EPIQ 7 Ultrasound System

User Manual
Release 1.0

4535 617 25341 Rev B 

August 2013

© 2013 Koninklijke Philips N.V. All rights reserved. Published in USA.

Manufactured by Philips Ultrasound
22100 Bothell-Everett Highway
Bothell, WA 98021-8431
USA
Telephone: +1 425-487-7000 or 800-426-2670
Fax: +1 425-485-6080
www.healthcare.philips.com/ultrasound

This Medical Device meets the provisions of the transposition of the Medical Device Directive
93/42/EEC within the country of origin of the Notified Body concerned with the device.
European Union Representative
Philips Medical Systems Nederland B.V.
Quality & Regulatory Affairs
Veenpluis 4-6
5684PC Best
The Netherlands
WARNING
United States federal law restricts this device to sale by or on the order of a physician.
This document and the information contained in it is proprietary and confidential information of Philips Healthcare ("Philips") and
may not be reproduced, copied in whole or in part, adapted, modified, disclosed to others, or disseminated without the prior
written permission of the Philips Legal Department. This document is intended to be used either by customers, and is licensed to
them as part of their Philips equipment purchase, or to meet regulatory commitments as required by the FDA under 21 CFR
1020.30 (and any amendments to it) and other local regulatory requirements. Use of this document by unauthorized persons is
strictly prohibited.
Philips provides this document without warranty of any kind, implied or expressed, including, but not limited to, the implied
warranties of merchantability and fitness for a particular purpose.
Philips has taken care to ensure the accuracy of this document. However, Philips assumes no liability for errors or omissions and
reserves the right to make changes without further notice to any products herein to improve reliability, function, or design. Philips
may make improvements or changes in the products or programs described in this document at any time.
Unauthorized copying of this document, in addition to infringing copyright, might reduce the ability of Philips to provide accurate
and current information to users.
This product may contain remanufactured parts equivalent to new in performance, or parts that have had incidental use.
This product and its accessories are manufactured under or operate in accordance with the following United States patents and
corresponding patents in other countries: U.S. Patent Numbers 5,469,851; 5,471,989; 5,482,045; 5,485,842; 5,577,505; 5,706,819;
5,720,291; 5,735,281; 5,795,297; 5,833,613; 5,879,303; 5,891,040; 5,908,389; 5,951,478; 5,993,390; 5,993,392; 6,036,643;
6,102,863; 6,126,599; 6,126,602; 6,210,328; 6,224,552; 6,231,510; 6,251,074; 6,283,919; 6,299,579; 6,306,089; 6,315,723;
6,319,203; 6,364,828; 6,368,281; 6,380,766; 6,390,981; 6,416,477; 6,443,896; 6,447,453; 6,465,937; 6,469,957; 6,471,649;
6,491,630; 6,497,660; 6,500,120; 6,516,215; 6,527,719; 6,527,721; 6,532,819; 6,540,684; 6,544,175; 6,544,177; 6,551,248;
6,575,910; 6,629,929; 6,632,179; 6,676,606; 6,679,849; 6,685,637; 6,723,050; 6,743,174; 6,755,786; 6,755,788; 6,761,689;

2 EPIQ 7 User Manual 4535 617 25341

6,780,155; 6,824,517; 7,037,264; 7,043,062; 7,131,947; 7,439,656; 7,484,412; 7,544,164; 7,593,554; 7,637,869; 7,645,237;
7,648,461; 7,656,418; 7,704,208; 7,758,508; 7,771,354; 7,859,170; 8,030,824; 8,038,618; 8,096,947; 8,137,272; 8,161,817;
8,169,125; 8,177,718; 8,257,260; Re43,048; Re36,564.
"Chroma," "Color Power Angio," "High Q," "PercuNav," "QLAB," "SonoCT," "xMATRIX," and "XRES" are trademarks of Koninklijke
Philips N.V.
Non-Philips product names may be trademarks of their respective owners.

EPIQ 7 User Manual 4535 617 25341 3

4 EPIQ 7 User Manual 4535 617 25341
Contents

Contents
1 Read This First .............................................................................................................. 15
Intended Audience .............................................................................................................. 15
Intended Use ....................................................................................................................... 15
Warnings .............................................................................................................................. 16
Warning Symbols ................................................................................................................. 17
User Information Components ............................................................................................ 17
Product Conventions ........................................................................................................... 18
User Information Conventions ............................................................................................ 19
Upgrades and Updates ........................................................................................................ 21
Customer Comments ........................................................................................................... 21
Supplies and Accessories ..................................................................................................... 21
Customer Service ................................................................................................................. 22
Recycling, Reuse, and Disposal ............................................................................................ 22
2 Safety ........................................................................................................................... 27
Basic Safety .......................................................................................................................... 27
Electrical Safety ................................................................................................................... 29
Defibrillators ................................................................................................................33
Fire Safety ....................................................................................................................34
Mechanical Safety ................................................................................................................ 34
Equipment Protection .......................................................................................................... 36
Product Compatibility .......................................................................................................... 37
Symbols ................................................................................................................................ 38
Biological Safety ................................................................................................................... 46
FDA Medical Alert on Latex .........................................................................................49
ALARA Education Program ...........................................................................................50
Output Display .............................................................................................................54
Control Effects .............................................................................................................58
Related Guidance Documents .....................................................................................60
Acoustic Output and Measurement ............................................................................60
Acoustic Output Tables ................................................................................................63
Acoustic Measurement Precision and Uncertainty .....................................................63
Operator Safety ................................................................................................................... 65

EPIQ 7 User Manual 4535 617 25341 5

Contents

Repetitive Strain Injury ...............................................................................................65

Foot Switch Warning ...................................................................................................65
Philips Transducers ......................................................................................................66
Glutaraldehyde Exposure ............................................................................................66
Infection Control ..........................................................................................................66
Electromagnetic Compatibility ............................................................................................ 68
Radio-Frequency Emissions .........................................................................................69
ECG Signal ....................................................................................................................70
Electrostatic Discharge Precautions ............................................................................70
Electromagnetic Emissions ..........................................................................................71
Approved Cables for Electromagnetic Compliance .....................................................72
Approved Transducers for Electromagnetic Compliance ............................................73
Approved Accessories for Electromagnetic Compliance .............................................73
Electromagnetic Immunity ..........................................................................................74
Electromagnetic Interference ......................................................................................77
Recommended Separation Distance ...........................................................................79
Avoiding Electromagnetic Interference .......................................................................81
Use Restrictions Due to Interference ...........................................................................81
3 System Overview .......................................................................................................... 83
System Capabilities .............................................................................................................. 83
Measurements .............................................................................................................83
Transducer Types .........................................................................................................84
Image Acquisition and Review .....................................................................................84
Patient Data Protection ...............................................................................................84
System Options .................................................................................................................... 84
Imaging Options ...........................................................................................................85
Connectivity Capabilities .............................................................................................85
Clinical/Analysis Applications ......................................................................................86
QLAB Advanced Quantification Software Options .......................................................86
Stress Echocardiography ..............................................................................................87
Data Security ................................................................................................................88
PercuNav Image Fusion and Interventional Navigation ..............................................88
System Components ............................................................................................................ 88
Video Monitor ..............................................................................................................90
Control Module ............................................................................................................90

6 EPIQ 7 User Manual 4535 617 25341

Contents

On/Off (Power) Control ...............................................................................................92

Data Storage ...............................................................................................................93
Peripherals ...................................................................................................................95
Transducer Receptacles and Cable Management ........................................................96
Physio (ECG) Receptacles .............................................................................................98
Wheel Brakes and Steering Locks ................................................................................99
4 Preparing the System .................................................................................................. 101
Connecting Devices ............................................................................................................ 101
External Printers ........................................................................................................102
Connecting an External Printer ..................................................................................103
Configuring Local Printers ..........................................................................................104
Connecting the Foot Switch .......................................................................................105
Connecting an External DVD Recorder ......................................................................105
Connecting an External Color Monitor ......................................................................105
Connecting the System to a Network ................................................................................ 106
Moving the System ............................................................................................................ 106
Preparing and Moving the System .............................................................................108
Positioning the System in Confined Spaces ...............................................................111
Setting Up After Moving ............................................................................................112
5 Using the System ........................................................................................................ 113
Turning the System On and Off ......................................................................................... 113
Setting the System Time and Date ..................................................................................... 114
Using the Brakes and Steering Locks ................................................................................. 115
Monitor Adjustments ........................................................................................................ 116
Positioning the Monitor .............................................................................................117
Changing the Monitor Tint .........................................................................................117
Changing the Default Monitor Brightness .................................................................118
Automatic Display Dimming ......................................................................................119
System Controls ................................................................................................................. 119
Control Panel .............................................................................................................119
Control Panel Adjustments ........................................................................................121
Adjusting Control Panel Brightness ...........................................................................121
Positioning the Control Panel ....................................................................................121
Setting the Depth Control ..........................................................................................122
Touch Screen .............................................................................................................122

EPIQ 7 User Manual 4535 617 25341 7

Contents

Touch Screen Layout ..................................................................................................123

Touch Screen Controls ...............................................................................................124
Utilities Touch Screen ................................................................................................125
System Tab Touch Screen Controls ............................................................................125
Trackball .....................................................................................................................126
Soft Key Controls .......................................................................................................127
Using the Keyboards ..................................................................................................128
Status Icons ................................................................................................................129
Power Management .......................................................................................................... 130
Sleep Mode ................................................................................................................131
Battery Indicators ......................................................................................................132
System Security .................................................................................................................. 133
Logging On to the System ..........................................................................................133
Logging Off of the System ..........................................................................................134
Changing Your Password ...........................................................................................134
Imaging Display .................................................................................................................. 135
Patient Bar .................................................................................................................136
Image Area .................................................................................................................136
Tools and Icons Area ..................................................................................................138
Emergency Studies ............................................................................................................. 138
Temporary ID .............................................................................................................139
Starting Emergency Studies .......................................................................................139
Setting the Auto Freeze Function ...................................................................................... 140
Transducer Receptacles and Cable Management ..............................................................140
Selecting a Transducer ....................................................................................................... 142
Selecting a Preset ............................................................................................................... 143
ECG Feature ....................................................................................................................... 143
DVD, CD, and USB Devices ................................................................................................. 143
Media Compatibility ..................................................................................................143
DVD Drive ..................................................................................................................144
Loading and Ejecting a Disc ........................................................................................144
Erasing a DVD .............................................................................................................144
USB Devices ...............................................................................................................145
DICOM Viewer ...........................................................................................................146
6 Customizing the System .............................................................................................. 147

8 EPIQ 7 User Manual 4535 617 25341

Contents

Presets ............................................................................................................................... 147

Setting the Default Transducer and Preset ................................................................148
Clinical Applications and Presets ...............................................................................148
Quick Save Presets .....................................................................................................148
Creating Quick Save Presets ......................................................................................149
Deleting Quick Save Presets ......................................................................................149
Copying Quick Save Presets to Removable Media .....................................................149
Loading Quick Save Presets from Removable Media .................................................150
System Setups .................................................................................................................... 150
Changing Setups ........................................................................................................151
Hiding the Doppler Velocity Minus Sign ....................................................................151
System Options .................................................................................................................. 152
Custom Procedures ............................................................................................................ 152
Creating a Custom Procedure ....................................................................................152
Selecting a Custom Procedure ...................................................................................153
7 Performing an Exam .................................................................................................... 155
New Patient Exams ............................................................................................................ 155
Entering Patient Data .................................................................................................156
Selecting in the Worklist ............................................................................................156
Searching in the Worklist ...........................................................................................157
Hiding Patient Name and ID on Images .....................................................................157
Imaging Modes .................................................................................................................. 158
Selecting a Transducer ....................................................................................................... 158
Annotation ......................................................................................................................... 159
Adding Labels .............................................................................................................159
Adding Labels Using the Keyboard ............................................................................161
Adding an Image Title ................................................................................................161
Displaying Body Markers ...........................................................................................161
Recording ........................................................................................................................... 162
Using the DVD Recorder ............................................................................................162
Printing .............................................................................................................................. 163
Printing in Live Imaging ..............................................................................................163
Review ............................................................................................................................... 164
Starting Review ..........................................................................................................164
Navigating Thumbnails and Images ...........................................................................165

EPIQ 7 User Manual 4535 617 25341 9

Contents

Capturing Images and Loops .............................................................................................. 165

Measurement and Analysis ............................................................................................... 167
Performing a 2D Distance Measurement ..................................................................168
Measuring M-Mode Distance ....................................................................................169
Measuring the Doppler Trace on a Sweeping Display ...............................................169
Obtaining a Typical Labeled Measurement ...............................................................169
Measuring Then Labeling ...........................................................................................170
Ending an Exam .................................................................................................................. 170
8 Transducers ................................................................................................................ 173
Selecting a Transducer ....................................................................................................... 173
Setting the Default Transducer and Preset ........................................................................174
Clinical Applications and Transducers ...............................................................................174
Indications for Use and Supporting Transducers ...............................................................176
xMatrix Array Transducers ................................................................................................. 177
X5-1 Description ........................................................................................................177
X6-1 Description ........................................................................................................178
Transducer Maintenance ................................................................................................... 178
Acoustic Artifacts ............................................................................................................... 179
Acoustic Artifacts in 3D Imaging ................................................................................181
Transducer Covers ............................................................................................................. 183
Ultrasound Transmission Gels ........................................................................................... 184
Transducer Storage ............................................................................................................ 185
Storage for Transport ................................................................................................185
Daily and Long-Term Storage .....................................................................................186
9 Intraoperative Transducers ......................................................................................... 187
Operators of Intraoperative Transducers ..........................................................................187
Intended Uses for Intraoperative Transducers ..................................................................188
Patient Safety During Intraoperative Studies ...................................................................188
Patient-Contact Parts .................................................................................................189
Preventing Intraoperative Transducer Problems ..............................................................190
L15-7io Description ............................................................................................................ 190
Preparing Transducers for Intraoperative Use ..................................................................191
Disposable Drapes .....................................................................................................192
Accessories for Intraoperative Transducers ..............................................................192
Electrical Safety and Intraoperative Transducers ..............................................................192

10 EPIQ 7 User Manual 4535 617 25341

Contents

Leakage Current Testing for Intraoperative Transducers ..................................................193

Testing Intraoperative Transducer Leakage Current (Source) ...................................196
Testing Intraoperative Transducer Leakage Current (Sink) .......................................197
10 Transesophageal Transducers ..................................................................................... 199
Operators of TEE Transducers ........................................................................................... 199
Patient Safety During TEE Studies ...................................................................................... 200
Patient-Contact Parts .................................................................................................204
Preventing TEE Transducer Problems ................................................................................ 204
Electrical Safety and TEE Transducers ............................................................................... 205
Leakage Current and TEE Transducers .......................................................................206
Reducing Risks of Using TEE Transducers ..................................................................206
TEE Deflection Control Basics ........................................................................................... 207
X7-2t TEE Transducer Description ..................................................................................... 209
Using the X7-2t TEE Transducer ......................................................................................... 210
X7-2t Deflection Controls ..........................................................................................211
Manipulating the X7-2t Tip ........................................................................................213
Rotating the X7-2t Image Plane ................................................................................215
S7-3t TEE Transducer Description ..................................................................................... 216
Using the S7-3t TEE Transducer ........................................................................................ 217
S7-3t TEE Controls .....................................................................................................218
Manipulating the S7-3t TEE Tip ..................................................................................220
S7-3t TEE Array Rotation ...........................................................................................221
Rotating the S7-3t TEE Array .....................................................................................222
Checking the TEE Transducer ............................................................................................. 223
TEE Transducer Inspection .........................................................................................223
TEE Transducer Controls Inspection ..........................................................................223
Special Considerations for TEE Studies .............................................................................. 223
Patient Selection for TEE Transducer Use ..................................................................224
Preparing Patients for TEE Studies ............................................................................225
TEE Study Guidelines .................................................................................................225
Tip Fold-Over ..................................................................................................................... 226
Recognizing Tip Fold-Over .........................................................................................226
Correcting Tip Fold-Over ............................................................................................227
Preventing Tip Fold-Over ..........................................................................................227
TEE Temperature Sensing .................................................................................................. 228

EPIQ 7 User Manual 4535 617 25341 11

Contents

Ensuring Safe TEE Temperatures ...............................................................................229

Manual Auto-Cool Feature ........................................................................................229
Using the Temperature Display ................................................................................230
Patient Temperature .................................................................................................231
Entering Patient Temperature ...................................................................................231
Resuming Imaging After Auto-Cool ...........................................................................231
Patient Care After a TEE Study ........................................................................................... 232
TEE Accessories and Supplies ............................................................................................ 233
Bite Guards ................................................................................................................233
TEE Transducer Covers ..............................................................................................233
Tip Protectors ............................................................................................................234
Disposable Drapes .....................................................................................................234
TEE Leakage Current Test .................................................................................................. 234
TEE Test Background ..................................................................................................234
Testing TEE Transducer Leakage Current ...................................................................237
TEE Transducer References ............................................................................................... 238
11 Endocavity Transducers .............................................................................................. 239
Operators of Endocavity Transducers ................................................................................ 239
Patient Safety During Endocavity Studies ..........................................................................239
Preparing Transducers for Endocavity Use ........................................................................240
C10-3v Description ............................................................................................................. 241
C10-4ec Description ........................................................................................................... 241
Patient-Contact Parts ......................................................................................................... 242
Biopsy with Endocavity Transducers ................................................................................. 243
12 Biopsy Guides ............................................................................................................. 245
Attaching and Removing a Biopsy Guide ...........................................................................245
Biopsy Guideline Display .................................................................................................... 246
Displaying the Biopsy Guideline ......................................................................................... 247
Moving the Biopsy Depth Cursor ....................................................................................... 248
Biopsy Guide Alignment .................................................................................................... 249
Preparation for Alignment Verification .....................................................................249
Verifying the Biopsy Guide Alignment .......................................................................250
Performing a Biopsy Procedure ......................................................................................... 252
Biopsy Guide Maintenance ................................................................................................ 254
13 Transducer Care .......................................................................................................... 255

12 EPIQ 7 User Manual 4535 617 25341

Contents

Transducer Care Safety ...................................................................................................... 255

Latex Product Alert ....................................................................................................256
Transmissible Spongiform Encephalopathy ...............................................................257
Choosing the Correct Transducer-Care Method ................................................................257
Transducer, Cable, and Connector Cleaning ......................................................................258
Cleaning a Transducer ...............................................................................................260
Cleaning and Disinfecting Cables and Connectors .....................................................261
Transducer Disinfection ..................................................................................................... 263
Isopropyl Alcohol Restrictions ...................................................................................264
Disinfecting Transducers Using a Wipe or Spray Method .........................................264
Transducer Disinfection by Immersion ......................................................................266
Minimizing the Effects of Residual Disinfectant ........................................................267
Disinfecting Non-TEE Transducers by Immersion ......................................................268
Cautions for TEE Transducer Disinfection ..................................................................269
Disinfecting TEE Transducers by Immersion ..............................................................270
Disinfecting TEE Transducers with an AER .................................................................273
Transducer Sterilization ..................................................................................................... 273
Sterilizing Transducers by Immersion ........................................................................275
Disinfectants Compatibility ................................................................................................ 276
Disinfectant Types .....................................................................................................277
Factors Affecting Disinfectant Efficiency ...................................................................278
Disinfectants and Cleaning Solutions Compatibility Table .........................................278
14 System Maintenance .................................................................................................. 287
Cleaning and Maintaining the System ............................................................................... 287
Cleaning the System and ECG Equipment .................................................................287
Disinfectants for System Surfaces .............................................................................289
Disinfecting System Surfaces .....................................................................................290
System Control Panel Maintenance ...........................................................................291
Cleaning the Trackball ................................................................................................291
Cleaning the System Air Filter ....................................................................................291
Specifying and Resetting the Air Filter Maintenance Status ......................................293
Transducer Maintenance ................................................................................................... 293
Printer and DVD Recorder Maintenance ...........................................................................294
Troubleshooting ................................................................................................................. 295
Error Messages .................................................................................................................. 296

EPIQ 7 User Manual 4535 617 25341 13

Contents

Test Patterns ...................................................................................................................... 296

Transferring the Test Patterns ...................................................................................296
Using the Test Patterns ..............................................................................................296
Testing the System ............................................................................................................. 297
For Assistance .................................................................................................................... 297
15 Specifications .............................................................................................................. 299
Safety and Regulatory Requirements ................................................................................ 302
16 Index .......................................................................................................................... 303

14 EPIQ 7 User Manual 4535 617 25341

Intended Audience Read This First

1 Read This First

This manual is intended to assist you with the safe and effective operation of your Philips
product. Before attempting to operate the product, read this manual and strictly observe all
warnings and cautions. Pay special attention to the information in the “Safety” section.
The user information for your Philips product describes the most extensive configuration of the
product, with the maximum number of options and accessories. Some functions described may
be unavailable on your product's configuration.

Intended Audience
Before you use your user information, you need to be familiar with ultrasound techniques.
Sonography training and clinical procedures are not included here.
This document is intended for sonographers, physicians, and biomedical engineers who operate
and maintain your Philips product.

Intended Use
This product is intended to be installed, used, and operated only in accordance with the safety
procedures and operating instructions given in the product user information, and only for the
purposes for which it was designed. For indications for use, see “Indications for Use and
Supporting Transducers” on page 176. However, nothing stated in the user information
reduces your responsibility for sound clinical judgment and best clinical procedure.
Installation, use, and operation of this product is subject to the law in the jurisdictions in which
the product is used. Install, use, and operate the product only in such ways that do not conflict
with applicable laws or regulations, which have the force of law.
Use of the product for purposes other than those intended and expressly stated by Philips, as
well as incorrect use or operation, may relieve Philips or its agents from all or some
responsibility for resultant noncompliance, damage, or injury.

EPIQ 7 User Manual 4535 617 25341 15

Read This First Warnings

WARNING
System users are responsible for image quality and diagnosis. Inspect the data that is being
used for the analysis and diagnosis and ensure that the data is sufficient both spatially and
temporally for the measurement approach being used.

Warnings
Before using the system, read these warnings and the “Safety” section.

WARNING
Do not remove the protective covers on the system; hazardous voltages are present inside.
Cabinet panels must be in place while the system is in use. All internal adjustments and
replacements must be made by a qualified Philips Ultrasound field service engineer.

WARNING
To avoid electrical shock, use only supplied power cords and connect only to properly
grounded wall (wall/mains) outlets.

WARNING
Do not operate this system in the presence of flammable gases or anesthetics. Explosion can
result. The system is not compliant in AP/APG environments as defined by IEC 60601-1.

WARNING
Medical equipment must be installed and put into service according to the special
electromagnetic compatibility (EMC) guidelines provided in the “Safety” section.

WARNING
The use of portable and mobile radio-frequency (RF) communications equipment can affect
the operation of medical equipment.

16 EPIQ 7 User Manual 4535 617 25341

Warning Symbols Read This First

Warning Symbols
The system may use the following warning symbols. For additional symbols used on the system,
see the “Safety” section.
Warning Symbols
Symbol Description
Identifies a safety note.

Dangerous voltages: Appears adjacent to high-voltage terminals, indicating the presence of

voltages greater than 1,000 Vac (600 Vac in the United States).

Identifies ESD (electrostatic-discharge) sensitivity of a connector that is not tested as

specified in IEC 60601-1-2. Do not touch exposed connector pins. Touching exposed pins
can cause electrostatic discharge, which can damage the product.
Indicates that the user should see the instructions for use for safety information.

User Information Components

The user information provided with your product includes the following components:
• User Information CD: Includes all of the user information, except the Operating Notes. The
instructions for using the CD are included with the CD.
• Operating Notes: Contains information that clarifies certain product responses that might
be misunderstood or cause user difficulty.
• User Manual: Provided with the product and included on the CD. The User Manual
introduces you to features and concepts, helps you set up your system, and includes
important safety information. This manual also includes procedures for basic operation. For
detailed operating instructions, see the Help.
• Quick Guide: Provided with the product and included on the CD. The Quick Guide helps you
perform an ultrasound exam step-by-step.

EPIQ 7 User Manual 4535 617 25341 17

Read This First Product Conventions

• Help: Available on the system in some languages and included on the CD, the Help contains
comprehensive instructions for using the system. The Help also provides reference
information and descriptions of all controls and display elements. To display the Help, touch
on the touch screen.
• Acoustic Output Tables: Included on the CD, it contains information about acoustic output
and patient-applied part temperatures.
• Medical Ultrasound Safety: Included on the CD, it contains information on bioeffects and
biophysics, prudent use, and implementing ALARA (as low as reasonably achievable).
• Shared Roles for System and Data Security: Included on the CD, it contains guidelines to
help you understand how the security of your Philips product could be compromised and
information on Philips' efforts to help you prevent security breaches.
• Media Compatibility: Included on the CD, it contains current information on media that are
compatible with your system.

Product Conventions
Your Philips product uses certain conventions throughout the interface to make it easy for you
to learn and use:
• Three unlabeled buttons near the trackball are used with the trackball. The two buttons on
either side of the trackball are called the "left and right trackball buttons," and they operate
somewhat similarly to PC mouse buttons. The button above the trackball is called the
"middle trackball button," and it is used to update the imaging display, complete
measurements, and other operations as specified in procedures. The trackball arbitration
icon, at the bottom of the display, indicates the current functions of the trackball buttons.
• Tabs along the top of the monitor display let you choose additional sets of setup options.
Tabs along the top of the touch screen let you choose additional pages of controls.
• To type text into a text field, click in the field and use the keyboard.
• To display a list, click the down arrow . To scroll through a list, click the arrows at either
end of the scroll bar or drag the scroll box up or down.
• Controls on the control panel include buttons, knobs, slide controls, and a trackball. Press a
button to activate or deactivate its function. Turn a knob to change the selected setting.
Press a knob-button to activate its function, or turn it to change the selected setting. Move
a slide control to change its setting. Roll the trackball in the direction that you want to move
an object.

18 EPIQ 7 User Manual 4535 617 25341

User Information Conventions Read This First

• Controls on the touch screen include buttons, knob labels, and sliders. To use a touch
screen button, simply touch it. To use a touch screen knob label, touch the label and adjust
the corresponding knob, located directly below it on the control panel. If two knob labels
are available for the knob, you must first touch the knob label that you want to adjust. To
use a slider, swipe the slider button, or touch a location on the slider, to move the slider
button.
• Many tabs on the touch screen contain two pages of controls. To display the second page,
place your finger on the touch screen and swipe to the left. To return to the first page, place
your finger on the touch screen and swipe to the right.
• Some areas of the display include chevrons . Clicking displays or hides additional
information, options, or fields.

User Information Conventions

The user information for your product uses the following typographical conventions to assist
you in finding and understanding information:
• All procedures are numbered, and all subprocedures are lettered. You must complete steps
in the sequence they are presented to ensure success.
• Bulleted lists indicate general information about a particular function or procedure. They do
not imply a sequential procedure.
• Control names and menu items or titles are spelled as they are on the system, and they
appear in bold text. Exceptions are the trackball, the buttons adjacent to it, and the TGC
slide controls, all of which are unlabeled.
• Symbols appear as they appear on the system.
• The pointer is the cursor used to select elements on the display. Use the Pointer control to
display the pointer.
• Point means to position the tip of the pointer or cursor on an item on the display.
• Click means to move the pointer or cursor to an object and press one of the unlabeled
trackball buttons located on either side of the trackball.
• Select means to move the pointer to an object and press one of the unlabeled trackball
buttons located on either side of the trackball to "highlight" the object (such as an item in a
list), or in the case of a check box or "radio button," to fill the object. Deselect means
clicking the item to remove the highlight or fill.
• Double-click means to quickly click twice to select an object or text.

EPIQ 7 User Manual 4535 617 25341 19

Read This First User Information Conventions

• Drag means to place the pointer over an object and then press and hold the left or right
trackball button while moving the trackball. Use this method to move an object on the
display.
• Touch means to press a button on the touch screen, located above the control panel.
• Swipe means to touch the touch screen with the tip of your finger and move your finger in a
quick motion either to the left or to the right. This action displays an additional touch
screen, if one is available.
• Highlight means to change the color of a display selection (such as an item in a list) or
overlay it with a colored bar, usually by clicking.
• The left side of the system is to your left as you stand in front of the system, facing the
system. The front of the system is nearest to you as you operate it.
• Transducers and pencil probes both are referred to as transducers, unless the distinction is
important to the meaning of the text.
Information that is essential for the safe and effective use of your product appears throughout
your user information as follows:

WARNING
Warnings highlight information vital to the safety of you, the operator, and the patient.

CAUTION
Cautions highlight ways that you could damage the product and consequently void your
warranty or service contract or ways that you could lose patient or system data.

NOTE
Notes bring your attention to important information that will help you operate the product
more effectively.

20 EPIQ 7 User Manual 4535 617 25341

Upgrades and Updates Read This First

Upgrades and Updates

Philips is committed to innovation and continued improvement. Upgrades may be announced
that consist of hardware or software improvements. Updated user information will accompany
those upgrades.

Customer Comments
If you have questions about the user information, or you discover an error in the user
information, in the USA, please call Philips at 800-722-9377; outside the USA, please call your
local customer service representative.

Supplies and Accessories

To order ECG trunk cables, lead sets, and electrodes; transducer covers; bite guards; biopsy
guides; and other supplies and accessories, contact CIVCO Medical Solutions:
CIVCO Medical Solutions
102 First Street South, Kalona, IA 52247‑9589
Telephone: 800‑445‑6741 (USA and Canada), +1 319‑248‑6757 (International)
Fax: 877‑329‑2482 (USA and Canada), +1 319‑248‑6660 (International)
E-mail: [email protected]
Internet: www.civco.com
To order the items listed in the following table, see the referenced section and then contact
your Philips representative.
System Accessories
Item Additional Information
Cables See “Approved Cables for Electromagnetic Compliance” on
page 72.

DVD recorder See “Approved Accessories for Electromagnetic

Compliance” on page 73

EPIQ 7 User Manual 4535 617 25341 21

Read This First Customer Service

Item Additional Information

Foot switch Contact your Philips representative.

Printers See “External Printers” on page 102.

Removable media See “Media Compatibility” on page 143.

