaging contrast agent. LVO lowers
the mechanical index (MI) of the
system to enhance visualization of
the contrast agent and endocardial
border.
This option depends on transducer
and exam type.
Orientation Select from four image orientations:
U/R (Up/Right), U/L (Up/Left), D/L
(Down/Left), D/R (Down/Right).
Brightness Adjusts the display brightness.
Settings range from 1 to 10.
The display brightness affects
battery life. To conserve battery life,
adjust brightness to a lower setting.
Biopsy Turns biopsy guidelines on and off.
This feature depends on transducer
type. See the SonoSite Biopsy user
guide.
Biopsy is not available when the
ECG cable is connected.
Guide Turns the guideline on and off.
This feature depends on transducer
and exam type. See the user guide
for L25x transducer and needle
guide.
Sector (Cardiac exam) Specifies the sector
width.
SonoMB On is available only for
Sector Full.
SonoMB
(MB)
MB On and MB Off turn SonoMB™
multi-beam imaging technology on
and off. When SonoMB is on, MB
appears in the upper left-hand
screen.
SonoMB depends on transducer and
exam type.
ECG Displays the ECG trace. See “ECG
Monitoring” on page 38.
This feature is optional and requires
a SonoSite ECG cable.
Clips Displays the clips options. See “To
capture and save a clip” on page 35.
This feature is optional.
THI Turns Tissue Harmonic Imaging on
and off.
When on, THI appears in the upper
left-hand screen. This feature is
optional and depends on transducer
and exam type.
Page x/x Indicates which page of options is
displayed. Select to display the next
page.
Chapter 3: Imaging 27
Imaging
3Setoptionsasdesired.
Manyoptimizationanddepthoptions
availablein2Dimagingarealsoavailablein
MModeimaging.See“2Doptions”on
page 25.
To display the M Mode trace
1DisplaytheM‐line.
2Adjustthedepthifnecessary.(See“Toadjust
depth”onpage 30.)
3PresstheMMODEkey.
Thetimescaleabovethetracehassmallmarks
at200msintervalsandlargemarksat
one‐secondintervals.
4Doanyofthefollowingasneeded:
•Selectthesweepspeed(Slow, Med,or
Fast).
•PresstheUPDATEkeytotogglebetween
theM‐lineandM‐Modetrace.
•Ifusingaduplexlayout,presstheMMODE
keytotogglebetweenthefull‐screen
M‐lineandtheduplexlayout.
Tosetaduplexlayout,see“Presetssetup”
onpage 22.
CPD and color Doppler imaging
ColorpowerDoppler(CPD)andcolorDoppler
(Color)areoptionalfeatures.
CPDisusedtovisualizethepresenceof
detectablebloodflow.Colorisusedtovisualize
thepresence,velocity,anddirectionofbloodflow
inawiderangeofflowstates.
To display the CPD or Color image
1PresstheCOLORkey.
AROIboxappearsinthecenterofthe2D
image.
2SelectCPDorColor.
Thecurrentselectionalsoappearsinthe
upperleft‐handscreen.
TheColorindicatorbarontheupperleft‐hand
screendisplaysvelocityincm/sinColor
imagingmodeonly.
3Usingthetouchpad,positionorresizetheROI
boxasneeded.PresstheSELECTkeytotoggle
betweenpositionandsize.
WhileyoupositionorresizetheROIbox,a
greenoutlineshowsthechange.TheROIbox
indicatorontheleft‐handscreenshowswhich
touchpadfunctionisactive.
4Setoptionsasdesired.See“CPDandColor
options.”
CPD and Color options
InCPDorColorimaging,youcansetthe
followingon‐screenoptions.
Color, CPD Toggle between CPD and Color.
The current selection appears in the
upper left-hand screen.
Color
Suppress
Shows or hides color information.
You can select Show or Hide while
in live or frozen imaging. The
setting shown on-screen is the
current selection.
Flow
Sensitivity
The current setting appears
on-screen.
•Low optimizes the system for low
flow states.
•Med optimizes the system for
medium flow states.
•High optimizes the system for
high flow states.
28 Imaging modes
PW and CW Doppler imaging
Pulsedwave(PW)Dopplerandcontinuouswave
(CW)Dopplerimagingmodesareoptional
features.
PWDopplerisaDopplerrecordingofbloodflow
velocitiesinarangespecificareaalongthelength
ofthebeam.CWDopplerisaDopplerrecording
ofbloodflowvelocitiesalongthelengthofthe
beam.
YoucanusePW/CWDopplerandCPD/Color
simultaneously.IfCPD/Colorimagingison,the
colorROIboxistiedtotheD‐line.TheSELECTkey
cyclesamongcolorROIboxposition,colorROI
boxsize,theD‐line,and(inPWDoppler)angle
correction.Theactiveselectionisgreen.Also,the
indicatorontheleft‐handscreenshowswhich
touchpadfunctionisactive.
