SECTION 4
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Attending physician: enter attending physician if desired. Press TAB.
History: selecting Yes, No, or Unknown will enter the patient’s history into the summary portion of the
report. If no selection is made, X-Scribe will default entry to Unknown. Press TAB.
Indications: enter indications for the test or select from the drop-down menu. Press TAB.
Medications: enter medications and dosages or other medication-related comments, or select from the
drop-down menu. Press TAB.
Notes: additional comments such as billing codes, etc., may be entered or selected from the acronyms list.
For automated entry of the data an acronym must be preceded with a forward slash (/) before the entry.
For example “/wnl” followed by the space bar will enter “Normal Cardiac Exercise Stress Test”.
Exit by clicking OK.
Select Begin to begin the Learn phase. The X-Scribe acquires ECG data to develop the patient's cardiac template
and uses the template for arrhythmia detection. Once the Learn mode is completed, the Pre-exercise phase will
begin. The phase time clock starts and the HR and ST level for the expanded lead displays along with the expanded
average complex.
Pre-Exercise Phase
During the Pre-exercise phase, the user should:
1. Enter the patient's baseline BP.
Entry of three characters in the systolic field automatically advances the cursor to the diastolic field.
An automatic timestamp as to when the NIBP was entered will appear below the diastolic pressure.
2. Obtain event documentation (i.e., supine, standing, and hyperventilation 12-lead ECGs) as desired.
The pre-exercise 12-lead ECG will be presented in the final report without the interpretation.
3. Instruct patient on the proper technique for using the exercise equipment.
4. If desired, change the exercise profile display options by selecting Format and selecting the desired
display options.
Acquiring a Resting ECG
X- Scribe allows for the acquisition and printing of a 12-lead resting ECG while the patient is in a supine position.
Include interpretation in the Pre-exercise phase of the exam only by using the Event menu or F4. The physician
may also acquire a Mason-Likar hookup if desired as a baseline for comparison throughout the test.
1. Have the patient resting on a bed or exam table. If the exam table is narrow, tuck the patient’s hands
under his/her buttocks to ensure their muscles are relaxed. Click on EVENT, select SUPINE, and then
click OK.
2. After a few seconds, X-Scribe will print a full 12-lead resting ECG to include measurements and
interpretation text if so selected. The printout format will be the one defined in the user profile.
3. Ask the patient to stand up and move to the treadmill or ergometer. You may need to reposition the
electrodes depending upon the 12-lead ECG acquired: supine or Mason-Likar.
Prior to starting the exercise portion of the test, the ECG template must be re-learned while the patient is in the
standing position to avoid ECG template differences caused by postural changes. Select ST LEAD or F8, then
MANUAL AVG/RELEARN. The process takes approximately thirty-five seconds.
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