Transducers See “Clinical Applications and Transducers” on page 174.

Customer Service
Customer service representatives are available worldwide to answer questions and to provide
maintenance and service. Please contact your local Philips representative for assistance. You
can also contact the following office for referral to a customer service representative, or visit
the Philips Healthcare "Contact Us" website:
www.healthcare.philips.com/main/about/officelocator/index.wpd
Philips Ultrasound Headquarters
22100 Bothell-Everett Highway, Bothell, WA 98021-8431, USA
800-722-9377

Recycling, Reuse, and Disposal

Philips is concerned with helping protect the natural environment and helping ensure
continued safe and effective use of this system through proper support, maintenance, and
training. Philips designs and manufactures equipment in compliance with relevant guidelines
for environmental protection. As long as the equipment is properly operated and maintained, it
presents no risk to the environment. However, the equipment may contain materials that could
be harmful to the environment if disposed of incorrectly. Use of such materials is essential for
the implementation of certain functions and for meeting certain statutory and other
requirements.
The European Union Directive on Waste Electrical and Electronic Equipment (WEEE) requires
producers of electrical and electronic equipment to provide reuse and treatment information
for each product. This information is provided in a Philips Healthcare Recycling Passport. Such
recycling passports for Philips Ultrasound systems are available on this website:

22 EPIQ 7 User Manual 4535 617 25341

Recycling, Reuse, and Disposal Read This First

www.healthcare.philips.com/main/about/sustainability/recycling/ultrasound.wpd
Recycling, reuse, and disposal information in this document is directed mainly at the entity with
legal authority over the equipment. Operators are usually uninvolved in disposal, except in the
case of certain batteries.

Passing Your System to Another User

If you pass this system to another user who will use the system for its intended purpose, then
pass it on in its complete state. Particularly, ensure that all the product-support documentation,
including all instructions for use, are passed on to the new user. Make the new user aware of
the support services that Philips Healthcare provides for installing, commissioning, and
maintaining the system, and for comprehensive operator training. Existing users must
remember that passing on medical electrical equipment to new users may present serious
technical, medical, privacy, and legal risks. The original user may remain liable, even if the
equipment is given away.
Philips strongly advises you to seek advice from your local Philips representative before
agreeing to pass on any equipment.
After you pass the system to a new user, you might still receive important safety-related
information, such as bulletins and field change orders. In many jurisdictions the original owner
has a clear duty to communicate such safety-related information to new users. If you are
unable or unprepared to do this, inform Philips Healthcare about the new user, so that Philips
Healthcare can provide the new user with safety-related information.

Final Disposal of Your System

Final disposal is when you dispose of the system in such a way that it can no longer be used for
its intended purposes.

EPIQ 7 User Manual 4535 617 25341 23

Read This First Recycling, Reuse, and Disposal

WARNING
Do not dispose of this system (or any parts of it) with industrial or domestic waste. The
system may contain materials such as lead, tungsten, or oil, or other hazardous substances
that can cause serious environmental pollution. The system also contains privacy-sensitive
information, which should be properly removed (scrubbed). Philips advises you to contact
your Philips service organization before disposing of this system.

Philips Healthcare gives support for the following:

• Recovery of useful parts
• Recycling of useful materials by competent disposal companies
• Safe and effective disposal of equipment
For advice and information, contact your Philips service organization, or see the following
website:
www.healthcare.philips.com/us/about/sustainability/recycling

Perchlorate Material
In this system, perchlorate material is present in lithium coin cells or batteries. Special handling
may apply to those items. For more information, see this website:
www.dtsc.ca.gov/hazardouswaste/perchlorate

Discarding Batteries
Batteries should be discarded if there are visual signs of damage. Batteries should be discarded
in an environmentally safe manner. Properly dispose of batteries according to local regulations.

WARNING
Do not disassemble, puncture, or incinerate batteries. Be careful not to short the battery
terminals because this could result in a fire hazard.

24 EPIQ 7 User Manual 4535 617 25341

Recycling, Reuse, and Disposal Read This First

CAUTION
Use caution when handling, using, and testing the batteries. Do not short circuit, crush, drop,
mutilate, puncture, apply reverse polarity, expose to high temperatures, or disassemble.
Misuse or abuse could cause physical injury.

NOTE
Wash skin with large amounts of water in the event of electrolyte leakage to prevent skin
irritation and inflammation.

EPIQ 7 User Manual 4535 617 25341 25

Read This First Recycling, Reuse, and Disposal

26 EPIQ 7 User Manual 4535 617 25341

Basic Safety Safety

2 Safety
Please read this information before using your ultrasound system. It applies to the ultrasound
system, transducers, recording devices, and any optional equipment. This section covers
general safety information only. Safety information that applies only to a specific task is
included in the procedure for that task.
This device is intended for use by, or by the order of, and under the supervision of a licensed
physician qualified to direct the use of the device.

WARNING
Warnings highlight information vital to the safety of you, the operator, and the patient.

CAUTION
Cautions highlight ways that you could damage the product and consequently void your
warranty or service contract or ways that you could lose patient or system data.

Basic Safety

WARNING
Do not use the system for any application until you have read, understood, and know all the
safety information, safety procedures, and emergency procedures contained in this "Safety"
section. Operating the system without a proper awareness of safe use could lead to fatal or
other serious personal injury.

EPIQ 7 User Manual 4535 617 25341 27

Safety Basic Safety

WARNING
Do not use this system for any application until you are sure that the system's periodic
maintenance is current. If any part of the system is known or suspected to be defective or
incorrectly adjusted, do not use the system until it is repaired. Operating the system with
defective or incorrectly adjusted components could expose you and the patient to safety
hazards.

WARNING
Do not use the system for any application until you are adequately and properly trained on
its safe and effective operation. If you are unsure of your ability to operate the system safely
and effectively, do not use it. Operation of the system without proper and adequate training
could lead to fatal or other serious personal injury.

WARNING
Do not operate the system with patients unless you have an adequate understanding of its
capabilities and functions. Using the system without such understanding may compromise
the system's effectiveness and the safety of the patient, you, and others.

WARNING
Never attempt to remove, modify, override, or frustrate any safety device on the system.
Interfering with safety devices could lead to fatal or other serious personal injury.

WARNING
Use the system only for its intended purposes. Do not use the system with any product that
Philips does not recognize as compatible with the system. Operation of the product for
unintended purposes, or with incompatible products, could lead to fatal or other serious
injury.

WARNING
Stop use immediately if the system or the transducer appear to be malfunctioning. Contact
your Philips representative immediately.

28 EPIQ 7 User Manual 4535 617 25341

Electrical Safety Safety

Electrical Safety
This equipment has been verified by a recognized third-party testing agency as a Class I device
with Type BF and Type CF isolated patient-applied parts. (The safety standards met by this
system are included in the “Specifications” section.) For maximum safety, observe these
warnings and cautions:

WARNING
Shock hazards may exist if this system, including all externally mounted recording and
monitoring devices, is not properly grounded. Protection against electrical shock is provided
by grounding the chassis with a three-wire cable and plug. The system must be plugged into a
grounded outlet. The grounding wire must not be removed or defeated.

WARNING
To avoid the risk of electrical shock, never connect the system power cord to a power strip or
an extension cord. When using the power cord, always connect it directly to a grounded wall
outlet.

WARNING
Use only Type CF transducers for invasive procedures. Type B transducers are insufficiently
electrically isolated for invasive use.

WARNING
Do not remove the protective covers on the system; hazardous voltages are present inside.
Cabinet panels must be in place while the system is in use. All internal adjustments and
replacements must be made by a qualified Philips Ultrasound field service engineer.

WARNING
Do not operate this system in the presence of flammable gases or anesthetics. Explosion can
result. The system is not compliant in AP/APG environments as defined by IEC 60601-1.

EPIQ 7 User Manual 4535 617 25341 29

Safety Electrical Safety

WARNING
To avoid risk of electrical shock hazards, always inspect the transducer before use: Check the
face, housing, and cable before use. Do not use if the face is cracked, chipped, or torn; the
housing is damaged; or the cable is abraded.

WARNING
To avoid risk of electrical shock hazards, always turn off the system and disconnect it from
the wall outlet before cleaning the system.

WARNING
All patient-contact devices, such as transducers, pencil probes, and ECG leads not specifically
indicated as defibrillation-proof, must be removed from patient contact before application of
a high-voltage defibrillation pulse. See “Defibrillators” on page 33.

WARNING
During transesophageal echocardiographic (TEE) procedures, either remove the TEE
transducer from the patient or disconnect the TEE transducer from the system immediately
following image acquisition.

WARNING
Ultrasound equipment in normal operation, as with other medical electronic diagnostic
equipment, uses high-frequency electrical signals that can interfere with pacemaker
operation. Though the possibility of interference is slight, be alert to this potential hazard and
stop system operation immediately if you note interference with a pacemaker.

WARNING
When using additional peripheral equipment powered from an electrical source other than
the ultrasound system, the combination is considered to be a medical system. It is your
responsibility to comply with IEC 60601-1 and test the system to those requirements. If you
have questions, contact your Philips representative.

30 EPIQ 7 User Manual 4535 617 25341

Electrical Safety Safety

WARNING
Do not use nonmedical peripherals, such as report printers, within 1.5 m (5 ft) of a patient,
unless the nonmedical peripherals receive power from an isolated power outlet on the Philips
ultrasound system, or from an isolation transformer that meets medical safety standards, as
defined by standard IEC 60601-1.

WARNING
The system and patient-applied parts meet the standard IEC 60601-1. Applied voltages
exceeding the standard, although unlikely, may result in electrical shock to the patient or
operator.

WARNING
Connection of optional devices not supplied by Philips Ultrasound could result in electrical
shock. When such optional devices are connected to your ultrasound system, ensure that the
total system earth leakage current does not exceed 500 µA.

WARNING
To avoid risk of electrical shock, do not use any transducer that has been immersed beyond
the specified cleaning or disinfection level.

WARNING
To avoid risks of electrical shock and fire hazards, inspect the system power cord and plug
regularly. Ensure that they are not damaged in any way.

WARNING
Do not drape the power cord over any of the cable hooks or the handle on the system cart.
Damage to the cord or power receptacle unit can occur if the cart is raised.

WARNING
Operating the system with physio input signals that are below the specified minimum levels
may cause inaccurate results. See the “Specifications” section.

EPIQ 7 User Manual 4535 617 25341 31

Safety Electrical Safety

WARNING
Electrosurgical units (ESUs) and other devices intentionally introduce radio frequency
electromagnetic fields or currents into patients. Because imaging ultrasound frequencies are
coincidentally in the radio frequency range, ultrasound transducer circuits are susceptible to
radio frequency interference. While an ESU is in use, severe noise interferes with the black-
and-white image and completely obliterates the color image. Concurrent failures in an ESU or
other device and in the outer layer of the TEE transducer shaft can cause electrosurgical
currents to return along the transducer conductors. This could burn the patient, and the
ultrasound system and the transducer could also be damaged. Be aware that a disposable
transducer cover provides no protective electrical insulation at ESU frequencies.

WARNING
To avoid risk of a burn hazard, do not use transducers with high-frequency surgical
equipment. A burn hazard may result from a defect in the high-frequency surgical neutral
electrode connection.

WARNING
Using cables, transducers, and accessories other than those specified for use with the system
may result in increased emissions from, or decreased immunity of, the system.

CAUTION
Although your system has been manufactured in compliance with existing EMI/EMC
requirements, use of this system in the presence of an electromagnetic field can cause
momentary degradation of the ultrasound image. When interference is present or
intermittent, use caution when continuing to use the system. If interference occurs often,
review the environment in which the system is being used, to identify possible sources of
radiated emissions. These emissions could be from other electrical devices used within the
same room or an adjacent room. Communication devices such as cellular phones and pagers
can cause these emissions. The existence of radio, TV, or microwave transmission equipment
located nearby can cause emissions. In cases where EMI is causing disturbances, it may be
necessary to relocate your system.

32 EPIQ 7 User Manual 4535 617 25341

Electrical Safety Safety

CAUTION
For information on electromagnetic emissions and immunity as it applies to the system, see
“Electromagnetic Compatibility ” on page 68. Ensure that the operating environment of
your system meets the conditions specified in the referenced information. Operating the
system in an environment that does not meet those conditions may degrade system
performance.

Defibrillators
Observe the following warnings when a defibrillation is required while using the ultrasound
system.

WARNING
Before defibrillation, always remove all patient-applied parts from the patient.

WARNING
Before defibrillation, always disconnect invasive transducers that remain in contact with the
patient from the system.

WARNING
A disposable transducer cover provides no protective electrical insulation against
defibrillation.

WARNING
A small hole in the outer layer of the transducer opens a conductive path to grounded metal
parts of the transducer. The secondary arcing that could occur during defibrillation could
cause patient burns. The risk of burns is reduced, but not eliminated, by using an ungrounded
defibrillator.

EPIQ 7 User Manual 4535 617 25341 33

Safety Electrical Safety

Use defibrillators that do not have grounded patient circuits. To determine whether a
defibrillator patient circuit is grounded, see the defibrillator service guide, or consult a
biomedical engineer.

Fire Safety

WARNING
On electrical or chemical fires, use only extinguishers that are specifically labeled for those
purposes. Using water or other liquids on an electrical fire can lead to fatal or other serious
personal injury. Before attempting to fight a fire, if it is safe to do so, attempt to isolate the
product from electrical and other supplies, to reduce the risk of electrical shock.

Use of electrical products in an environment for which they were not designed can lead to fire
or explosion. Fire regulations for the type of medical area being used should be fully applied,
observed, and enforced. Fire extinguishers should be available for both electrical and
nonelectrical fires.

Mechanical Safety
A list of precautions related to mechanical safety follows; observe these precautions when
using the system:

WARNING
Be aware of the wheels on the system cart, especially when moving the system. The system
could cause injury to you or others if it rolls over feet or into shins. Use caution when going
up or down ramps.

WARNING
When attempting to overcome an obstacle, do not push the system from either side with
excessive force, which could cause the system to tip over.

34 EPIQ 7 User Manual 4535 617 25341

Mechanical Safety Safety

WARNING
Position external hardcopy devices away from the system. Ensure that they are secure. Do
not stack them on the system.

WARNING
When positioning the monitor, move it carefully to avoid pinching hands or extremities
against other objects, such as a bed rail.

WARNING
Never park the system on an incline.

WARNING
The brakes are intended as a convenience. To increase cart security, use wheel chocks when
the system is parked.

WARNING
If system operation is abnormal after you move or transport the system, contact Philips
Ultrasound Customer Service immediately. System components are installed securely and can
withstand considerable shock, but excessive shock can cause a system failure.

WARNING
To avoid injury, Philips recommends against lifting the system cart.

WARNING
If you park the system on a floor that is tilted 10 degrees or more and set the brakes, one of
the braked casters might not be touching the floor, which can cause the system to move.

EPIQ 7 User Manual 4535 617 25341 35

Safety Equipment Protection

WARNING
Before moving the system, ensure that the keyboard is retracted, the control panel is
centered, and the monitor is locked. When extended, the keyboard might be damaged if it
hits another object, and the video monitor could swing out during transport, causing injury or
equipment damage.

CAUTION
Ensure that the cables for all patient-applied parts are secure before moving the system. Use
the cable management system to ensure that transducer cables are protected from damage.

CAUTION
Do not roll the system over transducer cables or power cables.

Equipment Protection
Follow these precautions to protect your system:

CAUTION
Excessive bending or twisting of cables on patient-applied parts may cause failure or
intermittent operation of the system. Do not roll the system over cables, which may damage
them.

CAUTION
Improper cleaning or sterilization of a patient-applied part may cause permanent damage.
For cleaning and disinfection instructions, see the “Transducer Care” section.

CAUTION
Do not submerge the transducer connector in solution. The cables and transducer bodies are
liquid‑tight, but the connectors are not.

36 EPIQ 7 User Manual 4535 617 25341

Product Compatibility Safety

CAUTION
Do not use solvents, such as thinner or acetone, or abrasive cleaners on the system,
transducers, or any hardcopy device.

CAUTION
For optimal performance, connect your ultrasound system to a circuit dedicated solely for the
system. Do not connect life-support devices to the same circuit as the ultrasound system.

CAUTION
If systems, transducers, and peripherals have been in an environment below 10°C (50°F),
allow them to reach room temperature before connecting or turning them on. Philips
recommends allowing 24 hours for complete normalization. Otherwise, condensation inside
the devices could cause damage. If the device was only briefly exposed to temperatures
below 10°C (50°F), then the time required for the device to return to room temperature could
be significantly less than 24 hours.

CAUTION
To avoid damaging the flat-panel display in the monitor, do not store the system where the
ambient temperature exceeds 65°C (149°F).

Product Compatibility
Do not use your system in combination with other products or components, unless Philips
expressly recognizes those other products or components as compatible. For information about
such products and components, contact your Philips representative.
Changes and additions to the system should be made only by Philips or by third parties
expressly authorized by Philips to do so. Such changes and additions must comply with all
applicable laws and regulations that have the force of law within the jurisdictions concerned,
and best engineering practices.

EPIQ 7 User Manual 4535 617 25341 37

Safety Symbols

WARNING
System changes and additions that are made without the appropriate training or by using
unapproved spare parts may void the Philips warranty. As with all complex technical
products, maintenance by unqualified persons or using unapproved spare parts carries
serious risks of system damage and personal injury.

Symbols
The International Electrotechnical Commission (IEC) has established a set of symbols for
medical electronic equipment that classify a connection or warn of potential hazards. Of those
symbols, the following may be used on your Philips product and its accessories and packaging.
USA federal law restricts this device to sale by or on the order of a physician.

Isolated patient connection (Type BF applied part).

Defibrillation-proof patient connection (Type BF applied part).

Non-isolated patient connection (Type B applied part).

Isolated patient connection for applied part intended for intraoperative use,
including direct cardiac application and contact with major vessels (Type CF
applied part).
Defibrillation-proof patient connection (Type CF applied part).

38 EPIQ 7 User Manual 4535 617 25341

Symbols Safety

Identifies ESD (electrostatic-discharge) sensitivity of a connector that is not

tested as specified in IEC 60601-1-2. Do not touch exposed connector pins.
Touching exposed pins can cause electrostatic discharge, which can damage the
product.
Identifies an On/Off control.

On a two-position power switch, represents On ( ) and Off ( ).

Identifies a safety note.

Indicates that the user should see the instructions for use for safety
information.

Identifies equipotential ground.

Identifies earth ground.

Identifies protective earth ground.

Nonionizing electromagnetic radiation. Indicates that interference may occur in

the vicinity of equipment marked with this symbol.

Indicates conformance with European Council Directive 93/42/EEC.

The radio component contained in this device is compliant to Council Directive

1999/5/EC (Radio Equipment and Telecommunications Terminal Equipment
Directive).

EPIQ 7 User Manual 4535 617 25341 39

Safety Symbols

Class 2 radio equipment identifier per Directive 1999/5/EC. European Union

member states may apply restrictions on putting this device into service or
placing it on the market. This device is intended to be connected to the Publicly
Available Interfaces for use throughout the European Economic Area.
Indicates that the device is protected against the effects of vertically falling
water. This degree of protection can apply to transducers.

Indicates that the device is protected against the effects of splashing liquids.
This degree of protection can apply to foot-operated devices.

Indicates that the device is protected against the effects of immersion. This
degree of protection can apply to transducers and foot-operated devices.

Indicates that the device is protected against the effects of immersion for up to
60 minutes. This degree of protection can apply to foot-operated devices or
transducers.
Indicates the need for separate collection for electrical and electronic
equipment in compliance with the Waste Electrical and Electronic Equipment

(WEEE) Directive. When accompanied by or , components of the device

may contain lead or mercury, respectively, which must be recycled or disposed
of in accordance with local, state, or federal laws. The backlight lamps in an LCD
system monitor contain mercury.
Do not throw away. Dispose of in accordance with local, state, or federal laws.

Do not reuse.

Use-by date.

40 EPIQ 7 User Manual 4535 617 25341

Symbols Safety

Global Medical Device Nomenclature Code.

Global Trade Item Number

Model name for the device

Indicates a possible crushing hazard to hands.

Warns that the system should not be used stacked with other equipment. If the
system is used stacked with or adjacent to other equipment, verify normal
operation before use.
Indicates the temperature range (noncondensing) for transport and storage.
(Does not apply to media.)

Indicates the atmospheric pressure range for transport and storage.

Indicates the relative humidity range (noncondensing) for transport and storage.

Indicates that a connector receives alternating current.

Identifies fuse boxes or their locations. For continued protection from fire and
shock, replace fuses only with fuses of the same type and rating.

Identifies the date of manufacture.

EPIQ 7 User Manual 4535 617 25341 41

Safety Symbols

Identifies the legal manufacturer.

This side up: Points toward the side of the shipping crate that should be kept
facing up.

Indicates that the device should be kept dry.

Indicates that the device is fragile; handle with care.

Do not use if damaged.

Warns of system over-balance due to external force. (Do not push on the
monitor or the transducer holders to move the system.)

Keep away from sunlight.

Non-sterile.

Sterilized using ethylene oxide.

Catalog number.

Batch code.

42 EPIQ 7 User Manual 4535 617 25341

Symbols Safety

Serial number.

Universal part number.

The following symbols may also be used on the system and its accessories and packaging:
Indicates a hazard to patients with pacemakers. Do not place field generator
within 200 mm (8 in) of a patient with a pacemaker.

Connection for a pencil probe

Connection for a pencil probe

Connection for a transducer

Connection for ECG and physio leads

Connection for ECG and physio leads

Print remote output

Input port for audio left/right, VHS/S-VHS, microphone, CD, or DVD

EPIQ 7 User Manual 4535 617 25341 43

Safety Symbols

Output port for audio left/right, VHS/S-VHS, video patient monitor, black-and-
white printer, or interlaced RGB output port

Input port

VGA or parallel output port

DVI video output receptacle

USB input/output port

FireWire (IEEE 1394) input/output port

Ethernet connection

RS-232 serial port

System microphone

Isolated auxiliary power provided for connection of Philips-approved remote

accessories.

Foot switch

44 EPIQ 7 User Manual 4535 617 25341

Symbols Safety

SVGA or DVI-I connection.

Video Connection

S-Video connection

B/W Composite video output connection

Color composite video output connection

Video print trigger connection

EU Authorized Representative

Russian approval (GOST)

Chinese Environmentally Friendly Use Period symbol.

EPIQ 7 User Manual 4535 617 25341 45

Safety Biological Safety

CSA (CSA International) classification symbol.

Indicates a possible pinch hazard when positioning the monitor.

The following symbols may be used inside the system:

Dangerous voltages: Appears adjacent to high-voltage terminals, indicating the
presence of voltages greater than 1,000 Vac (600 Vac in the United States).

Identifies equipotential ground.

Biological Safety
This section contains information about biological safety and a discussion of the prudent use of
the system.
A list of precautions related to biological safety follows; observe these precautions when using
the system. For more information refer to Medical Ultrasound Safety on your User Information
CD.

WARNING
Do not use the system if an error message on the video display indicates that a hazardous
condition exists. Note the error code, turn off power to the system, and call your customer
service representative.

WARNING
Do not use a system that exhibits erratic or inconsistent image updating. Discontinuities in
the scanning sequence indicate a hardware failure that must be corrected before use.

46 EPIQ 7 User Manual 4535 617 25341

Biological Safety Safety

WARNING
Perform ultrasound procedures prudently. Use the ALARA (as low as reasonably achievable)
principle.

WARNING
Use only acoustic standoffs that have been approved by Philips Ultrasound. For information
on ordering approved accessories, see “Supplies and Accessories” on page 21.

WARNING
Verify the alignment of the biopsy guide before use. See the “Biopsy Guides” section.

WARNING
Verify the condition of the biopsy needle before use. Do not use a bent biopsy needle.

WARNING
Transducer covers may contain natural rubber latex. Those covers may cause allergic
reactions in some individuals. See “FDA Medical Alert on Latex” on page 49.

WARNING
The M2203A bite guard strap contains natural rubber latex, which may cause allergic
reactions. See “FDA Medical Alert on Latex” on page 49.

WARNING
In contrast studies using a high-MI acoustic field, capillary rupture, due to microbubble
expansion within a capillary in an acoustic field, can cause extravasation. References: (1)
Skyba, D.M., Price, R.J., Linka, A.Z., Skalak, T.C., Kaul, S. "Direct in vivo visualization of
intravascular destruction of microbubbles by ultrasound and its local effects on tissue."
Circulation, 1998; 98:290-293. (2) van Der Wouw, P.A., Brauns, A.C., Bailey, S.E., Powers, J.E.,
Wilde, A.A. "Premature ventricular contractions during triggered imaging with ultrasound
contrast." Journal of the American Society of Echocardiography, 2000;13(4):288-94.

EPIQ 7 User Manual 4535 617 25341 47

Safety Biological Safety

WARNING
Preventricular contractions can be caused by the oscillations of microbubbles when a high-MI
acoustic field is triggered in the heart at the end of systole. In a very sick patient with certain
risk factors, theoretically, this could lead to ventricular fibrillation. Reference: van Der Wouw,
P.A., Brauns, A.C., Bailey, S.E., Powers, J.E., Wilde, A.A. "Premature ventricular contractions
during triggered imaging with ultrasound contrast." Journal of the American Society of
Echocardiography, 2000;13(4):288-94.

WARNING
If a sterile transducer cover becomes compromised during an intraoperative application
involving a patient with transmissible spongiform encephalopathy, such as Creutzfeldt-Jakob
disease, follow the guidelines of the U.S. Centers for Disease Control and this document from
the World Health Organization: WHO/CDS/ APH/2000/3, WHO Infection Control Guidelines
for Transmissible Spongiform Encephalopathies. The transducers for your system cannot be
decontaminated using a heat process.

WARNING
If the system becomes contaminated internally with bodily fluids carrying pathogens, you
must immediately notify your Philips service representative. Components inside the system
cannot be disinfected. In that case, the system must be disposed of as biohazardous material
in accordance with local or federal laws.

WARNING
The backlight lamps in the system displays may contain mercury and must be recycled or
disposed of according to local, state, or federal laws.

WARNING
Select the correct application when starting an exam, and remain in that application
throughout the exam. Some applications are for parts of the body that require lower limits
for acoustic output.

48 EPIQ 7 User Manual 4535 617 25341

Biological Safety Safety

FDA Medical Alert on Latex

March 29, 1991, Allergic Reactions to Latex-Containing Medical Devices
Because of reports of severe allergic reactions to medical devices containing latex (natural
rubber), the FDA is advising health care professionals to identify their latex sensitive patients
and be prepared to treat allergic reactions promptly. Patient reactions to latex have ranged
from contact urticaria to systemic anaphylaxis. Latex is a component of many medical devices,
including surgical and examination gloves, catheters, intubation tubes, anesthesia masks, and
dental dams.
Reports to the FDA of allergic reactions to latex-containing medical devices have increased
lately. One brand of latex cuffed enema tips was recently recalled after several patients died as
a result of anaphylactoid reactions during barium enema procedures. More reports of latex
sensitivity have also been found in the medical literature. Repeated exposure to latex both in
medical devices and in other consumer products may be part of the reason that the prevalence
of latex sensitivity appears to be increasing. For example, it has been reported that 6% to 7% of
surgical personnel and 18% to 40% of spina bifida patients are latex sensitive.
Proteins in the latex itself appear to be the primary source of the allergic reactions. Although it
is not now known how much protein is likely to cause severe reactions, the FDA is working with
manufacturers of latex-containing medical devices to make protein levels in their products as
low as possible.
FDA’s recommendations to health professionals in regard to this problem are as follows:
• When taking general histories of patients, include questions about latex sensitivity. For
surgical and radiology patients, spina bifida patients and health care workers, this
recommendation is especially important. Questions about itching, rash or wheezing after
wearing latex gloves or inflating a toy balloon may be useful. Patients with positive histories
should have their charts flagged.
• If latex sensitivity is suspected, consider using devices made with alternative materials, such
as plastic. For example, a health professional could wear a non-latex glove over the latex
glove if the patient is sensitive. If both the health professional and the patient are sensitive,
a latex middle glove could be used. (Latex gloves labeled “Hypoallergenic” may not always
prevent adverse reactions.)
• Whenever latex-containing medical devices are used, especially when the latex comes in
contact with mucous membranes, be alert to the possibility of an allergic reaction.

EPIQ 7 User Manual 4535 617 25341 49

Safety Biological Safety

• If an allergic reaction does occur and latex is suspected, advise the patient of a possible
latex sensitivity and consider an immunologic evaluation.
• Advise the patient to tell health professionals and emergency personnel about any known
latex sensitivity before undergoing medical procedures. Consider advising patients with
severe latex sensitivity to wear a medical identification bracelet.
The FDA is asking health professionals to report incidents of adverse reactions to latex or other
materials used in medical devices. (See the October 1990 FDA Drug Bulletin.) To report an
incident, contact the FDA Problem Reporting Program, MedWatch, at 1-800-332-1088, or on
the Internet:
www.fda.gov/Safety/MedWatch/
For a single copy of a reference list on latex sensitivity, write to: LATEX, FDA, HFZ-220, Rockville,
MD 20857.

NOTE
The ultrasound system and transducers described in this document do not contain natural
rubber latex that contacts humans. Natural rubber latex is not used on any Philips ultrasound
transducer. It also is not used on Philips ECG cables for the products described in this
document.

ALARA Education Program

The guiding principle for the use of diagnostic ultrasound is defined by the "as low as
reasonably achievable" (ALARA) principle. The decision as to what is reasonable has been left to
the judgment and insight of qualified personnel. No set of rules can be formulated that would
be sufficiently complete to dictate the correct response to every circumstance. By keeping
ultrasound exposure as low as possible, while obtaining diagnostic images, users can minimize
ultrasonic bioeffects.
Since the threshold for diagnostic ultrasound bioeffects is undetermined, it is the sonographer’s
responsibility to control total energy transmitted into the patient. The sonographer must
reconcile exposure time with diagnostic image quality. To ensure diagnostic image quality and
limit exposure time, an ultrasound system provides controls that can be manipulated during the
exam to optimize the results of the exam.

