Vicorder Manual

VICORDER
Instructions
for Use
English Language Version
Also applicable to the DopStudio
Version 6.6
Authorised :
Prof. R Skidmore
Managing Director
© Skidmore Medical Limited 2009

Skidmore Medical Limited, 1 The Old Estate Yard Office, North Stoke Lane, Upton Cheyney, Bristol, BS30 6NG, UK
The information contained herein is the property of Skidmore Medical Limited and is supplied without liability for errors or
omissions. No part may be reproduced or used except as authorised by contract or other written permission. The copyright and the
foregoing restriction on reproduction and use extend to all media in which this information may be embodied.
All trademarks are acknowledged of their respective owners.
CHAPTER 1 THE VICORDER
CONTENTS
Chapter Content Section
Front sheet
1 The Vicorder
Introduction 1.1
Safety Considerations 1.2
Package Contents 1.3
Minimum System Requirements 1.4
Installation and Setup 1.5
Launching the Vicorder Application 1.6
Cleaning, Calibration and Service 1.7
Compliance Information 1.8
Helpline 1.9
Technical Specification 1.10
2 Getting Started
The Administration screen 2.1
Drop down menus 2.2
Patients and Exams 2.3
The Report Page 2.4
Test Protocols Available 2.5
Protocol Modalities Available 2.6
3 Doppler Measurement
Real Time Doppler Measurement 3.1
Quick Launch Doppler Measurement 3.2
Doppler Pressure Measurement 3.3
4 PVR Measurement
Unilateral PVR Measurement 4.1
Bilateral PVR Measurement 4.2
Quick Launch PVR Measurement 4.3
5 PPG Measurement
Unilateral PPG Measurement 5.1
Bilateral PPG Measurement 5.2
Quick Launch PPG Measurement 5.3
Unilateral PPG Pressure Measurement 5.4
Bilateral PPG Pressure Measurement 5.5
6 Pulse Wave Velocity
Introduction 6.1
Single Segment Measurement 6.2
Whole Body Measurement 6.3
Aortic Measurement using the Neckpad 6.4
ABI Measurement 6.5
7 Pulse Wave Analysis
Introduction 7.1
PWV Mode 7.2
PWA Mode 7.3
8 ABI / TBI
ABI / TBI 8.1
9 Carotid
Carotid Measurement 9.1
10 Lower Arterial Stress Test
Lower Arterial Stress Test 10.1
11 Venous Tests
Venous Outflow Test 11.1
Venous Reflux Test 11.2
Quick Launch Outflow Test 11.3
Quick Launch Reflux Test 11.4
12 Generic Protocol Editor
Generic Protocol Editor 12.1
13 The Completed Report
The Completed Report Page 13.1
The Printed Report 13.2
Retrieving Patient Reports 13.3
Chapter 1 (V6.6) Vicorder Instructions for Use Page 2 of 78

1.1 INTRODUCTION
The Vicorder
The Vicorder instrument is a Medical Device

intended for the investigation of vascular
disorders by allowing a simple to operate
handheld box to be used with common Laptop
PC’s via a USB link. The Laptop will run the
Vicorder software.
The Vicorder provides two blood pressure

measurement channels and two
Photoplethysmography (PPG) channels for the
measurement of blood flow. There is also
provision for a stereo audio input for connection
of a proprietary instrument such as a Doppler
Ultrasound Probe.
All immediate functional controls are available

as buttons on the instrument case to provide a
powerful easy to use package which is light in
weight and can therefore be easily transported.
Various haemodynamic parameters may be measured by using one of the many Protocols available. The reports
may be stored, printed or electronically communicated. The stored reports may also be reviewed and manipulated
post Patient examination without the Vicorder being present.
The Vicorder is intended to run under the control of the Vicorder software and is run from a User supplied Laptop
PC via a USB link. The Laptop USB link also provides power to the Vicorder.
A Vicorder may be used with any Laptop PC (see Section 1.4 Minimum System Requirements) which is Vicorder
software enabled.
Features
 Sophisticated multi-protocol software package.
 Seven top panel buttons for User “immediate” controls.
 Two front panel PPG sockets to connect to PPG sensors.
 Two front panel Pressure connectors to connect to proprietary blood pressure cuffs via pneumatic hoses.
 Front panel power on LED.
 Rear panel USB cable connection via an 8 way connector.
 Rear panel Stereo Audio input via an RJ11 connector.
 The Vicorder draws its power requirements from the Laptop USB 5V DC supply.
Applicability
Note 1
These Instructions for Use are applicable to :
 Vicorder Serial number : 0100 and up

 Software version : 3.2.3336 and up
Note 1
Certain Protocols require licensing for use with your Vicorder, contact the Factory using one of the methods
given in Section 1.9 Helpline.
USA only
The Vicorder is a prescription device, Federal law restricts it to use by, or on the order of a physician.
DopStudio
The host Laptop should meet the minimum requirements of section 1.4 and leakage requirements in section 1.2
The Patient environment.
Chapter 2 Getting Started and Chapter 3 Doppler Measurement apply to the use of DopStudio.

1.2 SAFETY CONSIDERATIONS
The Patient environment
Observe National or local regulations regarding the use of Laptop PC’s in the Patient environment.
The Laptop PC - Vicorder should meet the leakage requirements stated in IEC 60601-1:2005 section 8 or the
Laptop PC should be powered via a medical grade isolation transformer meeting the leakage requirements.
Warnings or contra-indications
 The purpose and method of the Protocol should be explained to the Patient.
 When using the Neckpad or other cuffs the Patient should be advised that a mild pressure will be felt when
they are inflated.
 There are no other special pre-warnings or contra-indications which need Patient explanation.
Pressure settings
 The Pressure screens have a preset pressure included, Users may alter this at their discretion.
 The pressure is adjustable in 5mmHg steps.
 The maximum settable pressure is 280mmHg.
 The minimum settable pressure is 20mmHg.
 There is precautionary software overpressure protection, in the event of operation a warning message is
displayed.
 There is further hardware overpressure protection, if this operates the Vicorder system will be locked out and
it will be necessary to close and restart the Vicorder software.
 On operation of either overpressure device the cuffs will automatically deflate and the pump will stop.
 If the cuffs do not automatically deflate unplug the pneumatic cuff connectors.
 If either overpressure device operates and there is not an obvious reason it is advisable to have the equipment
examined, see Section 1.7 Cleaning, Calibration and Service.
Safe use of Ultrasound

Although the Vicorder exerts no controlling influence over Ultrasound levels Users are reminded when using
Doppler Ultrasound monitoring equipment plugged into the Auxiliary Stereo input to follow the ALARP (As Low As
Reasonably Practicable) principle for Ultrasound exposure.
Natural Rubber Latex

The cuffs supplied do not contain natural rubber latex.
Other commercially available cuffs may use Latex in their construction which may cause allergic reactions.
Explanation of Vicorder symbols
Caution! See Instructions for Use before connecting and using the Vicorder.
Consult instructions for use.
Type B Applied Part, meets allowable Patient leakage and auxiliary current limits.
Universal Serial Bus (USB) connection.
Auxiliary Audio input, see Section 1.5 Installation and Setup.
Accessories
With the exception of an external Audio device only accessories approved by Skidmore Medical Limited for use with
the Vicorder should be used. The use of non-approved accessories or an external Audio device operating outside
the stated specification will void the Warranty.
Skidmore Medical Limited cannot be held responsible for any problems caused through the use of non-approved
accessories.

1.3 PACKAGE CONTENTS
Hardware
Dependant on order the package content and quantities should be made up from some or all of the following :
Quantity Accessory
1 Vicorder Instrument
6 Size 10 Pressure cuffs
2 Disposable DP2.5 Pressure cuffs
2 TMC7 Pressure cuffs
2 Velcro Neckband
1 5MHz Doppler probe
1 8MHz Doppler probe
1 Lead (for use with the 5 and 8MHz Doppler probes)
1 PPG sensor, red
1 PPG sensor, blue
2 PPG caps
2 PPG Perspex clips
2 PPG Venous holder
40 Adhesive rings
1 Pressure hose, red
1 Pressure hose, blue
1 USB lead, 8 way to twin USB A types
1 Vicorder software and drivers on CD
1 Instructions for Use (included on the CD in .pdf)
1 Instructions for Use, paper copy
All of the above have been validated for use with the Vicorder.
You will need

Laptop or PC meeting the Minimum System Requirements given in Section 1.4 Minimum System Requirements.

1.4 MINIMUM SYSTEM REQUIREMENTS
The minimum system requirements to run the Vicorder software satisfactorily are :
Windows 2000 with SP2 or higher

Windows XP with SP1 or higher :
 Computer : 1∙2GHz Intel Pentium 4 or AMD equivalent processor.
 Memory : The Vicorder software requires 256 MB of RAM.
 Controls : Keyboard and mouse.
 Drives : Hard drive with 100 MB of free space, a 4x or faster CD-ROM drive
are required for installation.
 Video : DirectX 9.0c-compatible 64 MB video card.
 DirectX : DirectX version 9.0c or higher.
 Sound : 16-bit sound device.
 Internet (suggested) : Broadband at >2MB/sec (for web based downloads and data transfers)
Recommended System Requirements :

 Computer : 1∙7GHz Intel Pentium 4 or AMD equivalent processor or better.
 Memory : 512 MB of RAM.
Vista :
 Computer : 2∙0GHz Intel Pentium 4 or AMD equivalent processor.
 Memory : The Vicorder software requires 512 MB of RAM.
 Controls : Keyboard and mouse.
 Drives : Hard drive with 100 MB of free space, a 4x or faster CD-ROM drive
are required for installation.
 DirectX : DirectX version 9.0c or higher.
 Internet (suggested) : Broadband at >2MB/sec (for web based downloads and data transfers)
Recommended System Requirements :

 Computer : 2∙0GHz Intel Pentium 4 or AMD equivalent processor or better.
 Memory : 1GB of RAM.
Notes :
If your Laptop or PC has the minimum memory size fitted it is recommended that prior to running the Vicorder
software any other open applications are closed otherwise some display latency may be observed.
If you intend to use an Operating System not mentioned above or if your Laptop PC does not meet the minimum
requirements please contact us regarding suitability using one of the methods outlined in Section 1.9 Helpline.
Important : Do not connect the Vicorder to your Laptop PC via a hub.

1.5 INSTALLATION AND SETUP
The Vicorder
Vicorder Top, Front and Rear Panel User functions
Left
Up
Escape
Down Right
Space
Enter
Left channel :
Pressure connector PRESS1
PPG connector PPG1
Right channel :
PPG connector PPG2 Power LED
Pressure connector PRESS2
USB input Auxiliary Stereo input
Connecting the Vicorder :

1. Plug the USB Cable bifurcated ends into any two free USB ports on your Laptop or PC.
Important : Do not connect the Vicorder to your Laptop or PC via a hub.
2. Plug the other end of the USB cable into the 8 way socket on the rear panel of the Vicorder. After a short
pause the blue power LED on the front panel will light.
3. Connect the 2 colour coded pneumatic hoses to PRESS1 and PRESS2 on the Vicorder front panel.
4. Connect the 2 colour coded PPG connectors to PPG1 and PPG2 on the Vicorder front panel.
5. The Auxiliary Stereo input on the rear panel enables an external audio device to be connected, this device may
also be powered from the Vicorder (see below).
Auxiliary Stereo socket connections and basic specification :

Type RJ11, 4 pin :
Pin 1 Right audio input } sensitivity 100mV
Pin 3 Left audio input } bandwidth 240 to 7500Hz (-3dB)
Pin 2 Ground
Pin 4 6∙5V DC output 75mA maximum current

Note : familiarity with a Windows type operating environment is assumed throughout these Instructions for Use.
Vicorder Program Installation

Note : Patient Files are not overwritten during Program installation or upgrade but as a precaution it is
recommended that any existing Patient Files are backed up to a secure source prior to Program installation.
Any previously installed version of the Vicorder software will be overwritten (excluding Patient Files).
If installing over an older version

Back up any existing Patient Files. If you have previously used the default install setup then your data files will be
found in :
C:/Program Files/Skidmore Medical/DopStudio/Data
The entire data folder contents may be saved, copied and pasted into your new setup if required.
The installation process will automatically uninstall a previous version (excluding Patient Files), you may also
accomplish this manually using the “Add/remove software” tool in the Control Panel if desired.
Note : the Vicorder does not need to be present for Program installation to your Laptop PC.
If installing from new

Simply follow the instructions for the Web or CD based version below as appropriate.
Web based version

1. Full instructions are included as part of the download. The installation only takes a few minutes,
dependent on the Web data transfer rate.
2. Follow the on-screen prompts, during installation you will be asked to make selections or to input
information, defaults are provided in some cases which can be accepted or changed as required.
CD based version
1. Close any open applications. Place the CD in the CD drive and close the tray, the system will auto start the
CD load. The installation only takes a few minutes.
2. Follow the on-screen prompts, during installation you will be asked to make selections or to input
information, defaults are provided in some cases which can be accepted or changed as required.
Both versions
This box will be displayed on successful installation of the
Vicorder software application. If you want the application to run
now check the Run Vicorder now box and click on Finish. If you
want to run the application later leave the Run Vicorder now box
unchecked and click on Finish.
To subsequently launch the Vicorder application see Section 1.6

Launching the Vicorder Application.
Vicorder icon
A Vicorder icon will automatically be placed in the Control Panel
screen.
It is recommended that your computer is backed up to a secure source on a regular basis.