To display the D-line
ThedefaultDopplerimagingmodeisPW
Doppler.Incardiacexams,youcanselecttheCW
Doppleron‐screenoption.
1PresstheDOPPLERkey.
Note: IftheD‐linedoesnotappear,makesure
thatthesystemisinliveimaging.
2Doanyofthefollowingasneeded:
•Setoptions.See“PWDoppleroptions”on
page 29.
•Usingthetouchpad,positiontheD‐line
wheredesired.
•(PWDoppler)Tocorrecttheangle
manually,presstheSELECTkeyandthen
usethetouchpadtoadjusttheanglein2°
incrementsfrom‐74°to+74°.Pressthe
SELECTkeyagaintosetthedesiredangle.
TheSELECTkeytogglesbetweentheD‐line
andanglecorrection.
To display the spectral trace
1DisplaytheD‐line.
2PresstheDOPPLERkey.
Thetimescaleabovethetracehassmallmarks
at200msintervalsandlargemarksat
one‐secondintervals.
3Doanyofthefollowingasneeded:
•Setoptions.See“Spectraltraceoptions”
onpage 29.
•PresstheUPDATEkeytotogglebetween
theD‐lineandspectraltrace.
PRF Scale Select the desired pulse repetition
frequency (PRF) setting by pressing
the control keys.
There is a wide range of PRF
settings for each Flow Sensitivity
setting (Low, Med, and High).
Available on select transducers.
Wall Filter Settings include Low, Med, and
High.
Available on select transducers.
Steering Select the steering angle setting of
the color ROI box (-15, 0, or +15). If
adding PW Doppler, see “PW
Doppler options” on page 29.
Available on select transducers.
Variance Turns variance on and off.
Available only for cardiac exam.
Invert Switches the displayed direction of
flow.
Available in Color imaging.
Sector (Cardiac exam) Specifies the sector
width.
Page x/x Indicates which page of options is
displayed. Select to display the next
page.
Chapter 3: Imaging 29
Imaging
•Ifusingaduplexlayout,pressthe
DOPPLERkeytotogglebetweenthe
full‐screenD‐lineandtheduplexlayout.
Tosetaduplexlayout,see“Presetssetup”
onpage 22.
PW Doppler options
InPWDopplerimaging,youcansetthe
followingon‐screenoptions.
Spectral trace options
Inspectraltraceimaging,youcansetthe
followingon‐screenoptions.
PW, CW (Cardiac exam only) Toggle
between PW Doppler and CW
Doppler.
The current selection appears in the
upper left-hand screen.
Angle
Correction
Corrects the angle to 0°, +60°, or
-60°.
Gate Size Settings depend on transducer and
exam type.
In TCD or Orb exams, use the
touchpad to specify the Doppler
gate depth (the depth of the center
of the gate in the Doppler image).
The Doppler gate depth indicator is
on the lower right-hand screen.
TDI On,
TDI Off
Select TDI On to turn on tissue
Doppler imaging. When on, TDI
appears in the upper left-hand
screen. The default is TDI off.
Available only in cardiac exams.
Steering Select the desired steering angle
setting. The PW Doppler angle
correction automatically changes
to the optimum setting.
•-15 has an angle correction of
-60°.
•0 has an angle correction of 0°.
•+15 has an angle correction of
+60°.
You can manually correct the angle
after selecting a steering angle
setting. (See “To display the D-line”
on page 28.)
Available on select transducers.
Page x/x Indicates which page of options is
displayed. Select to display the next
page.
Scale Select the desired scale (pulse
repetition frequency [PRF]) setting.
(To change the Doppler scale to
cm/s or kHz, see “Presets setup” on
page 22.)
Line Sets the baseline position.
(On a frozen trace, the baseline can
be adjusted if Live Trace is off.)
Invert Vertically flips the spectral trace.
(On a frozen trace, Invert is
available if Live Trace is off.)
Volume Increases or decreases Doppler
speaker volume (0-10).
Wall Filter Settings include Low, Med, High.
Sweep Speed Settings include Slow, Med, Fast.
30 Adjusting depth and gain
Adjusting depth and gain
To adjust depth
Youcanadjustthedepthinallimagingmodes
butthetracemodes.Theverticaldepthscaleis
markedin0.5 cm,1cm,and5cmincrements,
dependingonthedepth.
Pressthefollowingkeys:
•UPDEPTHkeytodecreasethedisplayed
depth.
•DOWNDEPTHkeytoincreasethedisplayed
depth.
Asyouadjustthedepth,themaximumdepth
numberchangesinthelowerrightscreen.
To adjust gain automatically
PresstheAUTO GAINkey.Thegainadjusts
eachtimeyoupressthiskey.
To adjust gain manually
Turnagainknob:
•NEAR adjuststhegainappliedtothe
nearfieldofthe2Dimage.
•FAR adjuststhegainappliedtothefar
fieldofthe2Dimage.
•GAIN adjuststheoverallgainapplied
totheentireimage.InCPDorColor
imaging,theGAINknobaffectsthecolor
gainappliedtotheregionofinterest(ROI)
box.InPWandCWDopplerimaging,the
theGAINknobaffectsDopplergain.