50 EPIQ 7 User Manual 4535 617 25341

Biological Safety Safety

The ability of the user to abide by the ALARA principle is important. Advances in diagnostic
ultrasound, not only in the technology but in the applications of that technology, have resulted
in the need for more and better information to guide the user. The output display indices are
designed to provide that important information.
There are a number of variables which affect the way in which the output display indices can be
used to implement the ALARA principle. These variables include index values, body size,
location of the bone relative to the focal point, attenuation in the body, and ultrasound
exposure time. Exposure time is an especially useful variable, because it is controlled by the
user. The ability to limit the index values over time supports the ALARA principle.

Applying ALARA
The system imaging mode used depends upon the information needed. 2D and M‑mode
imaging provide anatomical information, while Doppler, Color Power Angio (CPA), and Color
imaging provide information about blood flow. A scanned mode, like 2D or Color, disperses or
scatters the ultrasonic energy over an area, while an unscanned mode, like M‑mode or Doppler,
concentrates ultrasonic energy. Understanding the nature of the imaging mode being used
allows the sonographer to apply the ALARA principle with informed judgment. Additionally, the
transducer frequency, system setup values, scanning techniques, and operator experience
allow the sonographer to meet the definition of the ALARA principle.
The decision as to the amount of acoustic output is, in the final analysis, up to the system
operator. This decision must be based on the following factors: type of patient, type of exam,
patient history, ease or difficulty of obtaining diagnostically useful information, and the
potential localized heating of the patient due to transducer surface temperatures. Prudent use
of the system occurs when patient exposure is limited to the lowest index reading for the
shortest amount of time necessary to achieve acceptable diagnostic results.
Although a high index reading does not mean that a bioeffect is actually occurring, a high index
reading should be taken seriously. Every effort should be made to reduce the possible effects of
a high index reading. Limiting exposure time is an effective way to accomplish this goal.
There are several system controls that the operator can use to adjust the image quality and
limit the acoustic intensity. These controls are related to the techniques that an operator might
use to implement ALARA. These controls can be divided into three categories: direct, indirect,
and receiver controls.

EPIQ 7 User Manual 4535 617 25341 51

Safety Biological Safety

Acoustic Output Limits

This ultrasound system maintains acoustic output below the appropriate limits for each
application, as listed here. The significant difference in magnitude emphasizes the need to
select the correct application and remain in that application, so the correct application limits
are in use for the appropriate application.
Limits for Non-Ophthalmic Applications
• Ispta.3 ≤ 720 mW/cm2
• MI ≤ 1.9
• TI ≤ 6.0
Limits for Ophthalmic Applications
• Ispta.3 ≤ 50 mW/cm2
• MI ≤ 0.23
• TI ≤ 1.0

Direct Controls
Application selection and the output-power control directly affect acoustic intensity. There are
different ranges of allowable intensity or output based on your selection. Selecting the correct
range of acoustic intensity for the application is one of the first things that occurs in any exam.
For example, peripheral vascular intensity levels are not recommended for fetal exams. Some
systems automatically select the proper range for a particular application, while others require
manual selection. Ultimately, the user has the responsibility for proper clinical use. The
ultrasound system provides both automatic (default) settings and manual (user-selectable)
settings.
Output power has direct impact on acoustic intensity. Once the application has been
established, the power control can be used to increase or decrease the intensity output. The
power control allows you to select intensity levels less than the established maximum. Prudent
use dictates that you select the lowest output intensity that is consistent with good image
quality.

Indirect Controls
The indirect controls are those that have an indirect effect on acoustic intensity. These controls
affect imaging mode, pulse repetition frequency, focus depth, pulse length, and transducer
selection.

52 EPIQ 7 User Manual 4535 617 25341

Biological Safety Safety

The choice of imaging mode determines the nature of the ultrasound beam. 2D is a scanning
mode; Doppler is a stationary or unscanned mode. A stationary ultrasound beam concentrates
energy in a single location. A moving or scanned ultrasound beam disperses the energy over an
area and the beam is concentrated on the same area for a fraction of the time as that of an
unscanned mode.
Pulse repetition frequency or rate refers to the number of ultrasound bursts of energy over a
specific period of time. The higher the pulse repetition frequency, the more pulses of energy in
a period of time. Several controls affect pulse repetition frequency: focal depth, display depth,
sample volume depth, flow optimization, scale, number of focal zones, and sector-width
controls.
Focus of the ultrasound beam affects the image resolution. To maintain or increase resolution
at a different focus requires a variation in output over the focal zone. This variation of output is
a function of system optimization. Different exams require different focal depths. Setting the
focus at the proper depth improves the resolution of the structure of interest.
Pulse length is the time during which the ultrasonic burst is turned on. The longer the pulse, the
greater the time-average intensity value. The greater the time-average intensity, the greater
the likelihood of temperature increase and cavitation. Pulse length, burst length, or pulse
duration is the output pulse duration in PW Doppler. Increasing the Doppler sample-volume
size increases the pulse length.
Transducer selection indirectly affects intensity. Tissue attenuation changes with frequency.
The higher the transducer operating frequency, the greater the attenuation of the ultrasonic
energy. A higher transducer operating frequency requires more output intensity to scan at a
deeper depth. To scan deeper at the same output intensity, a lower transducer frequency is
required. Using more gain and output beyond a point, without corresponding increases in
image quality, can mean that a lower frequency transducer is needed.

Receiver Controls
Receiver controls are used by the operator to improve image quality. These controls have no
effect on output. Receiver controls only affect how the ultrasound echo is received. These
controls include gain, TGC, dynamic range, and image processing. The important thing to
remember, relative to output, is that receiver controls should be optimized before output is
increased. For example, before increasing output, optimize gain to improve image quality.

EPIQ 7 User Manual 4535 617 25341 53

Safety Biological Safety

An Example of Applying the ALARA Principle

An ultrasound scan of a patient’s liver begins with selecting the appropriate transducer
frequency. After selecting the transducer and the application, which are based on patient
anatomy, adjustments to output power should be made to ensure that the lowest possible
setting is used to acquire an image. After the image is acquired, adjusting the focus of the
transducer, and then increasing the receiver gain to produce a uniform representation of the
tissue follows. If an adequate image can be obtained with the increase in gain, then a decrease
in output should be made. Only after making these adjustments should you increase output to
the next level.
Having acquired the 2D display of the liver, Color can be used to localize blood flow. As with the
2D image display, gain and image processing controls must be optimized before increasing
output.
Having localized the blood flow, use the Doppler controls to position the sample volume over
the vessel. Before increasing output, adjust velocity range or scale and Doppler gain to obtain
an optimal Doppler trace. Only if maximum Doppler gain does not create an acceptable image
do you increase output.
In summary: Select the correct transducer frequency and application for the job; start with a
low output level; and optimize the image by using focus, receiver gain, and other imaging
controls. If the image is not diagnostically useful at this point, then increase output.

Additional Considerations
Ensure that scanning time is kept to a minimum, and ensure that only medically required
scanning is performed. Never compromise quality by rushing through an exam. A poor exam
may require a follow‑up, which ultimately increases exposure time. Diagnostic ultrasound is an
important tool in medicine, and like any tool, it should be used efficiently and effectively.

Output Display
The system output display comprises two basic indices: a mechanical index and a thermal index.
The mechanical index is continuously displayed over the range of 0.0 to 1.9, in increments of
0.1 for all applications except contrast, where the minimum increment is 0.01.

54 EPIQ 7 User Manual 4535 617 25341

Biological Safety Safety

The thermal index further consists of the following indices: soft tissue (TIS), bone (TIB), and
cranial bone (TIC). Only one of these is displayed at any time. Each transducer application has a
default selection that is appropriate for that combination. The TIB, TIS, or TIC is continuously
displayed over the range of 0.0 to maximum output, based on the transducer and application,
in increments of 0.1. For the location of the output display, see “Imaging Display” on page 135.
The application-specific nature of the default setting is also an important factor of index
behavior. A default setting is a system control state that is preset by the manufacturer or the
operator. The system has default index settings for the transducer application. The default
settings are invoked automatically by the ultrasound system when power is turned on, when
new patient data is entered into the system database, or when an application change occurs.
The decision as to which of the three thermal indices to display should be based on the
following criteria:
• Appropriate index for the application: TIS is used for imaging soft tissue, TIB for a focus at or
near bone, and TIC for imaging through bone near the surface, as in a cranial exam.
• Mitigating factors that might create artificially high or low thermal index readings: location
of fluid or bone, or blood flow. For example, is there a highly attenuating tissue path so that
the actual potential for local zone heating is less than the thermal index displays?
• Scanned modes versus unscanned modes of operation affect the thermal index. For
scanned modes, heating tends to be near the surface; for unscanned modes, the potential
for heating tends to be deeper in the focal zone.
• Always limit ultrasound exposure time. Do not rush the exam. Ensure that the indices are
kept to a minimum and that exposure time is limited without compromising diagnostic
sensitivity.

Mechanical Index (MI) Display

Mechanical bioeffects are threshold phenomena that occur when a certain level of output is
exceeded. The threshold level varies, however, with the type of tissue. The potential for
mechanical bioeffects varies with peak rarefactional pressure and ultrasound frequency. The MI
accounts for these two factors. The higher the MI value, the greater the likelihood of
mechanical bioeffects occurring. There is no specific MI value that means that a mechanical
effect is actually occurring. The MI should be used as a guide for implementing the ALARA
principle.

EPIQ 7 User Manual 4535 617 25341 55

Safety Biological Safety

Thermal Index (TI) Displays

The TI informs the user about the conditions that exist that might lead to an increase in
temperature at the surface of the body, within the body tissue, or at the point of focus of the
ultrasound beam on bone. That is, the TI informs the user of the potential for temperature rise
in body tissue. It is an estimate of temperature increase in body tissue with specific properties.
The actual amount of any temperature rise is influenced by factors such as tissue type,
vascularity, mode of operation, and others. The TI should be used as a guide for implementing
the ALARA principle.
The bone thermal index (TIB) informs the user about potential heating at or near the focus after
the ultrasound beam has passed through soft tissue or fluid; for example, at or near second- or
third-trimester fetal bone.
The cranial bone thermal index (TIC) informs the user about the potential heating of bone at or
near the surface; for example, cranial bone.
The soft tissue thermal index (TIS) informs the user about the potential for heating within soft
homogeneous tissue.
You can choose to display TIS, TIC, or TIB. (For details on changing the TI display, see the system
Help.) On systems with transcranial applications, TIC is displayed when you select a transcranial
preset.

Mechanical and Thermal Indices Display Precision and Accuracy

The MI and TI precision is 0.1 unit on the system.
The MI and TI display accuracy estimates for the system are given in Acoustic Output Tables, on
your user information CD. Those accuracy estimates are based on the variability range of
transducers and systems, inherent acoustic output modeling errors, and measurement
variability, as discussed in this section.
The displayed values should be interpreted as relative information to help the system operator
achieve the ALARA principle through prudent use of the system. The values should not be
interpreted as actual physical values in interrogated tissue or organs. The initial data that is
used to support the output display is derived from laboratory measurements based on the
American Institute of Ultrasound in Medicine (AIUM) measurement standard. The
measurements are then put into algorithms for calculating the displayed output values.

56 EPIQ 7 User Manual 4535 617 25341

Biological Safety Safety

Many of the assumptions used in the process of measurement and calculation are conservative
in nature. Overestimation of actual in situ intensity exposure, for the vast majority of tissue
paths, is built into the measurement and calculation process. For example:
• The measured water tank values are derated using a conservative, industry standard,
attenuation coefficient of 0.3 dB/cm-MHz.
• Conservative values for tissue characteristics were selected for use in the TI models.
Conservative values for tissue or bone absorption rates, blood perfusion rates, blood heat
capacity, and tissue thermal conductivity were selected.
• Steady State temperature rise is assumed in the industry standard TI models, and the
assumption is made that the ultrasound transducer is held steady in one position long
enough for steady state to be reached.
A number of factors are considered when estimating the accuracy of the displayed values:
hardware variations, estimation algorithm accuracy, and measurement variability. Variability
among transducers and systems is a significant factor. Transducer variability results from
piezoelectric crystal efficiencies, process-related impedance differences, and sensitive lens-
focusing parameter variations. Differences in system pulser voltage control and efficiencies is
also a contributor to variability. There are inherent uncertainties in the algorithms used to
estimate acoustic output values over the range of possible system operating conditions and
pulser voltages. Inaccuracies in laboratory measurements are related to, among others,
differences in hydrophone calibration and performance, positioning, alignment, and digitization
tolerances, and variability among test operators.
The conservative assumptions of the output estimation algorithms of linear propagation, at all
depths, through a 0.3 dB/cm-MHz attenuative medium is not considered in the accuracy
estimate for the display. Neither linear propagation, nor uniform attenuation at the 0.3 dB/cm-
MHz rate, occur in water tank measurements or in most tissue paths in the body. In the body,
different tissues and organs have dissimilar attenuation characteristics. In water, there is
almost no attenuation. In the body, and in particular, in water tank measurements, nonlinear
propagation and saturation losses occur as pulser voltages increase.
Therefore, the display accuracy estimates are based on the variability range of transducers and
systems, inherent acoustic output modeling errors, and measurement variability. Display
accuracy estimates are not based on errors in, or caused by measuring according to, the AIUM
measurement standards, or the effects of nonlinear loss on the measured values.

EPIQ 7 User Manual 4535 617 25341 57

Safety Biological Safety

Control Effects

Controls Affecting the Indices

As various system controls are adjusted, the TI and MI values may change. This will be most
apparent as the output power control is adjusted; but other system controls affect the
on‑screen output values.

Power
The output power control affects the system acoustic output. Two real‑time output values are
on the display: TI and MI. They change as the system responds to power-control adjustments.
In combined modes, such as simultaneous Color, 2D, and PW Doppler, the individual modes
each add to the total TI. One mode will be the dominant contributor to this total. The displayed
MI will be from the mode with the largest MI value.

2D Controls
• Sector Width: Narrowing the sector angle may increase frame rate. This action will increase
the TI. Pulser voltage may be automatically adjusted down with software controls to keep
the TI below the system maximums. A decrease in pulser voltage will decrease MI.
• Zoom: Increasing the zoom magnification by pressing Zoom may increase frame rate. This
action will increase the TI. The number of focal zones may also increase automatically to
improve resolution. This action may change the MI, because the peak MI can occur at a
different depth.
• Number of Focal Zones: More focal zones may change both the TI and MI by changing
frame rate or focal depth automatically. Lower frame rates decrease the TI. MI displayed
will correspond to the zone with the largest MI value.
• Focus: Changing the focal depth will change MI. Generally, higher MI values will occur when
the focal depth is near the natural focus of the transducer.

Color and Power Controls

• Flow Opt: Increasing the color sensitivity with the Flow Opt control may increase the TI.
More time is spent scanning the color image. Color pulses are the dominant pulse type in
this mode.

58 EPIQ 7 User Manual 4535 617 25341

Biological Safety Safety

• Color Sector Width: Narrower color sector width will increase color frame rate and the TI
will increase. The system may automatically decrease pulser voltage to stay below the
system maximum. A decrease in pulser voltage will decrease the MI. If PW Doppler is also
enabled, then PW Doppler will remain the dominant mode and the TI change will be small.
• Color Sector Depth: Deeper color sector depth may automatically decrease color frame rate
or select a new color focal zone or color pulse length. The TI will change due to the
combination of these effects. Generally, the TI will decrease with increased color sector
depth. MI will correspond to the MI of the dominant pulse type which is a color pulse.
However, if PW Doppler is also enabled then PW Doppler will remain the dominant mode
and the TI change will be small.
• Scale: Using the scale control to increase the color velocity range may increase the TI. The
system may automatically adjust pulser voltage to stay below the system maximums. A
decrease in pulser voltage will also decrease MI.
• Sector Width: A narrower 2D sector width in Color imaging will increase color frame rate.
The TI will increase. MI will change little, if at all. If PW Doppler is also enabled, then PW
Doppler will remain the dominant mode and the TI change will be small.

M‑Mode and Doppler Controls

• Simultaneous and Update Methods: Use of combination modes affects both the TI and MI
through the combination of pulse types. During simultaneous mode, the TI is additive.
During Duplex, the TI will display the dominant pulse type. The displayed MI will be from
the mode with the largest MI value.
• Sample Volume Depth: When Doppler sample volume depth is decreased, the Doppler
pulse repetition frequency (PRF) may automatically increase. An increase in PRF will
increase the TI. The system may also automatically decrease the pulser voltage to remain
below the system maximum. A decrease in pulser voltage will decrease MI.

Other Control Effects

• Imaging Mode Controls: When a new imaging mode is selected, both the TI and MI may
change to default settings. Each mode has a corresponding pulse repetition frequency and
maximum intensity point. In combined or simultaneous modes, the TI is the sum of the
contribution from the modes enabled, and the displayed MI is the largest of the MI values
associated with each mode and focal zone enabled. The system will return to the previously
selected state if a mode is turned off and then reselected.

EPIQ 7 User Manual 4535 617 25341 59

Safety Biological Safety

• Transducer: Each transducer type has unique specifications for contact area, beam shape,
and center frequency. Defaults are initialized when you select a transducer. Factory defaults
vary with transducer, application, and selected mode. Defaults have been chosen below the
FDA limits for intended use.
• 2D Depth: An increase in 2D depth will automatically decrease the 2D frame rate. This will
decrease the TI. The system may also automatically choose a deeper 2D focal depth. A
change of focal depth may change the MI. The MI displayed is that of the zone with the
largest MI value.
• Application: Acoustic output defaults are set when you select an application. Factory
defaults vary with transducer, application, and mode. Defaults have been chosen below the
FDA limits for intended use.

Related Guidance Documents

For more information about ultrasonic bioeffects and related topics, see the following:
• "Bioeffects and Safety of Diagnostic Ultrasound." AIUM Report, January 28, 1993.
• "American Institute of Ultrasound in Medicine Bioeffects Consensus Report." Journal of
Ultrasound in Medicine, Vol. 27, Issue 4, April 2008.
• Acoustic Output Measurement Standard for Diagnostic Ultrasound Equipment. (AIUM,
NEMA, 2004)
• Second Edition of the AIUM Medical Ultrasound Safety brochure, 2009. (A copy of this
document is provided with each system.)
• Information for Manufacturers Seeking Marketing Clearance of Diagnostic Ultrasound
Systems and Transducers. FDA, September 2008.
• Standard for Real‑Time Display of Thermal and Mechanical Acoustic Output Indices on
Diagnostic Ultrasound Equipment. (AIUM, NEMA, 2004)
• WFUMB. "Symposium on Safety of Ultrasound in Medicine: Conclusions and
Recommendations on Thermal and Non‑Thermal Mechanisms for Biological Effects of
Ultrasound." Ultrasound in Medicine and Biology, 1998: Vol. 24, Supplement 1.

Acoustic Output and Measurement

Since the initial use of diagnostic ultrasound, the possible human bioeffects from ultrasound
exposure have been studied by various scientific and medical institutions. In October 1987, the
American Institute of Ultrasound in Medicine (AIUM) ratified a report prepared by its Bioeffects
Committee ("Bioeffects Considerations for the Safety of Diagnostic Ultrasound." Journal of

60 EPIQ 7 User Manual 4535 617 25341

Biological Safety Safety

Ultrasound in Medicine, Vol. 7, No. 9 Supplement, September 1988), sometimes referred to as

the Stowe Report, which reviewed available data on possible effects of ultrasound exposure.
Another report, “Bioeffects and Safety of Diagnostic Ultrasound,” dated January 28, 1993,
provides more-current information.
The acoustic output for this system has been measured and calculated in accordance with the
“Acoustic Output Measurement Standard for Diagnostic Ultrasound Equipment” (Revision 3,
AIUM, NEMA, 2004), the “Standard for Real-Time Display of Thermal and Mechanical Acoustic
Output Indices on Diagnostic Ultrasound Equipment” (Revision 2, AIUM, NEMA, 2004), and the
September 2008 FDA document "Information for Manufacturers Seeking Marketing Clearance
of Diagnostic Ultrasound Systems and Transducers."

In Situ, Derated, and Water Value Intensities

All intensity parameters are measured in water. Since water absorbs very little acoustic energy,
these water measurements represent a worst case value. Biological tissue does absorb acoustic
energy. The true value of the intensity at any point depends on the amount and type of tissue
and the frequency of the ultrasound that passes through the tissue. The intensity value in the
tissue, In Situ, has been estimated by using the following formula:
In Situ = Water [e-0.23alf]
Where:
Variable Value
In Situ In Situ intensity value
Water Water value intensity
e 2.7183
a Attenuation factor
Tissue a(dB/cm-MHz)
Amniotic Fluid 0.006
Brain 0.53
Heart 0.66
Kidney 0.79
Liver 0.43
Muscle 0.55
l Skin line to measurement depth (cm)
f Center frequency of the transducer/system/mode combination (MHz)

EPIQ 7 User Manual 4535 617 25341 61

Safety Biological Safety

Since the ultrasonic path during an examination is likely to pass through varying lengths and
types of tissue, it is difficult to estimate the true in situ intensity. An attenuation factor of 0.3 is
used for general reporting purposes; therefore, the In Situ value which is commonly reported
uses the formula:
In Situ derated = Water [e-0.069lf]
Since this value is not the true in situ intensity, the term “derated” is used.
Mathematical derating of water based measurements using the 0.3 dB/cm-MHz coefficient,
may yield lower acoustic exposure values than would be measured in a homogenous
0.3 dB/cm-MHz tissue. This is true because nonlinearly propagating acoustic energy waveforms
experience more distortion, saturation, and absorption in water than in tissue, where
attenuation present all along the tissue path will dampen the buildup of nonlinear effects.
The maximum derated and the maximum water values do not always occur at the same
operating conditions; therefore, the reported maximum water and derated values may not be
related by the in situ (derated) formula. For example: A multi-zone array transducer that has
maximum water value intensities in its deepest zone may have its largest derated intensity in
one of its shallowest focal zones.

Conclusions Regarding Tissue Models and Equipment Survey

Tissue models are necessary to estimate attenuation and acoustic exposure levels in situ from
measurements of acoustic output made in water. Presently, available models may be limited in
their accuracy because of varying tissue paths during diagnostic ultrasound exposures and
uncertainties in acoustical properties of soft tissues. No single tissue model is adequate for
predicting exposures in all situations from measurements made in water, and continued
improvement and verification of these models is necessary for making exposure assessments
for specific applications.
A homogeneous tissue model with an attenuation coefficient of 0.3 dB/cm-MHz throughout the
beam path is commonly used when estimating exposure levels. The model is conservative in
that it overestimates the in situ acoustic exposure when the path between the transducer and
the site of interest is composed entirely of soft tissue, because the attenuation coefficient of
soft tissue is generally higher than 0.3 dB/cm-MHz. When the path contains significant amounts
of fluid, as in many first- and second-trimester pregnancies scanned transabdominally, this
model may underestimate the in situ acoustical exposure. The amount of underestimation

62 EPIQ 7 User Manual 4535 617 25341

Biological Safety Safety

depends on each specific situation. For example, when the beam path is longer than 3 cm and
the propagation medium is predominantly fluid (conditions that may exist during
transabdominal OB scans), a more accurate value for the derating term is 0.1 dB/cm-MHz.
Fixed-path tissue models, in which soft tissue thickness is held constant, sometimes are used to
estimate in situ acoustical exposures when the beam path is longer than 3 cm and consists
largely of fluid. When this model is used to estimate maximum exposure to the fetus during
transabdominal scans, a value of 1 dB/MHz may be used during all trimesters.
The maximum acoustic output levels of diagnostic ultrasound devices extend over a broad
range of values:
• A survey of 1990-equipment models yielded mechanical index (MI) values between 0.1 and
1 at their highest output settings. Maximum MI values of approximately 2 are known to
occur for currently available equipment. Maximum MI values are similar for real-time 2D,
M-mode, PW Doppler, and Color flow imaging.
• Computed estimates of upper limits to temperature elevations during transabdominal scans
were obtained in a survey of 1988 and 1990 PW Doppler equipment. The vast majority of
models yielded upper limits less than 1°C and 4°C for exposures of first-trimester fetal
tissue and second-trimester fetal bone, respectively. The largest values obtained were
approximately 1.5°C for first-trimester fetal tissue and 7°C for second-trimester fetal bone.
Estimated maximum temperature elevations given here are for a “fixed-path” tissue model
and are for devices having Ispta (derated) values greater than 500 mW/cm2. The
temperature elevations for fetal bone and tissue were computed based on calculation
procedures given in Sections 4.3.2.1 through 4.3.2.6 in "Bioeffects and Safety of Diagnostic
Ultrasound" (AIUM Report, January 28, 1993).

Acoustic Output Tables

Acoustic output tables are in Acoustic Output Tables, on your User Information CD.

Acoustic Measurement Precision and Uncertainty

All table entries have been obtained at the same operating conditions that give rise to the
maximum index value in the first column of the tables. Measurement precision and uncertainty
for power, pressure, intensity, and center frequency are listed in the following tables.

EPIQ 7 User Manual 4535 617 25341 63

Safety Biological Safety

NOTE
Per Section 6.4 of the Output Display Standard, measurement precision on the following
quantities is determined by making repeated measurements and stating the standard deviation
as a percentage.

Acoustic Measurement Precision

Quantity Precision (Percentage Standard
Deviation)
Pr is the underated peak rarefactional pressure Pr: 5.4%
measured in megapascals (MPa).

Wo is the ultrasonic power in milliwatts (mW). 6.2%

fc is the center frequency in megahertz (MHz) <1%

(NEMA UD-2 definition).

PII.3 is the derated spatial-peak pulse intensity P11.3: 3.2%

integral in joules per square centimeter (J/cm2).

Acoustic Measurement Uncertainty

Quantity Measurement Uncertainty
(Percentage, 95% Confidence Value)
Pr is the underated peak rarefactional pressure Pr: ±11.3%
measured in megapascals (MPa).

Wo is the ultrasonic power in milliwatts (mW). ±10%

fc is the center frequency in megahertz (MHz) ±4.7%

(NEMA UD-2 definition).

PII.3 is the derated spatial-peak pulse intensity PII.3: +18% to -23%

integral in joules per square centimeter (J/cm2).

64 EPIQ 7 User Manual 4535 617 25341

Operator Safety Safety

Operator Safety
The following issues and situations can affect operator safety when you are using an ultrasound
system.

Repetitive Strain Injury

Repetitive ultrasound scanning has been associated with carpal tunnel syndrome (CTS) and
related musculoskeletal problems. Some investigators have looked at a large population of
sonographers with different types of equipment. An article, with feedback from a smaller
geographical area, makes the following recommendations:
• Maintain your joints in optimum positions with a balanced posture while scanning.
• Allow frequent breaks to give soft tissue a chance to recuperate from awkward positions
and repetitive movement.
• Avoid gripping the transducer with excessive force.

Repetitive Strain References

Pike, I., et al. "Prevalence of Musculoskeletal Disorders and Related Work and Personal Factors
Among Diagnostic Medical Sonographers." Journal of Diagnostic Medical Sonographers, Vol. 13,
No. 5: 219-227, September 1997.
Necas, M. "Musculoskeletal Symptomatology and Repetitive Strain Injuries in Diagnostic
Medical Sonographer." Journal of Diagnostic Medical Sonographers, 266-227, November/
December 1996.

Foot Switch Warning

WARNING
The foot switch is not intended for use in wet locations, such as emergency rooms and
operating theaters.

EPIQ 7 User Manual 4535 617 25341 65

Safety Operator Safety

Philips Transducers
Use only transducers that are approved by Philips for use with your Philips ultrasound system.
See “Clinical Applications and Transducers” on page 174 for a list of the transducers that are
compatible with your ultrasound system.
In the United States, the FDA 510(k) regulatory clearance for use of the product is applicable
only when Philips-manufactured transducers are connected to the system.

Glutaraldehyde Exposure
The United States Occupational Safety and Health Administration (OSHA) has issued a
regulation covering levels of acceptable glutaraldehyde exposure in the working environment.
Philips does not sell glutaraldehyde-based disinfectants with its products, but this type of
disinfectant is recommended for the disinfection of transducers used in TEE, intraoperative,
endocavity, and biopsy procedures.
To reduce the presence of glutaraldehyde fumes in the air, be sure to use a covered or
ventilated soaking basin. Such systems are commercially available. The most-current
information about disinfection products and Philips transducers can be found on the Philips
Transducer Care website:
www.healthcare.philips.com/us_en/products/ultrasound/Transducers/transducer_care/
index.wpd

Infection Control
Issues related to infection control affect the operator and the patient. Follow the infection-
control procedures established in your facility for the protection of both the staff and the
patient.

Handling Contaminated Transducers

The primary area of concern is the handling of transducers that have contacted infected
patients. Always wear gloves when you handle transducers used in TEE, endocavity,
intraoperative, and biopsy procedures that have not been previously disinfected.
For information on cleaning and disinfecting transducers, see the “Transducer Care” section.

66 EPIQ 7 User Manual 4535 617 25341

Operator Safety Safety

Removing Blood and Infectious Material from the System

CAUTION
Do not wipe the transducer housing joint, strain relief, or cable with isopropyl alcohol.
Isopropyl alcohol can damage these parts of the transducer. This damage is not covered by
the warranty or your service contract.

Use a gauze pad moistened with soap and water to remove blood on the system and the
transducer connectors and cables. Then dry the equipment with a soft cloth to prevent
corrosion. You can use a 70% solution of isopropyl alcohol on the system and only on certain
parts of some transducers. Additional cleaning agents are available for transducers. For more
information, see the “Transducer Care” section.
For more information about removing blood and other infectious material from the system, see
“Disinfecting System Surfaces” on page 290.

ECG Cables and Lead Sets

For information on cleaning ECG cables and lead sets, see “Cleaning the System and ECG
Equipment” on page 287.

Disposable Drape
If you believe contamination of the system might occur during an exam, Philips recommends
that you take universal precautions and cover the system with a disposable drape. Consult your
facility's rules regarding equipment use in the presence of infectious disease.

CAUTION
Position the disposable drape so that it does not block the vents on the system, the monitors,
or the peripherals.