1.6 LAUNCHING THE VICORDER APPLICATION
Vicorder Application activation
The Vicorder software application may be activated by double clicking on the Vicorder icon in the
Control Panel or by launching it from the Start menu.
The software version is given in the start up flash screen if required.
The Vicorder software application may also be activated without the Vicorder present, this will
allow file examination and manipulation.
Vicorder initialisation
The application will test the USB serial communications and display a
brief message if satisfactory. This will be followed by the system
exercising the Vicorder pneumatic valves which will be heard to click. On
completion the system will display the Administration window.
If communications are not satisfactory the system will still proceed to the
Administration window, this will allow file examination and manipulation
but it will not be possible to use the Vicorder for examinations.
If you experience a communication failure try disconnecting and

reconnecting the Vicorder USB lead then re-launching the application. If
this fails see Section 1.9 Helpline for Service and Factory contact details.
Vicorder Serial Number

On first start up after delivery you may be asked to enter and
verify the Serial Number of your Vicorder here followed by OK.
The serial number is found on the label on the underside of the
Vicorder, enter the complete number e.g. 0114 (it is not CE
0120!)
This will be followed by a check of the License status of your

Vicorder which takes a few moments to complete.
Initial Audio setup

For Vista Users setup is included in Chapter 2 Getting
Started, Section 2, under the Help drop down menu.
For non-Vista Users on first start up or after changing

the audio device the Setup Speakers audio configuration
dialogue box will appear. Before proceeding ensure the
sound on your Laptop is enabled and the volume level is
set at approximately mid scale.
Select Test Speaker and follow the on screen

instructions.
The Volume setting is User settable from within the

relevant Protocol acquire screens, no further setting via
your Laptop control is necessary. Note that your Laptop
sound must remain enabled.
This screen will not be displayed again on start up

unless a change is made to the audio settings or the
Vicorder is not present at launch.
Headphones or External speakers may be used, consult

your Laptop User Manual.

The Administration window
The Administration window will appear similar
to the opposite. For a new installation there will
be no Patient data, Exams or user defined
Protocols present. If the installation is an
upgrade, as in this example, these data will be
available from the previous application.
If the software application has been activated

without the Vicorder present the Administration
window will appear the same.
The Protocols discussed in the remainder of

these Instructions for Use assume a Vicorder is
connected.
Screen data cautionary notes

The recorded data used in the screen shots throughout these Instructions for Use is for illustration purposes only
and is not necessarily indicative of what might be expected under examination conditions.
The Vicorder does not perform a diagnostic function, the data presented is for interpretation by the Clinician.
It is recommended that your computer is backed up to a secure source on a regular basis.
Helpline
Section 1.9 has Helpline contact information.
Getting Started
You are now ready to start using your Vicorder as described in Chapter 2 Getting Started but before doing so
please take a few moments to familiarise yourself with the remaining Sections of this Chapter.

1.7 CLEANING, CALIBRATION AND SERVICE
Cleaning
 Cleaning of the Vicorder, its components and leads should only be undertaken by wiping with a soft cloth
moistened with a mild soap or antiseptic solution.
 Do not immerse the Vicorder, its components or leads.
 Do not use alcohol, solvents or abrasive cleaners.
 The Vicorder, its components and leads are not intended to be sterilised.
Calibration
The Vicorder requires periodic calibration of its pressure channels to maintain optimum accuracy, Skidmore Medical
recommend that this is carried out at 6 monthly intervals. The procedure can easily be accomplished at the point of
use and should take no more than a few minutes. The Vicorder does not need to be opened and no adjustment
tools are required, the calibration values are automatically stored in the Vicorder. The Vicorder is therefore
independent of which Laptop PC it is used with.
Required equipment :
A hand inflator connected to a Manometer and 2 way manifold. Both channels are calibrated in parallel.
Procedure :
Start the Vicorder software and launch any Default Protocol from the Exam list in the Administration window.
Enter Calibration mode by typing Ctrl+C and click on Calibrate.
This caution message is displayed before starting, click Yes.
Disconnect all tubes from the Vicorder to calibrate the pressure zero,
ensure still air near the Vicorder, click OK.
Connect the hand inflator, Manometer and 2 way manifold and inflate to
165mmHg :
(Sphygmo)Manometer
PRESS1
VICORDER
PRESS2
Hand inflator
This message is displayed on satisfactory calibration, click OK and close the

Calibration window. Disconnect the equipment.
If the system cannot calibrate for any reason this error message is displayed.
If there is no obvious reason contact the factory using one of the methods given
in Section 1.9 Helpline for advice.

Service
There are no User adjustable or serviceable parts inside the Vicorder or its components. In the event of difficulty
contact Skidmore Medical Limited, using one of the methods given in Section 1.9 Helpline, to be advised of our
Servicing arrangements. Non-UK repairs should be routed through your Local Distributor.
Please have available the Serial Number of your Vicorder which is found on the label on its underside (not CE
0120!) and the version of software installed, available by clicking on About in the Help drop down window in the
Administration screen :

1.8 COMPLIANCE INFORMATION
Quality System The Vicorder is designed and manufactured at our Bristol facility, which is approved by
SGS UK Ltd. to the following Standards :
ISO 9001:2008 Certificate number GB06/67764

ISO 13485:2003 Certificate number GB06/67766
CE mark Examined by SGS UK Ltd., Notified Body number 0120. The Vicorder is a Class IIa device
per Rule 10 of the Medical Devices Directive 93/42/EEC (amended by 2007/47/EC) :
Certificate number GB06/67765
FDA approval 510(k) K071730
Device Listing
Number D051259
Declaration of
Conformity ISO/IEC 17050-1 Number DSVI/05 (Copy available on request)
Safety and IEC 60601-1:2005

essential plus Corrigendum 1
performance and Corrigendum 2 Report number 101753268LHD-001
EMC EN 60601-1-2:2007 Certificate number TRA-008613-36-01A.
RoHS 2001/95/EC The Vicorder meets the requirements of this Directive.
Disposal 2002/96/EC WEEE for EU Member Countries, to be disposed of in accordance

with the Directive or by returning it to us at the address given
in Section 1.9 Helpline.
Elsewhere in accordance with local regulations.
Otherwise with consideration for the environment.
BS EN 60601-1-2 Tables are on page 13
EMC note
In order to maintain the Vicorder EMC performance only cables in good order should be connected with all screens
and grounds intact.
If difficulty with mutual interference is experienced when using the Vicorder near adjacent equipment try
repositioning the Vicorder or the adjacent equipment, moving leads or shortening them by coiling excess length.
The Vicorder is not intended to be opened by the User, service is by return to Skidmore Medical Limited. If the case
is opened maintain its EMC integrity on closure by ensuring that all existing internal connections are maintained
and all case securing screws are reinstated and fully tightened.

BS EN 60601-1-2 Tables
Table 1 Guidance and manufacturers declaration - electromagnetic emissions

The Vicorder is intended for use in the electromagnetic environment specified below. The Customer or User of the Vicorder
should assure that it is used in such an environment.
Emission test Compliance Electromagnetic environment - guidance
RF emissions Group 1 The Vicorder uses RF energy only for its internal function. Therefore, its RF
CISPR 11 emissions are very low and are not likely to cause any interference in
nearby electronic equipment.
RF emissions Class B The Vicorder uses RF energy only for its internal function. Therefore, its RF
CISPR 11 emissions are very low and are not likely to cause any interference in
nearby electronic equipment.
Harmonic emissions Not applicable
IEC 61000-3-2
Voltage fluctuations / Not applicable
flicker emissions
IEC 61000-3-3
The Vicorder is suitable for use in all establishments, including domestic establishments and those directly connected to the
public low-voltage power supply network that supplies buildings used for domestic purposes.
Table 2 Guidance and manufacturers declaration - electromagnetic immunity
Immunity test IEC 60601 test level Compliance level Electromagnetic environment - guidance
Electrostatic discharge ±6kV contact Pass Floors should be wood, concrete or ceramic tile. If
IEC 61000-4-2 ±8kV air floors are covered with synthetic material, the
relative humidity should be at least 30%.
Electrical fast ±2kV for power supply Pass Mains power quality should be that of a typical
transient/burst lines commercial or hospital environment.
IEC 61000-4-4 ±1kV for input/output
lines
Surge ±1kV line to line Dependant on Laptop Mains power quality should be that of a typical
IEC 60601-4-5 ±2kV line to earth PC specification. commercial or hospital environment.
Voltage dips, short 95% dip for 0.5 cycle Laptop PC has battery Mains power quality should be that of a typical
interruptions and 60% dip for 5 cycles backup. commercial or hospital environment. If the user of
voltage variations on 30% dip for 25 cycles the Vicorder requires continued operation during
power supply input >95% dip for 5 sec mains interruptions, it is recommended that the
lines Vicorder be powered from an uninterruptible
IEC 61000-4-11 power supply or via the Laptop PC battery.
Power frequency 3A/m Dependant on Laptop Mains power quality should be that of a typical
(50/60Hz) magnetic PC specification. commercial or hospital environment.
field
IEC 61000-4-8
Table 4 Guidance and manufacturers declaration - electromagnetic immunity
Immunity test IEC 60601 test level Compliance level Electromagnetic environment - guidance
For use in a typical hospital or clinic environment.
For use in a typical hospital or clinic environment.
Table 6 Recommended separation distances between portable and mobile RF communications
equipment and the Vicorder
The Vicorder is intended for use in the electromagnetic environment in which radiated RF disturbances are controlled. The
customer or user of the Vicorder can help prevent electromagnetic interference by maintaining a minimum distance between
portable and mobile RF communications equipment (transmitters) and the Vicorder as recommended below, according to the
maximum output power of the communications equipment.
Rated maximum output Separation distance according to frequency of transmitter
power of transmitter W 150kHz to 80MHz 80MHz to 800MHz 800MHz to 2.5GHz
0.01 >2m >2m >2m
0.1 >2m >2m >2m
1 >2m >2m >2m
These guidelines may not apply in all situations. Electromagnetic propagation is affected by absorption and reflection from
structures, objects and people.

1.9 HELPLINE
Contacting us
In the event of difficulty or query please contact :
Skidmore Medical Limited Office hours : 07:30 to 15:30 (UK time)

1 The Old Estate Yard Office
North Stoke Lane Tel : +44 (0)1179 324 612
Upton Cheyney Fax : +44 (0)1179 323 943
Bristol
BS30 6NG e-mail : enquiries@skidmoremedical.com
UK Website : www.skidmoremedical.com
Non-UK repairs should be routed through your Local Distributor.
Continuous improvement
Skidmore Medical Limited has a policy of continuous improvement to its products and we reserve the right to make
changes without prior notice.
Feedback
We welcome your feedback, both positive and negative, on any aspect of this product or if you have any
suggestions for improvement. Please feel free to contact us using one of the methods given above.
Environmental consideration
WEEE Directive, 2002/96/EC
At the end of the working life of the Vicorder please dispose of :
 In accordance with the Directive or

 Returning it to us at the address given above or
 Via a locally approved recycling scheme or
 With consideration for the environment.