Nearandfarcorrespondtothetimegain
compensation(TGC)controlsonother
ultrasoundsystems.
Freezing, viewing frames, and
zooming
To freeze or unfreeze an image
PresstheFREEZEkey.
Onafrozenimage,thecineiconandframe
numberappearinthesystemstatusarea.
To move forward or backward in the cine
buffer
Freezetheimage,anddooneofthefollowing:
•Turntheknob.
•Usethetouchpad.Rightmovesforward,
andleftmovesbackward.
•PresstheLEFTARROWandRIGHTARROW
keys.
Theframenumberchangesasyoumove
forwardorbackward.Thetotalnumberof
framesinthebufferappearson‐screeninthe
systemstatusarea.
To zoom in on an image
Youcanzoomin2DandColorimaging.Youcan
freezeorunfreezetheimageorchangethe
imagingmodeatanytimewhilezooming.
1PresstheZOOMkey.AROIboxappears.
2Usingthetouchpad,positiontheROIboxas
desired.
3PresstheZOOMkeyagain.
TheimageintheROIboxismagnifiedby
100%.
4(Optional)Iftheimageisfrozen,usethe
touchpadorarrowkeystopantheimageup,
Live Trace Displays a live trace of the peak or
mean. (See “Presets setup” on
page 22 to specify peak or mean.)
Page x/x Indicates which page of options is
displayed. Select to display the next
page.
Chapter 3: Imaging 31
Imaging
down,left,andright.(Youcannotpanin
Dual.)
Toexitzoom,presstheZOOMkeyagain.
Imaging modes and exams
available by transducer
Thetransduceryouusedetermineswhichexam
typesareavailable.Inaddition,theexamtype
youselectdetermineswhichimagingmodesare
available.
To change the exam type
Dooneofthefollowing:
•PresstheEXAMkey,andselectfromthe
menu.
•Onthepatientinformationform,select
fromtheTypelistunderExam.(See
“Patientinformationform”onpage 33.)
Imaging modes and exams available by
transducer
WARNING: To prevent misdiagnosis or harm to
the patient, understand your
system’s capabilities prior to use.
The diagnostic capability differs for
each transducer, exam type, and
imaging mode. In addition,
transducers have been developed
to specific criteria depending on
their physical application. These
criteria include biocompatibility
requirements.
To avoid injury to the patient, use
only an Orbital (Orb) or Ophthalmic
(Oph) when performing imaging
through the eye. The FDA has
established lower acoustic energy
limits for ophthalmic use. The
system will not exceed these limits
only if the Orb or Oph exam type is
selected.
Imaging Mode
Transducer
Exam Type1
2D2
M Mode
CPD3
Color3
PW Doppler4
CW Doppler
C11x Abd XXXX—
Neo XXXX—
Nrv XXXX—
Vas XXXX—
C60x OB XXXX—
Gyn XXXX—
Abd XXXX—
Nrv XXXX—
D2x Crd ———— X
HFL38x Bre XXXX—
SmP XXXX—
Vas XXXX—
Msk XXXX—
IMT XXXX—
Nrv XXXX—
Ven XXXX—
ICTx Gyn XXXX—
OB XXXX—
32 Annotating images
Annotating images
Youcanannotateliveimagesaswellasfrozen
images.(Youcannotannotateasavedimage.)
Youcanplacetext(includingpredefinedlabels),
anarrow,orapictograph.Tosetpreferencesfor
annotations,see“Annotationssetup”onpage 18.
To place text on an image
Youcanplacetextinthefollowingimaging
layouts:full‐screen2D,full‐screentrace,dual,or
duplex.Youcanplacetextmanuallyoradda
predefinedlabel.
1PresstheTEXTkey.Agreencursorappears.
2Movethecursorwheredesired:
•Usethetouchpadorarrowkeys.
•SelectHometomovethecursortothe
homeposition.
L25x Msk XXXX—
Vas XXXX—
Nrv XXXX—
Oph XXXX—
Sup XXXX—
Ven XXXX—
L38x Bre XXXX—
SmP XXXX—
Vas XXXX—
IMT XXXX—
Nrv XXXX—
Ven XXXX—
P10x Abd XXXX—
Crd X—XX X
Neo XXXX—
P21x Abd XXXX—
OB XXXX—
Crd X—XX X
TCD XXXX—
Orb XXXX—
SLAx Msk XXXX—
Nrv XXXX—
Sup XXXX—
Imaging Mode
Transducer
Exam Type1
2D2
M Mode
CPD3
Color3
PW Doppler4
CW Doppler
Vas XXXX—
Ven XXXX—
TEEx Crd X—XX X
1. Exam type abbreviations are as follows: Abd = Abdomen,
Bre = Breast, Crd = Cardiac, Gyn = Gynecology, IMT =
Intima Media Thickness, Msk = Muscle, Neo = Neonatal,
Nrv = Nerve, OB = Obstetrical, Oph = Ophthalmic, Orb =
Orbital, SmP = Small Parts, Sup = Superficial, TCD =
Transcranial Doppler, Vas = Vascular, Ven = Venous.