EPIQ 7 User Manual 4535 617 25341 67

Safety Electromagnetic Compatibility

Electromagnetic Compatibility
Electromagnetic compatibility (EMC) is defined as the ability of a product, a device, or a system
to function satisfactorily in the presence of the electromagnetic phenomena that exists in the
location of the product, the device, or the system being used; and, in addition, to not introduce
intolerable electromagnetic disturbances to anything in that same environment.
Electromagnetic immunity is the ability of a product, a device, or a system to function
satisfactorily in the presence of electromagnetic interference (EMI).
Electromagnetic emissions is the ability of a product, a device, or a system to introduce
intolerable electromagnetic disturbances into the use environment.
Your system has been manufactured in compliance with existing electromagnetic compatibility
requirements. Use of this system in the presence of an electromagnetic field can cause
momentary degradation of the tracking ability. If this occurs often, review the environment in
which the system is being used to identify possible sources of radiated emissions. These
emissions could be from other electrical devices used within the same room or an adjacent
room, or from portable and mobile RF communications equipment such as cellular phones and
pagers, or from the existence of radio, TV, or microwave transmission equipment located
nearby. In cases where electromagnetic interference (EMI) is causing disturbances, it may be
necessary to relocate your system.
The system complies with International Standard CISPR 11 for radiated and conducted
electromagnetic disturbances. Compliance with this standard allows the system to be used 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.

WARNING
Using cables, transducers, or accessories other than those specified for use with the system
may result in increased emissions or decreased immunity of the system.

CAUTION
Medical equipment has special precautions regarding EMC and must be installed and put into
service according to the EMC information provided in the system’s accompanying documents.

68 EPIQ 7 User Manual 4535 617 25341

Electromagnetic Compatibility Safety

This section includes information on electromagnetic emissions and immunity as it applies to

the system. Ensure that the operating environment of your system meets the conditions
specified in the referenced information. Operating the system in an environment that does not
meet these conditions may degrade system performance.
The information and warnings contained in this and other sections should be observed when
installing and using the system to ensure its EMC.

NOTE
See the other electrical-safety warnings and cautions in this section.

If the system is operated within the electromagnetic environment described in

“Electromagnetic Immunity” on page 74, the system will remain safe and will provide the
following essential performance:
• Imaging
• Doppler audio and spectral display
• Measurements
• Acoustic output
• ECG triggering
• Recording and playback on a VCR or DVD recorder
• Printing using system printers
• Patient information
• Date and time information

Radio-Frequency Emissions
The following information applies to the system and any radio-frequency device included in or
with the system. For information on related labeling, see “Symbols” on page 38.
FCC and Industry Canada Radio Compliance: This device complies with Part 15 of the FCC Rules
and RSS-210 of Industry Canada. Operation is subject to the following two conditions:
• This device may not cause harmful interference.
• This device must accept any interference received, including interference that may cause
undesired operation. Any changes or modifications to this equipment not expressly
approved by Philips may cause harmful radio frequency interference and void your
authority to operate this equipment.

EPIQ 7 User Manual 4535 617 25341 69

Safety Electromagnetic Compatibility

The radio component in this device is the LG-Ericsson USB-1040.

The wireless technology radio device used in this product is in compliance with the essential
requirements and other relevant provisions of Directive 1999/5/EC. This product is intended to
be connected to the Publicly Available Interfaces and used throughout the European Economic
Area.

ECG Signal

WARNING
Operation of your system with ECG signals below 0.25 mV may cause inaccurate results.

The amplitude of the electrocardiogram (ECG) signal is critical for reliable frame triggering.
Frame triggering should be used only when a clean, noise-free ECG waveform is observed on
the ECG display. The ECG signal should be at least 0.25 mV to ensure reliable triggering when
the system is used in the presence of the electromagnetic phenomena described in this section
and elsewhere in your system user information.

Electrostatic Discharge Precautions

Electrostatic discharge (ESD), commonly referred to as a static shock, is a naturally occurring
phenomenon that results in the flow of an electrical charge from a higher charged object or
person to a lower charged object or person. ESD is most prevalent during conditions of low
humidity, which can be caused by heating or air-conditioning. During low humidity conditions,
electrical charges naturally build up on individuals and objects and can create static discharges.
The following cautions can help to reduce ESD effect:

CAUTION
Do not touch transducer connector pins or the system’s transducer receptacle.

CAUTION
Handle the transducer by the metal connector shell.

70 EPIQ 7 User Manual 4535 617 25341

Electromagnetic Compatibility Safety

CAUTION
Make contact with a metal surface of the system before connecting a transducer to the
system.

CAUTION
The following precautions can help to reduce ESD: anti-static spray on carpets; anti-static
spray on linoleum; anti-static mats; or a ground wire connection between the system and the
patient table or bed.

CAUTION
On connectors labeled with the ESD sensitivity symbol , do not touch the connector pins,
and always observe the preceding ESD precautions when handling or connecting transducers.

NOTE
Electrostatic discharges (ESDs) may cause the ECG heart rate display to increase by 10% to 15%
for a few seconds after the discharge. However, the ECG heart rate display will return to normal
within 4 seconds.

Electromagnetic Emissions
The system is intended for use in the electromagnetic environment specified in the table. The
customer or the user of the system should ensure that it is used in such an environment.

EPIQ 7 User Manual 4535 617 25341 71

Safety Electromagnetic Compatibility

Electromagnetic Emissions: Environment Guidance

Emissions Test Compliance Electromagnetic Environment
Guidance
Radiated emissions, CISPR 11 Class B The system uses RF energy only for its
However, the use of intracardiac internal function. Therefore, its RF
echocardiography (ICE) or emissions are very low and are not
transesophageal echocardiographic likely to cause any interference in
(TEE) probes results in Class A nearby electronic equipment.
Radiated Emissions and should be
used only in a hospital environment.
Conducted emissions, CISPR 11 Group 1 Class B The system is suitable for use in all
Harmonic emissions, IEC 61000-3-2 Class B establishments, including domestic
Voltage fluctuations/flicker Complies establishments and those directly
emissions, IEC 61000-3-3 connected to the public low-voltage
power supply network that supplies
buildings used for domestic purposes.

Approved Cables for Electromagnetic Compliance

Cables connected to the system may affect its emissions. Use only the cable types and lengths
listed here.

WARNING
Using cables, transducers, and accessories other than those specified for use with the system
may result in increased emissions from, or decreased immunity of, the system.

Approved Cables
Cable Type Length Philips Part Number
Adult and pediatric ECG three-lead – 2.7 m (9 ft) with
patient trunk cable (for AAMI and IEC leadset
leadsets)

Adult ECG leadset (AAMI) – – 453561490131/M1671A

72 EPIQ 7 User Manual 4535 617 25341

Electromagnetic Compatibility Safety

Cable Type Length Philips Part Number

Adult ECG leadset (IEC) – – 453561490141/M1672A

Pediatric ECG leadset (AAMI) – – 453561490101/M1624A

Pediatric ECG leadset (IEC) – – 453561490121/M1669A

S -video S-video cable Any –

LAN Twisted pair Any –

USB Shielded Any –

Approved Transducers for Electromagnetic Compliance

The imaging transducers used with the system may affect its emissions. The transducers listed
in “Clinical Applications and Transducers” on page 174, when used with the system, have been
tested to comply with the Group 1, Class B emissions, as required by International Standard
CISPR 11. Use only those transducers.

WARNING
Using cables, transducers, and accessories other than those specified for use with the system
may result in increased emissions from, or decreased immunity of, the system.

NOTE
The use of an Intracardiac Echocardiography (ICE) Probe or an Transesophageal
Echocardiogram (TEE) probe results in Class A Radiated Emissions and should be used in a
hospitable environment only.

Approved Accessories for Electromagnetic Compliance

Accessories used with the system may affect its emissions. The accessories listed here, when
used with the system, have been tested to comply with the Group 1, Class B emissions as
required by International Standard CISPR 11. Use only the accessories listed here.

EPIQ 7 User Manual 4535 617 25341 73

Safety Electromagnetic Compatibility

When connecting other accessories to the system, such as a remote video monitor or
computer, it is the user’s responsibility to ensure the electromagnetic compatibility of the
system. Use only CISPR 11 or CISPR 22, Class B-compliant devices, unless otherwise noted.

WARNING
Using cables, transducers, and accessories other than those specified for use with the system
may result in increased emissions from, or decreased immunity of, the system.

CAUTION
Use only Class-B USB storage devices with the system. Some plastic-cased unshielded USB
devices may cause RF emissions that exceed Class-B limits. See the device’s documentation to
determine whether it is Class-B compliant.

Approved Accessories
Accessory Manufacturer Model Number
Ultrasonic imaging transducer Philips Use only the transducers listed in
“Clinical Applications and
Transducers” on page 174
DVD recorder Sony DVO-1000MD
Black-and-white printer Sony UP-D897MD
Color printer Sony UP-D25MD

Electromagnetic Immunity
The system is intended for use in the electromagnetic environment specified here. The
customer or the user of the system should ensure that it is used in such an environment.

NOTE
The guidelines specified here may not apply in all situations. Electromagnetic propagation is
affected by absorption and reflection from structures, objects, and people.

74 EPIQ 7 User Manual 4535 617 25341

Electromagnetic Compatibility Safety

NOTE
UT is the AC power voltage before application of the test level.

NOTE
At 80 MHz and 800 MHz, the separation distance for the higher frequency range applies.

Electromagnetic Immunity: Environment Guidance

Immunity Test IEC 60601 Test Level Compliance Level Electromagnetic
Environment Guidance
Electrostatic discharge ± 6 kV contact, ± 8 kV air Same as IEC 60601 test Floors should be wood,
(ESD), IEC 61000-4-2 level concrete, or ceramic tile. If
floors are covered with
synthetic material, the
relative humidity should be
at least 30%.
Electrical fast transient/ ± 2 kV for power supply Same as IEC 60601 test Mains power quality should
burst, IEC 61000-4-4 lines, ± 1 kV for input/ level be that of a typical
output lines commercial or hospital
environment.
Surge, IEC 61000-4-5 ± 1 kV differential mode, Same as IEC 60601 test Mains power quality should
±2 kV common mode level be that of a typical
commercial or hospital
environment.
Voltage dips, short Drop out <40 msec Same as IEC 60601 test Mains power quality should
interruptions, and voltage level be that of a typical
variations on power supply commercial or hospital
input lines, IEC 61000-4-11 environment. If you require
continued operation during
power mains interruptions,
Philips recommends that
the system be powered
from an uninterruptible
power supply or a battery.

EPIQ 7 User Manual 4535 617 25341 75

Safety Electromagnetic Compatibility

Immunity Test IEC 60601 Test Level Compliance Level Electromagnetic

Environment Guidance
Power frequency 3 A/m Same as IEC 60601 test Power frequency magnetic
(50/60 Hz) magnetic field, level fields should be at levels
IEC 61000-4-8 characteristic of a typical
location in a typical
commercial or hospital
environment.
Conducted RF, 3 VRMS 3 mVRMS For recommended
IEC 61000-4-6 150 kHz to 80 MHz separation distances, see
“Recommended Separation
Distance” on page 79.
Radiated RF, IEC 61000-4-3 3 V/m 3 V/m For recommended
80 MHz to 2.5 GHz separation distances, see
“Recommended Separation
Distance” on page 79.

CAUTION
If the system is connected to other customer-supplied equipment, such as a local area
network (LAN) or a remote printer, Philips cannot guarantee that the remote equipment will
work correctly in the presence of electromagnetic phenomena.

Although most remote devices comply with their applicable standards for immunity, those
device requirements may not be as stringent as those required for medical equipment. It is the
responsibility of the installer and the user of this remote customer-supplied equipment to
ensure that it functions properly in the electromagnetic environment where the system is
installed. Philips suggests that the installer or the user of such a system consult with experts in
the field of electromagnetic compatibility and safety for guidance to ensure the safe and
effective use of the created system.

76 EPIQ 7 User Manual 4535 617 25341

Electromagnetic Compatibility Safety

Electromagnetic Interference
Electromagnetic interference may appear in many ways on the system and depends on the
mode the equipment is operating in, the imaging control settings, the type of transducer being
used, the type of electromagnetic phenomena, and the intensity level of the phenomena.

CAUTION
When interference is present or intermittent, use caution when continuing to use the system.

NOTE
Electromagnetic phenomena are not always present and may be transitory in nature. It may be
extremely difficult to identify the source of the interference.

NOTE
The following table describes a few typical interferences seen in imaging systems. It is
impossible to describe all manifestations of interference, because it depends on many
parameters of the transmitting device, such as the type of modulation used by the signal
carrier, the source type, and the transmitted level. It is also possible for the interference to
degrade the imaging system's performance and not be visible in the image. If the diagnostic
results are suspicious, other means should be used to confirm the diagnosis.

EPIQ 7 User Manual 4535 617 25341 77

Safety Electromagnetic Compatibility

Typical Interference on Ultrasonic Imaging Systems

Imaging Mode ESD1 RF2 Power Line3
2D or 3D Change of operating mode, For sector imaging White dots, dashes, or
system settings, or system transducers, white radial diagonal lines near the
reset. Brief flashes in the bands or flashes in the center of the image.
displayed or recorded center lines of the image.
image. For linear imaging
transducers, white vertical
bands, sometimes more
pronounced on the sides of
the image.
Color Change of operating mode, Color flashes, radial or Color flashes, dots, dashes,
system settings, or system vertical bands, increase in or changes in the color
reset. Brief flashes in the background noise, or noise level.
displayed or recorded changes in image color.
image.
Doppler Change of operating mode, Horizontal lines in the Vertical lines in the spectral
system settings, or system spectral display or tones, display, "popping" noise in
reset. Brief flashes in the abnormal noise in the the audio, or both.
displayed or recorded audio, or both.
image.
M-mode Change of operating mode, Increase in the image White dots, dashes,
system settings, or system background noise or white diagonal lines, or increase
reset. Brief flashes in the M-mode lines. in image background noise.
displayed or recorded
image.

1. Electrostatic discharge (ESD) caused by discharging of electric charge buildup on insulated

surfaces or persons.
2. Radio frequency (RF) energy from RF transmitting equipment such as portable phones,
handheld radios, wireless devices, commercial radio and TV stations, and so on.
3. Conducted interference on power lines or connected cables caused by other equipment,
such as switching power supplies, electrical controls, and natural phenomena such as
lightning.

78 EPIQ 7 User Manual 4535 617 25341

Electromagnetic Compatibility Safety

Recommended Separation Distance

The following table provides recommended separation distances, which are guidelines on the
distances that any RF transmitting equipment should be kept away from the ultrasound system
to reduce the risk of interference with the system. Portable and mobile RF communications
equipment should be used no closer to any part of the system, including cables, than the
recommended separation distance calculated from the equation applicable to the frequency of
the transmitter. Field strengths from fixed RF transmitters, as determined by an
electromagnetic site survey, should be less than the compliance level in each frequency range
as noted in the table. Interference may occur in the vicinity of equipment marked with the
following symbol: .
Field strengths from fixed transmitters, such as base stations for radio (cellular/cordless)
telephones and land mobile radios, amateur radio, AM and FM radio broadcast, and TV
broadcast, cannot be predicted theoretically with accuracy. To assess the electromagnetic
environment due to fixed RF transmitters, an electromagnetic site survey should be considered.
If the measured field strength in the location in which the system is used exceeds the applicable
RF compliance level in the table, the system should be observed to verify normal operation. If
abnormal performance is observed, additional measures may be necessary, such as reorienting
or relocating the system.

NOTE
For transmitters rated at a maximum output power not listed in the following table, the
recommended separation distance d in meters (m) can be estimated using the equation
applicable to the frequency of the transmitter, where P is the maximum output power rating of
the transmitter in watts (W) according to the transmitter manufacturer.

NOTE
At 80 MHz and 800 MHz, the higher frequency range applies.

EPIQ 7 User Manual 4535 617 25341 79

Safety Electromagnetic Compatibility

NOTE
The recommended separation distance guidelines in the following table may not apply to all
situations. Electromagnetic propagation is affected by absorption and reflection from
structures, objects, and people.

The information provided here, in conjunction with “Electromagnetic Interference” on page 77,
provides guidance on conducted and radiated interference from portable and fixed RF
transmitting equipment.
Recommended Separation Distances by Transmitter Frequency
Rated Maximum Output 150 kHz to 80 MHz 80 to 800 MHz 800 MHz to 2.5 GHz
Power of Transmitter (Watts)

0.01 117 m (384 ft) 0.12 m (4.7 in) 0.24 m (9.5 in)

0.1 369 m (1210 ft) 0.38 m (15 in) 0.76 m (30 in)

1 1170 m (3840 ft) 1.2 m (3.9 ft) 2.4 m (7.9 ft)

10 3690 m (12100 ft) 3.8 m (12.5 ft) 7.6 m (25 ft)

100 11700 m (34800 ft) 12 m (39.4 ft) 24 m (78.7 ft)

The conducted RF test level is 3 V, and the system has a compliance level of 3 mV. For the
system, this means that the imaging system is extremely sensitive to RF interference in the
transducer passband. For example, for a 5-MHz imaging transducer, the frequency range of
interference from a 3-V/m field may be from 2 to 10 MHz and manifest itself as described in
“Electromagnetic Interference” on page 77.
The 0.3 mV level is where the interference becomes acceptable to some clinical specialists.
Sensitivity to interference is dependent on operating mode and imaging control settings. The
order of increasing sensitivity to interference as a function of operating mode is 2D mode, 3D
mode, M-mode, Color mode, PW Doppler mode, and CW Doppler mode. The system is more
sensitive to interference in the CW Doppler or PW Doppler operating modes, but the

80 EPIQ 7 User Manual 4535 617 25341

Electromagnetic Compatibility Safety

probability of interference is lower than in 2D mode or Color mode, because the susceptible
frequency range is lower. Therefore, you are more likely to see interference in 2D or Color
modes.
As an example, if a portable transmitter has maximum radiated power of 1 W and an operating
frequency of 156 MHz, it should only be operated at distances greater than 1.2 m (3.9 ft) from
the system. Likewise, a 0.01-W Bluetooth wireless LAN device operating at 2.4 GHz should be
placed no closer than 0.24 m (9.5 in) from any part of the system.

Avoiding Electromagnetic Interference

A medical device can either generate or receive electromagnetic interference. The EMC
standards describe tests for both emitted and received interference. Emission tests deal with
interference generated by the device being tested. Philips ultrasound systems do not generate
interference based on the tests described in the referenced standards.
An ultrasound system is designed to receive signals at radio frequencies and is therefore
susceptible to interference generated by RF energy sources. Examples of other sources of
interference are medical devices, information technology products, and radio and television
transmission towers. Tracing the source of radiated interference can be a difficult task.
Customers should consider the following in an attempt to locate the source:
• Is the interference intermittent or constant?
• Does the interference show up only with one transducer or with several transducers?
• Do two different transducers operating at the same frequency have the same problem?
• Is the interference present if the system is moved to a different location in the facility?
• Can the EMC coupling path be attenuated? For example, placement of a transducer or
printer close to an ECG cable can increase electromagnetic interference. Moving the cable
or other medical equipment away from the location of the transducer or printer can result
in reduced electromagnetic interference.
The answers to these questions will help determine if the problem resides with the system or
the scanning environment. After you answer the questions, contact your Philips service
representative.

Use Restrictions Due to Interference

The physician must determine if an artifact caused by radiated interference will have a negative
impact on image quality and the subsequent diagnosis.

EPIQ 7 User Manual 4535 617 25341 81

Safety Electromagnetic Compatibility

WARNING
The physician must determine if tracking is accurate. Tracking in an untested environment or
a location known to cause electromagnetic interference can contribute to inaccurate
information and possible personal injury.

82 EPIQ 7 User Manual 4535 617 25341

System Capabilities System Overview

3 System Overview
Use this section to acquaint yourself with the ultrasound system and its components.

System Capabilities
The EPIQ 7 Ultrasound System is a high-resolution system intended for general imaging,
interventional radiology, cardiology, vascular, and OB/GYN applications, and analysis. The cart
is ergonomically designed to be both highly mobile and adjustable for a range of users and
operating conditions. You can use it for 2D, Live 3D Echo, M-mode, Doppler, and Color imaging.
You can also perform Duplex, Triplex, and Live xPlane imaging. Stress echocardiography is
standard on the system, and QLAB Advanced Quantification Software Q-Apps are available as
options. The system supports a wide range of transducers. The system provides measurement
tools, analysis options, and DICOM network capabilities.

Measurements
The system provides tools and controls for measuring distance, area, and volume. Additionally,
the following application-specific tools are available:
• Aliasing Velocity
• 3D Volume
• Generic Angle
• Heart Rate
• High Q automatic Doppler analysis
• Hip Tools
• Percent Reduction
• Simpson's Method
• Time/Slope
• Velocity
• Volume Flow
After you perform measurements, the system makes the pertinent calculations and organizes
the measurements, calculations, and patient information into a patient report.

For information, see the Help. To display the Help, touch . To close the Help, touch again.

EPIQ 7 User Manual 4535 617 25341 83

System Overview System Capabilities

Transducer Types
Available transducer types include sector array, linear array, curved array, Doppler probes,
endocavity, intraoperative, transesophageal, volume, and xMATRIX. Applications for specific
transducers are listed in “Clinical Applications and Transducers” on page 174.

Image Acquisition and Review

You can acquire and review single images and cineloop sequences. Images and cineloop
sequences can be stored on DVDs, CDs, or USB devices, or sent over a network to an archive
server or a printer.
Stress Echo capabilities also use the ability to acquire and review image loops. Stress Echo
protocols of up to 10 stages are used to assess cardiac wall motion at various heart rates.
Peripheral devices are available for recording images and exams. You can connect a black-and-
white image printer or a color image printer. You can also connect a report printer.

Patient Data Protection

The data security feature, if enabled on your system, limits access to previously stored patient
data and images. To gain access to such data, you must first log on to the system using a
password. When you are finished using the system, you can log off manually, or you can simply
shut down the system, which logs you off automatically. The system stores a record of each
user logon.
This data protection feature can be used to help meet the requirements of the U.S. Health
Insurance Portability and Accountability Act (HIPAA).
For more information on protecting patient data, see “System Security” on page 133.

System Options
In addition to the standard features available in the system, other features are available as
purchasable options. The types of options available include clinical applications, QLAB
Advanced Quantification Software, protocols, imaging capabilities, and connectivity capabilities.
A foot switch is available as an option.

84 EPIQ 7 User Manual 4535 617 25341

System Options System Overview

Imaging Options
• 3D/4D (mechanical transducers)
• 3D Single Sweep Color Flow
• 3D Fetal Echo STIC
• Auto Doppler Optimization
• Color for 3D imaging
• Contrast perfusion
• Strain Elastography
• ElastPQ Shear Wave Elastography
• Exam protocols
• Freehand 3D
• iSCAN Intelligent Optimization
• Live 3D and xPlane imaging (xMATRIX transducers)
• Panoramic 2D imaging
• Panoramic 3D imaging
• Physio
• Sleep/Portability Mode (Battery Option)
• Stress Echo protocols
• Tissue Doppler Imaging (TDI)

NOTE
The elastography feature is available only in selected regions. For information specific to your
region, contact your local Philips representative.

Connectivity Capabilities
The following features are standard:
• Image and waveform export to removable media
• Printing to DICOM printers
• Printing to local printers
• Printing report pages
• Wireless DICOM transfer

EPIQ 7 User Manual 4535 617 25341 85

System Overview System Options

In addition to those standard features, the Basic Connectivity purchasable option includes the
following features:
• DICOM Networking
• Image and waveform export to network storage servers
• DICOM Modality Worklist
• DICOM Performed Procedure Step (PPS)
• DICOM Storage Commit (SC)
• DICOM Structured Reporting
• DICOM Query/Retrieve
• Digital Navigation Link (DNL)

Clinical/Analysis Applications
Clinical applications are available on the system as separate purchasable options. The following
clinical applications and their presets (for example, small parts superficial) are associated with
specific transducers:
• Abdominal
• Adult Echo
• Fetal Echo
• General
• GYN
• Intervention CV
• Intervention GI
• Musculoskeletal
• OB
• Pediatric Echo
• Pediatric GI
• Small Parts
• TCD
• Urology
• Vascular

QLAB Advanced Quantification Software Options

The following QLAB Q-Apps are supported for use on your ultrasound system:

86 EPIQ 7 User Manual 4535 617 25341

System Options System Overview

NOTE
The EA Q-App is only available in the United States.

NOTE
The EQ Q-App is not available in the United States.

• Auto 2D Quantification (a2DQ)

• Auto Cardiac Motion Quantification (aCMQ)
• Cardiac 3D Quantification (Cardiac 3DQ)
• Cardiac 3D Quantification Advanced (Cardiac 3DQ Advanced)
• Cardiac Motion Quantification Stress (CMQ-Stress)
• Elastography Analysis (EA)
• Elastography Quantification (EQ)
• Fetal Heart Navigator (FHN)
• General Imaging 3D Quantification (GI3DQ)
• Intima Media Thickness (IMT)
• MicroVascular Imaging (MVI)
• Mitral Valve Navigator (MVN)
• Region of Interest Quantification (ROI)
• Strain Quantification (SQ)

Stress Echocardiography
Stress Echocardiography (Stress Echo) is a protocol-driven study that allows a cardiologist to
assess cardiac wall motion at various heart rates by acquiring views of the heart at different
stages of the study. Stress Echo includes these Philips protocols:
• Exercise 2-Stage
• Exercise 3-Stage
• iRotate Stress
• Pharmacological 4-Stage
• Quantitative 4-Stage
• Wall Motion and Contrast
You can create custom presets based on those protocols.

EPIQ 7 User Manual 4535 617 25341 87

System Overview System Options

Data Security
A data security feature is available to help maintain the confidentiality of archived patient files.
With this option, access to patient exam files is restricted to authorized personnel through user
ID and password protection. For more information, see “System Security” on page 133.

PercuNav Image Fusion and Interventional Navigation

You can use the PercuNav Image Fusion and Interventional Navigation option to fuse diagnostic
images and guide tracked instruments to targets that have been defined by a physician. The
target can be indicated either pre-procedurally or intra-procedurally, either using images or
relative to an indicated position on the patient.
Features include the following:
• Multiple applications: The PercuNav option supports multiple applications and can be used
for ablations, biopsies, and other diagnostic and guidance procedures.
• Multiple modalities: The PercuNav option works with images from multiple modalities,
including but not limited to CT, MR, PET, ultrasound, and rotational fluoroscopy.
Instructions for using PercuNav are in the PercuNav User Manual.

NOTE
PercuNav is a purchasable licensed option. Its user interface is available only when the
PercuNav license is enabled.

System Components
The system is housed in an ergonomic cart. The cart is adjustable to accommodate a wide range
of operator heights and operating positions. Adjustable components can be locked in place so
the cart can be safely moved. The major components include the monitor, control module,
On/Off switch, DVD+RW drive, peripheral bay, transducer receptacles, ECG/physio receptacles,
USB ports, brakes and steering locks, and foot switch receptacle.

88 EPIQ 7 User Manual 4535 617 25341

System Components System Overview

System Components
1 Monitor
2 On/Off switch
3 Control module
4 Transducer receptacle locks
5 Transducer receptacles
6 Side panel
7 Brake/steering lock pedal
8 Touch screen
9 Peripheral bays

EPIQ 7 User Manual 4535 617 25341 89

System Overview System Components

Video Monitor
The system video monitor consists of a 53.3-cm (21-in) flat-panel display on an articulated
mounting arm. The monitor is adjustable to accommodate different operating positions and
operator heights. The monitor can also be locked in position for moving the system (see
“Moving the System” on page 106).

Control Module
The control module includes three main components: the control panel, the touch screen, and
the keyboard. For more information on the control module, refer to “System Controls” on page
119.
The control panel contains the main imaging controls. These controls include buttons, knobs,
and a trackball. The control module also allows you to select transducers, enter patient data,
review and annotate images, perform measurements and calculations, and change setups.
The touch screen, located above the control panel, displays controls used to select applications
and imaging modes, as well as controls that are specific to the current operating mode. Touch
screen controls include buttons and knobs.

90 EPIQ 7 User Manual 4535 617 25341

System Components System Overview

Control Module
1 Control panel
2 Touch screen
3 Trackball
4 TCG slide controls

You can adjust the position of the control module vertically and side-to-side. You can also
swivel the control module.
Beneath the control panel is a retractable keyboard. The keyboard is used to enter patient data,
comments, and text annotation on images.

EPIQ 7 User Manual 4535 617 25341 91

System Overview System Components

Retractable Keyboard

On/Off (Power) Control

The (On/Off) control is located on the control panel. When the system is off, pushing this
control brings the system into a fully operational state. Pushing this control again turns off the
system.

92 EPIQ 7 User Manual 4535 617 25341

System Components System Overview

On/Off Control

Data Storage
You can store exam data and images onto removable media. Removable media includes USB
storage devices and the DVDs and CDs. The DVD+RW drive is located on the right side of the
control panel behind the transducer holders.

EPIQ 7 User Manual 4535 617 25341 93

System Overview System Components

DVD+RW Drive

94 EPIQ 7 User Manual 4535 617 25341

System Components System Overview

Data Port Locations

1 Network connection
2 Phono (ECG)
3 External monitor
4 USB ports

Peripherals
The peripheral bays at the back of the system provide space for up to two peripheral devices.
Those devices can be any combination of the following devices: a black-and-white printer, a
color printer, and a DVD recorder.

EPIQ 7 User Manual 4535 617 25341 95

System Overview System Components

NOTE
If your system configuration includes the PercuNav Image Fusion and Interventional Navigation
option, then the top peripheral bay is dedicated to the PercuNav hardware and is unavailable
for other peripherals. Only one other peripheral can be installed in the bay.

Peripheral Bays

Transducer Receptacles and Cable Management

The system includes four receptacles for imaging transducers, one receptacle for a pulsed- or
continuous-wave Doppler probe, and one receptacle for physio, if physio is included in your
system's configuration. All receptacles can be occupied simultaneously, but only one transducer
at a time can be active.