1.10 TECHNICAL SPECIFICATION
Vicorder
Laptop PC required : See Section 1.4 Minimum System Requirements
Power requirements : 5 Volts from two USB ports on Laptop PC via dedicated cable
Power indication : Power connected indicated by a blue LED
Pressure : 2 x Pressure inputs
PPG : 2 x PPG inputs
Auxiliary Stereo connector : Input 100mV for full scale
Bandwidth 240 to 7500Hz (-3dB)
Output 6∙5V DC at 75mA maximum to power external equipment
RJ11 connector, see Section 1.5 Installation and Setup for pinouts
Pressure
Pump rate, large cuff : 500cc to 150mmHg, less than 10 seconds
Pump rate, digit cuff : 1∙9cm cuff to 100mmHg, less than 6 seconds
Bleed rate : Typically 5mmHg per second, adjustable
Deflation time : 500cc, 150mmHg to 10mmHg, typically 3 seconds
Resolution : 1μmHg at maximum gain
Accuracy of display : ±3∙5% of full scale
Minimum settable pressure : 20mmHg
Maximum settable pressure : 280mmHg
Pressure setting steps : 5mmHg
Accuracy of setting : ±2∙5% of full scale (at 200mmHg)
Sweep speeds : 1∙75, 3∙5, 7 and 14 seconds
Filter : 0∙34Hz or 1∙0Hz
Display modes : Unilateral or bilateral
Overpressure Safety : Incorporated, see Section 1.2 Safety Considerations
PPG
PPG : Manufactured by Summit Medical
Sweep speeds : 1∙75, 3∙5, 7 and 14 seconds
Filter : 0∙34Hz or 1∙0Hz
Display modes : Unilateral or bilateral
Doppler
Probe : 5MHz or 8MHz, manufactured by Summit Medical
Display : 256 point FFT
Accuracy : ±3∙5% of full scale
Filter : 300Hz and 7200Hz (-3dB)
Sound : Laptop PC speakers, level adjustable via Vicorder screen control
Sweep speeds : 2∙5, 5, 10 and 20 seconds
Ranges : ±3, 6, 12 and 24kHz
Trace : +ve, +ve/-ve or Off
Flow direction : Forward or reverse
Display modes : Unilateral only
Label
Rear panel label : Information given on the label is intended to be read from a minimum
distance of 0.5 metres
Environmental
Operating Temperature : +5˚C to +35˚C
Operating Humidity : 20% to 80%
Storage Temperature : -30˚C to +60˚C

User Notes

CHAPTER 2 GETTING STARTED
The Administration screen

The first screen encountered after loading the application software and initial setup is the Administration window.
For a new installation there will be no Patient data, Exams or user defined Protocols present. If the installation is an
upgrade, as in this example, these data will be available here.
The Vicorder Administration window will still appear if the software application has been activated without the
Vicorder present.
Navigation and selection

Navigation and selection within the Administration window is by pointing device and left click.
Closing the Application

To close the Vicorder application either select Exit Vicorder from the File drop down menu or click on the
symbol in the top right hand corner of the screen.
Administration screen facilities

The Administration screen is divided into grouped areas, each area along with the facilities available are explained
in the following pages of this Section.

2.2 DROP DOWN MENUS
Drop down menus
There are four drop down menus available in the top left hand corner of
this screen, the functions available under each heading are described in
the following pages.
Some functions have duplicated boxes within this or other screens.
File
New Patient
In the Patient History Page Patient
basic details may be entered in the
white boxes.
Click on the Hide/Show Patient History

button to show the (hidden) Patient
History section, enter data in this
section as required.
Click on the Symptom Page to load the

Symptom Page, see below.
Click on Save and Exit when complete.
Symptom Page
(The top part of the Symptom Page
only is shown in this example)
The Symptom Page is divided into

functional areas which may be selected
as required. De-selected functional
areas are not displayed.
Select Edit in the Symptom Page and click on the list to select/de-select
those required.
Enter symptom data in the Symptom Page as required.
Return to the Patient History Page if required by clicking on History Page

or click on Save and Exit when complete.
Amend Patient data

Patient details may be amended after saving if required by
opening the Patient History / Symptoms Page, you will be
prompted with the Database Update box to confirm the change,
click on Update to confirm.
Continued……

Hospital Settings
In the Setup window your Institute details may be entered.
You may also import into the Print Logo: area a picture, logo or caption.
Use the browse folder icon to locate and import the file. The Hospital
data and the import will be displayed at the top of Reports.
This Setup screen is also available from the Admin Setup box in the
Administration window.
Import Patient (Note 1)

Click on Import Patient to open the Open dialogue box,
from here you may navigate to the location where the
Patient file to be imported is held.
The imported Patient name(s) will be placed in the

Patient List and exams will appear in the Exams List.
Items such as logo’s may not import in which case an

error message may be displayed.
To select multiple files for import, use the Control

(random select) or Shift (block select) keys.
If the data file was created using a User defined Protocol

that Protocol will added to the User Defined list if not
already present.
Separate databases for the same Patient will be merged.
Export Patient (Note 1 overleaf)

Select the Patient to be exported from the Patient List.
Click on Export Patient to open the Save As dialogue
box, from here you may navigate to the location where
the file is to be saved. A timestamped directory will be
created, all exported files are held at this location.
To select multiple files from the Patient List for export,

use the Control (random select) or Shift (block select)
keys.
Fix Database (Note 1 overleaf)

If problems are experienced with the database after an upgrade this function will auto-
correct the pathnames.
It may also be used after an upgrade if there is a problem trying to launch previously
licensed Protocols.
If no errors are found this “No Errors In Database” message box is displayed.
If your problem persists after trying Fix Database contact the Factory using one of the
methods given in Chapter 1 Section 1.9 Helpline.
Continued……

Save
Reports may be saved to the preset Folder or to the Folder of your choice.
Save and Close (Note 2)

Reports may be saved to the preset Folder or to the Folder of your choice.
Print… (Note 2)
Sends the Report to the printer of your choice.
Page Setup… (Note 2)

Here you may set up the Report page parameters.
Print Preview (Note 2)

Here you may preview the printout.
Exit Vicorder
Closes the Vicorder application.
Note 1 not available in the Report pages.

Note 2 not available in the Administration window.
Edit
Edit Exam
Here the Exam screens and order may be set to the Users preference.
Settings
Audio Settings
Enables setup of the Laptop speakers and the selection
of sample signals. Click on Audio Settings, the Setup
Speakers menu will appear which will enable auto set-up
of the Vicorder Laptop audio path or to change the input
to sample sounds.
The audio configuration may be set up or changed by

selecting Test Speaker, follow the on screen
instructions.
The Volume setting is User settable from within the

relevant Protocol acquire screens, no further setting via
your Laptop control is necessary. Note that your Laptop
sound must remain enabled.
Using Example Signals

To use the sample signals select Change Input then click
on Example Signal and follow the on screen instructions.
Sample sound should be heard over the Laptop speakers

which will repeat until Freeze is selected or the Acquire
window is closed. These sample signals may be saved
and manipulated as described within these Instructions
for Use.
Select Vicorder again to return to normal operation.
Full instruction on the use of the various Protocols is

contained within these Instructions for Use.
Language
Select the required Language from those available, the
chosen language will be used for all buttons, headings,
menus, sites, etc.
Similarly the date format will change to that commonly

used where applicable.
Continued…..

Global Settings
In the Report Page click on the required tab at the top
of the Exam Settings screen to allow various global
settings to be set. Note : Global Setting is not possible
in the Acquire mode. Functions available under Global
Settings are :
General
Checking the box will apply the settings to all sites.
Pressures
Check the box then enter your own default target

pressure in the space alongside.
If the DC Gain Enabled box is unchecked the

corresponding button will be omitted from screens.
If the Auto Bleed box is unchecked delay selection is

not possible and bleed back will start when the Space
bar is pressed.
Check the Auto Bleed box then drag the slider to set the
Hold time in seconds between the cuff attaining target
pressure and the start of bleed back.
Drag the slider to the required setting to set the Large

Cuff bleed rate.
Drag the slider to the required setting to set the Digit

Cuff bleed rate.
Restores the Factory bleed settings for this screen.
ABI/TBI
Switches between saving Full and Displayed only data,

see Chapter 8 ABI/TBI.
Enter the file path for Export Pressure Data Path. The
file path may also be selected by clicking on the browse
icon and selecting.
PVR
Unlink PVR Gain enables the gains in Bilateral screens to

be set independently.
Enter the required PVR Gain here.
Continued…….

Venous
VO time can be adjusted between 1 and 10 seconds,

click on and drag the slider. Factory preset is 3 seconds.
Sets the Thigh cuff occlusion pressure, click on and drag

the slider to set the required Occlude Pressure. Factory
preset is 60mmHg.
Quick Launch
Enter the file path and Folder for saving Quick Launch
examinations. It may also be selected by clicking on the
browse icon and selecting.
Printing Prefs
When selected automatically attaches the Patient

History to the Exam report.

Help
Manual F1
These Instructions for Use are also available as part of
the Program installation in Portable Document Format
(.pdf) and may be accessed by clicking Help and
selecting Manual F1 from the drop down menu.
Note that to use the installed Instructions for Use Adobe

Reader is required, it is available gratis from their
website.
License
Here you may view which Protocols are licensed for use,
these are shown checked. Some Protocols are included
with the Basic set-up of the Vicorder, others will require
additional licensing.
Vicorder Licensing information is held in the Vicorder

memory and is therefore independent of which Laptop it
is used with.
When additional Protocols are licensed the Factory will

give you a License Key string, it is entered in the Enter
License Key: here. Take care to enter it correctly as it is
unique to your Vicorder and not transferable.
To enquire about the addition of Protocols please

contact the Factory using one of the methods given in
Chapter 1 Section 1.9 Helpline or in the About screen
below. Please have available the serial number (not CE
0120!) of your Vicorder which may be found on the label
on the underside and the version of software installed,
available from the About screen below or from the flash
screen displayed at application launch.
About
In the About screen you can view :
The version number of the software installed.

Your product id which is unique to your computer.
Contact information is also provided.
Vista Audio Setup (Vista Users only)

This menu allows audio setup for Vista users, click on
Vista Audio Setup and follow the on screen instructions.

2.3 PATIENTS AND EXAMS
This section deals with the remainder of the functions available within the Administration window.
Patient List
A full list of Patients, in alphabetical order, is given in the Patients: list. All
previous examinations for a selected Patient are displayed in the Examination
List, see below.
Note : The Patient list default display is by Last Name in alphabetical order (“A”
at the top). The order in which names are displayed can be altered by clicking on
the appropriate column headers, e.g., click on Last Name to display names in
reverse alphabetical order (“Z” at the top), click on Last Name again to reverse
the order (“A” at the top). Similarly for First Name(s) and ID.
The default for no Patient surname is “Anonymous”.
It is possible to conduct a rapid search for a particular Patient by ID number or

Patient Last Name, input the required ID or Name into these Filter boxes. Clear
Filters removes the entry from these boxes.
A selected Patient details are displayed here.
Selecting Patient Details allows that data to be viewed and manipulated.
A New Patient details may be entered, see Hospital Settings under the File drop
down menu for details.
Examination List
The top centre section contains a list of examinations by
Patient name with date and time, these may be viewed
and manipulated by double clicking on the desired entry.
New Examiner and Reviewer entry window

Ordered By:
Enter the name of the person requesting the test in the
Ordered By: box.
New Examiner / New Reviewer

You can add a New Examiner or Reviewer by clicking on
the respective New Examiner or New Reviewer boxes
and inputting the required details in the Examiner /
Physician box below :
Examiner and Reviewer selection

Examiners and Reviewers previously entered are
displayed in list form, select from the drop down list or
enter a New Examiner or Reviewer as described above.
Note that the Examiner and Reviewer entry facility is

only available with the Exam list, not with the Quick
Launch list.