2. The optimization settings for 2D are Res, Gen, and Pen.
3. The optimization settings for CPD and Color are low,
medium, and high (flow sensitivity) with a range of PRF
settings for Color depending on the setting selected.
4. For the cardiac exam type, PW TDI is also available. See
“PW Doppler options” on page 29.
Imaging Mode
Transducer
Exam Type1
2D2
M Mode
CPD3
Color3
PW Doppler4
CW Doppler
Chapter 3: Imaging 33
Imaging
Thedefaulthomepositiondependsonthe
imagingscreenlayout.Youcanresetthe
homeposition.See“Toresetthehome
position”onpage 33.
3Usingthekeyboard,typetext.
•Thearrowkeysmovethecursorleft,right,
up,anddown.
•TheDELETEkeydeletesalltext.
•The Wordoptionremovesaword.
•SelectSymbolstoenterspecialcharacters.
See“Symbols”onpage 10.
4(Optional)Toaddapredefinedlabel,select
Label,andthenselectthedesiredlabelgroup:
, , or .Selectthegroupagainfor
thedesiredlabel.
Thefirstnumbershowswhichlabelinthe
groupisselected.Thesecondnumberisthe
numberoflabelsavailable.
See“Annotationssetup”onpage 18.
Toturnofftextentry,presstheTEXTkey.
To reset the home position
1PresstheTEXTkey.
2Usingthetouchpadorarrowkeys,position
thecursorwheredesired.
3SelectHome/Set.
To place an arrow on an image
Youcanaddanarrowgraphictopointouta
specificpartoftheimage.
1PresstheARROWkey.
2Ifyouneedtoadjustthearrowʹsorientation,
presstheSELECTkeyandthenusethe
touchpad.Whentheorientationiscorrect,
presstheSELECTkeyagain.
3Usingthetouchpad,positionthearrowwhere
desired.
4PresstheARROWkeytosetthearrow.
Thearrowchangesfromgreentowhite.
Toremovethearrow,presstheARROWkeyand
thenselectHide.
To place a pictograph on an image
Thepictographsetavailabledependson
transducerandexamtype.
1PressthePICTOkey.
2Select x/xtodisplaythedesired
pictograph,andthenpresstheSELECTkey.
Thefirstnumbershowswhichpictographin
thesetisselected.Thesecondnumberisthe
numberofpictographsavailable.
3Usingthetouchpad,positionthepictograph
marker.
4(Optional)Torotatethepictographmarker,
presstheSELECTkeyandthenusethe
touchpad.
5Selectascreenlocationforthepictograph:U/L
(Up/Left),D/L(Down/Left),D/R
(Down/Right),U/R(Up/Right).
Inaduplexlayout,thepictographisrestricted
toupperleft.InDual,allfourpositionsare
available.
Toremovethepictograph,selectHide.
Patient information form
Thepatientinformationformletsyouenter
patientidentification,exam,andclinical
informationforthepatientexam.This
informationautomaticallyappearsinthepatient
report.
Whenyoucreateanewpatientinformationform,
allimages,clips,andotherdatayousaveduring
theexamarelinkedtothatpatient.(See“Patient
report”onpage 68.)
34 Patient information form
To create a new patient information form
1PressthePATIENTkey.
2SelectNew/End.
3Fillintheformfields.See“Patient
informationformfields”onpage 34.
4SelectDone.
Seealso“Toappendimagesandclipstoapatient
exam”onpage 37.
To edit a patient information form
Youcaneditpatientinformationiftheexamhas
notbeenarchivedorexportedandifthe
informationisnotfromaworklist.
Seealso“Toeditpatientinformationfromthe
patientlist”onpage 36.
1PressthePATIENTkey.
2Makechangesasdesired.
3Selectoneofthefollowing:
•Canceltoundochangesandreturnto
imaging.
•Donetosavechangesandreturnto
imaging.
To end the exam
1Makesurethatyouhavesavedimagesand
otherdatayouwanttokeep.(See“Saving
imagesandclips”onpage 35.)
2PressthePATIENTkey.
3Select New/End.
Anewpatientinformationformappears.
Patient information form fields
Thepatientinformationformfieldsavailable
dependonexamtype.Insomefieldsyoucan
selectSymbolstoentersymbolsandspecial
characters.See“Symbols”onpage 10.
Patient
•Last, First, Middle Patientname
•IDPatientidentificationnumber
•Accession Enternumber,ifapplicable.
•Date of birth
•Gender
•Indications Enterdesiredtext
•UserUserinitials
•Procedure (button)AvailableiftheDICOM
Worklistfeatureislicensedandconfigured.
SeetheDICOMuserguide.
SelectBacktosaveentriesandreturntothe
previousscreen.