96 EPIQ 7 User Manual 4535 617 25341

System Components System Overview

Transducer Receptacles
1 Physio probe receptacle
2 Doppler probe receptacle
3 Imaging transducer receptacle

When a transducer is not in use, store it in one of the transducer holders on the system cart.
Always loop transducer cables over the cable hangers to prevent cables from being stepped on
or run over by the cart wheels.

EPIQ 7 User Manual 4535 617 25341 97

System Overview System Components

Transducer Holders and Cable Hangers

1 Transducer holder
2 Cable hanger

Physio (ECG) Receptacles

For physio support, your system includes input receptacles for ECG (for the connector location,
see the figure in “Transducer Receptacles and Cable Management” on page 140), pulse, phono,
and auxiliary signals.

98 EPIQ 7 User Manual 4535 617 25341

System Components System Overview

ECG and Physio Receptacles

1 Physio out
2 Pulse/Phono/Aux 2 input
3 Physio input
4 S-VHS output

Wheel Brakes and Steering Locks

The system includes brakes that you can engage to help keep the system stationary during use.
You can release the brakes and engage steering locks on the front wheels to aid in steering
while moving the system, or you can release all locks, which allows all wheels to move freely.
When the pedal is fully pressed down, all brakes are engaged. To release all brakes, move the
pedal to the middle position. To engage the steering locks, pull the pedal fully up.
For more information, see “Using the Brakes and Steering Locks” on page 115.

EPIQ 7 User Manual 4535 617 25341 99

System Overview System Components

Brake/Steering Lock Pedal

100 EPIQ 7 User Manual 4535 617 25341

Connecting Devices Preparing the System

4 Preparing the System

The information and procedures in this section will help you prepare the system for use.
Preparations include connecting transducers and external devices, locking articulated
components for moving, and ensuring that system operating requirements are met.

Connecting Devices
In addition to the devices installed in the system cart, the system supports external devices.
These devices include printers, a foot switch, and a color monitor.
The system also supports a DVD recorder. This recorder is considered an external device, even
when it is installed on the system. The DVD recorder can be installed before the system is
shipped, or it can be installed later by your Philips representative.

WARNING
When using additional peripheral equipment powered from an electrical source other than
the ultrasound system, the combination is considered to be a medical system. It is your
responsibility to comply with IEC 60601-1 and test the system to those requirements. If you
have questions, contact your Philips representative.

WARNING
Do not use nonmedical peripherals, such as report printers, within 1.5 m (5 ft) of a patient,
unless the nonmedical peripherals receive power from an isolation transformer that meets
medical safety standards, as defined by standard IEC 60601-1.

WARNING
Philips ultrasound systems are tested to the requirements of IEC 60601-1, with on-cart
peripherals that are powered by the built-in system isolation. The system peripherals meet
general electrical safety usage requirements.

EPIQ 7 User Manual 4535 617 25341 101

Preparing the System Connecting Devices

WARNING
Off-cart devices connecting to the ultrasound system must comply with the applicable IEC or
national standards, such as IEC 60601-1, IEC 60950, or the equivalent.

CAUTION
Using accessories, transducers, peripherals, or cables not supplied with the ultrasound
system or recommended by Philips can affect the system in the form of increased emissions
or decreased immunity to external EMI/EMC occurrences. Non-specified peripherals, and
cables in some cases, can also increase leakage current or compromise the safety of the
grounding scheme.

CAUTION
If systems, transducers, and peripherals have been in an environment below 10°C (50°F),
allow them to reach room temperature before connecting or turning them on. Philips
recommends allowing 24 hours for complete normalization. Otherwise, condensation inside
the devices could cause damage. If the device was only briefly exposed to temperatures
below 10°C (50°F), then the time required for the device to return to room temperature could
be significantly less than 24 hours.

NOTE
Any device that is not purchased from Philips or a Philips-authorized agent is not covered under
a Philips service agreement or warranty.

External Printers
You can connect different external printers to your system.

WARNING
Images printed on a report printer are intended only for reference and should not be used for
diagnostic purposes.

102 EPIQ 7 User Manual 4535 617 25341

Connecting Devices Preparing the System

NOTE
Use only the printers listed here with your ultrasound system.

NOTE
The system uses the HP Universal Print Driver and the Epson Universal Print Driver, which
support additional printers not listed here. For the supported printers, see the manufacturer's
website and search for "universal print driver."

Supported External Printers

Printer Type Printer Manufacturers and Model Numbers
Black-and-white image Sony UP-D897/SYN
printer
Color printer Sony UP-D25MD

Connecting an External Printer

WARNING
When using additional peripheral equipment powered from an electrical source other than
the ultrasound system, the combination is considered to be a medical system. It is your
responsibility to comply with IEC 60601-1 and test the system to those requirements. If you
have questions, contact your Philips representative.

WARNING
Do not use nonmedical peripherals, such as report printers, within 1.5 m (5 ft) of a patient,
unless the nonmedical peripherals receive power from an isolation transformer that meets
medical safety standards, as defined by standard IEC 60601-1.

1. Turn off the system and unplug the power cord from the power source.
2. Connect a standard USB cable between the USB port on the printer and a USB port
on the system.

EPIQ 7 User Manual 4535 617 25341 103

Preparing the System Connecting Devices

3. Connect the printer’s power cord into the back of the printer, and plug the other end into
an appropriate power source (see “Warnings” on page 16).
4. Plug the system's power cord into an appropriate power source.
5. Turn on the printer, and then turn on the system. The system installs the printer drivers
automatically.
6. After the system installs the new printer drivers, restart the system.

Configuring Local Printers

You can add a local printer to the system and then, in the setups, associate it with either a
touch screen control or the Acquire 1 or Acquire 2 control. You can print only to a printer that
has been selected. You can also change other printing parameters.

WARNING
Multi-image prints made on small-size paper are intended only for reference and should not
be used for diagnostic purposes. Text annotation and scaling markers may not be visible on
such prints.

NOTE
Before adding a local printer, connect the printer to the ultrasound system.

1. Touch Utilities.
2. On the System tab, touch Setups.
3. Click Acquisition/Capture.
4. Click the Archive/Printer tab.
5. To assign a printer to the Acquire 1 or the Acquire 2 control, do the following:
a. From the Acquisition Type list, select a type.
b. Select the printer that you want to use.
6. To assign a printer to a touch screen control, do the following:
a. Under Select a Touch Screen Button, select the name of the control that you want to
assign.
b. In Destination(s) for the Button, select a printer.
7. To exit the setups, touch Close.

104 EPIQ 7 User Manual 4535 617 25341

Connecting Devices Preparing the System

Connecting the Foot Switch

The foot switch is available as an option.
1. Turn off the system.
2. Connect the foot switch cable to an available USB connector on the system.

Connecting an External DVD Recorder

You can connect the Sony DVO–1000MD DVD Recorder to your ultrasound system as an
external device.
The external DVD recorder record from the ultrasound system; it does not provide playback on
the system monitor. The DVD recorder must be installed with the Philips DVD recorder
installation kit. (For the kit, contact your Philips representative.) If you connect this DVD
recorder without the installation kit or connect any other DVD recorder, you must control it
from the front panel controls on the DVD recorder or the remote controls supported by the
DVD recorder. The remote controls DSRM‑10 or SVRM‑100A provide a convenient way to
control the external DVD recorder.
1. Turn off the system and unplug the power cord from the power source.
2. Connect an S-Video cable between the S-Video input on the DVD recorder and the S-Video
output on the ultrasound system.
3. Connect the DVD recorder's power cord into the back of the DVD recorder, and plug the
other end into an appropriate power source.
4. Turn on the DVD recorder, and then turn on the ultrasound system.

Connecting an External Color Monitor

You can connect a compatible external color monitor to the receptacle on the rear panel of
the system. This receptacle provides standard DisplayPort digital output. You also can connect
an external analog monitor to the (S-Video) receptacle. A digital monitor connected to the
DisplayPort receptacle provides the best-quality image. The power cord for the external
monitor plugs directly into a wall socket.
For monitors and video projectors requiring other connectors, such as VGA or DVI, a converter
is required.

EPIQ 7 User Manual 4535 617 25341 105

Preparing the System Connecting the System to a Network

The DisplayPort output includes the entire display. The aspect ratio of the screen is 16:9. To
display this properly, select the 16:10 or 16:9 mode on the monitor or projector, if available.
Also, you may be able to adjust the horizontal and vertical image size controls to create the
correct aspect ratio. You can best judge the aspect ratio by displaying the circle test pattern on
the system.
The setups provide these outputs:
Full Screen, 1920x1080 (1080p): The full display, which is output at 60 frames per second on
the DisplayPort connector. When this option is selected, you cannot use the S-video output.

Image Area Only,1024x768: Outputs the region of interest of the image area to the S-Video
connector in NTSC or PAL format (depending on the system setting).

Connecting the System to a Network

For information on changing the network configuration for the system, see "System
Administration" in the Help. To display the Help, touch . To close the Help, touch again or
touch Close.
1. Turn off system power.
2. Connect one end of the provided network connection cable to the wall receptacle for your
network.
3. Connect the other end of the cable to the network receptacle on the system.
4. Turn on the system.

Moving the System

Observe the following warnings and cautions before moving the system.

WARNING
Be aware of the wheels, especially when moving the system. The system could cause injury to
you or others if it rolls over feet or into shins. Use caution when going up or down ramps.

106 EPIQ 7 User Manual 4535 617 25341

Moving the System Preparing the System

WARNING
When attempting to overcome an obstacle, do not push the system from either side with
excessive force, which could cause the system to tip over.

WARNING
Position external hardcopy devices away from the system. Ensure that they are secure. Do
not stack them on the system.

WARNING
When positioning the articulated monitor, move it carefully to avoid pinching hands or
extremities against other objects, such as a bed rail.

WARNING
Never park the system on an incline.

WARNING
The brakes are intended as a convenience. To increase cart security, use wheel chocks when
the system is parked.

WARNING
Before moving the system, ensure that the keyboard is retracted, the control panel is
centered, and the monitor is locked. When extended, the keyboard might be damaged if it
hits another object, and the video monitor could swing out during transport, causing injury or
equipment damage.

WARNING
To avoid injury, Philips recommends against lifting the system cart.

EPIQ 7 User Manual 4535 617 25341 107

Preparing the System Moving the System

CAUTION
Before moving the system, ensure that the brakes are completely released by moving the
brake pedal to its middle position. Otherwise, the engaged brake pad can damage the rubber
casters on the wheels.

CAUTION
Ensure that the cables for all patient-applied parts are secure before moving the system. Use
the cable management system to ensure that transducer cables are protected from damage.

CAUTION
Do not roll the system over transducer cables or power cables.

CAUTION
When transporting the system in a vehicle, avoid exposing the monitor to direct sunlight, and
do not let the inside temperature of the vehicle exceed 65°C (149°F). Either of these
conditions can permanently damage the monitor.

Preparing and Moving the System

CAUTION
When shipping the system, make sure the batteries are inserted upside down to prevent
electrical discharge.

1. Press (On/Off) to turn off the system.

2. Engage the wheel brakes by pressing the pedal fully down.
3. Squeeze the release button on the front handle and use the handle to center the control
module and move it to a comfortable height for moving.

108 EPIQ 7 User Manual 4535 617 25341

Moving the System Preparing the System

Control Module Release Button

4. Disconnect all external cables, including those to power, network, and external devices.
Secure all cables, transducers, and accessories so that they do not interfere with the
wheels.
5. Retract the keyboard.
6. Lock the monitor arm by pressing the articulating sections of the arm together.

EPIQ 7 User Manual 4535 617 25341 109

Preparing the System Moving the System

Locking the Monitor Arm

7. Release the wheel brakes and set the steering locks by moving the foot pedal to its top
position.

WARNING
Do not move the system with the steering locks engaged and the wheels pointing in the
direction you are moving the system. To avoid system instability while moving it, engage the
steering lock only after you have moved the system a short distance in the intended
direction. This engages the steering locks with the wheels correctly aligned.

110 EPIQ 7 User Manual 4535 617 25341

Moving the System Preparing the System

8. Move the cart using the front handle.

Front Handle

Positioning the System in Confined Spaces

1. Release the steering lock and wheel brakes by moving the pedal to its middle position.
2. Move the system in any direction using the front handle.
3. When the system is in position, set the wheel brakes by pushing the pedal down fully.

EPIQ 7 User Manual 4535 617 25341 111

Preparing the System Moving the System

Brake/Steering Lock Pedal

Setting Up After Moving

CAUTION
If the system behaves abnormally after moving, contact your Philips representative
immediately. The components are installed securely and can withstand considerable shock;
however, excessive shock can cause a system failure.

1. With the system in position, set the brakes, connect the power, network, and other cables
from the system to the appropriate wall receptacles.
2. Release the monitor from its locked transport position.
3. Position the monitor where you want it.
4. Squeeze the release button on the front handle and position the control module to the
position you want.
5. Press the (On/Off) control to turn on the system.

112 EPIQ 7 User Manual 4535 617 25341

Turning the System On and Off Using the System

5 Using the System

The topics that follow will help you understand and use the features of the system.

Turning the System On and Off

The (On/Off) control is located on the upper left section of the control panel. The lighting of
the control changes to indicate its status. The different indicators are described in the following
table.
Power Status and Indicators
System Status Power Cord Status Power Control Indicator Sleep Control Indicator
Power off Disconnected Unlighted Unlighted
Power off Connected Lighted white Unlighted
Power on Connected Lighted green Lighted white
Sleep Mode on Disconnected Blinking amber Unlighted
Sleep Mode on Connected Blinking green Unlighted

CAUTION
If you press and hold the (On/Off) control to force the system to shut down, you will have
to wait longer than usual to use your system the next time you turn it on. You may also
corrupt files, which can result in an inoperative system or the loss of patient data. Wait
90 seconds (or 3 minutes if DICOM activity is occurring) before forcing the system to shut
down.

CAUTION
The batteries are used to ensure quick system startup and easy movement of the system
only. You cannot perform scans while in battery mode.

EPIQ 7 User Manual 4535 617 25341 113

Using the System Setting the System Time and Date

NOTE
If battery power is unavailable, or if the battery charge level is critically low, as indicated by the
(low battery power) icon, connect the system power cord to a wall outlet.

NOTE
The system must be connected to a wall outlet to be used for imaging.

1. If you are turning off the system, first close all dialog boxes by clicking Close or Done
2. Do one of the following:
• When the system is off, press the (On/Off) control to turn it on.
• When the system is on, press the (On/Off) control to turn it off. A confirmation
message appears briefly on the display immediately before the system turns off.
3. If the system does not turn off after 90 seconds (or 3 minutes if DICOM activity is
occurring), press and hold the (On/Off) control for 7 to 10 seconds to force the system
to turn off.
4. To break the connection from the main power supply, remove the ultrasound system plug
from the wall outlet.

Setting the System Time and Date

The system includes a clock/calendar function, which maintains accurate time and date even
when the system is turned off and disconnected from power. The system uses the clock/
calendar function to display the time and date on the imaging display, and to provide a time
stamp on patient studies and acquired images. The system automatically adjusts the date for
leap years but does not automatically set the time zone or update for daylight saving time.

NOTE
The system time and date cannot be set when a study is active. It is recommended that you
check the system time and date periodically before a study, and set the correct time and date,
if necessary.

114 EPIQ 7 User Manual 4535 617 25341

Using the Brakes and Steering Locks Using the System

NOTE
If you change the system date while a study is paused, existing results for date-dependent
calculations in the paused study are not recalculated by the system at any time.

NOTE
When you enter invalid characters in the time and date setups on the Header tab of System
Settings, some characters are displayed and then erased, but others are not displayed at all. An
invalid date may be displayed in the setups but not entered when you close the setups. After
changing a date and exiting the setups, always check the date on the imaging display.

NOTE
This system supports the Network Time Protocol (NTP), which keeps your system's time
accurate by synching with the NTP server. To activate this feature, your system administrator
must create a connection to an NTP server.

1. Touch Utilities.
2. On the System tab, touch Setups.
3. Click System Settings and then Header.
4. In Set Time, select a Format (12 hours or 24 hours), click the time in the Time box to select
it, and then use the number keys to enter the correct setting. Select Am or Pm, if necessary.
5. In Set Date, select a Format, click the Date to select it, and then use the number keys to
enter the correct setting.

Using the Brakes and Steering Locks

All four wheels swivel to aid in maneuvering the system. You can engage steering locks to make
steering easier when moving the cart. Brakes help keep the cart stationary while in use. The
brakes and the steering locks are designed so that they cannot be engaged simultaneously.
Your system has a foot pedal at the lower front of the cart. Operate the brakes and the steering
locks with the foot pedal using the appropriate procedure.

EPIQ 7 User Manual 4535 617 25341 115

Using the System Monitor Adjustments

WARNING
Never park the system on an incline.

WARNING
The brakes are intended as a convenience. To increase cart security, use wheel chocks when
the system is parked.

Do any of the following:

1 To engage the steering locks and release the brakes, lift the pedal fully.
2 To release both the steering locks and the brakes, move the pedal to its middle position.
3 To engage the brakes and release the steering locks, press the pedal fully.

Monitor Adjustments

CAUTION
To avoid damaging the flat-panel display in the monitor, do not operate it in direct sunlight.
Also, do not operate or store the system where the ambient temperature exceeds 65°C
(149°F).

116 EPIQ 7 User Manual 4535 617 25341

Monitor Adjustments Using the System

The monitor is mounted on an articulated arm that permits it to be positioned vertically and in
an arc from side to side. The monitor arm can also be locked for moving the system. You can
adjust the brightness of the monitor image to compensate for ambient light. You can also
change the default brightness setting for the monitor.

Positioning the Monitor

You can adjust the position of the monitor to suit different operating positions and operator
heights.
1. Press the button on the articulation arm, just above the control panel, to release the
monitor from its locked transport position.

Monitor Articulation Arm Button

2. Grasp the monitor firmly and do one of the following:
• Tilt the monitor up and down
• Swivel the monitor left and right
• Move the monitor side to side

Changing the Monitor Tint

In the setups, you can change the tint of the system display. The Monitor Tint setting affects
only the appearance of images on the monitor; it does not affect saved or exported images.
Three settings are available:
• sRGB provides the maximum dynamic range and most-balanced tint. Use it to match the
look of the system display to a review station display that is set to the sRGB standard.

EPIQ 7 User Manual 4535 617 25341 117

Using the System Monitor Adjustments

• 1 is balanced toward a blue tint for those that have a cooler preference
• 2 is balanced toward a brown tint for those that have a warmer preference
1. Touch Utilities.
2. On the System tab, touch Setups.
3. Click System Settings, and then click the Display tab.
4. Select the appropriate Default Monitor Tint setting. Philips recommends the sRGB setting
for routine use.
5. Click Close.

NOTE
Rendered 3D volumes are particularly susceptible to changes in display tint. Some clinicians
prefer the following settings for optimal viewing of 3D volumes: set Default Monitor Tint to 1
or 2 and set Default Monitor Brightness to 1.

You can also change the monitor tint temporarily:

1. Touch Utilities.
2. On the System tab, touch Monitor Tint to choose from sRGB, 1, or 2.

Changing the Default Monitor Brightness

You can change the default brightness of the monitor image in the setups. The system uses this
default value to set monitor brightness each time the system is turned on.
1. Touch Utilities.
2. On the System tab, touch Setups.
3. Click System Settings, and then click the Display tab.
4. Select a setting for Default Monitor Brightness from 1 (darkest) to 6 (lightest).
5. Click Close.
You can also change the monitor brightness temporarily:
1. Touch Utilities.
2. On the System tab, touch Monitor Brightness to choose from 1 (darkest) to 6 (lightest).

118 EPIQ 7 User Manual 4535 617 25341

Monitor Adjustments Using the System

Automatic Display Dimming

To preserve monitor life and prevent burned-in display artifacts, the system automatically dims
the display after more than 2 hours of operation with no control changes. The system restores
full brightness as soon as you use any system control.

System Controls
System controls are located on the control panel, the touch screen, and the keyboard.

Control Panel
The control panel contains the main imaging controls. These controls include buttons, knobs,
TGC slide controls, and a trackball. The control module also allows you to select imaging modes,
review and annotate images, perform measurements and calculations, and access Philips
SupportConnect.
The touch screen, located above the control panel, displays controls used to select transducers,
enter patient data, select applications, and change setups.

EPIQ 7 User Manual 4535 617 25341 119

Using the System System Controls

Control Panel
1 Touch screen
2 Power and Sleep Mode controls
3 TGC slide controls
4 Trackball
5 Soft key knobs and mode controls
6 Philips SupportConnect

120 EPIQ 7 User Manual 4535 617 25341

System Controls Using the System

Control Panel Adjustments

The control panel is mounted on an articulated arm that permits it to be positioned vertically
and in an arc from side to side. The control panel arm can also be locked for moving the system.
You can adjust the brightness of the control panel to compensate for ambient light. You can
also change the default brightness setting for the control panel.

Adjusting Control Panel Brightness

The control panel and touch screen brightness controls in the setups allow you to adjust the
brightness of the control panel and touch screen to compensate for changes in ambient light.
1. Touch Utilities.
2. On the System tab, touch Setups.
3. Do one of the following:
• Select System Settings, and click Display. Select a setting for Control Panel Brightness.
• Turn the CP Brightness knob, or touch CP Brightness until your preferred brightness is
selected.

Positioning the Control Panel

You can swivel the control panel, move it side-to-side, and move it up and down to improve
ergonomics.
1. Press the (On/Off) control to turn on the system.
2. Push the foot pedal fully down to engage the brakes. See “Using the Brakes and Steering
Locks” on page 115.

CAUTION
You must engage the brakes to change the position of the control panel. If the brakes are not
engaged, the release button on the front handle will light when pressed, but the control
panel will not unlock.

3. Press the release button on the front handle.

EPIQ 7 User Manual 4535 617 25341 121

Using the System System Controls

Control Panel Release Button

4. When the release button lights, the control panel is unlocked.
5. Use the front handle to rotate the control module or move it up or down.
6. Press the release button again to lock the control panel. When the control panel is locked,
the release button light is off.

Setting the Depth Control

The System Settings display in the setups provides an option for you to select how the Depth
control responds when you turn it.
1. Touch Utilities.
2. On the System tab, touch Setups.
3. Click System Settings, and then click the Mode tab.
4. Under Depth Control, do one of the following:
• Select Increase Clockwise to increase depth when the control is turned clockwise.
• Select Increase Counter Clockwise to increase depth when the control is turned
counter-clockwise.
5. Click Close.

Touch Screen
The touch screen above the control panel provides controls that change function according to
the current mode or system function.

122 EPIQ 7 User Manual 4535 617 25341

System Controls Using the System

For more information about the layout of the touch screen, see “Touch Screen Layout” on page
123.
For more information about the available controls on the touch screen, see “Touch Screen
Controls” on page 124.

Touch Screen Layout

The controls on the touch screen are organized by function.

Touch Screen
A Workflow area: Contains tools that enable the major workflow activities for starting, performing, and
completing an exam.
1 Transducer selection controls
2 Tools
B Tabs: Contains mode-specific or application-specific controls in different tabs.
C Controls: The main area of the touch screen, which shows the controls for the currently selected tab in
the current mode or application.
3 Sub-mode controls

EPIQ 7 User Manual 4535 617 25341 123

Using the System System Controls

4 Page indicator: Touch the indicator to go to the next page of controls, or swipe the screen to move
between pages.
D Soft key labels: Displays the labels for the current functions of the soft keys. Some modes and
applications have two rows of labels, while some have no soft keys.
You can select the functions assigned to the soft keys by touching the labels or by pressing or turning
the knob below the label.
5 General-purpose soft keys
6 Dynamic soft keys

Touch Screen Controls

The touch screen can contain several types of controls, which vary by the functions of the
controls.
The color and state of the backlight on the soft key controls and their labels indicates the status
of controls and modes:
• White backlight: available but inactive
• Amber backlight: active
• Gray (off) backlight: unavailable
For multi-use controls, such as Res Spd or Compress, touch the control to change the active
function.
Types of Touch Screen Controls
For this type of control Do this
Touch a tab to display a different set of controls. Touching the tab in this
example displays controls associated with 2D mode.

Touch Next or Previous to display the next or previous page of controls

associated with the current tab. Most tabs have two pages of buttons. You
can also swipe the tip of your finger left or right across the touch screen to
view additional pages.

124 EPIQ 7 User Manual 4535 617 25341

System Controls Using the System

For this type of control Do this

Touch to turn a function on or off. The control is amber when the function is
on. In this example, XRES imaging is on.

Touch to change the value displayed on the control. Repeatedly touching

this type of control cycles through the range of available values.

Utilities Touch Screen

The Utilities touch screen displays three sub-tabs:
• Physio: contains the controls for the Physio features. For details about Physio controls, see
the "Physio Touch Screen Controls" topic in the Help.
• DVR: contains the controls to operate the DVD recorder. For details about the DVD recorder
controls, see the "Video Touch Screen Controls" topic in the Help.
• System: contains controls that allow you to temporarily adjust system configurations for an
exam. You can also access Setups from this tab to make permanent changes to the system.
For details about the System controls, see “System Tab Touch Screen Controls” on page
125.

System Tab Touch Screen Controls

This topic describes the touch screen controls for the System tab on the Utilities touch screen.
Some of the controls are visible immediately, and others may be visible only when particular
transducers or presets are active.
To use a touch screen control or change its setting, touch it. If it is in the bottom row, you can
also turn or press the knob directly below it.
System Tab Touch Screen Controls
Name Description
Accept Prior to Store A control used to display image loops for approval before they are stored.
Capture Type A control used to select the capture type: prospective (for a number of beats) or
retrospective (for a number of seconds).
CP Brightness A control used to adjust the brightness of the control panel and the touch screen
display.
Export IQ Optimization A control used to start the Export IQ Wizard.

EPIQ 7 User Manual 4535 617 25341 125

Using the System System Controls

Name Description
External Video Brightness/ A control used to adjust the brightness and controls of an image that is being viewed
Contrast externally.
Hide Image Info A control used to show and hide image information in the imaging display.
Hide Patient Info A control used to show and hide the patient information in the patient bar. See
“Hiding Patient Name and ID on Images” on page 157.
Hide Thumbnails A control used to show and hide the image thumbnail pane in the imaging display.
Loop Type A control used to set the loop type to either Time (in seconds) or Beats (heart beats).
Loop length is then set using the Time control or the Beats control. The Loop Type
depends on the active transducer and preset. For example, the Beats control is
available only for cardiac transducers and presets.
Monitor Brightness A control used to adjust monitor brightness to compensate for changes in ambient
light. Use this control to quickly make temporary adjustments to the monitor
brightness setting in the setups. Touch Monitor Brightness to select a setting from 1
(darkest) to 5 (lightest).
Monitor Tint A control used to adjust the tint of the system display. This control affects only the
appearance of images on the monitor; it does not affect saved or exported images.
Print Screen A control used to save an image of the full screen to the system hard drive and a copy
to the same destination devices as the Print control. Print Screen is available in review
and when the image is frozen.
Setups A control used to access the system parameters that you can change.

Trackball
The trackball is located in the center of the control panel. Moving the trackball moves the active
object on the display, such as the pointer or the measurement caliper.
The tools and icons area of the imaging display includes a trackball icon that identifies the
function assigned to each trackball button. The functions of the buttons change to match your
current task. There are trackball assignments for each major system mode, protocols, labels,
body markers, calculations, and measurements.

126 EPIQ 7 User Manual 4535 617 25341

System Controls Using the System

Trackball Arbitration Icon

For example, the functions of the left and right trackball buttons can include:
• Cycle through cineloop sequences when the image is frozen or in Review.
• Erase traces.
• Select measurements within a group.
The functions of the middle trackball button include:
• Activate the spectral trace in M-mode and Doppler imaging.
• Complete measurements and calculations.
The labels under the trackball image indicate the functions that are available for the entire
trackball.

NOTE
For some measurements, the trackball functions become available only after you press
Measure.

Also, you can configure the left and right trackball buttons by using the Left Select Key and
Right Select Key settings in the Tools & Results tab of the Analysis setups.

Soft Key Controls

Soft key controls (knobs that can be pressed and turned) are located along the top of the
control panel. Two rows of labels for soft key functions and settings appear along the bottom of
the touch screen. Each column of labels corresponds to the soft key below it on the control
panel. The soft keys select imaging features and settings. The functions of the soft keys change
depending on the mode, the application, the preset, and the transducer.

EPIQ 7 User Manual 4535 617 25341 127

Using the System System Controls

If a function is assigned to a soft key, the ring around the knob is amber. If no function is
assigned to a soft key, the ring is dark.
Sometimes, two functions are available for a soft key. Only one of the functions can be active at
a time. Pressing the corresponding knob on the control panel or touching the label selects the
active function. The label for active functions is amber. The label for inactive functions is white.
Many modes offer two or more pages of soft keys. To display the second page place your finger
on the touch screen and swipe to the left. To return to the first page place your finger on the
touch screen and swipe to the right. You can also touch the page indicator, located above the
soft keys, to display the next available page of soft keys.

Soft Key Page Indicator

Using the Keyboards

The system has two keyboards, which you can use to enter patient data, exam comments,
image annotation, and your logon password.
Touch Screen Keyboard
One keyboard is located on the touch screen. That keyboard may appear automatically during
certain activities.
To use the touch screen keyboard:

1. If necessary, touch (keyboard) to display the keyboard.

2. When you are done typing, touch Close.
Retractable Keyboard
A retractable keyboard is located beneath the control panel.
To use the retractable keyboard:
1. Pull out the keyboard. The keyboard lights after you pull it out completely.
2. When you are done typing, push in the keyboard in completely.

128 EPIQ 7 User Manual 4535 617 25341

System Controls Using the System

Status Icons
Status icons on the display let you control certain features and check the status of tasks. Status
can be indicated by colors or symbols within an icon, and by the absence of an icon.
Icon Description
Displayed when the system is HIPAA compliant.

Displayed when the iSCAN Intelligent Optimization or AutoSCAN feature is on.

Displayed when Physio Trace is active.

Displayed when a Send on Demand request is active.

Displayed when remote access is enabled, but there is no active remote session.

Displayed when a remote session is active.

Displayed when the system is acquiring an image or an image is opening in the Review
pane.