Report Thumbnail
Selecting a report from the Examination List will give a
thumbnail of the Report Page plus the examination date,
Examiner and Physician, as opposite.
Click on the Report Page thumbnail to preview it as a

larger image, see below.
Three icons are available :

Save
Saves the Report to the destination of your choice
Print
Sends the Report to the Printer of your choice.
E-mail
E-mails Reports, discussed below.
E-mail
Select the report you wish to e-mail, click on Send or
click the thumbnail and select the E-mail icon.
In the E-Mail Exam box enter the recipients e-mail

address(es) in the To… and Cc… boxes. Double clicking
on these boxes will bring up your Address Book.
Add the Subject: header.
Add any accompanying text in the box provided, which

may exceed the box size in length.
Click the Send! button. The selected Report, as an

attachment to the e-mail, will be placed in the outbox of
your e-mail software.
Administration screen bottom bar
Admin Setup Search Import

Enables entry of Institute Displays a View By Exam list Same as Import Patient, see
data, its use is described in of all exams carried out, Section 2.2.
Hospital Settings under the described in the View By
File drop down menu. Exam list section overleaf : Export
Same as Export Patient, see
Section 2.2.

View By Exam list
Entered by clicking on Search. The Exam list is made up
of Patient attributes entered in the Patient History Page.
It is initially displayed with the most recent Exam by
Date at the top.
Use the horizontal scroll bar to display data off screen.
The order in which Exams are displayed can be altered

by clicking on the appropriate column header, e.g., click
on DOB to display the oldest Patient at the top first,
click on DOB again to reverse the order. Similarly for
other data headings.
Double click on the required entry or click the entry and

click on View to open.
Exam Selection
Click on Exam in the Administration window.
It is possible to copy frequently used Protocols from the User

Defined or Default Protocols to the Favourites section for easy
retrieval, simply click and hold on the desired Protocol and drag
it to the Favourites section.
User defined Protocols are possible, creating these is discussed

in Chapter 12 Generic Protocol Editor, the list of these Protocols
is displayed here.
The Default Protocols are listed here. Unlicensed Protocols are

shown “greyed”, see License in Section 2.2 and under Unlicensed
Protocols overleaf.
Protocols may be launched by either double clicking on the

desired Protocol or selecting and then clicking on the Begin
Exam box near the bottom right hand corner of the screen.
A blank Report Page will be displayed, see Section 2.4 The

Report Page.
Quick Launch Selection

Click on Quick Launch in the Administration window.
Any of the nine tests listed may be selected (subject to licensing), click on the test you
wish to perform, the Acquire screen will be displayed.
The tests will be single screen unilateral / bilateral format.
There is no Report Page or 3-D figure in these screens.
The Report may also be reviewed and manipulated post Patient examination (the Vicorder
does not need to be present for this activity), see Chapter 13 The Completed Report.

Unlicensed Protocols
Unlicensed Protocols appear “grey” in the lists. To check which Protocols are licensed select License from the Help
menu in the Administration screen, described in Section 2.2 Drop down menus.
If you attempt to launch a Protocol from either the

Exam or Quick Launch list which has not been licensed
this message is displayed.
The message may also appear after an application

upgrade when attempting to launch a previously
licensed Protocol, see Fix Database in Section 2.2 to
remedy.

2.4 THE REPORT PAGE
The Report Page
The blank Report Page will be similar to the
example given opposite (Lower Arterial w/PVR)
The function of the seven buttons is described

in Chapter 13 The Completed Report.
When the cursor is placed over the chosen

Pressure or Waves box the 3-D figure
dynamically moves to show the User where to
make the recording (except for User Defined
Protocols).
When Acquire screen data has been saved you

will be automatically returned to this Report
Page, the data will show as a thumbnail for that
site. Select the next site. Note : data may be
acquired in the order preferred or set by the
Clinician.
If this symbol is displayed within a site box the

Acquire screen may not be opened and no data
is collected for that site.
Launching an Acquire screen

Place the cursor over the chosen site and either left click or press the Vicorder Enter button or press the Laptop
Enter key to activate the chosen Acquire screen.
Navigation and setting within the Acquire screens

To navigate around the buttons and change settings within the Acquire screens use :
Setting Method Vicorder Laptop PC Pointing device

To move left or right ◄ or ► keys ◄ or ► keys Fn key cursor and left click
To change a setting up or down ▲ or ▼ keys ▲ or ▼ keys F or Shift + F left or right click
Scrolling ▲ or ▼ keys ▲ or ▼ keys left or right press
The selected button is a lighter colour.
Where appropriate the current/full scale value or other information is shown at the bottom of each button.
The 7 keys on the Vicorder mimic Laptop keyboard functions including Space, Enter (Return,  ) and Esc(ape).
The Escape key

The Escape (Esc) key or button functions as follows :
 Acquire screen, acquiring : Close it and return to the Report Page.
 Acquire screen, inflating : Immediately stop an inflation sequence and deflate the cuffs.
 Acquire screen, frozen : Close it without saving any data and return to the Report Page.
 Report Page : Close it without saving any data and return to the Administration window
Control of cuff pressure and inflation in Pressure screens

There are several ways in which cuff pressure and inflation can be controlled :
 The preset pressures may be altered at the discretion of the User either locally or globally.
 To initiate inflation to a set target pressure press the Spacebar, click on the Space button or press the
appropriate F key. Bleedback will start after a settable preset period or when the spacebar is pressed.
 Hold the Spacebar down for approximately 4 seconds and release, inflation will immediately stop and
bleedback commence.
 Hold the Spacebar down until beyond target pressure, inflation will stop and bleedback commence without
stopping at the target pressure.
 Hold the Spacebar down for approximately 4 seconds and release then activate Top Up, the cuff will inflate
to the top up pressure before bleedback.
 Hold the Spacebar down for approximately 4 seconds and release then hold the Top Up button down for a
similar period, inflation will stop and bleedback commence without stopping at the target pressure.
 Top Up will return the pressure to the target value. In some screens Top Up will automatically increase the
pressure by 10mmHg before re-inflation.
Other buttons and functions are described within these Instructions for Use where needed.
The Completed Report page

The Report Page handling, review and manipulation is explained in Chapter 13 The Completed Report.

2.5 TEST PROTOCOLS AVAILABLE
Lower Arterial
Doppler waves and pressures may be collected for the lower arterial tree.
Lower Arterial PVR

PVR waves and pressures may be collected for the lower arterial tree.
Lower Digits PPG

PPG waves and pressures may be collected for the 10 lower digits.
Lower Digits PVR

PVR waves and pressures may be collected for the 10 lower digits.
Lower Limb Stress Test

Pre and post exercise pressures may be collected for the Lower Limbs.
Upper Arterial
Doppler waves and pressures may be collected for the arms.
Upper Arterial PVR

PVR waves and pressures may be collected for the arms.
Upper Digits PPG

PPG waves and pressures may be collected for the 10 upper digits.
Upper Digits PVR

PVR waves and pressures may be collected for the 10 upper digits.
Pulse Wave Velocity

Allows measurement of the Transit Time and hence Pulse Wave Velocity between various arterial segments.
Pulse Wave Analysis

This Protocol differs from the Pulse Wave Velocity Protocol in that additional calculations are performed for Aortic
indicators in addition to Transit time and Pulse wave velocity.
ABI
Left and right Ankle Brachial Indices may be collected.
ABI / TBI
Left and right ABI / TBI indices for three body segments may be collected.
Carotid
Allows collection of data from the Carotid region using a pre-determined set of sites and “guided probe”. The order
in which the test is conducted is User-definable.
Venous Outflow
This test measures the resistance of returning venous blood flow to the abdomen from the lower limb. A low
outflow is associated with obstruction to the venous return from the limb.
Venous Reflux
The VRT measures the degree of retrograde Venous flow in the lower limbs which is associated with Venous
incompetence.
Generic Protocol Editor

Enables Users to generate their own Test Protocols with up to 20 User designated sites. Vessel names can be
assigned as can the order in which the test is conducted. It allows for the entry of probe frequency and insonation
angle, vessel size and pressures enabling volume flow and peripheral resistance calculations to be performed.
General notes
Generally methods of test are left to the Clinician.
Many of the functions and controls are common between Protocols, to avoid over repetition they are not given in
every section.
Some Protocols require licensing to activate.
Most Protocols employ a guide in the form of a “3-D” figure to aid placement of the measurement device, it is not
available for Protocols from the Quick Launch list or designed using the Generic Protocol Editor.
The Reports generated for any of the above Protocols may be stored, printed or electronically communicated.
The Reports may be reviewed and manipulated post Patient examination, the Vicorder does not need to be present
for this activity.

2.6 PROTOCOL MODALITIES AVAILABLE
Lower and Upper Limb Protocols
The Upper and Lower Limb Protocol screens allow the collection of Pressure and Waves data for chosen sites.
The acquisition of data and its subsequent manipulation is explained more fully in the relevant Chapters.
Lower and Upper Digit Protocols

The Upper and Lower Digit Protocol screens allow the collection of Pressure and Waves data for chosen sites.
The acquisition of data and its subsequent manipulation is explained more fully in the relevant Chapters.
Other Protocols
These are more specific in application and are explained in the relevant Chapters.
Available Protocols :
Protocol Doppler PPG PVR Stress

Lower Arterial    
Lower Digits    
Upper Arterial    
Upper Digits    
Carotid    
Pulse Waves    
ABI / TBI    
Venous  *  
Generic Protocol Editor
* not in Quick Launch
Flow Chart of the Modalities :
Select Quick Launch / Protocol Test
Front Page (blank Report Page)
Waves Pressure
Doppler Unilateral Doppler
Unilateral
PPG PPG
Bilateral
Unilateral Real Time and Frozen

screens are available for all
PVR Unilateral and Bilateral
Modes
Bilateral
Completed Report
Post Exam review
Page
Final Report Page

CHAPTER 3 DOPPLER MEASUREMENT
3.1 REAL TIME DOPPLER MEASUREMENT
Real Time Doppler Acquire screen
The Probe operating frequency is automatically detected
and displayed near the top left hand corner of the
screen.
The function of the controls is :
Scales
Increase or decreases the spectrum analyser range, i.e.
the size of the spectrum.
Sweep
Increases or decreases the sweep speed of the display.
Trace
Activates the maximum frequency tracker providing a
trace for forward and reverse bi phasic flow or a trace
for mono phasic flow which is above the baseline.
Flow Dir
Inverts the spectral display.
Volume
Controls the volume of the sound output.
Gain
Controls the sensitivity of the spectral display.
Auto Gain
Spectral sensitivity automatically set by software for an
optimum display.
Calcs
Brings up the Calculation Parameters window, allows
setting of the probe frequency and insonation angle.
Boost
Increases the overall sensitivity.
Baseline
Moves the zero baseline.
Spectrum
Switches the spectral part of the display on or off.
Freeze
Pressing the spacebar will freeze the display.
Close
Pressing Escape will close the display without saving any
data and return to Report page.
Selection of Calculations
Displayed computed indices may be selected by right
clicking in the screen area, place the cursor over the
Calculations box and select from the resultant list.

The frozen Doppler screen
Once a satisfactory Doppler display has been achieved
for three or four screen widths pressing the Spacebar
will freeze the screen.
Beat markers are added at the start of the upsweep.
If the cursor is placed in the acquire area a data bar is

added at the top of the screen giving time from start,
frequency and velocity at 0 and 60 degrees in m/sec.
The frozen screen buttons operate in the same way as in

the Real Time display and their functions are :
Scroll
Scrolls spectral display.
DopTrax
Allows replay of the spectral display.
Export Data
Clicking on the Export Data button will open the Exam
Settings Save Options screen where options for saving
the data may be selected.
Select one of the three options : Database + CSV or

Database or CSV and check the box if raw wave data is
to be included in the csv file, then press ok. The option
selected will be reflected under the Save button.
Calcs
Brings up the calculation window, allows setting of the
probe frequency and insonation angle.
Unfreeze
Pressing the spacebar will unfreeze the display.
Close
Pressing Escape will close the screen without saving any
data.
Save
Pressing Return (Enter) closes the screen and saves the
data.
Right click in the data area to select or de-select the

displayed calculation parameters.
Inserting and clearing Beat markers

The beat markers that identify each cardiac cycle can be
manually inserted, place the cursor at the point of
interest then left click, alternatively right click in the
display area and select Add Beat Marker from the menu.