Exam
•Type Examtypesavailabledependon
transducer.See“Imagingmodesandexams
availablebytransducer”onpage 31.
•LMP Estab. DD(OBorGynexam)InanOB
exam,selectLMPorEstab. DDandthenenter
eitherthedateofthelastmenstrualperiodor
theestablishedduedate.InaGynexam,enter
thedateofthelastmenstrualperiod.TheLMP
datemustprecedethecurrentsystemdate.
•Twins (OBexam)SelecttheTwinscheckboxto
displayTwin AandTwin Bmeasurementson
thecalculationsmenuandforaccesstoTwin
AandTwinBscreensforpreviousexamdata.
•Previous Exams (button)(OBexam)Displays
fieldsforfivepreviousexams.Thedatefora
previousexammustprecedethecurrent
systemdate.Fortwins,selectTwin A/Bto
togglebetweenTwinAandTwinBscreens.(If
theTwin A/Boptiondoesnotappear,select
Back,andmakesurethattheTwinscheckbox
isselected.)
SelectBacktosavechangesandreturntothe
previousscreen.
•BP(Cardiac,IMT,Orbital,Transcranial,or
Vascularexam)BloodPressure
•HR (Cardiac,Orbital,Transcranial,orVascular
exam)HeartRate.Enterthebeatsperminute.
Chapter 3: Imaging 35
Imaging
Savingtheheartrateusingameasurement
overwritesthisentry.
•Height (Cardiacexam)Thepatientheightin
feetandinchesormetersandcentimeters.(To
changetheunits,see“Presetssetup”on
page 22.)
•Weight (Cardiacexam)Thepatientweightin
poundsorkilos.(Tochangetheunits,see
“Presetssetup”onpage 22.)
•BSA(Cardiacexam)BodySurfaceArea.
Automaticallycalculatedafteryouenter
heightandweight.
•Ethnicity (IMTexam)Ethnicorigin
•Reading Dr.
• Referring Dr.
•Institution
Images and clips
Saving images and clips
Whenyousaveanimageorclip,itsavesto
internalstorage.Thesystembeepsafterwardif
BeepAlertison,andthepercentageiconflashes.
(See“A u d i o , Batterysetup”onpage 19.)Toaccess
savedimagesandclips,openthepatientlist.(See
“Reviewingpatientexams”onpage 36.)
Thepercentageiconinthesystemstatusarea
showsthepercentageofspaceusedininternal
storage.Toreceivealertswhenstorageisnear
capacity,see“Toreceivestoragealerts”on
page 20.
Toaccesssavedimagesandclips,openthe
patientlist.See“Reviewingpatientexams”on
page 36.
To save an image
PresstheSAVEkey.
Theimagesavestointernalstorage.
Bydefault,theSAVEkeysavesonlytheimage.As
ashortcutduringcalculations,theSAVEkeycan
saveboththeimagetointernalstorageandthe
calculationtothepatientreport.See“Presets
setup”onpage 22.
To capture and save a clip
Clips,anoptionalfeature,letsyoucapture,
preview,andsaveclips.
1SetClipsoptions.(See“TosetClipsoptions”
onpage 35.)
2PresstheCLIPkey.
Oneofthefollowingoccurs:
•IfPrev/Offisselected,theclipsaves
directlytointernalstorage.
•IfPrev/Onisselected,theclipplaysback
inpreviewmode.Youcanselectanyofthe
followingon‐screen:
•Aplaybackspeed(1x,1/2x,1/4x)
•Pausetointerruptplayback
•Left: xorRight: xtoremoveframes
fromtheleftorrightsidesoftheclip
(wherexisthebeginningorending
framenumber)
•Savetosavethecliptointernalstorage
•Deletetodeletetheclip
To set Clips options
SettingClipsoptionsensuresthatclipsare
capturedtoyourspecifications.
1In2Dimagingmode,selectClipson‐screen.
2Setoptionsasdesired.
36 Images and clips
Clips options
Reviewing patient exams
Thepatientlistorganizessavedimagesandclips
inpatientexams.Youcandelete,view,print,or
archiveexams.YoucanalsocopythemtoaUSB
storagedevice.
Figure 1 Patient List
To display the patient list
1PresstheREVIEWkey.
2Ifthereisanactiveexam,selectListon‐screen.
To sort the patient list
Afterthesystemstarts,thepatientlistisarranged
bydateandtime,withthemostrecentpatientfile
first.Youcanre‐sortthepatientlistasneeded.
Selectthecolumnheadingthatyouwantto
sortby.Selectitagainifsortinginreverse
order.
Note: Thecolumnheadingisselectable.
To select patients in the patient list
Usingthetouchpad,selectthecheckboxfor
oneormorepatients.
Select Allselectsallpatients.
Todeselectpatients,selectcheckedboxesorClear
All.
To edit patient information from the patient
list
YoucaneditthepatientnameandIDfromthe
patientlistinsteadoffromthepatient
informationformiftheexamhasnotbeen
exportedorarchived.