Indicates the status of a remote session:

• No dot: Remote session is enabled but not active
• Green dot: Remote session is enabled and active
• Red X: Remote session is disabled
Indicates the status of a Network Packet Capture:
• Green dot: Enabled and running
• Red X: Enabled but not running
Displayed when the microphone is on.

EPIQ 7 User Manual 4535 617 25341 129

Using the System Power Management

Icon Description
Indicates the status of the network and exports:
• Green dot: Connected
• Red X: Disconnected or error
Click the icon to view details of network status or export queue.
Indicates the status of the wireless network:
• Green dot: Connected
• Red X: Disconnected or error
• Blue vertical bands: Strength of wireless signal
Click the icon to open the DICOM Setup dialog box. This icon appears only if the DICOM
licensed options are installed.
Indicates the status of the DVD drive:
• No dot: Available
• Green dot: Writing data
• Yellow dot: Drive is empty (or malfunctioning)
• Red X: Failed
Click the icon to open the DVD Status dialog box. You can cancel, pause, or resume any data
transfer job listed.
Indicates the status of the DVD recorder (if installed):
• Green dot: DVD recorder is recording.
• Pause symbol: DVD recording is paused.
• Icon is hidden: DVD recorder is not recording.
Indicates the status of the current print job:
• Icon is displayed: a print job is being sent.
• Icon is hidden: a print job has been sent.
• Green dot: a print job is being printed.
• Red X: a print job has failed; an error occurred.

Power Management
The system includes a power management feature that monitors the power level of the
optional battery and notifies you when the battery is low on charge. Additionally, the power
management feature can safely shut down the system before the battery loses power.

130 EPIQ 7 User Manual 4535 617 25341

Power Management Using the System

The batteries charge whenever the system is connected to AC power.

CAUTION
The batteries are used to ensure quick system startup and easy movement of the system
only. You cannot perform scans while in battery mode.

CAUTION
When shipping the system, make sure the batteries are inserted upside down to prevent
electrical discharge.

NOTE
When the system is turned on and in Sleep Mode, the batteries power the system.

NOTE
When the battery-charge level reaches a critically low state, the system shuts down
automatically.

NOTE
The batteries may need to be replaced. For information on replacing the batteries, see the
system Service Manual.

Sleep Mode
Sleep Mode uses battery power and allows quick startup of the system. It does not eliminate
power consumption and should be used only for short periods of time, such as when you
transport the system between exam locations. The Sleep Mode control ( ) is in the upper left
corner of the control panel, next to the (On/Off) control. When the system is in Sleep Mode,
it freezes live imaging, pauses any open study, exits any QLAB study, and terminates any
remote connection. Awaken the system to resume normal system operation.

EPIQ 7 User Manual 4535 617 25341 131

Using the System Power Management

When the system is on battery power, the Sleep Mode time-out is approximately 20 minutes.
The system remains in Sleep Mode until it is awakened or powered off, or until the batteries
discharge to a critically low state. If the system batteries discharge to a critically low state, the
system safely shuts down from Sleep Mode.

To put the system in Sleep Mode, press or disconnect the power cord.

To awaken the system, press .

For information on the Sleep Mode status indicators, see “Turning the System On and Off” on
page 113.

NOTE
When the system is in Sleep Mode and is connected to AC power, the system remains in Sleep
Mode until it is awakened.

Battery Indicators
The battery charge level is indicated by icons on the system display.

CAUTION
The batteries are used to ensure quick system startup and easy movement of the system
only. You cannot perform scans while in battery mode.

NOTE
The system batteries are a purchasable option. If this option is not purchased, the battery icon
is not displayed.

132 EPIQ 7 User Manual 4535 617 25341

System Security Using the System

Battery Status Indicators

The system is running on AC power and the battery is 80% to 100% charged.

The system is running on AC power and the battery is 60% to 80% charged.

The system is running on AC power and the battery is 40% to 60% charged.

The system is running on AC power and the battery is 20% to 40% charged.

The system is running on AC power and the battery is 0% to 20% charged.

The system is running on AC power and the battery is not charged or is disconnected.

System Security
The data security feature, if enabled on your system, limits access to previously stored patient
data and images. To gain access to such data, you must first log on to the system using an ID
and a password. When you are finished using the system, you can log off manually or simply
shut down the system, which logs you off automatically. Only a registered user can change the
password.
The data security feature is set up by your system administrator. For information, see “System
Administration” in the Help. To display the Help, touch .

Logging On to the System

When data security is enabled, you must log on to the system before you are able to view or
load patient files.

1. Click (Log On) at the bottom of the imaging display.

EPIQ 7 User Manual 4535 617 25341 133

Using the System System Security

2. In the Logon dialog box, type your user name.

3. Press the Tab key and type your password. (If you forget your system password, contact
your system administrator.)
4. Click OK to log on to the system and start the valid access period.

NOTE
Logging off of the system does not change the current patient, but it does deny further access
to protected patient data.

Logging Off of the System

If you do not log off, the system automatically logs you off when you shut down the system or
after the system has been inactive for the length of time shown in Auto Log Off on the User
Settings tab of the Data Security setups.

1. Click (Log Off) at the bottom of the imaging display.

2. In the LogOff dialog box, click Yes.

Changing Your Password

If the data security feature is enabled on your system, you must log on to the system to gain
access to patient data and images.
Once the system administrator has given you a password for the system, you can change it as
needed. A password must be 6 to 10 characters long and can contain only letters and numbers;
punctuation marks and symbols are not allowed.

NOTE
The Auto Log Off time shown on the User Settings display indicates how long the system can be
inactive before you are logged off automatically. Only the system administrator can change this
setting.

1. Touch Utilities.

134 EPIQ 7 User Manual 4535 617 25341

Imaging Display Using the System

2. On the System tab, touch Setups.

3. Click Data Security.
4. On the User Settings tab, click Change Password.
5. For Old Password, type your current password, and then press the Tab key.
6. For New Password, type the new password you want to use, and then press the Tab key.
7. For Confirm Password, type your new password again.
8. Click OK.
9. To exit setups, click Close.

Imaging Display
The imaging display contains three, distinct regions:

Imaging Display

EPIQ 7 User Manual 4535 617 25341 135

Using the System Imaging Display

1 Patient bar
2 Image area
3 Tools and icons

Patient Bar
After you start an exam, patient and exam data appear in the patient bar, which is directly
above the ultrasound image. With the Header setting in the System Settings setups, you can
select three of the five additional information options to display on the patient bar: Patient
Birth Date, Patient Gender, Institution Name, System Model, and Performed By (three
initials).

Patient Bar
1 Patient name
2 Patient ID
3 Date and time
4 Expand patient bar icon: Click to view all of the available patient data during an exam.

Image Area
The image area is approximately in the center of the display and includes the following:
• Image tabs: The left tab displays the live image. Additional tabs provide quick access to
acquired images from the current exam, retrieved images from previous exams, images
acquired in other modalities, or analysis summary results (for example, fetal trending
graphs).
• Left pane: Lists available calculations and protocols, and the calculations and measurements
being performed; displays calculation results; and provides other tools as necessary. Tabs at
the top of the left pane enable you to switch among those lists. To hide the left pane, click
, in the top right corner of the pane.

136 EPIQ 7 User Manual 4535 617 25341

Imaging Display Using the System

• Imaging area: Displays the live image (or other applications, such as Q-Apps), a depth scale
that includes the focus setting (to the right of the image), a TGC curve, a grayscale bar, and
a color bar (to the right of the depth scale). In M-mode and Doppler, the sweeping display
appears either below the 2D image or to the right of it, depending on the format you select.
• Thumbnail pane: Displays thumbnail images from the current exam.

For general imaging, a scan plane orientation marker appears at the top left of the image.
For cardiac exams, the orientation marker appears at the top right of the image. The marker
corresponds to the orientation marker on the transducer. The marker always follows the
orientation of the image. When you invert the image by using Left/Right or Top/Bottom, the
marker position changes accordingly.

Image Area
A Left pane
B Imaging area
1 Image tabs
2 Scan plane orientation marker

EPIQ 7 User Manual 4535 617 25341 137

Using the System Imaging Display

3 MI and TI values
4 Focal indicator
5 Color bar
6 Grayscale bar
7 ECG Display
C Thumbnail images

Tools and Icons Area

The tools and icons area displays the following:
• Status icons: Provide status of system features and cannot be selected.
• Trackball arbitration icon: Displays the current function of trackball and the trackball
buttons. The labels above and to the left and right of the trackball icon indicate the function
assigned to the middle trackball button and the left and right trackball buttons,
respectively. The labels under the trackball icon indicate the functions that are available for
the entire trackball. For details, see “Trackball” on page 126.
• System management icons: Provide status and can be selected. When you click a system
management icon, a dialog box displays additional information or available actions.
For definitions of status and system management icons, see “Status Icons” on page 129.

Tools and Icons Area

1 Status icons
2 Trackball arbitration icon
3 System management icons (interactive)

Emergency Studies
If the system administrator has enabled the data security feature on your system, it is
important to understand how to start a study in an emergency situation.

138 EPIQ 7 User Manual 4535 617 25341

Emergency Studies Using the System

In an emergency, you can start a study without entering patient data. During an emergency
study, the system provides a temporary ID for image acquisition and report editing. You should
change the temporary ID to correct the patient data before you end the study. Otherwise, the
temporary ID is the only identifier for that study.

Temporary ID
Use the temporary ID feature to start an exam quickly. This feature allows you to perform an
exam without first entering patient data. When you select this feature, the system enters
unique, temporary placeholders for the patient's last name and ID. Using the temporary ID
feature allows you to perform an exam as you would normally.
When you use the temporary ID workflow, images can be sent to a PACS or to a DICOM printer
before entering actual patient data, if the system is configured to send or print images as you
scan.
For an exam started with a temporary ID, edit patient data before ending the exam. After the
exam is ended, you cannot change patient data. When the patient data is changed, all images
are automatically resent to any local printers that they were previously sent to. If your system is
connected to a DICOM Worklist Server, you can load patient data to replace the temporary ID
data.

NOTE
If you have configured a DICOM performed-procedure-step-server, PPS messages are sent for
the temporary ID. If you have configured a PPS server, PPS discontinue messages are sent for
the temporary ID if you edit the patient data before you end the exam.

Starting Emergency Studies

In an emergency, you can use the temporary ID feature to start an exam without first having to
enter patient data. Just click Use Temporary ID after you acquire an image.
You can create a temporary ID when starting a protocol, printing, acquiring an image, or saving
a volume.
1. Touch Patient and then click Use Temporary ID.
2. Click Done.

EPIQ 7 User Manual 4535 617 25341 139

Using the System Setting the Auto Freeze Function

3. When the exam is finished, do the following:

a. Touch End Exam.
b. Edit the information in the Patient Data display
c. Click End Exam.
d. Click Done.

Setting the Auto Freeze Function

The Auto Freeze function stops imaging and freezes the image, if a control is not manipulated
within the Wait time that you specify. The default time is 5 minutes. After Auto Freeze has been
invoked, press any control to restart imaging.
1. Touch Utilities.
2. On the System tab, touch Setups.
3. Click System Settings.
4. Click the Display tab.
5. Under Auto Freeze, select On, and then select the Wait time.
6. Click Done.

Transducer Receptacles and Cable Management

The system includes four receptacles for imaging transducers, one receptacle for a pulsed- or
continuous-wave Doppler probe, and one receptacle for physio, if physio is included in your
system's configuration. All receptacles can be occupied simultaneously, but only one transducer
at a time can be active.

140 EPIQ 7 User Manual 4535 617 25341

Transducer Receptacles and Cable Management Using the System

Transducer Receptacles
1 Physio probe receptacle
2 Doppler probe receptacle
3 Imaging transducer receptacle

When a transducer is not in use, store it in one of the transducer holders on the system cart.
Always loop transducer cables over the cable hangers to prevent cables from being stepped on
or run over by the cart wheels.

EPIQ 7 User Manual 4535 617 25341 141

Using the System Selecting a Transducer

Transducer Holders and Cable Hangers

1 Transducer holder
2 Cable hanger

Selecting a Transducer
When the system is turned on, the system initializes the last active transducer. If that
transducer is not connected, the system initializes the transducer that is connected to the
leftmost connector, unless you have defined another transducer as the default transducer. If
you have set a default transducer and it is connected, then the system initializes that
transducer. For information on setting a default transducer, see “Setting the Default Transducer
and Preset” on page 148.
If multiple transducers are connected when the system is turned on, the system selects the
transducer that was in use when the system shut down. You can select among the connected
transducers during system operation. If the system does not recognize a transducer, it will
switch back to the original transducer. Disconnect and reconnect the unrecognized transducer
or move it to a different receptacle.
You can select or deselect a transducer during live imaging without damaging the transducer or
the system.
1. Touch the transducer name to select it.
2. Touch the clinical application preset that you want to use.

142 EPIQ 7 User Manual 4535 617 25341

Selecting a Preset Using the System

After you select the clinical application/preset, the system calibrates the transducer, enables
the transducer for operation, and updates system status to reflect the transducer type and the
preset you selected.

Selecting a Preset
When the system is turned on, the system selects the same preset that was in use when the
system shut down (unless it is incompatible with the initially selected transducer). For more
information, see “Setting the Default Transducer and Preset” on page 148.
During system operation, you can select a different preset for the selected transducer.
1. Touch the transducer name.
2. Touch a preset to select it.

ECG Feature
The system can display three physio traces, each representing a physiological input. These
inputs can include low-level ECG, high-level ECG, respiratory, pulse, phono, and auxiliary
signals. (Low-level ECG comes from leads connected to the patient; high-level ECG comes from
a patient monitor or other similar equipment.) Heart rate, derived from the ECG signal, is
displayed on the screen whenever ECG is connected and displayed.

DVD, CD, and USB Devices

The system supports a variety of removable media including DVD, CD, and USB storage devices.
For additional information on specific applications of the DVD drive, see the Help. To display the
Help, touch . To close the Help, touch Close or touch again.
For details about DVD and CD devices, see “DVD Drive” on page 144.
For details about USB devices, see “USB Devices” on page 145.

Media Compatibility
CD media capacity is approximately 700 MB; single-layer DVD media capacity is approximately
4.7 GB. Rewritable media types (indicated by the RW suffix) can be erased and used again, but
you cannot erase media that has the R suffix. Dual-layer DVD media is unsupported.

EPIQ 7 User Manual 4535 617 25341 143

Using the System DVD, CD, and USB Devices

DVD and CD media are available in a number of types. Not all media types are fully compatible
with the system DVD drive. To ensure consistent performance, use only high-quality CD or DVD
media in the system DVD drive. For more information, see Media Compatibility on the User
Information CD.
For information regarding USB media, see “USB Devices” on page 145.
Multiple studies can be written to a disc, during one upload, up to the limit of its capacity. After
the studies are written to the disc, the disc is finalized and cannot be written to again. To reuse
a finalized RW disc, you must first reformat it. To record multiple studies to a disc, you must
end the exam you just recorded before removing the disc.

NOTE
A single disc can be used between different EPIQ 7 systems, but only for writing logs and setup
data.

DVD Drive
The system includes a DVD drive, located on the right side of the control module. You can use
this drive to store and transfer patient files, including full exams, 3D data sets, and reports. In
addition, you can save, restore, and distribute configuration data.
You do not need to format a disc before storing data on it.

Loading and Ejecting a Disc

Do one of the following:
• To load a disc, gently guide a disc into the drive slot, until the disc is pulled into the drive.
• To eject a disc, press the Eject button on the drive.

Erasing a DVD
Erasing a rewritable disc (DVD+RW, DVD-RW, or CD-RW) erases all of the data on it and
prepares it for reuse. After a disc is erased, the entire capacity of the disc is once again
available. You can also erase a write-once disc (DVD+R, DVD-R, or CD-R), but you will not be
able to write files to the erased portion of the disc.

144 EPIQ 7 User Manual 4535 617 25341

DVD, CD, and USB Devices Using the System

NOTE
If the system cannot erase the disc, use a computer to erase it. If the computer cannot erase
the disc, it may be damaged.

1. Touch Review.
2. Load a disc into the drive and wait for it to become available.
3. In the Review Exam display, click Erase.
4. In the Erase Disc dialog box, click OK to erase the disc.
5. When the dialog box indicates that erasing is complete, click OK.
6. Click Close.

USB Devices
The system provides USB ports that can be used to connect USB storage devices. Such devices
include USB memory devices and USB hard disk drives. USB ports are on the front left of the
system behind the transducer holders and on the rear panel. Read the following information
before using USB storage devices.
The system supports the following USB devices:
• Single-partition USB flash memory drives
• USB flash memory drives that do not use or contain any antivirus or other executable
software
• USB hard disk devices that require 500 mA or less per USB port
• USB 2.0 compliant devices
• USB 3.0 compliant devices
Some portable hard drives do not work when connected to a single USB port on the system.
Connect a dual-port USB cable between the drive and two USB ports behind the right panel of
the system.

WARNING
Connecting externally powered USB hard disk drives to the system involves electrical safety
risks. If you connect such drives to the system, you must observe the electrical safety
warnings in the “Safety” section. Philips recommends that you use only USB hard disk drives
powered from the USB connector, or use USB flash memory devices.

EPIQ 7 User Manual 4535 617 25341 145

Using the System DVD, CD, and USB Devices

CAUTION
When transferring data to or from a USB device, be sure the transfer is complete before
removing the USB device. For USB devices that have an indicator, be sure the indicator is no
longer flashing before removing the device.

CAUTION
Ultrasound systems may become vulnerable to security breaches when they accept
removable media. Removable USB storage devices may contain viruses. Philips recommends
that you use the system to format USB storage devices before working with them.

CAUTION
Philips does not recommend that you use USB storage devices for long-term storage. Follow
your IT department's recommended practices for intended use of USB storage devices. For
more information about security on the ultrasound system, see Shared Roles for System and
Data Security, included on your User Information CD.

CAUTION
Use only Class-B-compliant USB storage devices with the system. USB devices that are not
Class-B compliant may cause RF emissions that exceed Class B limits. See the device's
documentation to determine whether it is Class-B compliant.

DICOM Viewer
When you export patient data in DICOM format and select Include DICOM Viewer, the system
exports a copy of the DICOM viewer along with the patient data. The DICOM viewer lets you
view images, play clips, and adjust images. Changes made to the images cannot be saved. The
DICOM viewer lets you view stress echo data by stage or anatomic view. The viewer supports
the electronic submission requirements of ICAEL (Intersocietal Commission for the
Accreditation of Echocardiography Laboratories).

146 EPIQ 7 User Manual 4535 617 25341

Presets Customizing the System

6 Customizing the System

You can customize your system to increase efficiency and streamline your workflow. You can do
the following:
• Create presets designed specifically for the exams you perform
• Change system settings to reflect your needs
• Add options to enhance your imaging abilities
• Create custom procedures for specific patients, transducers, and presets.

Presets
A preset is a group of settings that optimizes the system for a specific type of exam. Presets
establish many initial settings, such as gain value, color map, filter, and items on the touch
screen.
When you turn on your system, the default preset is active. Before you begin an exam, be sure
that the appropriate preset is active.
You can choose from several default presets. You cannot delete these default presets.
However, they provide a starting point from which you can create your own presets. You can
create and store up to 45 presets per transducer/application combination, depending on the
space available on the touch screen. If you need to create more than 45 presets per transducer,
you can save presets to a DVD or USB storage device and restore them when you need to use
them.
The available presets are determined by the selected transducer.

NOTE
Presets are available only if you purchased the corresponding application-package option.

EPIQ 7 User Manual 4535 617 25341 147

Customizing the System Presets

Setting the Default Transducer and Preset

You can set a default transducer and preset so that each time the system is turned on, that
transducer and preset are initiated automatically. The system selects the default transducer
regardless of which receptacle it is connected to. If the default transducer is not connected
when the system is turned on, the system initiates the transducer connected to the left-most
connector and the first available preset for that transducer.
1. Touch the name of the transducer you want to use.
2. Touch the preset you want.
3. Touch the transducer name a second time.
4. Touch Set Default.

Clinical Applications and Presets

Clinical applications are broad areas of medical study. Within each clinical application, there are
Philips presets for specific areas of study. For example, within the Small Organs clinical
application, the presets are Thyroid, Testicle, and Breast. The transducer touch screen lists the
available clinical application preset combinations for the selected transducer.
You specify how the system will be set up for operation by selecting a clinical application
preset.

Quick Save Presets

Quick Save presets provide a quick way to set imaging parameters to the values you prefer for a
specific exam type. Using the Quick Save feature, you can define presets for any combination of
clinical application, preset, and transducer. A Quick Save preset stores the primary imaging
mode and settings that are active when you create the Quick Save preset.
Once you create a Quick Save preset, it appears on the transducer touch screen when the
associated transducer is selected. When you select the Quick Save preset, the system
automatically invokes the settings in the preset. You can delete existing Quick Save presets,
copy them onto a DVD or USB storage device, and load them into another EPIQ 7 system.
The number of Quick Save presets you can store for a transducer/application combination is
limited only by the number of buttons available on the corresponding transducer touch screen.
The number of buttons available, in turn, is dependent on which application is selected and
how many presets that application includes.

148 EPIQ 7 User Manual 4535 617 25341

Presets Customizing the System

Creating Quick Save Presets

You can create a new Quick Save preset that is based on an existing preset. You can do this
even during an exam, while using the preset.
1. Touch the Transducer name.
2. Touch the preset on which you want to base your Quick Save preset.
3. Adjust the system controls to create the settings for your preset. (You can select an imaging
mode, an image orientation, the number of focal zones, and so on.)
4. Swipe the touch screen, from right to left, to view the second page of the transducer
presets.
5. Touch Save Preset.
• For the Quick Save Label, type the name of the new preset. If you do not enter a name
before saving a preset, the system assigns a name.
• For Calculation Package, select a calculation package.
• For Annotation/Body Marks, select the annotation and body mark you want as the
defaults.
6. Click OK.

Deleting Quick Save Presets

You can delete any Quick Save preset on the system except the active preset.
1. If a preset you want to delete is active, deactivate it by touching the associated transducer
name and a different preset.
2. Swipe the touch screen, from right to left, to view the second page of the transducer
presets.
3. Touch Delete User Presets.
4. Click OK.

Copying Quick Save Presets to Removable Media

You can copy Quick Save presets to a DVD or a USB storage device. This function is useful for
archiving presets and for sharing presets among other EPIQ 7 systems. When you copy Quick
Save presets, all available data is copied.

EPIQ 7 User Manual 4535 617 25341 149

Customizing the System Presets

NOTE
If you receive an error message when exporting data to a DVD or when viewing exam data on a
DVD, you may need to eject the DVD from the drive and re-insert it.

1. Load a DVD into the DVD drive, or connect a USB device to a USB port on the system.
2. On the control panel, press Support.
3. Click System Management.
4. Click Backup/Restore.
5. From the Select the Media menu, select the removable media that you are using.
6. Click Backup. The backup list shows the data that is backed up.
7. If a dialog box indicates that the media is too full to complete the copy process, replace the
media and click Backup again.
8. After the backup is complete, click Close.
9. Click Done.

Loading Quick Save Presets from Removable Media

1. Load the DVD containing the data into the DVD drive, or connect the USB device containing
the data to a USB port on the system.
2. On the control panel, press Support.
3. Click System Management.
4. Click Backup/Restore.
5. From the Select the Media menu, select the media type that you are using.
6. Deselect the data that you do not want to import.
7. After the import is complete, click OK.
8. To close the Philips SupportConnect display, click Close. A displayed message might prompt
you to restart the system.

System Setups
Setups are system parameters that you can change. By changing setups, you can customize the
system to meet your operating preferences.

150 EPIQ 7 User Manual 4535 617 25341

System Setups Customizing the System

Setups are organized into five standard categories: System Settings, Analysis, Annotation,
Acquisition/Capture, and Data Security. An additional category, Setup Wizard, helps you
quickly prepare your system for use. Changes in setups take effect immediately and remain in
effect until you change them again or load setups from a DVD or USB device.

NOTE
The institution name exported with DICOM data always reflects the name shown in the setups
at the time the study ended. Philips recommends restarting the system after changing
Institution Name in the setups.

Procedures for using setup options and descriptions of settings are included throughout the
Help.

Changing Setups
1. Touch Utilities.
2. On the System tab, touch Setups.
3. Click a setup category on the left side of the setups display.
4. Click a tab or sub-tab at the top of the setups display.
5. Enter text or make selections necessary to set up your system.
6. Click Close.

Hiding the Doppler Velocity Minus Sign

You can choose to include only the numeric value of the Doppler velocity measurements.
Doppler velocity is marked as negative (-) when the flow is moving away from the transducer.
When reporting on the measurements, you may want only the value, not the direction of flow.
When hidden, the negative sign does not appear on the displayed or printed patient reports;
however, the sign is still part of the number and is visible when editing a patient report and is
included in DICOM structured reports exported from the system.
The option to hide the Doppler velocity minus sign is available in all calculation packages except
Adult Echo and Pediatric Echo.

EPIQ 7 User Manual 4535 617 25341 151

Customizing the System System Options

NOTE
When Hide Doppler Velocity Minus Sign is enabled, avoid using the Doppler velocity value
displayed in the results and report for manual calculations. The sign value, whether visible or
not, affects any calculations performed with the reported value. The system includes the sign
value in calculations.

To specify the display of the Doppler velocity minus sign:

1. Touch Utilities.
2. In the System tab, touch Setups.
3. Click Analysis.
4. Select the tab of the calculations package that you want to change, and then click Tools &
Results.
5. Under Hide Doppler Velocity Minus Sign, select On or Off.
6. Click Close.

System Options
In addition to the standard features available in the system, other features are available as
purchasable licensed options. The types of options available include clinical applications,
protocols, imaging capabilities, QLAB Advanced Quantification Software Q-Apps, PercuNav
Image Fusion and Interventional Navigation, and connectivity capabilities.
To add licensed options to your system, you purchase them from your Philips representative.
Once purchased, they are installed in your system by a Philips field service engineer.

Custom Procedures
You can automate a variety of workflows by creating custom procedures for specific patients,
transducers, and presets.

Creating a Custom Procedure

1. Touch Utilities.
2. On the System tab, touch Setups.
3. Click System Settings.
4. Click the Patient Data tab.

152 EPIQ 7 User Manual 4535 617 25341

Custom Procedures Customizing the System

5. Under Procedure Setup, do one of the following:

• To create a new procedure, click Create New.
• To modify an existing procedure or create a new procedure from an existing
procedure, select an item from the Procedure list, and then click Modify.
• To delete an existing procedure, select an item from the Procedure list, and then click
Delete.
6. For new or modified procedures, complete the following:
• Procedure Name: Enter the name of a new procedure, or modify the name of an
existing procedure.
• Study Description: Enter the type of study for which the new or modified procedure is
intended.
• Gender: Select the gender of the patient.
• Study Description: Enter a brief, meaningful description of the study in which the new
or modified procedure is used.
• Transducer: Select a transducer from a list of all of the transducers that are supported
by the system.
• Preset: Select a preset from a list of all of the presets that are available for the
selected transducer.
7. Click Save and then click Close.
To use the new custom procedure, see “Selecting a Custom Procedure” on page 153.

Selecting a Custom Procedure

Custom procedures are available from the Patient Data form.

NOTE
Custom procedures are linked to specific transducers. If the transducer required for the
procedure is unconnected, procedures that use it do not appear in the Procedure menu.

1. Touch Patient.
2. In the Clinical Procedure section of the Patient Data form, select the custom procedure
from the Procedure menu.
3. Click Done.
4. Start the exam.

EPIQ 7 User Manual 4535 617 25341 153

Customizing the System Custom Procedures

154 EPIQ 7 User Manual 4535 617 25341

New Patient Exams Performing an Exam

7 Performing an Exam
This section guides you through procedures commonly used in performing patient exams with
the system. These procedures include entering patient data; acquiring, annotating, and
reviewing images; and making measurements and calculations.

New Patient Exams

WARNING
Failing to end the current exam before starting a new exam can result in data being acquired
and stored under the wrong patient name.

You start an exam by entering patient data into the system. There are two ways to enter
patient data.
• If the Modality Worklist feature is disabled or unused on your system, you enter patient
data into the Patient Data form.
• If your system is connected to a DICOM network with the Modality Worklist feature
enabled, you can select an exam to load patient data instead of entering that information
manually. See “Selecting in the Worklist” on page 156.
If you want to start an exam without first entering patient data, you can select Use Temporary
ID after you acquire an image.
The system uses a unique ID to identify each patient. You can enter an ID, or you can have the
system create one automatically. Stored images, fetal growth graphs, and reports are stored
based on the patient ID.
If the sonographer name needs to be different on images within the exam, end the current
exam and append a new exam with the images from the new sonographer.
An accession number is an optional entry assigned to each patient file by an institution for
internal information-management purposes.
The exam date is set by the system when you first acquire an image during the exam.

EPIQ 7 User Manual 4535 617 25341 155

Performing an Exam New Patient Exams

Entering Patient Data

If you are not using the worklist option, you start an exam by entering patient data into the
system.
If you want to start an exam without first entering patient data, you can select Use Temporary
ID after you acquire an image.

NOTE
You can clear all patient data from the Patient Data form by clicking Clear. Do not use this
control unless you want to delete all of the patient data you have entered into the form.

1. Touch Patient.
2. Ensure that the previous exam ended by doing one of the following:
• Touch End Exam while the Patient Data form is displayed.
• Click End Exam on the Patient Data form.
3. On the Patient Data form, type the patient information. (Press the Tab key to move the
cursor from field to field.)
4. For Study Type, select the study you will be performing. It is important to select the correct
study type at this time. Selecting a study type after you have entered patient data and
exited the Patient Data form does not update the report with the correct study type.
5. Enter the pertinent study information for the patient.
6. If you have created a custom procedure for this patient, select the custom procedure from
the Procedure menu. (For information about custom procedures, see “Custom Procedures”
on page 152.)
7. When you are finished, click Done.

Selecting in the Worklist

1. Touch Patient.
2. On the Patient Data form, click the Worklist tab.
3. On the worklist, select the exam you want, and click Close.
The system loads the patient information, and you are ready to begin an exam for that
patient.