3.2 QUICK LAUNCH DOPPLER MEASUREMENT
Launching Doppler from the Quick Launch list will enable non-site specific Doppler measurements to be taken.
Operation is similar to Section 3.1 Real Time Doppler Measurement.

3.3 DOPPLER PRESSURE MEASUREMENT
Introduction
This screen will undertake systolic blood pressure measurement, it combines the real time Doppler modality with
controls for cuff inflation and automated bleed.
Real Time Doppler Pressure

A cuff is placed around the limb of interest and a
Doppler signal obtained distal to the cuff. By pressing
the Spacebar the cuff automatically inflates to the pre-
selected target pressure. The cuff will then automatically
bleed pressure, the Doppler signal reappears when the
cuff reaches systolic pressure. At any point after the
reappearance of the Doppler signal the display may be
frozen by pressing the Spacebar.
In this screen the function of the keys is :
Scales
Sweep
Trace
Flow Dir
Volume
Controls the volume of the speakers.
Gain
Allows the manual setting of gain.
Boost
Target
Set target Pressure.
Mode
Selects between Doppler and PPG (for PPG use see
Chapter 4 PPG Pressure Measurement).
Spectrum
Inflate or Freeze
Pressing the Spacebar will start the inflation cycle after
which the function will freeze the display.
Deflate
Pressing Escape will immediately deflate the cuff.
Top Up
If the Target pressure is set below the point of occlusion
pressing Return will automatically increase the pressure
by 10mmHg and restart the sequence. Repeat if
necessary.

Frozen Doppler Pressure
The exact reappearance of the Doppler signal and the
systolic Doppler pressure is automatically picked and
marked by the on screen cursor which can then be
manually placed with the left and right scroll keys and a
left click of the mouse. The pressure at the point of
placement of the cursor is displayed.
The function of the keys is :
Scroll
Allows scrolling of the displayed cursor left or right.
Calcs
Allows setting of Probe frequency and insonation angle.
Unfreeze
Pressing the Spacebar will unfreeze the display, note
that all data will be lost.
Close
Pressing Escape will close this screen without saving
data.
Save
Pressing Return will save the data and return to Report
page.

CHAPTER 4 PVR MEASUREMENT
4.1 UNILATERAL PVR MEASUREMENT
Real Time PVR
This screen allows the display of a single channel PVR
signal, once a cuff has been tightly wrapped around the
limb of interest depressing the Spacebar automatically
inflates the cuff to the selected target pressure,
normally set at 65mmHg, once the target has been
reached the PVR wave is displayed on the screen.
Operating the Space bar again will freeze the trace.
Sweep
This controls the sweep time across the screen.
Venous Filter
Filters out trace corruption due to venous flow.
Multi-Chan
Switches between unilateral and bilateral modes.
AC Gain
This controls the amplitude of the PVR signal.
Calcs
Brings up the calculation window.
Target
Sets target pressure.
Freeze
Pressing the spacebar freezes the display and deflates
the cuff.
Deflate
Top Up
Pressing Return will top the cuff back up to the Target
pressure.
PVR Single Frozen

Once the real time display has been frozen the trace is
normalised to the baseline.
Computed indices may be selected or de-selected by

right clicking over the Calculations Site area and
selecting from the resultant list.
The operation of the buttons is :
Scroll
Allows scrolling of the display left or right.
Unfreeze
Pressing Space will unfreeze the trace.
Close
Pressing Escape will close the screen without saving
data.
Save
Pressing Return will save the data and return to the
Report Page.

4.2 BILATERAL PVR MEASUREMENT
Real Time PVR Bilateral
Two PVR channels can be displayed in real time by
clicking on Multi-Chan.
It is important when in dual channel mode that the

channel of interest is first selected with the Site button
before applying the appropriate controls such as gain
and cursor positioning. The selected site is highlighted
by the illumination of the bar either red or blue.
Operation and the function of the buttons is per

unilateral operation in Section 4.1 Unilateral PVR
Measurement.
PVR Bilateral Frozen

When the real time display is frozen the traces are
normalised to the baseline, for both channels each
heartbeat is identified and the calculations are
performed.
The function of the buttons is per unilateral operation in

Section 4.1 Unilateral PVR Measurement.

4.3 QUICK LAUNCH PVR MEASUREMENT
Launching PVR from the Quick Launch list will enable non-site specific PVR measurements to be taken. These may
be undertaken in unilateral or bilateral modes.
Operation for either mode is similar to Sections 4.1 Unilateral PVR Measurement or 4.2 Bilateral PVR Measurement.

CHAPTER 5 PPG MEASUREMENT
5.1 UNILATERAL PPG MEASUREMENT
Real Time PPG Unilateral
PPG measurement requires the positioning of the PPG
sensor on the appropriate digit, extraneous light should
be excluded.
Operating the Space bar will freeze the trace.
The function of the buttons is :
Sweep
Venous Filter
Multi-Chan
Switches between unilateral and bilateral modes, see
Section 5.2 for bilateral operation.
AC Gain
Mode
Switches between PPG and Doppler, for Doppler
operation see Chapter 3 Doppler Measurement.
Freeze
Pressing Space will freeze the display.
Close
data.
PPG Unilateral Frozen

Scroll
Unfreeze
Close
data.
Save
Report Page.

5.2 BILATERAL PPG MEASUREMENT
Real Time PPG Bilateral
The PPG may also be operated in Dual channel mode by
selecting Multi-Chan.
PPG measurement requires the positioning of the PPG

sensors on the appropriate digits, extraneous light
should be excluded.

Operation and the function of the buttons is per

unilateral operation in Section 5.1 Unilateral PPG
Measurement.
PPG Bilateral Frozen

The function of the buttons is per unilateral operation in
Section 5.1 Unilateral PPG Measurement.

5.3 QUICK LAUNCH PPG MEASUREMENT
Launching PPG from the Quick Launch list will enable non-site specific PPG measurements to be taken. These may
be undertaken in unilateral or bilateral modes.
Operation for either mode is similar to Sections 5.1 Unilateral PPG Measurement or 5.2 Bilateral PPG Measurement.

5.4 UNILATERAL PPG PRESSURE MEASUREMENT
Introduction
This screen will undertake systolic blood pressure measurement, it combines the real time PPG modality with
controls for cuff inflation and automated bleed.
Real Time PPG Pressure

A cuff is placed around the limb of interest and a PPG
signal obtained distal to the cuff. By pressing the
Spacebar the cuff automatically inflates to the pre-
selected target pressure. The cuff will then automatically
bleed pressure, the PPG signal reappears when the cuff
reaches systolic pressure. At any point after the
reappearance of the Doppler signal the display may be
frozen by pressing the Spacebar.
Sweep
Multi Chan
Switches between unilateral and bilateral operation, for
bilateral operation see Section 5.2 Bilateral PPG
Measurement.
DC Gain
Adjusts the gain of the DC component of the PPG wave.
AC Gain
Controls the amplitude of the PPG signal.
Target
Sets the target pressure.
Mode
Selects Doppler or PPG mode of operation.
Inflate or Freeze
Pressing the Spacebar will start the inflation cycle after
which the function will freeze the display.
Deflate
Top Up
If the Target pressure has been set below the point of
occlusion pressing Return will automatically increase the
pressure by 10mmHg and restart the sequence.
Frozen PPG Pressure

The exact reappearance of the PPG signal and the
systolic Doppler pressure is automatically picked and
marked by the on screen cursor which can then be
manually placed with the left and right scroll keys and a
left click of the mouse. The pressure at the point of
placement of the cursor is displayed.
Scroll
Allows scrolling of the displayed cursor left or right.
Unfreeze
Pressing the spacebar will unfreeze the trace.
Close
data.
Save
Pressing Return will save the data and return to Report
Page.

5.5 BILATERAL PPG PRESSURE MEASUREMENT
Real Time Bilateral PPG Pressure
Bilateral mode can be selected in the PPG pressure
mode which allows two limbs to be measured
simultaneously.

All other controls are the same as for single channel PPG
operation, Section 5.1 Unilateral PPG Measurement.
The pressure cursors are automatically positioned once

a PPG pulse is detected for each channel.
Frozen Bilateral PPG Pressure

The cursor can be positioned manually as for the single
channel PPG measurement, use the Site button to select
the channel of interest.
The resultant data may be stored using the Return

button.
Other buttons are as for the single channel mode of

operation, Section 5.1 Unilateral PPG Measurement.

CHAPTER 6 PULSE WAVE VELOCITY
6.1 INTRODUCTION
Introduction
By placing the PVR PRESS2 cuff proximal and PRESS1 distal to the selected arterial segment the time delay
between the two simultaneously measured cardiac cycles is computed and displayed in real time.
PVR Pressure cuffs or PPG sensors may be used.
Methods
Real Time Pulse Wave Velocity (PWV) measurement is possible using four methods :
Method From list Launch Section

Single segment Quick Launch PWV 6.2
Whole body Exam PWV 6.3
Aortic Single segment or Whole body methods above 6.4
PWV ABI Exam PWV ABI 6.5
In PWV mode the display is always dual channel.
The methodology is similar for all four.

6.2 SINGLE SEGMENT MEASUREMENT
Single segment Real Time PWV
Select PWV from the Quick Launch list in the Administration window.
You will first be asked to input Patient data via the PWV Study screen. Measure
the distance between the cuffs in centimetres and enter for Length.
The Systolic and Diastolic pressures may be obtained using any method and
entered manually.
Select, enter or amend any other data as necessary.
Click on OK when done.
The Acquire screen will then load.
The Acquire screen

Right click in either trace area to activate or de-activate
the displayed calculation parameters at the right hand
side of the display.
The illustration shows a typical display prior to freezing,

in this example in PPG mode.
The calculations are displayed after two complete

screens and are then updated as the screen scrolls.
Record
Allows Transit Time and Pulse Wave Velocity versus time
to be saved as a Excel file (.csv extension)
Site
Selects between the upper and lower trace areas.
AC Gain
Adjusts the amplitude of the display. Note, this affects
the displayed waveform only, calculations are performed
on the pre-attenuated signal.
Data
Will display the PWV Study Patient data window again,
corrections may be made to data if required.
Target (absent in PPG mode)

Mode
Switches between PVR and PPG. Note : it is possible to
use the PPG sensors or combination PVR-PPG to obtain
PWV timings, select by clicking Site to activate the
required area and selecting the required mode with the
Mode button.
Close
data.
Inflate (absent in PPG mode)

Pressing the Spacebar will start inflating the cuffs.
Freeze (in PPG mode and post Inflate in PVR mode)

Pressing the Spacebar will freeze the traces.

The frozen screen
After acquiring several steady pulses of data pressing
the Space bar will freeze the display.
If activated, the Start Time (during scrolling), length

between cuffs, number of beats used and Heart rate are
displayed against the upper trace
If activated the Transit Time (TT) in milliseconds and the

Pulse Wave Velocity (PWV) in metres per second will be
displayed against the lower trace.
The length may be altered via the Data button if

required, the Pulse Wave Velocity will automatically be
re-calculated.
Scroll
Scrolls the display left and right.
Export Options
Clicking on the Export Options button will open the
Exam Settings Save Options screen where options for
saving the data may be selected.

Site
Selects between the upper and lower trace areas.
Data
Will display the PWV Study Patient data window again,
corrections may be made to data if required.
Unfreeze
Restarts the display.
Close
data.
Save
Closes the screen and saves data to the file defined in
the PWV Study window.