1Inthepatientlist,selectthepatient.
Time, ECG Time and ECG share the same
location on-screen.
•With Time, capturing is based
on number of seconds. Select
the time duration.
•With ECG, capturing is based
on the number of heart beats.
Select the number of beats.
Preview On,
Preview Off
PrevOn and PrevOff turn the
preview feature on and off.
•With Prev/On, the captured
clip automatically plays
on-screen. The clip can be
trimmed, saved, or deleted.
•With Prev/Off, the clip saves
to internal storage, and the
trim and delete options are
not available.
Prospective,
Retrospective
Pro and Retro determine how
clips are captured:
•With Pro, a clip is captured
prospectively, after you press
the CLIP key.
•With Retro, a clip is captured
retrospectively, from
pre-saved data before you
press the CLIP key.
Caution: If the internal storage icon does not
appear in the system status area,
internal storage may be defective.
Contact SonoSite Technical
Support. (See “SonoSite Technical
Support” on page vii.)
Chapter 3: Imaging 37
Imaging
2SelectEdit.
3Fillintheformfields,andselectOK.
To append images and clips to a patient
exam
Althoughyoucannotaddimagesandclipstoa
patientexamthatisended,exported,orarchived,
youcanautomaticallystartanewpatientexam
thathasthesamepatientinformation.
Dependingonyourarchiver,thetwoexams
appearasonestudywhenexportedorarchived.
1Selecttheexaminthepatientlist.
2SelectAppendon‐screen.
Anewpatientinformationformappears.The
formhasthesameinformationastheexam
youselected.
To review images and clips
Youcanreviewimagesandclipsinonlyone
patientexamatatime.
1Inthepatientlist,highlightthepatientexam
whoseimagesandclipsyouwanttoreview.
2SelectReviewon‐screen.
3Select x/xtocycletotheimageorclipyou
wanttoreview.
4(ClipOnly)SelectPlay.
Theclipplaysautomaticallyafterloading.
Theloadtimedependsoncliplength.
YoucanselectPausetofreezetheclipandcan
selectaplaybackspeed 1x,1/2x,1/4x.
5Selectx/xtocycletothenextimageorclip
youwanttoview.
Toreturntothepatientlist,selectList.Toreturn
toimaging,selectDone.
Printing, exporting, and deleting images
and clips
To print an image
1Verifythataprinterisselected.See“To
configurethesystemforaprinter”on
page 19.
2Dooneofthefollowing:
•Inthepatientlist,reviewthepatient’s
images.SelectPrintwhentheimage
appears.
•Withtheimagedisplayed,presstheA
shortcutkey.
Bydefault,theAshortcutkeyprints.To
reprogramtheAandBshortcutkeys,see
“Presetssetup”onpage 22.
To print multiple images
1Verifythataprinterisselected.See“To
configurethesystemforaprinter”on
page 19.
2Dooneofthefollowing:
•Printallimagesformultiplepatients:
Selectoneormorepatientsinthepatient
list.Thenselect Print.
•Printallimagesforonepatient:Highlight
thepatientinthepatientlist,andthen
selectPrint.
WARNING: To avoid damaging the USB
storage device and losing patient
data from it, observe the following:
• Do not remove the USB storage
device or turn off the ultrasound
system while the system is
exporting.
• Do not bump or otherwise apply
pressure to the USB storage
device while it is in a USB port on
the ultrasound system. The
connector could break.
38 ECG Monitoring
Eachimageappearsbrieflyon‐screen
whileprinting.
To export patient exams to a USB storage
device
AUSBstoragedeviceisfortemporarystorageof
imagesandclips.Patientexamsshouldbe
archivedregularly.Tospecifyfileformat,see
“USBDevicessetup”onpage 23.
1InserttheUSBstoragedevice.
2Inthepatientlist,selectthepatientexamsyou
wanttoexport.
3SelectExp. USB on‐screen.AlistofUSB
devicesappears.
4SelecttheUSBstoragedevice.Ifyouwantto
hidepatientinformation,deselectInclude
patient information on images and clips.
OnlyavailableUSBdevicesareselectable.
5SelectExport.
Thefilesarefinishedexporting
approximatelyfivesecondsaftertheUSB
animationstops.RemovingtheUSBstorage
deviceorturningoffthesystemwhile
exportingmaycauseexportedfilestobe
corruptedorincomplete.Tostopin‐progress
exporting,selectCancel Export.
To delete images and clips
1Selectoneormorepatientsinthepatientlist.
2SelectDeletetodeletetheselectedpatients.A
confirmationscreenappears.
To manually archive images and clips
YoucansendpatientexamstoaDICOMprinter
orarchiver,ortoaPCusingSiteLink.DICOM
andSiteLinkareoptionalfeatures.Formore
informationaboutarchiving,seetheSiteLinkand
DICOMdocumentation.
1Selectoneormorepatientsinthepatientlist.
2SelectArchive.
To display information about a patient exam
1Onthepatientlist,selecttheexam.