156 EPIQ 7 User Manual 4535 617 25341

New Patient Exams Performing an Exam

Searching in the Worklist

If necessary, you can search for a specific exam by using Patient Search on the Patient Data
form.
1. Touch Patient, then click the Worklist tab.
2. To search for a patient by exam date, click Search.
3. To further specify the date criteria, do one of the following:
• Select the Exam Date.
• Select Today; select ± (plus or minus), +, or –; and then select the number of days.

NOTE
You can also search for a patient by last name, patient ID, modality, accession number, or
procedure ID.

4. Click Search.
5. Select the patient from the worklist.
6. Click Done.

Hiding Patient Name and ID on Images

WARNING
Images printed without the patient name and ID could be incorrectly associated with another
patient. One way to alleviate this risk is to configure the DICOM printer so that the patient
data that is included in the header of the image file is printed along with the image. However,
some printers do not support that feature.

NOTE
If the intent of hiding the patient name and ID is patient privacy, be aware that if the original
file name includes the patient name, you will need to rename the file when you export it.

EPIQ 7 User Manual 4535 617 25341 157

Performing an Exam Imaging Modes

The patient name and ID are displayed in the patient bar, which is outside of the image area
and not acquired in an image. However, patient information is overlaid on to an image when it
is printed. To hide the patient name and ID on the printed image, touch Utilities, and then
touch Hide Patient Info on the System tab. All other information displayed in the patient bar
(time/date, institution name, and so on) remains in the overlay and is included on the printed
image.
Any loop or still frame acquired while the patient name is hidden will also be exported with the
patient name hidden.

Imaging Modes
Your ultrasound system offers a set of imaging modes to accommodate a variety of imaging
applications. Some modes display a live grayscale image. Others are Doppler modes to evaluate
the amplitude or the direction of the blood flow and the spectral information. Special modes
are also available for 3D imaging and Panoramic imaging.

NOTE
Some modes are available on your system only if the corresponding option has been purchased
and installed.

Selecting a Transducer
When the system is turned on, the system initializes the last active transducer. If that
transducer is not connected, the system initializes the transducer that is connected to the
leftmost connector, unless you have defined another transducer as the default transducer. If
you have set a default transducer and it is connected, then the system initializes that
transducer. For information on setting a default transducer, see “Setting the Default Transducer
and Preset” on page 148.

158 EPIQ 7 User Manual 4535 617 25341

Annotation Performing an Exam

If multiple transducers are connected when the system is turned on, the system selects the
transducer that was in use when the system shut down. You can select among the connected
transducers during system operation. If the system does not recognize a transducer, it will
switch back to the original transducer. Disconnect and reconnect the unrecognized transducer
or move it to a different receptacle.
You can select or deselect a transducer during live imaging without damaging the transducer or
the system.
1. Touch the transducer name to select it.
2. Touch the clinical application preset that you want to use.
After you select the clinical application/preset, the system calibrates the transducer, enables
the transducer for operation, and updates system status to reflect the transducer type and the
preset you selected.

Annotation
You can place text labels and arrows on an image to identify anatomical structures and
locations. You can also annotate an image with a body marker graphic that indicates the part of
the anatomy that you are scanning.

Trackball Functionality in Annotation

Use the touch screen to select annotation labels and body markers, and use the trackball to
position them on the imaging display. The trackball icon identifies the function available for
each trackball button as you add labels and body markers. When adding body markers the
following functionality is available:
• Left or right trackball button: Highlight and move body marker and the transducer icon.
• Middle trackball button: Set the position of the body marker and exit annotation mode. (To
reenter annotation mode, touch the Label tab.)

Adding Labels
1. Press ABC Label.

EPIQ 7 User Manual 4535 617 25341 159

Performing an Exam Annotation

NOTE
If you press a trackball button, unfreeze the image, or change the imaging mode or settings that
affect the trackball assignment, annotation mode goes into standby. To return to annotation,
press ABC Label.

2. Touch ABC Labels.

3. Use the trackball to position the text cursor on the display, or touch Home to return it to
the home location.

NOTE
You cannot move a label once you have added it to the display.

4. Do any of the following:

• To add text, type the text that you want to appear on the display.
• To display predefined labels, touch a label control to display its text.
• To display an arrow, press the Arrow soft key, position the arrow with the trackball,
and then click to fix the position.
• To erase an arrow, touch Erase Last.
• To erase the last word typed, touch Erase Last to erase all arrows and then erase
words one at a time.
• To erase all text, touch Erase All.
• To move the text cursor to the home position, touch Home.
• To set a new home position, position the cursor and touch Set Home.
• To exit annotation mode, press ABC Label again.
• To use text replace, see Changing Labels Using Text Replace in the online help.

NOTE
Erase Last erases all arrows from the image display before it erases text labels.

160 EPIQ 7 User Manual 4535 617 25341

Annotation Performing an Exam

Adding Labels Using the Keyboard

You can add labels using either the retractable keyboard or the touch screen keyboard. You can
manually format the annotation labels that you add using either keyboard.
1. Press ABC Label.
2. Press the space bar on the keyboard.
3. Use the trackball to position the text cursor on the display.
4. Type the text that you want to add. You can use spaces before and after the words to
center the text or improve the text flow.
5. To erase text, press the Backspace key.
6. When finished, press ABC Label again to remove the text cursor.
7. To remove text, press ABC Label and then touch Erase Last Word or Erase All Text.

Adding an Image Title

You can add a title to the image display.
1. Press ABC Label.
2. Touch ABC Labels.
3. Touch Keyboard.
4. Touch Title on the keyboard touch screen.
5. Type the text that you want to add for the title.
6. To erase text, touch Backspace.
7. When finished, touch Title again.

Displaying Body Markers

NOTE
During Review, the Body Markers touch screen is available only when 1‑up is selected for
Layout. You cannot add body markers and system-provided labels to single frame images in
Review, although you can add them to loops in Review. You can type text in single frame
images in Review.

1. Press ABC Label.

EPIQ 7 User Manual 4535 617 25341 161

Performing an Exam Recording

2. Touch Body Markers on the ABC Label touch screen to display the Body Markers touch
screen for the current transducer and preset.
3. Touch a body marker control to put the corresponding body marker on the display in the
home location or to replace an existing body marker.
4. Use the trackball to position the transducer scan plane indicator on the body marker. Turn
Probe Rotate to change the orientation of the transducer scan plane indicator.
5. Do any of the following:
• To move the marker, exit and reenter the Body Markers touch screen, or exit and
reenter annotations mode. When you reenter the Body Markers touch screen you can
edit the marker.
• To remove a body marker, touch Erase Body Mark.
• To close the Body Markers touch screen, touch another tab title or press ABC Label.

Recording
You can record live imaging to a local DVD recorder and simultaneously record comments. You
can play back recordings on other DVD players. Playback is not supported on the system.

Using the DVD Recorder

NOTE
Use only DVD+RW media in the DVD recorder.

NOTE
Always format a new disc before using it with the DVD recorder. Also, Philips recommends
reformatting a used disc before using it with the DVD recorder.

1. To turn on the DVD recorder, press on the front panel.

2. To insert a disc, press OPEN/CLOSE (on the recorder front panel), place a disc in the tray,
and press OPEN/CLOSE again.
3. To record, touch DVR on the touch screen and use any of the following controls on either
the DVR touch screen or the DVD recorder:
• (Play) to play back the video at normal speed

162 EPIQ 7 User Manual 4535 617 25341

Printing Performing an Exam

• (Stop) to stop the recording

• (Record) to start recording
• (Pause) to temporarily halt the recording
• (Eject) to stop the current recording mode and eject the media

Printing
You can print single-frame images and reports to a local printer, usually installed in the system,
or to DICOM printers on a network.

WARNING
Multi-image prints made on small-size paper are intended only for reference and should not
be used for diagnostic purposes. Text annotation and scaling markers may not be visible on
such prints.

Two print controls are available for printing images, Print and Alt Print. The Acquire 1, Acquire
2, Acquire Screen, and Acquire Report controls also have print capabilities associated with
them. In the setups, you can assign each of these controls separately to one or more image
printers. In addition, you can select whether the controls print the entire display or just the
image area.

NOTE
If you print a monochrome image while a Chroma map is selected, the system sends the image
to the color printer. Also, if you export a monochrome image while a Chroma map is selected,
the system sends the image as a color image. This is normal. To ensure that black-and-white
images are sent to the black-and-white printer, set Chroma to Off.

Printing in Live Imaging

You can print live or frozen images during an exam. To print using the Acquire 1 or Acquire 2
controls, a printer must be assigned to those controls in the setups.

EPIQ 7 User Manual 4535 617 25341 163

Performing an Exam Review

1. Display the live or frozen image you want to print.

2. Do one of the following:
• Press Acquire 1 or Acquire 2 on the system control panel.
• Touch Alt Print on the touch screen.
• Touch Print Screen on the Utilities tab.

NOTE
If your print setting includes multiple images per page, the printer will not print an image until
the total number is reached. For example, if you have a 2x2 format selected, the printer will not
print the page until you have captured four images or, if the number captured is less than four,
until the end of the exam.

Review
During or after an exam, you can use Review to examine and compare images acquired in the
exam. You can also review multiple exams for one patient.
In Review, you can look at the images or cineloop sequences that you stored. You can view,
send, print, and back up your stored images. You can also perform analysis on images in
Review. Images that are in image memory can be stored on the ultrasound system hard drive,
on removable media, or on DICOM‑compatible devices on a network. You can display images
within an exam in several layouts, and you can display images from different exams.

Starting Review
1. Touch Review to enter Review mode. You can also double-click a thumbnail image to open
that image in thumbnail review. The display that appears depends on whether an exam is
active on the system.

NOTE
If an exam is in progress, pressing Review opens the Image Review display. If no exam is in
progress, pressing Review opens the Patient Directory display.

164 EPIQ 7 User Manual 4535 617 25341

Review Performing an Exam

2. To return to live imaging, touch Review again.

Navigating Thumbnails and Images

In Review, you can view small images, called thumbnails. Thumbnails are located on the right
side of the Review Exam display. From these thumbnails, you can also display one or more
images in their original format. If an image represents a 3D data set, it opens in 3D review
mode.

NOTE
When reviewing images of an exam loaded from the Patient Directory, thumbnails are
unavailable in some circumstances. For example, exams copied from DVD to the hard drive may
not have thumbnails, if the images they contain are no longer in their native format.

Do any of the following:

• Click or to move up or down through available thumbnails one or two images at a

time.
• Click a thumbnail to jump to the page that contains the corresponding image.
• To view a thumbnail full screen, double-click it. (If the image represents a 3D data set, it
opens in 3D review mode.) To return to the review screen, double-click the full screen
image or set Layout to 4-up.
• Drag the scroll bar to move up or down through available thumbnails quickly.
• Turn Page to move backward or forward through the available images, one page at a time.
• To select an image, either click the image or click the number of its corresponding
thumbnail.

Capturing Images and Loops

You can capture and save a single frame or a cineloop sequence. The captured frame or
cineloop sequence is saved in the patient study, and a thumbnail of it is available in the live
imaging display and the Review display. Images are automatically exported across the network,

EPIQ 7 User Manual 4535 617 25341 165

Performing an Exam Capturing Images and Loops

either when you capture or print an image, or when you end an exam, depending on your
selection for Send Images/Clips on the Acquisition/Capture tab in the Acquisition/Capture
setups.
Use the Freeze control to stop and start system image acquisition and update. Pressing Freeze
results in the system entering cineloop pause and assigning the trackball to manual cineloop
review (frame-by-frame).
During acquisition, a spinning hourglass icon appears at the bottom of the display. When the
capture is complete, a thumbnail of the image is displayed.
Do one of the following:
• To capture a single image, press Freeze, and then press Acquire 1 or Acquire 2.
• To capture a cineloop sequence, press Acquire 1 or Acquire 2 in live imaging or while
reviewing a cineloop sequence. Capturing during live imaging saves prospective or
retrospective frames, as specified in Live Capture Type in the setups. A prospective capture
captures a specified acquired loop length. A retrospective capture captures a specified loop
length that was acquired previously. A retrospective capture captures a loop that ends
when you press Acquire 1 or Acquire 2. Capturing while reviewing a cineloop sequence
saves all retrospective frames in the cineloop sequence.
You can configure the Acquire 1, Acquire 2, and touch screen print controls in the
Acquisition/Capture setups. The default setting is for Acquire 1 to capture single frames
when the image is frozen and to capture loops when the image is live. Acquire 2 captures
single frames, regardless of the imaging state. If an Acquire control is set to acquire a still
frame, you can use it to acquire the frame without freezing the image.

NOTE
When an image is captured, you will hear a beep to confirm that the loop or image was saved in
the patient's study. Do not press Review until you hear the beep.

NOTE
If you press Acquire 1 in a non-simultaneous mode while a live M-mode or Doppler trace is
active, you capture a cineloop sequence. If you press Acquire 1 in a simultaneous mode, you
capture a single image.

166 EPIQ 7 User Manual 4535 617 25341

Measurement and Analysis Performing an Exam

NOTE
If you attempt to capture a loop that was imported from media, only a frame of the loop is
captured and displayed in the appending exam.

Measurement and Analysis

The measurement tools appear on the touch screen. Touching a tool label on the touch screen
launches the tool. (The labels of inactive tools are gray.)
A calculations package contains one or more collections that organize groups, measurements,
and calculations into a coherent tool for diagnostic analysis.
Measurement tools provide measurements and derived calculations. Various methods are
available for generating results. The two primary methods allow you to “measure then label” or
“label then measure.” Either way, the results can appear on the display, on printed pages, and
in patient reports, where they are available for your analysis.
The Analysis setups provide the configuration capability that allows you to create your own calc
lists, including collections, groups, measurements, and calculations. In addition, the
measurements and calculations can be associated with system and custom tables and
equations.
The ultrasound system supports a number of measurement and quantification methods. The
basic measurements report the size, speed, or duration of image data. The image data may be
contained in a 2D ultrasound image, a Physio region, an M-mode trace, or a Doppler spectral
trace. The accuracy of the measurement depends, in part, on the ability of the operator.
Measurements are available if the image scaling data is available. This prevents measurements
on Doppler or M-mode still images in Review that do not include scaling information in the
trace data, or on imported image loops that use different scaling parameters.
Measurements must be labeled for the results to appear in patient reports. Unlabeled
measurements appear in the results but are not retained, unless they are associated with a
labeled measurement.

EPIQ 7 User Manual 4535 617 25341 167

Performing an Exam Measurement and Analysis

Labeled measurements and calculations are stored in the patient data and report. The
information is labeled according to the measurement or calculation label. Within the report,
the information is organized by the calculations package. The values displayed can be the
results of multiple measurements.
Calculations packages are system options that are associated with transducers and presets. A
calculations package contains one or more collections that organize measurements and
calculations into a coherent tool for diagnostic analysis. The Calc Package tab provides access
to the various measurements and calculations in the available calculations packages.
The measurements and their derived calculations included with the calculations packages are
based on medical references. See the "References" section in the Help.

NOTE
Ensure that you follow current medical practices when identifying specific measurement points
on an image.

Performing a 2D Distance Measurement

A 2D distance measurement uses two calipers to measure the length of a straight line between
the two points. You can set the display of the line in the setups.

NOTE
The left and right trackball buttons can each be set to one of three measurement operations:
End Measurement, Toggle, or Next Measurement.

1. Obtain the 2D image you want to measure and press Freeze.

2. Press or touch Measure.
3. Press or touch Measure, and then touch Tools.
4. Touch Distance.
5. Use the trackball to position the caliper for the first end point and click to anchor it.
6. Use the trackball to position the caliper for the second end point. The results update as the
distance between the calipers changes.

168 EPIQ 7 User Manual 4535 617 25341

Measurement and Analysis Performing an Exam

7. To end the measurement, press the middle trackball button.

Measuring M-Mode Distance

1. Start M-mode by pressing the M-mode soft key, and then press the middle trackball button
to update the M-mode display.
2. Obtain the desired M-mode display and press Freeze.
3. Press or touch Measure, and then touch Tools.
4. Touch Distance.
5. Use the trackball to position the vertical time caliper and press the left or right trackball
button.
6. Use the trackball to position the horizontal depth caliper. The distance between the depth
calipers appears in the results.
7. To make additional measurements, repeat step 5 and step 6.
8. Press the middle trackball button to complete the measurement.

Measuring the Doppler Trace on a Sweeping Display

The measurements that appear depend on the settings for Doppler in the Tools and Results
setups.
You can measure Doppler velocity on a live image.
1. Press PW.
2. Press the middle trackball button to update the Doppler display.
3. Obtain the Doppler image you want to measure (spectral waveform).
4. Touch Measure.
5. Use the trackball to position the horizontal cursor.
6. There are no measurement values in the results; you can read the velocity or frequency
value from the velocity or frequency scale.

Obtaining a Typical Labeled Measurement

This general procedure describes how to measure by using a typical labeled measurement tool.
1. Obtain the image you want to measure and press Freeze.
2. Press or touch Measure.
3. Do one or more of the following:
• On the Calc Package tab of the touch screen, touch a collection and then a
measurement label.

EPIQ 7 User Manual 4535 617 25341 169

Performing an Exam Measurement and Analysis

• In the Calc List, click a collection and then click a measurement label.
4. If a set of associated measurements are required, touch or click a group label to display
multiple measurement labels.
5. Touch or click a measurement label and make the measurement. First, the caliper or trace
tool appears on the display. Then, as you make the measurement, the results and derived
calculations appear in the results and are simultaneously added to the patient report.
6. For each measurement label within a group, touch or click a label and make the
measurement.
7. Press the middle trackball button to complete the measurement.

NOTE
The measurement automatically completes if you unfreeze the image, change modes, or enter
a report.

Measuring Then Labeling

The measure-then-label method of obtaining results uses caliper controls for making
measurements, without first having to select measurement labels. These measurements are
not explicitly associated with a report region and do not appear in the report unless associated
with a measurement. You can assign these measurements to labels on an as-needed basis.
After making a measurement, you can choose whether to assign the value to a label.

NOTE
The measurement will be lost if you unfreeze the image or change modes before you assign a
label to it.

Ending an Exam
Each time you finish an exam, you must end the exam to save images, reports, and other exam
data. You can end an exam in the current exam display or with the current exam open in the
Review display. You cannot end a paused exam while in the Patient Directory.

170 EPIQ 7 User Manual 4535 617 25341

Ending an Exam Performing an Exam

You will not be able to end the exam until the system has saved exam data for the current
exam. (The system saves exam data when you acquire an image.) Ending an exam stores all
exam data, clears the Patient Data form, and prepares for the next exam.

WARNING
Failing to end the current exam before starting a new exam can result in data being acquired
and stored under the wrong patient name. If you turn off the system without ending the
exam, the system pauses the exam before shutting down.

When the exam is complete, do one of the following:

• Touch End Exam.
• Click End Exam in the Patient Data display.

EPIQ 7 User Manual 4535 617 25341 171

Performing an Exam Ending an Exam

172 EPIQ 7 User Manual 4535 617 25341

Selecting a Transducer Transducers

8 Transducers
The transducer that you select is the most important factor in image quality. Optimal imaging
cannot be obtained without the correct transducer. The system is optimized for use based on
your transducer selection.
The system limits patient contact temperature to 43 degrees Celsius, and acoustic output
values to their respective U.S. Food and Drug Administration limits. A power-protection circuit
protects against over-current conditions. If the power monitor protection circuit senses an
over-current condition, then the drive voltage to the transducer is shut off immediately,
preventing overheating of the transducer surface and limiting acoustic output. Validation of the
power protection circuit is done under normal system operation.
Non-TEE transducers are rated minimum IPX7 in accordance with IEC 60529. Transesophageal
transducers are rated minimum IPX1 (control area) and IPX7 (endoscope area) in accordance
with IEC 60529.

WARNING
All TEE transducers are designed to be defibrillator safe in accordance with IEC 60601-1.
Nevertheless, always remove the transducer from the patient before defibrillation.

WARNING
To limit potential harm when scanning neonatal, pediatric, and medicated patients, minimize
the time spent imaging at temperatures above 41°C (106°F).

Selecting a Transducer
When the system is turned on, the system initializes the last active transducer. If that
transducer is not connected, the system initializes the transducer that is connected to the
leftmost connector, unless you have defined another transducer as the default transducer. If

EPIQ 7 User Manual 4535 617 25341 173

Transducers Setting the Default Transducer and Preset

you have set a default transducer and it is connected, then the system initializes that
transducer. For information on setting a default transducer, see “Setting the Default Transducer
and Preset” on page 174.
If multiple transducers are connected when the system is turned on, the system selects the
transducer that was in use when the system shut down. You can select among the connected
transducers during system operation. If the system does not recognize a transducer, it will
switch back to the original transducer. Disconnect and reconnect the unrecognized transducer
or move it to a different receptacle.
You can select or deselect a transducer during live imaging without damaging the transducer or
the system.
1. Touch the transducer name to select it.
2. Touch the clinical application preset that you want to use.
After you select the clinical application/preset, the system calibrates the transducer, enables
the transducer for operation, and updates system status to reflect the transducer type and the
preset you selected.

Setting the Default Transducer and Preset

You can set a default transducer and preset so that each time the system is turned on, that
transducer and preset are initiated automatically. The system selects the default transducer
regardless of which receptacle it is connected to. If the default transducer is not connected
when the system is turned on, the system initiates the transducer connected to the left-most
connector and the first available preset for that transducer.
1. Touch the name of the transducer you want to use.
2. Touch the preset you want.
3. Touch the transducer name a second time.
4. Touch Set Default.

Clinical Applications and Transducers

A clinical application, available for one or more transducers, optimizes the system for a specific
application.
The clinical applications for each transducer available for the system are listed here.
The following table lists the transducers that are compatible with your ultrasound system.

174 EPIQ 7 User Manual 4535 617 25341

Clinical Applications and Transducers Transducers

System Transducers and Supported Clinical Applications

Transducer Clinical Applications
C5-1 Abdominal, Fetal Echo, GYN, Intervention, OB, Pediatric
Abdomen, Vascular

C8-5 Pediatric Abdomen, Neonatal Head, Vascular

C9-2 Abdominal, Fetal Echo, GYN, OB, Pediatric Abdomen

C10-3v Fetal Echo, GYN, OB, Urology

C10-4ec Fetal Echo, GYN, OB, Urology

D2cwc Adult Echo

D2tcd TCD

D5cwc Vascular

L12-3 Abdominal, Musculoskeletal, Small Parts, Vascular

L12-5 50 Abdominal, Musculoskeletal, OB, Pediatric Abdomen, Pediatric

Hip, Small Parts, Vascular

L15-7io Epiaortic, Musculoskeletal, Vascular

L18-5 Musculoskeletal, Pediatric Abdomen, Pediatric Hip, Small Parts,

Vascular

S5-1 Adult Echo, Pediatric, TCD

S7-3t Adult Echo, Pediatric

S8-3 Adult Echo, Pediatric

S12-4 Adult Echo, Neonatal Head, Pediatric

V6-2 Fetal Echo, OB

X5-1 Abdomen Vascular, Adult Echo, Pediatric, TCD

X6-1 Abdominal, Fetal Echo, GYN, Intervention, OB

X7-2t Adult Echo

EPIQ 7 User Manual 4535 617 25341 175

Transducers Indications for Use and Supporting Transducers

Indications for Use and Supporting Transducers

The following are the indications for use for this system and the transducers supporting each
indication.
Use only transducers that are approved by Philips for use with your Philips ultrasound system.
In the United States, the FDA 510(k) regulatory clearance for use of the product is applicable
only when Philips-manufactured transducers are connected to the system.
System Indications for Use and Supporting Transducers
Indication for Use Supporting Transducers
Abdominal C5‑1, C8‑5, C9‑2, L12‑3, L12‑5 50, L18‑5, S5‑1, V6‑2, X5‑1, X6‑1
Cardiac Adult D2cwc, S5‑1, S8‑3, S12‑4, X5‑1
Cardiac other (Fetal) C5‑1, C9‑2, C10‑3v, C10‑4ec, S5‑1, V6-2
Cardiac Pediatric D2cwc, S5‑1, S8‑3, S12‑4, X5‑1
Cerebral Vascular C8-5, D2tcd, D5cwc, L12‑3, L12‑5 50, L15‑7io, L18‑5, X6-1
Cephalic (Adult) D2tcd, S5‑1, X5‑1
Cephalic (Neonatal) C8‑5, L12-3, S8‑3, S12‑4
Fetal/Obstetric C5‑1, C9‑2, C10‑3v, C10‑4ec, L12‑5 50, L18‑5, S5‑1, S8‑3, V6‑2, X6‑1
Gynecological C5-1, C9-2, C10-3v, C10-4ec, X6-1
Intraoperative (Vascular) L15‑7io
Intraoperative (Cardiac) L15‑7io
Musculoskeletal L12-3, L12‑5 50, L15‑7io, L18‑5
(Conventional)
Musculoskeletal (Superficial) L12-3, L12‑5 50, L15‑7io, L18‑5
Other: Urology C5-1, C9-2, C10-3v, C10‑4ec
Pediatric C5‑1, C8‑5, C9‑2, L12‑5 50, L15‑7io, L18‑5, S5‑1, S8‑3, S12‑4, X5‑1, X6‑1
Peripheral Vessel C5‑1, C8‑5, C9‑2, C10-4ec, D5cwc, L12‑3, L12‑5 50, L15‑7io, L18‑5, S5‑1, X6‑1
Small Organ (Breast, L12‑3, L12‑5 50, L15‑7io, L18‑5
Thyroid, Testicle)
Transesophageal (Cardiac) S7‑3t, X7‑2t
Transrectal C10‑4ec
Transvaginal C10‑3v, C10‑4ec

176 EPIQ 7 User Manual 4535 617 25341

xMatrix Array Transducers Transducers

xMatrix Array Transducers

xMatrix array transducer technology provides volume acquisitions of the beating heart with
remarkable image quality. You can use these transducers to acquire two planes simultaneously
from the same heartbeat. The system's multi-directional beam steering lets you select
unlimited planes in all directions, so you can get the precise view you want, with no
degradation in image quality.
The following xMatrix array transducers are available with this system:
• X5-1 (see “X5-1 Description” on page 177)
• X6-1 (see “X6-1 Description” on page 178)
• X7-2t (see “X7-2t TEE Transducer Description” on page 209)
Use Live xPlane imaging to simultaneously create two Use Live Volume imaging to acquire and render full
full-resolution planes. volume data at true real-time frame rates.

X5-1 Description
Features of the X5-1 transducer include:
• Operating range: 1.3 to 4.2 MHz.
• 2D xMATRIX phased array with 3,000 elements.
• 2D imaging provides a 90-degree field of view, while volumetric imaging is 90 x 90 degrees.
• 2D imaging modes with PW, CW, M-mode, Color M-Mode, Color, TDI, TDI PW and LVO,
xPlane, xPlane Color, and xPlane LVO.
• 3D imaging modes with 3D Zoom, Live 3D grayscale, Live 3D color, Live 3D LVO, Full Volume
grayscale, Full Volume Color, and Full Volume LVO. (All 3D imaging modes available with
one-beat and multi-beat acquisition.)

EPIQ 7 User Manual 4535 617 25341 177

Transducers xMatrix Array Transducers

X6-1 Description
Features of the X6-1 transducer include:
• Operating range: 1.5 to 6 MHz.
• Biopsy capable.
• Internal temperature monitoring.
• 2D xMATRIX phased array with more than 9,000 elements.
• 2D imaging provides a 100-degree field of view, while volumetric imaging is 90 x 90
degrees.
• 2D imaging modes with Tissue Harmonic Imaging, M-mode, PW, Color, and CPA.
• 3D and 4D imaging modes with xPlane, Elevation Compounding, single-sweep 3D grayscale,
Color, CPA, Directional CPA, live 4D grayscale imaging, 3D Panoramic, and iSTIC grayscale
and color with automated heart rate estimation.

Transducer Maintenance
Transducers require proper care, cleaning, and handling. Reasonable care includes inspection,
cleaning, and disinfection or sterilization, as necessary.
Inspect the transducer cable, case, and lens before each use. Check for cracks or other damage
that jeopardizes the integrity of the transducer. Report any damage to your Philips customer
service representative, and discontinue use of the transducer.
For all information on transducer cleaning and disinfection, see the “Transducer Care” section.
For all information about the use of acoustic coupling gels, see “Ultrasound Transmission Gels”
on page 184.

CAUTION
Some ultrasound coupling gels, as well as some solutions for precleaning, disinfecting, and
sterilizing can damage a transducer. Before using a gel or solution on a transducer, see
“Ultrasound Transmission Gels” on page 184 or the “Transducer Care” section. You can also
contact your local Philips representative. For contact information, see “Customer Service” on
page 22.

178 EPIQ 7 User Manual 4535 617 25341

Acoustic Artifacts Transducers

If you encounter poor image quality or transducer problems, see “Troubleshooting” on page
295.

Acoustic Artifacts
The transducer adds its own signature to the echo information in the form of beam width
effects, axial resolution limitations, and frequency characteristics. The control choices made by
the sonographer that affect amplification, signal processing, and echo signal display can lead to
significant differences in the displayed appearance of echo data. Following is a brief discussion
of acoustic artifacts. An understanding of the physical basis for the production of signals
displayed on ultrasound images is helpful in minimizing artifacts on images and interpreting the
results of studies.
An artifact is an echo displayed in a different position than its corresponding reflector in the
body. Artifacts can also be caused by intervening tissue properties. Artifacts can originate from
external noise, reverberations, multi-path reflections, or misadjusted equipment. They can also
come from the ultrasonic beam geometry and unusual changes in beam intensity. Artifacts and
their manifestations are listed below, and following are some definitions of various artifacts.
• Added objects displayed as speckle, section thickness, reverberation, mirror image, comet
tail, or ring down
• Missing objects due to poor resolution
• Incorrect object brightness due to shadowing or enhancement
• Incorrect object location due to refraction, multi-path reflections, side lobes, grating lobes,
speed error, or range ambiguity
• Incorrect object size due to poor resolution, refraction, or speed error
• Incorrect object shape due to poor resolution, refraction, or speed error
Acoustic saturation occurs when received signals reach a system's high-amplitude limit. At that
point the system becomes unable to distinguish or display signal intensities. At the point of
saturation, increased input will not increase output.
Aliasing occurs when the detected Doppler frequency exceeds the Nyquist limit. It is
characterized on the spectral display by the Doppler peaks going off the display, top or bottom,
and then continuing on the other side of the baseline. On the Color display an immediate
change in color from one Nyquist limit to the other is seen.