6.3 WHOLE BODY MEASUREMENT
Entering the PWV Protocol via Exam in the Administration screen will enable velocity and transit time data from
three segments on each side of the body to be collected and stored. The three segments are :
 Brachial to Wrist
 Brachial to Thigh
 Thigh to Ankle
The Blank Report screen

The Report screen will appear as opposite.
The Report screen operates in segment pairs, an

example of a pair is given opposite.
Right click on an upper site box to select :
Calculations
Select the calculations performed for that site :
Right click on a lower site box to select :
Calculations
Both will select :
Clear Data
Will delete any data present for that site.
Edit Name
Allows re-naming of the site if desired.
Pressure sites
The pressures for the four Pressure sites may obtained by any method and entered manually. In the example
above the four pressures have already been added.
Placing the cursor over the measurement site box will show on the 3-D figure where to place the cuff.
Acquire screen activation

To activate the Acquire screen place the cursor over the upper box of the first segment pair and either left click or
press Enter, the PWV Study screen will appear.
If this the first Acquire screen to be activated for this

Exam input additional Patient data and Data Save Path
in the PWV Study screen as required. Measure the
distance between the cuffs in centimetres and enter for
Length. The Systolic and Diastolic pressures may be
obtained using any method.

The Acquire screen
Right click in either trace area to activate or de-activate
the displayed calculation parameters at the right hand
side of the display.

The calculations are displayed after two complete

screens and are then updated as the screen scrolls.
The function of the buttons is the same as for Single

segment PWV, Section 6.2.
The Frozen screen

If activated, the Start Time (during scrolling), length

between cuffs, number of beats used and Heart rate are
displayed against the upper trace area.
If activated the Transit Time (TT) in milliseconds and the

Pulse Wave Velocity (PWV) in metres per second will be
displayed against the lower trace area.

re-calculated.
Return will close the screen and save the data to the
PWV Report window.
The function of the buttons is the same as for Single

segment PWV, Section 6.2.
Continue the Exam

Repeat the above for the remainder of the segment
pairs remembering to select using the upper box of the
pair. Measure the distance between the cuffs in
centimetres and amend the Length in the PWV Study
screen as required.
The completed Report page

The completed Report page will look similar to the
example given opposite.
Exam Notes may be added if required.
Click on the Save And Close box to finish. The system

will then return to the Administration screen.
The function of the other buttons on this bar and

subsequent retrieval and manipulation of saved files is
covered in Chapter 13 The Completed Report.

6.4 AORTIC MEASUREMENT USING THE NECKPAD
Aortic Pulse Wave Velocity measurement using the Neckpad
The Patient should be in a semi-prone position with the head and shoulders raised by approximately 30 degrees,
this should prevent Venous contamination of the Arterial signal.
The Neckpad is placed around the Patients neck with the pressure pad
over the Right Carotid area……
......and secured with the Velcro fixing, do not over-tighten! Connect

to PRESS2 on the Vicorder.
A cuff is placed around the Patients upper Right Thigh and connected
to PRESS1 on the Vicorder.
PWV Study window data

Open the PWV Study window. Measure the distance between the
Supra-Sterna Notch and the Thigh cuff in centimetres and enter for
Length.
The Systolic and Diastolic pressures may be obtained using any

method and entered manually.
Single site use :

Follow the sequence given in Section 6.2 Single Segment
Measurement to acquire and save data.
Multi-site use :
Follow the sequence given in Section 6.3 Whole Body Measurement to
acquire and save data. Measure the distance between the cuffs in
centimetres and amend the Length in the PWV Study screen as
required.
Note that the 3-D figure will not show Carotid cuff placement nor will
the site boxes be correctly named, the names may be amended by
right clicking on the site and selecting Edit Name from the list.
Jugular Vein modulation

If the Jugular Vein is particularly active (example opposite) make sure
the Patients head and shoulders are at 30 degrees, if so ask the
Patient to take a deep breath, exhale and hold. Take the
measurement during the held breath.

6.5 ABI MEASUREMENT
Entering the PWV ABI Protocol via Exam in the Administration screen will enable ABI, velocity and transit time data
from two segments on each side of the body to be collected and stored. The two segments are :
 Arm to Thigh
 Arm to Ankle

The Report screen will appear as opposite.
The Report screen operates in segment pairs, an

example of a pair is given opposite.
Right click on an upper site box to select :
Calculations
Right click on a lower site box to select :
Calculations
Both will select :
Clear Data
Will delete any data present for that site.
Edit Name
Allows re-naming of the site if desired.
Pressure sites
The pressures for the four Pressure sites may obtained by any method and entered manually, right click on the
Pressure site and select Manual Pressure.
Placing the cursor over the measurement site box will show on the 3-D figure where to place the cuff.
Acquire screen activation

To activate the Acquire screen place the cursor over the upper box of the first segment pair and either left click or
press Enter, the PWV Study screen will appear.
If this the first Acquire screen to be activated for this

Exam input additional Patient data and Data Save Path
in the PWV Study screen as required. Measure the
distance between the cuffs in centimetres and enter for
Length.
The Systolic and Diastolic pressures may be obtained

using any method and entered manually.

The Acquire screen
Right click in either trace area to select the displayed
calculation parameters at the right hand side of the
display.

The selected calculations are displayed after two

complete screens and are then updated as the screen
scrolls.
The function of the buttons is the same as given in

Section 6.2 Single Segment Measurement.
The Frozen screen

The selected calculations are displayed against the

upper and lower trace area.

re-calculated.
Pressing Return will close the screen and save the data
to the PWV Report window.
The function of the buttons is the same as given in

Section 6.2 Single Segment Measurement.
Continue the Exam

Repeat the above for the remainder of the segment
pairs remembering to select using the upper box of the
pair. Measure the distance between the cuffs in
centimetres and amend the Length in the PWV Study
screen as required.

example given opposite.

The function of the other buttons on this bar and


CHAPTER 7 PULSE WAVE ANALYSIS
7.1 INTRODUCTION
Introduction
This Chapter covers operation of the Pulse Wave Analysis Protocol. It differs from the standard Pulse Wave Velocity
Protocol in that additional calculations are performed for Aortic activities in addition to Transit time and Pulse wave
velocity. The proximal cuff display is always present and it is possible to select the distal cuff display as well.
Note that in Quick Launch PWA mode operation is PVR only, PPG operation is not possible.
Cuff placement
With the Patient supine place the cuffs :
PWV mode
PRESS2 cuff proximal (Carotid, Left or Right Brachial or Femoral)
PRESS1 distal (Left or Right Wrist, Femoral or Ankle).
PWA mode
PRESS2 Brachial.
Launching the Pulse Wave Analysis Protocol

Select PWA from the Quick Launch list in the Administration window.
The acquire screen will appear, shown here in PWV

mode, overlaid with the PWV Study screen.
Enter the Study Name.
Patient data is displayed (which may be reviewed and

edited by clicking on the View/Edit Patient Information
box)
Select the Proximal and Distal examination Sites.
In PWV mode measure the distance between the cuffs in

centimetres and enter for Length. This parameter is not
required for PWA and is inactive. The Systolic and
Diastolic pressures may be obtained using any method
and entered manually.
Enter or amend the Data Saving information as

required.
Click on OK when done, the PWV Study window will

close.
The Acquire screen and its use

The two modes of operation available are discussed in :
 Section 7.2 PWV Mode

 Section 7.3 PWA Mode

7.2 PWV MODE
The Acquire screen - PWV mode
Various parameters may be measured or calculated
between the two simultaneously measured cardiac
cycles, see the displayed indicators panel below the
screenshot.
Mode
Switches between bilateral PWV Brachial - Thigh and
unilateral PWA Brachial (Section 7.3 PWA Mode). This
function is inhibited at the commencement of an exam.
Record
Allows Transit Time and Pulse Wave Velocity versus time
to be saved as a Excel file (.csv extension)
Site
Select the displayed indicators by right clicking over Toggles between the upper and lower traces to allow
each display indicator area in turn and selecting from parameter setting for the selected site.
the Calculations list :
AC Gain
Red (proximal) channel : Adjusts the amplitude of the display. Note, this affects
BP Blood pressure the displayed waveform only, calculations are performed
AoBP Aortic blood pressure on the pre-attenuated signal.
PP Pulse pressure
AoPP Aortic pulse pressure Data
pAI Peripheral augmentation index Will display the PWV Study Patient data window for
Aug pressure Augmentation pressure review, changes may be made if required (except to the
HR Heart rate Patients name).
Aug Index Augmentation index
Beats Number of beats Target
Blue (distal) channel :
BP Blood pressure Close
PP Pulse pressure Pressing Escape will close the screen without saving any
PPI Pulse pressure index data.
Pidx Pressure index
TT Transit time Inflate
PWV Pulse wave velocity Press the Spacebar to inflate the cuffs.
Length
PWV screen acquiring data

The averaging proximal and distal windows on the right
hand side will appear after two complete sweeps (to
accumulate sufficient averaging data) and will update
with each sweep. Acquire several screens of steady data
before freezing or recording.
Activating Record allows data to be saved as an Excel

file (.csv extension), during use you will be prompted for
a filename if you have not already specified one, the csv
file extension is automatically added.
The function of the buttons is described in The Acquire

screen - PWV mode above except for :
Freeze
Pressing the Space bar will freeze the display.
Top Up
Pressing Return will top up the cuff pressure to the
Target value.

The frozen PWV screen
After a short pause the frozen PWV screen will appear
similar to the example opposite. The various indicators
will have data added and the averaging proximal and
distal pressure windows will also freeze. These windows
are explained overleaf.
Press the Database + CSV bar under the Save button to

save the data.
Scroll
Scrolls the display left and right. Displayed indicator
calculations and averaging windows are modified as the
screen is scrolled.
Export Options
Clicking on the Export Options button will open the
Exam Settings PWV/PWA Save Options screen where
options for saving the data may be selected.

to be included in the csv file then press ok. The option
Site
Selects between the upper and lower trace areas to
allow parameter setting for the selected site.
Data
Will display the PWV Study Patient data window for
review, changes may be made if required (except to the
Patients name).
Unfreeze
Restarts the display.
Close
data.
Save
Pressing return closes the screen and saves the data in
the form selected under the Export Options button
above.
Excel screen
The opened Excel file will look similar to the example
opposite.
An error message may be displayed if the Excel file is

viewed while still recording.
Note that the last row of information (34 in this

example) continues over several screen widths.
When the file is first viewed some of the information

may not fit the default preset column widths in the Excel
sheet and therefore may not be viewable, they may
appear either incomplete (for text) or as # marks (for
figures). To make them viewable select all columns with
information present, click on Format, select Format
Column and then AutoFit Selection. Save the file in this
format.

The proximal averaging window
The upper window will appear similar to the example
opposite.
Averaged Brachial pressure.
Averaged central blood pressure pulse.
Indicates the Peak Aortic pressure.
Start of augmentation phase, it may be moved if

required, click on the line, move the cursor to the
desired point and click again.
Placing the cursor in the averaging window area will

display the time and % (or pressure if selected, see
Display areas right click facilities below) at that point.
Averaged distal pressure

The lower window shows the Averaged Thigh pressure.

display the time and pressure (or % if selected, see
Display areas right click facilities below) at that point,
similar to the proximal window above.
Display areas right click facilities

Right click in the upper display area to display a menu,
available options are :
PWV Average Scales

May be set to mmHg or %.
Export Average Waves to CSV file

Export to the CSV file.
Calculations
Tick those required from the list.
Repeat the above if required for the lower display area.

7.3 PWA MODE
The Acquire screen - PWA mode
Various parameters may be measured or calculated
from the cardiac cycles, see the displayed indicators
panel below the screenshot.
Mode
Toggles between unilateral PWA Brachial and bilateral
PWV Brachial and Thigh (Section 7.2 PWV Mode). This
function is inhibited at the commencement of an exam.
AC Gain
Data
Will display the PWV Study data window for review,
Select the displayed indicators by right clicking over the changes may be made if required (except to the Patients
display indicator area and selecting from the name).
Calculations list :
Target
BP Blood pressure Sets the target pressure.
AoBP Aortic blood pressure
PP Pulse pressure Close
AoPP Aortic pulse pressure Pressing Escape will close the screen without saving any
pAI Peripheral augmentation index data.
Aug pressure Augmentation pressure
HR Heart rate Inflate
Aug Index Augmentation index Press the Spacebar to inflate the cuff.
Beats Number of beats
PWA screen acquiring data

The averaging window on the right hand side will appear
after two complete sweeps (to accumulate sufficient
averaging data) and will update with each sweep.
Acquire several screens of steady data before freezing.
The function of the buttons is described in The Acquire

screen - PWA mode above except for :
Freeze
Pressing the Space bar will freeze the display.
Top Up
Pressing Return will top up the cuff pressure to the
Target value.