2Select Info.
ECG Monitoring
ECGMonitoringisanoptionalfeatureand
requiresaSonoSiteECGcable.
To monitor ECG
1ConnecttheECGcabletotheECGconnector
ontheultrasoundsystem,mini‐dock,or
dockingsystem.
ECGMonitoringturnsonautomatically.
Note: AnexternalECGmonitormaycausealag
inthetimingoftheECGtrace,correspondingwith
the2Dimage.Biopsyguidelinesarenotavailable
whenECGisconnected.
2SelectECGon‐screen.(ECGmaybeonanother
page.ItappearsonlyiftheECGcableis
connected.)
3Selectoptionsasdesired.
WARNING: To prevent misdiagnosis, do not use
the ECG trace to diagnose cardiac
rhythms. The SonoSite ECG option
is a non-diagnostic feature.
To avoid electrical interference with
aircraft systems, do not use the ECG
cable on aircraft. Such interference
may have safety consequences.
Caution: Use only accessories recommended
by SonoSite with the system. Your
system can be damaged by
connecting an accessory not
recommended by SonoSite.
Chapter 3: Imaging 39
Imaging
ECG Monitoring options
Show/Hide Turns on and off ECG trace.
Gain Increases or decreases ECG gain.
Settings are 0-20.
Position Sets the position of the ECG trace.
Sweep Speed Settings are Slow, Med, and Fast.
Delay Displays Line and Save for clip
acquisition delay. (For instructions
to capture clips, see “To capture and
save a clip” on page 35.)
Line The position of the delay line on the
ECG trace. The delay line indicates
where the clip acquisition is
triggered.
Save Saves the current position of the
delay line on the ECG trace. (You
can change the position of the
delay line temporarily. Starting a
new patient information form or
cycling system power reverts the
delay line to the most recently
saved position.)
Select Delay to display these
options.
40 ECG Monitoring
Chapter 4: Measurements and Calculations 41
Measurements
Chapter 4: Measurements and Calculations
Youcanmeasureforquickreference,oryoucan
measurewithinacalculation.Youcanperform
generalcalculationsaswellascalculations
specifictoanexamtype.
Measurementsareperformedonfrozenimages.
Forreferencesused,seeChapter 7,“References.”
Measurements
Youcanperformbasicmeasurementsinany
imagingmodeandcansavetheimagewiththe
measurementsdisplayed.(See“Tosavean
image”onpage 35.)ExceptfortheMModeHR
measurement,theresultsdonotautomatically
savetoacalculationandthepatientreport.Ifyou
prefer,youcanfirstbeginacalculationandthen
measure.See“Performingandsaving
measurementsincalculations”onpage 45.
Someoptionsmaynotapplytoyoursystem.
Optionsavailabledependonyourconfiguration,
transducer,andexamtype.
To save a measurement to a calculation and
patient report
1Withthemeasurementactive(green),press
theCALCSkey.
2Fromthecalculationsmenu,selecta
measurementname.
Onlymeasurementnamesavailableforthe
imagingmodeandexamtypeareselectable.
3Savethecalculation.(See“Tosavea
calculation”onpage 45.)
Tostartacalculationbeforemeasuring,see
“Performingandsavingmeasurementsin
calculations”onpage 45.
Working with calipers
Whenmeasuring,youworkwithcalipers,often
inpairs.Resultsbasedonthecalipers’position
appearatthebottomofthescreen.Theresults
updateasyourepositionthecalipersbyusingthe
touchpad.Intracemeasurements,theresults
appearafteryoucompletethetrace.
Outsideacalculation,youcanaddcalipersby
pressingtheCALIPERkey.Youcanhavemultiple
setsofcalipersandcanswitchfromonesetto
another,repositioningthemasneeded.Eachset
showsthemeasurementresult.Theactive
calipersandmeasurementresultarehighlighted
green.Ameasurementiscompletewhenyou
finishmovingitscalipers.
Withinacalculation,calipersappearwhenyou
selectfromthecalculationsmenu.(See“Toselect
fromthecalculationsmenu”onpage 45.)
Foranaccuratemeasurement,accurate
placementofcalipersisessential.
To switch the active calipers
Dooneofthefollowing:
•Toswitchtheactivecaliperwithinaset,
presstheSELECTkey.
•Toswitchtheactivesetwhenmeasuring
outsideacalculation,selectSwitch
on‐screen.
To delete or edit a measurement
Withthemeasurementactive(highlighted),
dooneofthefollowing:
•Todelete,selectDeleteon‐screen.
•Toedit,usethetouchpadtomovethe
calipers.
Note: Tracemeasurementscannotbeeditedonceset.
42 Measurements
To improve precision of caliper placement
Doanyofthefollowing:
•Adjustthedisplayformaximum
sharpness.
•Useleadingedges(closesttothe
transducer)orbordersforstartingand
stoppingpoints.
• Maintainaconsistenttransducer
orientationforeachtypeofmeasurement.
