Unique cfm Quick Set-up Guide Prior to operation: Refer to Instructions for Use. You will need: PC / Monitor (running Windows XP or 7 software) Unique CFM Headbox Electrodes (choice of Needle or Hydrogel) Optional: USB Video camera Skin Preparation Gel such as Nu-Prep (for use with Hydrogel electrodes) Adhesive tape (for use with Needle electrodes) SETUP AND RECORD Plug the PC / Monitor cable cord in to the rear socket and connect to the mains electricity, and turn on. Turn on CFM amplifier module. Note: Monitor and amplifier module will pair automatically via Bluetooth. A low beep will confirm pairing. If pairing is not established refer to the user manual. Check battery power level on amplifier module is adequate, plug in to the mains supply to charge if required. Clip the selected headbox in to the amplifier module. Connect electrodes to patient (see Electrode Placement section for correct placement). Connect electrodes to the headbox by pushing them all the way down to the hub. Press New Patient button on screen. NEW PATIENT Note: If entering a new patient enter the relevant information. (Minimum information: Patient Identification Number) using the onscreen keyboard. Click on Append Record to continue recording on an existing patient file. Select OK to enter Preview mode. Note: In Preview you can run an impendence check to test the electrode connection. Click on IMP. Click on Record button to start recording. APPEND RECORD TREATMENT GUIDE aEEG (amplitude integrated electroencephalography) provides a trend over time of the electrocortical background activity of the brain. Unique CFM displays the aEEG. Below is a basic interpretation guide for aEEG traces. Normal Moderately abnormal ONSCREEN TOUCH NAVIGATION In Record Adjust EEG and aEEG scale using the scroll keys on the left panel. Enter a predefined marker. Free text marker. Resize Screen, useful if using the multipatient mode. Alarm Silencer, for high impedance and high aEEG amplitude. Drop in a marker with no description. Switch between CSA and DSA. REVIEW Click to review patient data. PAUSE Pause recording to return to Preview mode. aEEG (CFM) will show an Upper Margin of >10 µvolts and a Lower Margin >5µvolts. aEEG is characterized by Sleep/Wake cycles. aEEG (CFM) will show an Upper Margin of >10 µvolts and a Lower Margin <5µvolts and is characterized by an increase in inconsistent erratic activity. No Sleep/Wake Cycles in aEEG (CFM). Severely abnormal Seizures In Review Page through the raw EEG trace. Scroll through the aEEG using the page and scroll bar. Create an online word report. To view all entered markers. Click on a specific marker to be taken to the correct part in the recording. aEEG (CFM) will show an Upper Margin of <10 µvolts and is characterized by a reduction of activity. aEEG (CFM) shows the injured brain has increased continuous high activity. No Sleep/Wake Cycles in aEEG (CFM). EEG is predictable and consistent. aEEG (CFM) to narrow and rise up. Greatly reduced variability. Burst suppression EEG is synchronised with the aEEG recording and is displayed onscreen. SHUT DOWN When monitoring is no longer required: Press “Quit” button on screen to stop recording and return to the master menu. QUIT Files can be archived to USB Stick or to CD. Select “Flash Stick” or Archive from the master menu to save the data. Pattern of high amplitude EEG activity interrupted by relatively low amplitude activity. Quit the master menu and shut down the computer through windows. Turn off the Unique CFM amplifier using the on/off switch. Remove electrodes from headbox. Unique CFM can now be removed from the clinical area. Amplifier and headbox can be wiped down with alcohol wipes as appropriate. Needles and Hydrogel electrodes should be removed carefully from the patient and disposed of appropriately. Spectral Arrays (DSA/CSA) can be displayed onscreen this is also synchronised with the aEEG and EEG. This is a function of Frequency rather than amplitude and can give further diagnosis and interpretation of artefact. Cool Colours indicate less dominant frequencies. Warm Colours indicate more dominant frequencies. ELECTRODE PLACEMENT Number of electrodes will vary from 3 – 5, dependant on the headbox chosen and aEEG channels to be displayed. 3 Electrodes for Single Channel recording P3 P4 P3 P4 Ground (Black) electrode placed in midline in front of the fontanel. Reference (Red) and Active (Yellow) electrodes placed bi-parietal, 75mm apart evenly spaced from midline P3/P4. 4 Electrodes for Dual Channel & Unipolar recording P3 P4 Ground (Black) electrode placed in midline in front of the fontanel (or shoulder). Reference (Red) electrode should be placed in midline in front of the fontanel. Active (Yellow) electrodes placed bi-parietal, 75mm apart evenly spaced from midline P3/P4. 5 Electrodes for Dual Channel & Unipolar recording C3 P3 C4 P4 Ground (Black) electrode placed in midline front of the fontanel (or shoulder) Reference (Red) electrodes placed bi-parietal, 75mm apart evenly spaced from midline C3/C4. Active (Yellow) bi-parietal, 75mm apart evenly spaced from midline P3/P4. Note: In all positions if hair or Oedema does not allow for bi-parietal placement, bi-temporal placement can be used. If needle electrodes are to be used, they should be placed superficially and secured with tape. If hydrogel electrodes are to be used, the skin should be clean, dry and prepared with Nu-Prep to remove dead skin etc. ECG Placement ECG can be measured using the dual channel style headboxes. Place Active (Yellow) and Reference (Red) electrodes in the appropriate position. Ground electrode is already sited for aEEG. 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