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Prolonged non-invasive blood pressure measurements in Auto mode may be associated with purport, ischemia and neuropathy in the limb wearing the cuff. When monitoring a patient, examine the extremities of the limb frequently for normal color, warmth and sensitivity. If any abnormality is observed, stop the blood pressure measurements.
How to setup ABPM50 for continuous monitoring? ABPM50 must be properly initialized prior to doing ambulatory monitoring. Follow the steps outlined below.
Is there any ABPM data in my device? From SYSTEM MENU >> ABPM >> ABPM Data, you should be able to scroll through all the ABPM measurements. Note that these measurements are not the same as those taken manually.
How to download the data to the computer? After initializing the system and create a patient, follow the steps below to archive the measurements from ABPM.
Where can I find the data on the computer? After saving the data to the computer, go to File >> Open Data and the dialog box (top diagram) would appear. By default, the data would be stored in [ABPM] folder. Select this folder, the dialog box (bottom diagram) shows all the data saved. Select the one you wanted and click "Okay". A window would appear displaying the data.
The above dialog box shows the patient name, patient ID, start time and file name. If the patient has not been setup, "nostring" would appear in the patient name field. The file name is based on the data timestamp.
By default, the files are stored in a sub-folder "Program Files\ABPM50\Data\ABPM50". If you are using WXP computer, the folder would be "c:\Program Files\ABPM50\Data\ABPM50"; For later versions of Windows (Vista, 7 and 8), the actual location would be "C:\Users\UserName\AppData\Local\VirtualStore\Program Files\ABPM50\Data\ABPM50." For the sake of security and ease of maintenance, Windows prevents software from writing into the "c:\Program Files" folder directly; Windows creates a Virtual Store for saving the data and different users using the computer can have their own virtual stores.
In Windows Explorer, one can go directly from "c:\Program Files\ABPM50\Data\ABPM50" to the corresponding virtual store by selecting the "Compatibility Files" button on the top.
How to assign patient info to a file? Select and open the file. Then go to Edit(tab) >> Patient Data and enter the patient related information. This would assign a patient ID and name to the selected file. The name and ID would show up in the "Open Data" screen next to the file name.
How to reinstall software? You would need to remove the program first prior to installing a new one. Follow the following steps.
How to install the driver in Windows 8? Windows 8 would prevent the driver from being installed as it is not digitally signed. To get around this issue, disable the driver signature enforcement before installing the software. To disable this feature:
Is the driver installed properly? If the installed software cannot find the ABPM50, the device driver may not be installed properly. To check for this possibility, plug in the ABPM50 in the computer USB port and make sure that it is turned on. Right click on "Computer" and select "Manage" > "Device Manager". If "STM32 Virtual COM port Device (COMx)" appears (see diagram below) , the device driver is installed properly; if "CD Class example" appears (see diagram below), Windows finds the device but not the driver; if no extra entry is found, Windows cannot find the device.
How to reinstall the device driver? Follow the following steps.
Depending on your computer configuration, Windows may interfere with the installation because "file could not be verified because it does not have an associated catalog signed via Authenticode(tm)." If so, you would need to disable the Windows driver signature enforcement before installing the driver.
To disable the driver signature enforcement, when booting the computer and before starting Windows, press F8 key to enter the Advance Boot Options Menu and select disable driver signature enforcement.
How to check the USB connection? Try a different USB cable and/or USB port. Get another USB device to verify that the USB cable and USB port work.
Everthing checks out, but there is still no connection? Software conflict is the most common cause and the most difficult one to solve. The programs running on your PC are interfering with each other in accessing the COM port. One fix is to remove the offending program; however this works only if you know this is the problem and the trick is to find the offending programs. I am not aware of any easy way to determine the conflict. There are a few things you can do to look for hints.
On a computer we used for testing various devices, we finally reinstalled Windows to solve the problem.
Possible fixes for resolving software conflicts are:
The application does not use a lot of resources. Any old computer running WXP would work. If you encounter any software conflict, just re-install Windows to get a clean machine.
You should try to install the software on another computer first to verify the problem before trying multi-boot or virtual machine. These two approaches, though not difficult, require some expertise in installing Windows. There are many other advantages in running multiple instances of Windows on one computer, which has saved us many times in the past.
Which cuff should I used? The width of the cuff should be either 40% of the limb circumference (50% for neonates) or 2/3 of the upper arm length. The inflatable part of the cuff should be long enough to encircle 50-80%of the limb. The wrong size of cuff can cause erroneous readings. If the cuff size is in question, then use a larger cuff.
Make sure that the cuff edge falls within the range of mark <->. If it does not, use a larger or smaller cuff that fits better.
|Patient||Limb Perimeter||Cuff Width|
|Neonate||6-11 cm||4.8 cm|
|Infant||10-19 cm||8 cm|
|Child||18-26 cm||10.6 cm|
|Adult1||25-35 cm||14 cm|
|Adult2||33 - 47 cm||17 cm|
|Thigh||46-66 cm||21 cm|
Will the insurance pay for the use of ABPM? This depends on the insurance. The most likely answer is yes for some medical conditions. Medicare has approved the use of ABPM under certain medical situations.
CPT code 93784 thru 93790 may be used for billing purposes, including:
|Ambulatory blood pressure monitoring; including recording, scanning analysis, interpretation and report.||93784|
|Scanning analysis with report||93788|
|Physician review with interpretation and report||93790|
|Elevated blood pressure reading without diagnosis of hypertension (The only ICD-9 code covered by Medicare)||796.2|
|Essential hypertension - Unspecified (Resistant)||401.9|
|Hypertensive heart disease||402|
|Hypertensive renal disease||403|
|Ill-defined descriptions and complications of heart disease||429|
|Hypertension complicating pregnancy, childbirth, and the puerperium||642|
|Transient hypertension of pregnancy||642.2|
|Mild or unspecified pre-eclampsia||642.4|
|Unspecified hypertension complicating pregnancy||642.9|
|Maternal hypotension syndrome||669.2|
|Syncope and collapse||780.2|
|Other Hypertension (Episodic, Labile, Postural)||997.91|