•Makesurethattheareaofinterestfillsas
muchofthescreenaspossible.
•(2D)Minimizethedepth,orzoom.
2D measurements
Thebasicmeasurementsthatyoucanperformin
2Dimagingareasfollows:
•Distanceincm
•Areaincm2
• Circumferenceincm
Youcanalsomeasureareaorcircumferenceby
tracingmanually.
Figure 1 2D image with two distance and one
circumference measurement
Youcanperformacombinationofdistance,area,
circumference,andmanualtracemeasurements
atonetime.Thetotalnumberpossibledepends
ontheirorderandtype.
To measure distance (2D)
Youcanperformuptoeightdistance
measurementsona2Dimage.
1Onafrozen2Dimage,presstheCALIPERkey.
Apairofcalipersappears,connectedbya
dottedline.
2Usingthetouchpad,positionthefirstcaliper,
andthenpresstheSELECTkey.
Theothercaliperbecomesactive.
3Usingthetouchpad,positiontheothercaliper.
Ifyoumovethecalipersclosetogether,they
shrinkandthedottedlinedisappears.
See“Tosaveameasurementtoacalculationand
patientreport”onpage 41.
To measure area or circumference (2D)
1Onafrozen2Dimage,presstheCALIPERkey.
2SelectEllipseon‐screen.
Note: Ifyouexceedtheallowednumberof
measurements,Ellipseisnotavailable.
3Usethetouchpadtoadjustthesizeand
positionoftheellipse.TheSELECTkeytoggles
betweenpositionandsize.
See“Tosaveameasurementtoacalculationand
patientreport”onpage 41.
To trace manually (2D)
1Onafrozen2Dimage,presstheCALIPERkey.
2SelectManualon‐screen.
Note: Ifyouexceedtheallowednumberof
measurements,Manualisnotavailable.
3Usingthetouchpad,positionthecaliper
whereyouwanttobegin.
Chapter 4: Measurements and Calculations 43
Measurements
4PresstheSELECTkey.
5Usingthetouchpad,completethetrace,and
presstheSETkey.
See“Tosaveameasurementtoacalculationand
patientreport”onpage 41.
M Mode measurements
Thebasicmeasurementsthatyoucanperformin
MModeimagingareasfollows:
•Distanceincm/Timeinseconds
•HeartRate(HR)inbeatsperminute(bpm)
Thetimescaleabovethetracehassmallmarksat
200 msintervalsandlargemarksatone‐second
intervals.
To measure distance (M Mode)
Youcanperformuptofourdistance
measurementsonanimage.
1OnafrozenMModetrace,presstheCALIPER
key.
Asinglecaliperappears.
2Usingthetouchpad,positionthecaliper.
3PresstheSELECTkeytodisplaythesecond
caliper.
4Usingthetouchpad,positionthesecond
caliper.
See“Tosaveameasurementtoacalculationand
patientreport”onpage 41.
To measure heart rate (M Mode)
1OnafrozenMModetrace,presstheCALIPER
key.
2SelectHRon‐screen.
Averticalcaliperappears.
3Usingthetouchpad,positionthevertical
caliperatthepeakoftheheartbeat.
4PresstheSELECTkey.
Asecondverticalcaliperappears.
5Usingthetouchpad,positionthesecond
verticalcaliperatthepeakofthenext
heartbeat.
See“Tosaveameasurementtoacalculationand
patientreport”onpage 41.Savingtheheartrate
measurementtothepatientreportoverwrites
anyheartrateenteredonthepatientinformation
form.
Seealso“Tomeasurefetalheartrate(MMode)”
onpage 63.
Doppler measurements
Thebasicmeasurementsthatyoucanperformin
DopplerimagingareVelocity(cm/s),Pressure
Gradient,ElapsedTime,+/xRatio,Resistive
Index (RI),andAcceleration.Youcanalsotrace
manuallyorautomatically.
ForDopplermeasurements,theDopplerscale
mustbesettocm/s.See“Presetssetup”on
page 22.
To measure Velocity (cm/s) and Pressure
Gradient (Doppler)
1OnafrozenDopplerspectraltrace,pressthe
CALIPERkey.
Asinglecaliperappears.
2Usingthetouchpad,positionthecalipertoa
peakvelocitywaveform.
Thismeasurementinvolvesasinglecaliperfrom
thebaseline.
See“Tosaveameasurementtoacalculationand
patientreport”onpage 41.
44 Measurements
To measure Velocities, Elapsed Time, +/x
Ratio, Resistive Index (RI), and Acceleration
(Doppler)
1OnafrozenDopplerspectraltrace,pressthe
CALIPERkey.
Asinglecaliperappears.
2Usingthetouchpad,positionthecalipertoa
peaksystolicwaveform.
3PresstheSELECTkey.
Asecondcaliperappears.
4Usingthetouchpad,positionthesecond
caliperattheenddiastoleonthewaveform.
See“Tosaveameasurementtoacalculationand
patientreport”onpage 41.
To measure time duration (Doppler)
1