The frozen PWA screen
After a short pause the frozen PWA screen will appear
similar to the example opposite. The various indicators
will have calculation data added and the averaging
window will also freeze.
The function of the buttons is as for PWV frozen, Section

7.2 PWV Mode (except no Site option).
The indicator calculation values displayed and the

averaging window are modified as the screen is scrolled.
The averaging window
Averaged Brachial pressure.
Averaged central blood pressure pulse.
Indicates the Peak Aortic pressure.
Start of augmentation phase, it may be moved if

required, click on the line, move the cursor to the
desired point and click again.

display the time and pressure (or % if selected, see
Display area right click facilities below) at that point.
Display area right click facilities

Right click in the display area to display a menu,
available options are :
PWA Average Scales

May be set to mmHg or %.
Export Average Waves to CSV file

Export to the CSV file.
Calculations
Tick those required from the list.

CHAPTER 8 ABI / TBI
8.1 ABI / TBI
The ABI/TBI Protocol allows automatic ABI / TBI indices to be obtained from three segments on each side of the
body, these are :
Brachial to below Knee

Brachial to Ankle
Brachial to Toe

The blank Report screen will appear as opposite.
Use either the Doppler technique discussed in Chapter 3

Doppler Measurement or the PPG technique discussed in
Chapter 5 PPG Pressure Measurement to obtain
pressures. If using the PPG technique bilateral
measurement is possible. Click on the required Pressure
site to activate the Acquire screen.
Pressure data may be obtained by other means and

entered manually by right clicking over the Pressure box
and selecting Manual Pressure.
Pressures are displayed for each site together with the

ABI or TBI figure referenced to the Right Brachial.
A PVR recording for the Ankles may also be made using

the technique discussed in Chapter 5 PVR Measurement.
The Acquire screen

The acquire screen will be similar to the example.
Right click in either the top or bottom display area to

select the calculations performed for that area.
Sweep
Venous Filter
Multi-Chan
Switches between unilateral and bilateral modes.
Site
Toggles between upper or lower trace area.
AC Gain
Target
Close
Pressing Escape will return to the Report page without
saving any data.
Inflate
Pressing the space bar will start inflation. When target
pressure has been reached the button function will
change to Freeze which will freeze the display.
Top Up
Pressing Return will top up the pressure to the target
value.

CHAPTER 8 ABI / TBI
The frozen screen

The frozen screen will appear similar to the example
opposite. Independent scrolling of the two halves is
possible with the calculation parameters valid for the
area displayed, select using the Site button.
Selection of the calculations performed is possible

similar to the Acquire screen.
Scroll
Site
Toggles between upper or lower trace area.
Unfreeze
Close
data.
Save
Report Page.
Save options
Select Exams Settings from the Settings drop down
menu and then ABI/TBI. Select the option required :
Save Full Data

Will save the entire exam and will allow scrolling where
more than one screen has been saved in recalled
exams.
Save Displayed Data Only

Will save the displayed area only and will not permit
scrolling in recalled exams.

example given opposite if pressures have been added
manually. Pressures collected using Doppler/PPG/PVR
methods will have the pressure displayed in the
Pressure site along with the waveform for that site per
the partial example below.
Exam Notes
Export Pressures
The Export Pressures button will open a Windows style
Save screen, it will save the site names together with
pressures as a text file (.txt extension) with a default
filename made up of the ID, date and time (or your
filename) to a destination folder of your choice.
Save And Close

The function of the other buttons on this bar plus the


CHAPTER 9 CAROTID
9.1 CAROTID MEASUREMENT
This Chapter should enable the User to become acquainted with the Vicorder Carotid Protocol.
The Carotid Report Page

Enter the Carotid Report Page by selecting Carotid from
the Exam list in the Administration window.
The function of these controls is described in Chapter 13

The Completed Report.
The test sequence is automated. The 3-D figure will

show where to place the probe, press Enter to load the
Acquire screen.
When the first Acquire screen data has been saved the
next site in the sequence will be highlighted, press Enter
to load the Acquire screen.
The test sequence can also be accomplished manually,

place the cursor over the site box of interest, the 3-D
figure will show where to place the probe, press Enter to
load the Acquire screen.
For both methods the measurement site is also marked

on the Arterial diagram.
The Acquire Screen

The Acquire screen will look similar to the example
opposite when acquiring data. The Probe operating
frequency is automatically detected and displayed.
Selection of calculations is possible by right click in the

display area and selecting the parameters required as
described in Chapter 3 Doppler Measurement.
The function of the controls is :
Scales
Sweep
Trace
Flow Dir
Volume
Controls the volume of the sound output.
Gain
Controls the sensitivity of the spectral display.
Auto Gain
Spectral sensitivity automatically set by software for an
optimum display.
Calcs
Boost
Continued……

CHAPTER 9 CAROTID
Baseline
Moves the zero baseline.
Spectrum
Freeze
Pressing the spacebar will freeze the display.
Close
data and return to Report page.
Computed indices may be selected or de-selected by

right clicking in the screen area, place the cursor over
the Calculations box and select from the resultant list.
The Frozen screen

The vessel name remains displayed above the Acquire
window.
Selection of calculations is possible by right click in the

display area and selecting the parameters required as
described in Chapter 3 Doppler Measurement.
The frozen screen buttons operate in the same way as in

the Real Time display and their functions are :
Scroll
Scrolls spectral display.
DopTrax
Allows replay of the spectral display.
Export Data
Clicking on the Export Data button will open the Exam
Settings Save Options screen where options for saving
the data may be selected.

Calcs
Unfreeze
Pressing the spacebar will unfreeze the display.
Close
data.
Save
Pressing Return (Enter) closes the screen and saves the
data.

CHAPTER 10 LOWER ARTERIAL STRESS TEST
10.1 LOWER ARTERIAL STRESS TEST
Introduction
The programme has been design to allow the user first to record resting systolic pressure at both Brachial (B) sites
and at both Dorsalis Pedis (DP) and Posterior Tibial (PT) sites. During the exercise period the onset of symptoms is
recorded as well as the exercise time. During the post exercise period waveforms for the DP and PT site can be
recorded followed by pressure recordings at the B, DP and PT sites. There is a real time display of the results which
can be in the form of pressures versus time or ABI versus time.
Enter the Protocol by selecting Lower Arterial Stress from the Exam window in the Administration screen. If it is
intended to import pressures from the Lower Arterial report package the User should be fully acquainted with its
use before using this Protocol, see Chapter 13 The Completed Report.
Patient at rest
Input the Right and Left Brachial and Ankle Posterior
Tibial sites pressures at rest. This may be achieved by
using the Lower Arterial Protocol to obtain the pressures
at the required sites and then exporting via the Report
page.
The pressures may also be collected by other means

and entered manually, right click on the Pressure box,
select Manual Pressure then enter the reading for that
site. The pressure reading is not displayed in the
Pressure site box.
Start Exercise
Start the Patient exercising and simultaneously start the
timer by clicking the Start Exercise button in the Exam
Clock window.
Symptom onset
As soon as the Patient complains of symptoms click on
the Symptom Onset button in the Exam Clock window.
Continuing the exercise

Continue exercise at the discretion of the Patient, click
on the Stop Exercise button in the Exam Clock window
when exercise ceases.

CHAPTER 10 LOWER ARTERIAL STRESS TEST
Select and record waveforms
Record Right and Left Ankle Posterior Tibial and Dorsalis
Pedis Doppler waveforms before taking any post
exercise pressures.
The Exam Clock will continue to run in Recovery mode.
Post exercise pressures

Input the Right and Left Ankle Posterior Tibial and
Dorsalis Pedis site pressures post exercise as described
in the Patient at rest section.
The Exam Clock will continue to run in Recovery mode.

Stress Graphs
The resultant Stress Graphs, both right and left, will be
updated automatically in real time. Right click in the
graph area allows the option of selecting pressure or ABI
versus time and the option of displaying Brachial data.
Stress Tables
The Stress Tables tabulate the significant events and
data versus time.
About
Here you can view your product id which is unique to
your computer and the version number of the software
installed.
Print
Enables selection of destination printer and will send a
copy of the Report Page to that Printer.
Print Preview
Enables pre-viewing of the Report prior to printing.
Exam Notes
Allows the Examiner to add notes to the Report.
Patient Info
Displays the Patient data screen which can be amended
if required.
Save and Close

Saves the Report page and returns to the Administration
window.

CHAPTER 11 VENOUS TESTS
11.1 VENOUS OUTFLOW TEST
The Patient
The patient should be supine with the feet slightly
raised.
Attach cuffs as shown. Note that PRESS1 should be

attached to the (occlude) thigh cuff and PRESS2 to the
(collect) calf cuff. The 3-D figure in the Blank Report
screen illustrates where to place the cuffs and which run
is being conducted.

Launch the test by selecting Venous Outflow from the
Exam list in the Administration window. The Report
screen will appear as opposite.
The Acquire screen in PVR mode

Launch the Acquire screen, it will appear as opposite.
The trace will scroll from right to left.
DC Gain
Zero
Will return the trace to the baseline zero.
Mode
Switches between PVR and PPG mode, see below.
Close
data.
Start
Pressing Space starts the test.
Calculations
Right click in the display area to select the calculations
performed for that site.

The Acquire screen in PPG mode

The Acquire screen in PPG mode will appear as opposite.
The trace will scroll from right to left.
The button functions are covered above, additional

buttons for the PPG mode are :
Multi-Chan
Switches between unilateral and bilateral operation.
Site
Toggles between the upper and lower traces in bilateral
mode.
Performing the test

Press the spacebar to begin the test, the sequence is
automated and will go through the following 4 steps :
Step 1
The cuffs will be inflated to seat them.
Step 2
The collect cuff will be inflated.
Step 3
The trace will automatically zero.
Step 4
The collect cuff will be inflated to the target pressure, no
message is displayed.
The trace will start to rise, when it levels out press the
spacebar (this is reading VC)
Wait for the trace to drop and level out then press the
spacebar again to freeze the display.
The frozen acquire screen will appear as opposite with

the complete sequence shown and the 3 second marker
lines added in red. This section is shown expanded and
annotated below.
VO/VC is the percentage change.
Press Return to save the test.

Repeat the test sequence for
the remaining screens.
VO 6.37mmHg
VC 7.74mmHg
3 secs

Exam Settings
Select Edit Exam from the Edit drop down window in the
Report page to display the Exam Settings screen.
VO measurement time is factory preset to 3 seconds, it

can be adjusted between 1 and 10 seconds by dragging
the slider to the required time.
The Thigh cuff occlusion pressure is factory preset to

60mmHg, it can be adjusted by dragging the slider to
set the required Occlude Pressure.

11.2 VENOUS REFLUX TEST
The Patient
The patient should be sitting with the foot resting on the
floor. Allow the Patient to sit for several minutes prior to
starting the test to allow the venous system to settle.
Attach a PPG sensor above the inner ankle using a PPG
Venous holder and Adhesive ring as shown and connect
to PPG2 on the Vicorder.
Blank Report screen

Launch the test by selecting Venous Reflux from the
Exam list in the Administration window. The Report
screen will appear as opposite.
Placing the cursor over the measurement site box will

show on the 3-D figure where to place the Tourniquet
cuff (if required)
The Acquire screen

Launch the Acquire screen, it will appear as opposite,
shown in bilateral mode in this example. The trace will
scroll from right to left.
Multi-Chan
Switches between unilateral and bilateral operation.
Site
Toggles between the upper and lower traces in bilateral
mode.
DC Gain
Adjusts the amplitude of the display. Note that this
affects the displayed waveform only, calculations are
performed on the pre-attenuated signal.
Zero
Will return the trace to the baseline zero.
Target
Continued…..

Tourniquet
An optional cuff attached above the knee to inhibit
superficial venous reflux.
Close
data.
Inflate
Pressing the Spacebar will inflate the Tourniquet cuff if
selected.
Metronome
When enabled starts a 2 second period audible “tick”
(Laptop sound must be enabled)
Conducting the test

The screen as shown is in unilateral mode with the test
completed, all the stages are shown.
Start the test by zeroing the trace, press the Zero

button until the trace ceases to rise.
Start the metronome and have the Patient lift and lower
the front part of their foot whilst keeping the heel on the
floor in time with the metronome beat. Do this five
times in total.
Rest the foot and allow the trace to rise, when it has
levelled out press the spacebar to stop the test.
The time between the last

flexure and the trace levelling
out is indicated by the red
markers and given in seconds.
This section is shown expanded
and annotated below.
Press Return to save the test.

Repeat the test sequence for
the remaining screens.
Trace zero
0
Foot flexures
Relax

11.3 QUICK LAUNCH OUTFLOW TEST
The Acquire screen
Launch the Acquire screen by selecting Outflow from the
Quick Launch list, the screen will appear as opposite.
The trace will scroll from right to left
The function of the keys and conduct of the test is the

same as for the Venous Outflow test, Section 11.1.

11.4 QUICK LAUNCH REFLUX TEST
The Acquire screen
Launch the Acquire screen by selecting Reflux from the
Quick Launch list, the screen will appear as opposite. It
is shown in bilateral mode. The trace will scroll from
right to left.
The function of the keys and conduct of the test is the

same as for the Venous Reflux test, Section 11.2.

CHAPTER 12 GENERIC PROTOCOL EDITOR
12.1 GENERIC PROTOCOL EDITOR
Introduction
The Generic Protocol Editor may be used to design a User defined Protocol where the mode of operation, number of
sites, their titles, order of testing and the calculated parameters may be selected.
Tutorial
In order to learn how to programme your own Generic Test a tutorial example will be used.
Let us consider producing a simple Protocol for the Carotid Artery examination.
Sites required :
three on the right side and three on the left side, namely :
1. Right Common Carotid 2. Left Common Carotid
3. Right External Carotid 4. Left External Carotid
5. Right Internal Carotid 6. Left Internal Carotid
The measurement order will be as labelled above and displayed Calculations will be Mean Pressure, PI, No of Beats
and RT for each Site.
Step 1, launch the Generic Protocol Editor

In the Administration window select Generic Protocol
Editor in the Default Protocols section of the Exam list.
The Generic Protocol Editor screen consists of up to 20

sites which may be assigned to any vessel in any order.
For each site the Calculations performed may be
selected. Acquire screen mode and parameters may be
set.
Note : the 3-D figure is always absent in the Generic

Protocol mode and will not be present on the completed
User Defined Protocol and any subsequent Reports.
Step 2, setting the required number of sites

As we only require 3 sites on either side we must
remove the surplus sites, this done by right clicking on a
non-required site and then left clicking the Delete Site
selection, you will be asked to confirm “Yes” before the
deletion is made. Which numbered sites for each side
are deleted to achieve the required number of remaining
sites is immaterial.
Repeat for all non-required sites.

Step 3, site naming
To name a site right click on the required box and then
choose the Edit Name option (see Step 2), enter the
vessel name in the Site Title box and click OK when
done.
Repeat for the remaining five sites
If necessary a previously entered site name may be

amended in the same way.
This example shows the Report screen with all six sites
named.
Step 4, set up the Acquire screens

For each site we now have to set up the Acquire screen.
In the Report screen right click on the required box and
then select Mode, select the mode of operation -
Doppler, PPG or PVR from the list.
Right click again on the site box and select Calculations,

left click to select those calculations you require for that
site.
Button parameters are set by placing the cursor over

the required site and activating the Acquire screen by
left clicking. Set up the Button parameters as required.
The calculations may also be set up in the Acquire

screen, right click in the display area and place the
cursor over the Calculations box, left click to select
those calculations you require.
Press the Escape key to return to the Report page.
Repeat for the remaining five sites.

Step 5, completing the process
The order in which the tests are undertaken can now be
addressed and this is done by first activating the Edit
Exam from the Edit drop down menu in the top left hand
corner of the Report screen.
Type your name for the Protocol in the Exam Title: box.
A list of named sites from the Generic screen is

displayed in the default order. To alter a site placing in
the list select it by left clicking on it and use the Move
Up or Move Down buttons as required to place it. Repeat
for the remaining sites.
Checking Automate enables automatic examination site

stepping.
An image, logo or icon may be displayed in the centre of

the Report page, enter the path name in the the Custom
Image Path:. Alternatively click on the browse folder
image and select the path.
When done click on Add As New Protocol to save. You

will now be taken back to the Administration window.
The exercise is now complete and your tailored Protocol

is now ready for use.
Administration window Exam list

The updated portion of the Administration window will
now appear as opposite.
Your new Protocol name is displayed in the User Defined

list under Exam. A message window will display that the
new protocol was created successfully, click on OK to
close it.
Your tailored Protocol may be moved to the Favourites

section if required by clicking and holding on the name
and dragging it to the Favourites section.
Your Protocol may be launched by either double clicking

on it or selecting and then clicking on the Begin Exam
box near the bottom right hand corner of the screen.
User Defined Protocol Report screen

The example User Defined Protocol Report screen as
launched from the Administration window is given
opposite.
Reminder : the 3-D figure is not present in the User

Defined Protocol Report page nor any Subsequent
Reports. If you have selected a Custom Image it will be
displayed in the centre of the screen.
Further User Defined protocols may be created if

required.

CHAPTER 13 THE COMPLETED REPORT
13.1 THE COMPLETED REPORT PAGE
Completed Report Page
The completed Report Page will look similar to the
opposite, in this case for Lower Arterial w/Doppler.
The icon button functions are :
About
Here you can view your product id which is unique to
your computer and the version number of the software
installed.
Print
Enables selection of destination printer and will send a
copy of the Report Page to that Printer.
Print Preview
Enables pre-viewing of the Report prior to printing.
Exam Notes
Allows the Examiner to add notes to the Report.
Patient Info
Displays the Patient data screen which can be amended
if required.
Save and Close

Saves the Report page and returns to the Administration
window.
Stress Test
This warning message is displayed for Lower Arterial
Protocols only. Use the current protocol to collect
pressure data then select Stress Test to export the
pressures, see Chapter 10 Lower Arterial Stress Test.
Calculation selection for reports

Right click on the site window.
Calculations
The reported calculations for each site can be selected by left clicking on
the desired calculation.
Clear Data
The data for that site can be deleted.
Edit Name
The site name may be edited.
Play Audio
The audio may be replayed (Laptop sound must be enabled)

Pressure editing
Right clicking on a pressure site allows pressures to be
reviewed for that site.
Pressures
The pressure data window allows adjustment of the
cursor position if necessary.
Manual Pressure
The pressure may be obtained by other means and
entered manually.
Clear Data
Will remove the data recorded at that site.
Edit name
Allows the site name to be edited.
CNO recorded means Can Not Occlude
Note : for more than one pressure recorded at any site

the resultant pressure displayed is the mean of all the
pressures and is indicated with a bar over the number.
Exam Notes
From the Report Page click on the Exam Notes icon to
bring up the notes boxes.
Existing conditions : Enter notes as required.
Doctors Summary : Enter notes as required.
Click OK to close the Exam Notes.
Save and Close

Click on Save and Close to save the completed Report
Page.
Reviewing Patient Reports

Completed and stored Patient data files may retrieved at a later time for review and manipulation. See Section
13.3. Retrieving Patient Reports. This activity does not require the Vicorder to be connected.

13.2 THE PRINTED REPORT
Print Preview
In the Report screen, Section 13.1, click on the Print
Preview icon to review the Report prior to printing.
Print Report
In the Report screen, Section 13.1, click on the Print
icon to select the destination printer and print the
Report Page.
The Printed Report

Opposite is an example of what you can expect to see
printed on an A4 sheet of paper (in practice it will
occupy the whole of the A4 sheet)
Printing from the Administration screen

Printing Patient Reports is also possible from the
Administration screen, Select the Patient from the list,
select the Report and double click on the report
thumbnail, click on the Print icon.

13.3 RETRIEVING PATIENT REPORTS
Retrieval, review and manipulation of Patient Reports can take place without the Vicorder being connected.
Individual Patient retrieval and editing

Left click on a Patient name in the Patients: column, a
list of all tests conducted on a Patient will be displayed.
The ID Filter and Last Name Filter may be used to
search a list more rapidly.
The selected Patient profile is displayed at the bottom

left of the screen.
Right click on a selected Patient provides an editing drop

down window to enable Patient History page editing,
entry deletion and Patient list presentation style.
Double clicking on a Patient name or clicking on the

Patient Details box will display the Patient History plus
Symptoms data.
Individual Test retrieval and editing

A list of all the saved examinations carried out together
with date and time for the selected Patient is displayed.
Left clicking on an individual Test will display the Report
Page as a thumbnail below. Double clicking on the
required test will retrieve it for review, manipulation and
subsequent re-saving.
E-mail Patient reports

Highlight (do not open) the Patient Report that you wish
to send by left clicking on it once.
Click on the Send button in the Administration screen.
In the E-Mail Exam box enter the recipients e-mail

address(es) in the To… and Cc… boxes (Double clicking
on these boxes will bring up your Address Book)
Add the Subject: header and any accompanying text in

the boxes provided.
Click the Send! button.
The selected Report, as an attachment to the e-mail,

will be placed in the outbox of your e-mail software.

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VICORDER

Also applicable to the DopStudio

© Skidmore Medical Limited 2009

Chapter 1 (V6.6) Vicorder Instructions for Use Page 2 of 78

The Vicorder instrument is a Medical Device

The Vicorder provides two blood pressure

All immediate functional controls are available

 Seven top panel buttons for User “immediate” controls.

 Two front panel PPG sockets to connect to PPG sensors.

 Front panel power on LED.

 Rear panel USB cable connection via an 8 way connector.

 Rear panel Stereo Audio input via an RJ11 connector.

 Vicorder Serial number : 0100 and up

Chapter 1 (V6.6) Vicorder Instructions for Use Page 3 of 78

Safe use of Ultrasound

Natural Rubber Latex

Explanation of Vicorder symbols

Consult instructions for use.

Universal Serial Bus (USB) connection.

Auxiliary Audio input, see Section 1.5 Installation and Setup.

Chapter 1 (V6.6) Vicorder Instructions for Use Page 4 of 78

You will need

Chapter 1 (V6.6) Vicorder Instructions for Use Page 5 of 78

Windows 2000 with SP2 or higher

Recommended System Requirements :

Recommended System Requirements :

Important : Do not connect the Vicorder to your Laptop PC via a hub.

Chapter 1 (V6.6) Vicorder Instructions for Use Page 6 of 78

Vicorder Top, Front and Rear Panel User functions

USB input Auxiliary Stereo input

Connecting the Vicorder :

Auxiliary Stereo socket connections and basic specification :

Chapter 1 (V6.6) Vicorder Instructions for Use Page 7 of 78

Vicorder Program Installation

If installing over an older version

C:/Program Files/Skidmore Medical/DopStudio/Data

If installing from new

Web based version

To subsequently launch the Vicorder application see Section 1.6

It is recommended that your computer is backed up to a secure source on a regular basis.

Chapter 1 (V6.6) Vicorder Instructions for Use Page 8 of 78

The software version is given in the start up flash screen if required.

If you experience a communication failure try disconnecting and

Vicorder Serial Number

This will be followed by a check of the License status of your

Initial Audio setup

For non-Vista Users on first start up or after changing

Select Test Speaker and follow the on screen

The Volume setting is User settable from within the

This screen will not be displayed again on start up

Headphones or External speakers may be used, consult

Chapter 1 (V6.6) Vicorder Instructions for Use Page 9 of 78

If the software application has been activated

The Protocols discussed in the remainder of

Screen data cautionary notes

It is recommended that your computer is backed up to a secure source on a regular basis.

Chapter 1 (V6.6) Vicorder Instructions for Use Page 10 of 78

Enter Calibration mode by typing Ctrl+C and click on Calibrate.

This caution message is displayed before starting, click Yes.

This message is displayed on satisfactory calibration, click OK and close the