EPIQ 7 User Manual 4535 617 25341 179

Transducers Acoustic Artifacts

Comet tail is a form of reverberation artifact produced when two or more strong reflectors are
close together and have a high propagation speed. In this case, sound does not travel directly to
a reflector and back to the transducer; and a strong linear echo appears at the reflector and
extends deeper than the reflector.
Enhancement is an increased relative amplitude of echoes caused by an intervening structure
of low attenuation.
Focal enhancement, also known as focal banding, is the increased intensity in the focal region
that appears as a brightening of the echoes on the display.
Mirror imaging artifact is most commonly seen around the diaphragm; this artifact results from
sound reflecting off another reflector and back.
Mirroring is the appearance of artifacts on a spectral display when there is improper separation
of forward and reverse signal processing channels. Consequently, strong signals from one
channel mirror into the other.
Multi-path positioning and refraction artifacts describe the situation in which the paths to and
from a reflector are different. The longer the sound takes traveling to or from a reflector, the
greater the axial error in reflector positioning (increased range). Refraction and multi-path
positioning errors are normally relatively small and contribute to general degradation of the
image rather than to gross errors in object location.
Propagation speed errors occur when the assumed value for propagation speed by the
ultrasound system is incorrect. If the actual speed is greater than that assumed, the calculated
distance to a reflector is too small, and the reflector will be displayed too far from the
transducer. Speed error can cause a structure to be displayed with incorrect size and shape.
Range ambiguity can occur when reflections are received after the next pulse is transmitted. In
ultrasound imaging, it is assumed that for each pulse produced, all reflections are received
before the next pulse is sent out. The ultrasound system calculates the distance to a reflector
from the echo arrival time assuming that all echoes were generated by the last emitted pulse.
The maximum depth to be imaged unambiguously by the system determines its maximum
pulse repetition frequency.
Reverberation is the continuing reception of a particular signal because of reverberation rather
than reflection from a particular acoustic interface. This phenomenon is analogous to the effect
created by mirrors positioned on opposite walls when an object, a head for instance, is placed

180 EPIQ 7 User Manual 4535 617 25341

Acoustic Artifacts Transducers

between the mirrors. The image of the head is reflected back and forth infinitely between the
two mirrors, creating the optical illusion of multiple heads. Reverberations are easily
identifiable, because they are equally spaced on the display.
Scattering is the diffuse, low-amplitude sound waves that occur when acoustic energy reflects
off tissue interfaces smaller than a wavelength. In diagnostic ultrasound, Doppler signals come
primarily from acoustic energy back-scattered from red blood cells.
Shadowing is the reduction in echo amplitude from reflectors that lie behind a strongly
reflecting or attenuating structure. This phenomenon occurs when scanning a lesion or
structure with an attenuation rate higher than that of the surrounding tissue. The lesion causes
a decrease in beam intensity, which results in decreased echo signals from the structures
beyond the lesion. Consequently, a dark cloud behind the lesion image forms on the display.
This cloud, or shadow, is useful as a diagnostic clue.
Side lobes (from single-element transducers) and grating lobes (from array transducers) cause
objects that are not directly in front of the transducer to be displayed incorrectly in lateral
position.
Speckle appears as tissue texture close to the transducer but does not correspond to scatterers
in tissue. It is produced by ultrasound wave interference and results in general image
degradation.
Spectral broadening is a display phenomenon that occurs when the number of energy-bearing
Fourier frequency components increases at any given point in time. As a consequence, the
spectral display is broadened. Spectral broadening can indicate the disturbed flow caused by a
lesion, and therefore it is important diagnostically. However, broadening can also result from
interaction between flow and sample volume size, in which case it is an artifact.
Speed of sound artifacts occur if the sound propagation path to a reflector is partially through
bone, and the speed of sound is greater than in the average soft tissue. Echo position
registration artifacts will be produced. Reflectors appear closer to the transducer than their
actual distance because of this greater speed of sound, resulting in a shorter echo transit time
than for paths not containing bone.

Acoustic Artifacts in 3D Imaging

Acquisition, rendering, and editing artifacts are specific to 3D volume images. Acquisition
artifacts are related to patient motion, organ motion, or position-sensing errors. Rendering
artifacts include elimination of structures by limiting the region of interest boundaries,

EPIQ 7 User Manual 4535 617 25341 181

Transducers Acoustic Artifacts

thresholding that eliminates structures, and adjacent structure artifacts that add additional
information or hide structures. Editing artifacts result from data deleted from a rendered
image.
Color and Color Power Angio artifacts relating to gain may also be confusing in rendered
images. A color flash artifact can occur when the gain is set high and the transducer or patient
moves. When the gain is set too high, the color ROI box fills with color flash. When the gain is
set low, color bleed can occur. When the gain is set too low, insufficient color data renders the
image undiagnosable.
Color gain, directional, and motion artifacts can present themselves in 3D imaging. Color and
Color Power Angio gain artifacts are mainly related to the use of excessive gain resulting in
random color patterns in the 3D image that might be interpreted as diagnostically significant.
Directional artifacts are due to aliasing or directional confusion: The velocity range must be set
properly, and the relationship between the transducer orientation and the flow vector must be
understood. Patient motion can produce flash artifacts that are less obvious in 3D images than
in 2D imaging.
Dropout and shadowing are present in 3D imaging although they are more difficult to
recognize due to different and unfamiliar displays. Acoustic shadowing and other artifacts look
very different when displayed in 3D volumes and may be more difficult to recognize than on
standard 2D imaging. Those artifacts may produce apparent defects, such as limb abnormalities
or facial clefts, where they are not present. Acquiring data from multiple orientations may
avoid artifacts of this type.
Fetal limb deficit artifacts are specific to 3D volume images. Partially absent fetal limb bones
have been demonstrated. One explanation for the missing limbs was shadowing caused by
adjacent skeletal structures. Overcoming the limb deficit artifact can be accomplished by
changing the transducer position and the acquisition plane.
Motion artifacts in 3D volumes can be caused by patient motion, fetal movement, cardiac
motion, and movement of adjacent structures. Patient motion can produce flash artifacts that
are more obvious in 3D images than in 2D imaging.
Pseudoclefting and pseudonarrowing artifacts may be related to limb deficit artifacts. Artifacts
may be present in 3D imaging of the fetal face. Being aware of pseudoclefting of the fetal face
and pseudonarrowing of the fetal spine can help the sonographer understand and identify
these artifacts. As with 2D imaging, it is important to verify putative physical defects by using
additional images and other modalities.

182 EPIQ 7 User Manual 4535 617 25341

Transducer Covers Transducers

Resolution, attenuation, and propagation artifacts are all common to 3D imaging. Careful
scrutiny of the original 2D images is necessary to identify and preclude these types of artifacts
from the 3D volume image.

Transducer Covers
To prevent contamination by blood-borne pathogens, sterile transducer covers are required for
intraoperative and biopsy procedures; in China, sterile covers are also required for transrectal,
intravaginal, and transesophageal procedures. Protective covers are recommended for
transrectal, intravaginal, and transesophageal procedures; the protective covers are mandatory
in China and Japan. Philips recommends the use of qualified covers.
For procedures for using transducer covers, see the instructions provided with the covers.

WARNING
Latex and talc are commonly used in sheaths marketed to help with infection control in
transesophageal, endocavity, and intraoperative imaging applications and during biopsies.
Examine the packaging to confirm latex and talc content. Studies have shown that patients
can experience allergic reactions with natural rubber latex. See the FDA Medical Alert, March
29, 1991, reprinted in “FDA Medical Alert on Latex” on page 49.

WARNING
In intraoperative applications, sterilized transducers should be used with sterile gel and a
sterile transducer cover.

WARNING
Do not apply the transducer cover until you are ready to perform the procedure.

WARNING
Inspect transducer covers before and after use.

EPIQ 7 User Manual 4535 617 25341 183

Transducers Ultrasound Transmission Gels

WARNING
If the sterile transducer cover becomes compromised during an intraoperative application
involving a patient with Creutzfeldt-Jakob disease, follow the recommendations described in
“Transmissible Spongiform Encephalopathy” on page 257.

WARNING
Transducer covers are disposable and must not be reused.

WARNING
If an installed transducer cover is cut or contaminated before use, the probe should be
cleaned and disinfected or sterilized, and a new sterile cover installed.

Ultrasound Transmission Gels

For proper transmission of the acoustic beam, use the ultrasound transmission gel supplied by
or recommended by Philips, or another glycol-, glycerol-, or water-based acoustic coupling
medium. Products that do not contain mineral oil are acceptable for use. Never use lotion-
based products.

WARNING
Do not apply the transducer gel until you are ready to perform the procedure. Transducers
should not be left soaking in gel.

WARNING
For intraoperative applications, use only the Sterile Aquasonic or Sterile Ultraphonic gel
provided with the transducer cover.

CAUTION
Do not use gels that contain mineral oil or lotion. Such products may damage the transducer
and void the warranty.

184 EPIQ 7 User Manual 4535 617 25341

Transducer Storage Transducers

CAUTION
Gels listed here are recommended because of their chemical compatibility with product
materials.

Some recommended gels include:

• Aquasonic 100
• Aquasonic Clear
• Carbogel-ULT
• ECG Gel (Nicom)
• Nemidon Gel
• Scan
For additional compatibility information, call Philips at 800-722-9377 (North America) or your
local Philips Ultrasound representative (outside North America).

Transducer Storage
Use the appropriate guidelines for storing transducers for transport, and daily and long-term
storage.

Storage for Transport

If a carrying case is provided with your transducer, always use the carrying case to transport the
transducer from one site to another. Follow these guidelines to properly store transducers for
transport:
• Make sure that the transducer is clean and disinfected before placing it in the case to avoid
contaminating the foam that lines the carrying case.
• Place the transducer in the case carefully to prevent kinking of the cable.
• Before closing the lid, make sure no part of the transducer is protruding from the case.
• Wrap the case in plastic material containing air pockets (such as Bubble Wrap material), and
pack the wrapped case in a cardboard carton.
• To avoid damaging the shaft or steering mechanism of TEE transducers, do not bend or coil
the flexible shaft of the transducer in less than a 0.30-m (1-ft) diameter circle.

EPIQ 7 User Manual 4535 617 25341 185

Transducers Transducer Storage

Daily and Long-Term Storage

Follow these guidelines to protect your transducer:
• Always store transducers in the transducer holders on the side of your system or on a
securely mounted wall rack when you are not using them.
• Ensure the transducer holders are clean before storing transducers (see “Disinfecting
System Surfaces” on page 290).
• Avoid storing transducers in areas of temperature extremes or in direct sunlight.
• Store transducers separately from other instruments to avoid inadvertent transducer
damage.
• When storing transducers, use the cable-management clips to secure the transducer cable.
• Before storing transducers, make sure they are thoroughly dry.
• For TEE transducers, be sure the distal tip is straight and protected before storing the
transducer.
• Never store a TEE transducer in the carrying case, except to transport it.

186 EPIQ 7 User Manual 4535 617 25341

Operators of Intraoperative Transducers Intraoperative Transducers

9 Intraoperative Transducers
An intraoperative transducer is used during surgery to help the surgeon locate and visualize
anatomical structures, to visualize blood flow patterns and quantify velocities, and to image
and measure anatomical and physiological parameters of interest to the surgeon.
The system supports the L15-7io transducer for use in intraoperative applications.

WARNING
All intraoperative transducers are designed to be defibrillator safe in accordance with IEC
60601-1. Nevertheless, always remove the transducer from the patient before defibrillation.

NOTE
Intraoperative transducers will be unavailable in the US and Canada until regulatory clearance is
received.

Operators of Intraoperative Transducers

Philips intraoperative transducers are designed to be used under the guidance of physicians
who are properly trained in intraoperative ultrasound imaging techniques according to
currently approved relevant medical practices. Philips recommends that physicians operating
any Philips intraoperative transducer have the following qualifications:
• Proficiency in recognizing and interpreting imaging patterns.
• Thorough familiarity with the safe operation, care, and maintenance of the ultrasound
system and the intraoperative transducers.
• Thorough familiarity with the latest intraoperative methods through literature and
seminars.

EPIQ 7 User Manual 4535 617 25341 187

Intraoperative Transducers Intended Uses for Intraoperative Transducers

Intended Uses for Intraoperative Transducers

Intraoperative studies are performed by surgeons, anesthesiologists, or sonographers to obtain
images that can be used for the following purposes:
• Helping a surgeon locate and visualize anatomical structures before, during, or after a
surgical procedure
• Helping a surgeon visualize blood flow patterns and quantify velocities before, during, or
after a surgical procedure
• Imaging and measuring anatomic and physiologic parameters before, during, or after a
surgical procedure

WARNING
Intraoperative transducers used in animal studies should not be used on humans. Transducer
disinfection procedures for cross-usage between animals and humans have not been
validated.

Patient Safety During Intraoperative Studies

To operate an intraoperative transducer, you must be under the guidance of a physician who is
properly trained in intraoperative ultrasound imaging techniques, according to currently
approved relevant medical practices. You also must be thoroughly familiar with the safe
operation, care, and maintenance of the ultrasound system used with the transducer, as well as
proficient at interpreting the images generated.
To help ensure patient safety when using an intraoperative transducer, observe the following
guidelines:
• Scrutinize the entire transducer before each use. (See the “Transducer Care” section.)
• Use mandatory protective equipment, including an approved sterile protective transducer
cover, during intraoperative studies. For information about using transducer covers, see
“Preparing Transducers for Intraoperative Use” on page 191.
• Operate the transducer properly.

188 EPIQ 7 User Manual 4535 617 25341

Patient Safety During Intraoperative Studies Intraoperative Transducers

• Do not allow water or other liquids to drip onto the transducer connector, the interior of
the system, or the keyboard.
• Maintain a sterile field.

WARNING
All intraoperative studies must be performed with a Type CF classified transducer. If your
transducer is not labeled Type CF on the transducer connector, contact your Philips
service representative.

WARNING
Be sure to use a market-approved sterile transducer cover and sterile ultrasound
transmission gel when performing all intraoperative studies.

WARNING
Always remove the transducer from the patient before defibrillation.

Patient-Contact Parts
Latex is commonly used in sheaths marketed to help with infection control in transesophageal,
endocavity, and intraoperative imaging applications and during biopsies. Examine the packaging
to confirm latex content. Studies have shown that patients can experience allergic reactions
with natural rubber latex. See “FDA Medical Alert on Latex” on page 49.

NOTE
The ultrasound system and transducers discussed here do not contain natural rubber latex that
contacts humans. Natural rubber latex is not used on any Philips ultrasound transducers.

EPIQ 7 User Manual 4535 617 25341 189

Intraoperative Transducers Preventing Intraoperative Transducer Problems

Preventing Intraoperative Transducer Problems

WARNING
If you find any signs of damage to the transducer, patient safety may be compromised. Do
not use the transducer, and contact your Philips service representative.

Meticulous inspection and correct and careful operation of intraoperative transducers are
imperative to patient safety. The situations listed here affect safe operation as well as the
ability to service mechanical problems under the Philips warranty or service contract.
Transducer repairs necessitated by misuse are not covered and can be very costly, often
requiring complete disassembly and rebuilding of the transducer.
There are three primary areas of transducer misuse:
• Cuts and abrasions on the transducer insulation and lens from sharp instruments such as
scalpels, scissors, and clamps
• Improper disinfection techniques, causing fluid to enter the transducer or damage
transducer materials
• Damage caused by dropping the transducer on a hard surface
To minimize the chance of damage, Philips strongly recommends that you clearly post stringent
protocols for the care of intraoperative transducers, based on the information provided here.

L15-7io Description
The L15-7io transducer is described here. For more information on connecting, activating,
caring for, and maintaining transducers, see the “Transducers” and “Transducer Care” sections.

190 EPIQ 7 User Manual 4535 617 25341

Preparing Transducers for Intraoperative Use Intraoperative Transducers

L15-7io Transducer

NOTE
This transducer is available only in countries or regions where it is approved. For information
specific to your region, contact your local Philips representative.

L15-7io Transducer Features and Specifications

Features Linear array designed for mid- to high-frequency superficial imaging and high-resolution
intraoperative vascular applications. Supports 2D, PW Doppler, Color Doppler, Color Power
Angio imaging, and XRES processing. Used for evaluating blood vessels, musculoskeletal
exams, small parts (breast, testicles, thyroid) imaging, and epicardiac imaging.
• Phased linear array with 128 elements
• 8 degrees of trapezoidal imaging, 23 mm (0.9 in) effective aperture length
Frequency Operating range: 15 to 7 MHz
Biopsy Capable No
Specifications • Lens footprint: elevation, 10 mm (0.4 in); scan plane, 32 mm (1.25 in)
• Transducer length: 89 mm (3.5 in)
• Cable length: 2 m (80 in)

Preparing Transducers for Intraoperative Use

1. Place 20 cc of sterile gel or saline into the transducer cover.

EPIQ 7 User Manual 4535 617 25341 191

Intraoperative Transducers Preparing Transducers for Intraoperative Use

2. Carefully inspect each transducer cover before use, and discard it if you find tears or
blemishes. Also inspect each transducer cover after use. If you find a tear, the patient or the
transducer may have been contaminated.
3. Insert the transducer into the transducer cover and unfurl the transducer cover until it
covers the transducer and its cable. The cover must be unfurled far enough to maintain the
sterile field.
4. Use a sterile elastic band or clip to hold the proximal end of the transducer cover in place.
5. Ensure that wrinkles and bubbles over the face of the transducer are minimized. Check the
transducer cover for tears or damage before proceeding.
6. When operating the transducer, make sure that proper orientation is maintained to avoid
interpretation confusion.

NOTE
To achieve good acoustic contact, make sure that the imaging surface is moist.

NOTE
Imaging improves with adequate coupling between the patient surface and the transducer-
cover surface. Sterile water is a good acoustic-coupling agent during surgery.

Disposable Drapes
During studies in which you believe contamination of the ultrasound system can occur, Philips
recommends that you take universal precautions and cover the system with a disposable drape.
Consult your hospital’s rules regarding equipment use in the presence of infectious disease.

Accessories for Intraoperative Transducers

For information on ordering accessories, see “Supplies and Accessories” on page 21.

Electrical Safety and Intraoperative Transducers

All Philips ultrasound systems and transducers comply with common medical device electrical
safety standards.

192 EPIQ 7 User Manual 4535 617 25341

Leakage Current Testing for Intraoperative Transducers Intraoperative Transducers

Intraoperative transducers are classified as a Type CF isolated patient-applied part, as

described in IEC 60601-1. There are no exposed conductive surfaces on the transducer head. To
ensure safe operation of this transducer, read the cautions and warnings in the “Safety”
section, especially those that address electrosurgical units, pacemakers, and defibrillators.

Leakage Current Testing for Intraoperative Transducers

Philips transducers approved for intraoperative use are labeled on the transducer connector as
Type CF in accordance with the IEC 60601-1. Type CF classification indicates that the degree
of protection from electrical shock afforded by the transducer is suitable for all patient
applications, including direct cardiac and intraoperative applications.
Leakage current tests should be performed by a technically qualified person any time that the
transducer is dropped or if cracks or cuts are found on the transducer.
Normal leakage current testing frequency should be based on the procedures established by
the hospital for operating-room-based equipment.
Regularly perform the electrical safety check to ensure that IEC 60601-1 Type CF leakage limits
are not exceeded. You can perform this procedure with any commercially available safety
analyzer that is designed for hospital use.

WARNING
Only a technically qualified person should perform the leakage current test procedure.

Test 1 tests the current leakage, using a Dynatech Nevada 232 Safety/ECG Analyzer. This
procedure shows one example of a current leakage test (source and sink). The procedure for
your safety analyzer may be very different.

EPIQ 7 User Manual 4535 617 25341 193

Intraoperative Transducers Leakage Current Testing for Intraoperative Transducers

Test 1: Leakage Current Test with Mains Voltage Applied (Source) for Intraoperative Transducers

Key to Source Test Diagram

C Stray capacitance from the ultrasound system power wiring to the system
grounded metal chassis (1 to 3 MΩ reactance)

Z Impedance between the metal parts of the transducer and a test electrode placed
in the bucket of saline solution (about 850 kΩ with an intact outer insulating layer,
500 Ω with a hole in the layer)

A Microammeter to measure leakage current from the transducer to the earth lift
ground through Z to the test electrode

e Line power source, either 110 Vac or 220 Vac

I Current caused by e and stray capacitance, and optionally Z

S1 Open earth lift ground switch

S2 Line polarity switch

194 EPIQ 7 User Manual 4535 617 25341

Leakage Current Testing for Intraoperative Transducers Intraoperative Transducers

L Line mains supply

N Neutral mains supply

E Earth ground

Test 2: Leakage Current Test with Mains Voltage Applied (Sink) for Intraoperative Transducers

Key to Test 2 Diagram

C Stray capacitance from the ultrasound system power wiring to the system
grounded metal chassis (1 to 3 MΩ reactance)

Z Impedance between the metal parts of the transducer and a test electrode placed
in the bucket of saline solution (about 850 kΩ with an intact outer insulating layer,
500 Ω with a hole in the layer)

A Microammeter to measure leakage current from a line supply to the transducer

and back to earth ground through electrode Z and the equipment chassis

e Line power source, either 110 Vac or 220 Vac

EPIQ 7 User Manual 4535 617 25341 195

Intraoperative Transducers Leakage Current Testing for Intraoperative Transducers

I Current caused by e and stray capacitance, and optionally Z

S1 Open earth lift ground switch

S2 Line polarity switch

S3 Isolation test button

L Line mains supply

N Neutral mains supply

E Earth ground

Testing Intraoperative Transducer Leakage Current (Source)

This test checks leakage current without mains voltage applied. For a diagram of this test, Test
1, see “Leakage Current Testing for Intraoperative Transducers” on page 193.

WARNING
Electrical shock hazard: Do not touch the lead that you connect to the safety analyzer in step
7.

1. Plug the safety analyzer into the power source.

2. Plug the ultrasound system into the safety analyzer.
3. Connect the transducer being tested to the ultrasound system.
4. Immerse 5 cm (2 in) of the transducer in saline solution.
5. Set the safety analyzer Mode switch to the ECG position.
6. Set the safety analyzer Leads switch to the ALL (all ECG leads) position.
7. Connect a lead to any ECG terminal on the safety analyzer, and immerse the other end into
the saline solution.
8. Set the safety analyzer Line Polarity switch to Normal.
9. Note the normal condition leakage reading.
10. Hold the safety analyzer Ground Open switch in the Open position (single fault condition),
and note the leakage reading.
11. Repeat step 9 and step 10 with the Polarity switch in the Reverse position. These are the
applicable limits:

196 EPIQ 7 User Manual 4535 617 25341

Leakage Current Testing for Intraoperative Transducers Intraoperative Transducers

• 10 µA RMS (normal condition)

• 50 µA RMS (single fault condition)

Testing Intraoperative Transducer Leakage Current (Sink)

WARNING
There is considerable hazard in performing this test. Use precautionary measures to avoid
accidental contact with line voltage. In addition, any time that the ground connection has
been opened, do not touch the chassis or the patient cable during the test.

This test checks leakage current with mains voltage applied. For a diagram of this test, Test 2,
see “Leakage Current Testing for Intraoperative Transducers” on page 193.
1. Plug the safety analyzer into the power source.
2. Plug the ultrasound system into the safety analyzer.
3. Connect the transducer being tested to the ultrasound system.
4. Immerse 5 cm (2 in) of the transducer in saline solution.
5. Set the safety analyzer Mode switch to the ECG position.
6. Set the safety analyzer Leads switch to the Isolation Test position.
7. Connect a lead to any ECG terminal on the safety analyzer. Leave the other end of the lead
disconnected for now.
8. Press and hold the Isolation Test button and note the leakage reading. This is the correction
factor that will be subtracted from the final reading.
9. Immerse the other end of the lead into the saline solution.
10. Press and hold the Isolation Test button and take the leakage reading again.
11. Subtract the correction factor found in step 8 to get the accurate leakage measurement.
The leakage must be less than 50 µA RMS.

EPIQ 7 User Manual 4535 617 25341 197

Intraoperative Transducers Leakage Current Testing for Intraoperative Transducers

198 EPIQ 7 User Manual 4535 617 25341

Operators of TEE Transducers Transesophageal Transducers

10 Transesophageal Transducers
A transesophageal echocardiography (TEE) study is performed with a transducer mounted in a
gastroscope, which is positioned in the esophagus or stomach. TEE transducers offer images
that are unobstructed by lungs and ribs, making them important diagnostic tools for conditions
that transthoracic echocardiography cannot adequately image.
All transesophageal transducers are rated minimum IPX1 (control area) and IPX7 (endoscope
area) in accordance with IEC 60529.
The system supports the compact X7-2t and S7-3t TEE transducers. The imaging array in the
X7-2t and the S7-3t transducers can be rotated electronically using controls on the transducer
or on the control panel.

WARNING
All TEE transducers are designed to be defibrillator safe in accordance with IEC 60601-1.
Nevertheless, always remove the transducer from the patient before defibrillation.

Operators of TEE Transducers

Philips TEE transducers are designed for use under the guidance of physicians who are properly
trained in esophagogastroscopic techniques, according to currently approved relevant medical
practices. Philips recommends that physicians operating any Philips TEE transducer have the
following qualifications:
• Proficiency in recognizing and interpreting transesophageal imaging patterns
• Thorough familiarity with the safe operation, care, and maintenance of the ultrasound
system and TEE transducers
• Thorough familiarity with the latest TEE methods through literature and seminars

EPIQ 7 User Manual 4535 617 25341 199

Transesophageal Transducers Patient Safety During TEE Studies

Patient Safety During TEE Studies

Philips recommends that you practice using the TEE transducer controls before performing any
procedure mentioned here. You must also be thoroughly familiar with the safe operation, care,
and maintenance of the ultrasound imaging system used with the TEE transducer, as well as
proficient at interpreting the images generated.
You can help ensure patient safety when using a TEE transducer by following these guidelines:
• Have a backup system present during TEE exams to ensure completion of the exam in the
event that the primary system fails.
• Use informed judgment when selecting patients for TEE studies. See “Patient Selection for
TEE Transducer Use” on page 224.
• Verbally prepare each patient for the procedure before the study. See "Preparing Patients
for TEE Studies" in the Help.
• Scrutinize the entire transducer, turn on the system, and test all of the transducer controls
and related system controls, before inserting the TEE transducer into the patient's
esophagus. See “Checking the TEE Transducer” on page 223.
• Insert, remove, and operate the transducer properly.
• Ensure that the transducer handle does not rest on or touch the patient.
• Use protective equipment, such as a bite guard and a market-approved sterile transducer
cover during a TEE study. See “TEE Accessories and Supplies” on page 233.
• Do not allow water or other liquids to come in contact with the interior of the system, the
interior of the transducer connector, the inside of the transducer control handle, or to drip
onto the keyboard.
• Minimize the possibility of transducer tip fold-over. This problem has occurred rarely, but
its consequences can be serious. See “Tip Fold-Over” on page 226.
To prevent tissue damage such as pressure necrosis, gastroesophageal lacerations, bleeding,
tearing of adhesions, ligament damage, and perforation, observe the following warnings and
cautions.

WARNING
Never apply excessive force when inserting or withdrawing a TEE transducer, or when
operating the transducer deflection controls.

200 EPIQ 7 User Manual 4535 617 25341

Patient Safety During TEE Studies Transesophageal Transducers

WARNING
Do not allow the transducer to remain at a maximum deflection for long periods of time.

WARNING
Lock medial/lateral movement of the TEE transducer during insertion.

WARNING
Whenever the TEE transducer is not being used during a procedure, ensure that it is in
freewheeling mode and unplugged from the system.

WARNING
To prevent tissue damage, Philips recommends that the tip of the TEE transducer be
straightened and both detent brakes released before you reposition the transducer or
withdraw the transducer from the patient. In the neutral position, the tip is straight when the
indicators on the control wheels are aligned and point toward the center of the array rotation
button.

WARNING
Bite guards are mandatory; protective transducer covers are recommended for TEE
transducers, but in China and Japan, the covers are mandatory. See “Electrical Safety and TEE
Transducers” on page 205.

CAUTION
To avoid damaging gastroscope cables, be sure that the distal tip of the transducer is in the
neutral (straight) position when inserting a transducer into, or removing it from, the
transducer cover.

EPIQ 7 User Manual 4535 617 25341 201

Transesophageal Transducers Patient Safety During TEE Studies

The TEE transducers are classified as Type BF isolated patient-applied parts, as described in IEC
60601-1. There are no exposed conductive surfaces distal to the transducer handle. To ensure
safe operation of this transducer, read the cautions and warnings in the “Safety” section,
especially those that address electrosurgical units, pacemakers, and defibrillators.
The following table summarizes patient safety problems, describes how to prevent them, and
lists the sections in this manual where details are provided.

WARNING
If you encounter an irregularity not listed in the following table, do not use the transducer.
Potentially serious consequences could result. Contact your Philips representative.

Ensuring Patient Safety During TEE Studies

Problem Effect on Patient Prevention See
Mechanical Severe trauma, cuts, Inspect the transducer, using both sight “Checking the TEE
damage bleeding, perforations and touch, before the study. Transducer” on page
223
Electrical Esophageal burns Check the transducer for frayed insulation, “Electrical Safety and
damage kinks, or other abnormalities. Follow TEE Transducers” on
procedures for checking electrical safety. page 205
Biting, scraping Tooth damage, Always use a bite guard. “Bite Guards” on page
transducer esophageal burns 233
Insufficient Spread of illness or Thoroughly clean and disinfect the “Transducer Care”
cleaning disease transducer after each use. Cover the tip section
protocol and shaft with a transducer cover. Cover
the imaging system with a disposable
drape if highly pathogenic organisms are
known or suspected.

202 EPIQ 7 User Manual 4535 617 25341

Patient Safety During TEE Studies Transesophageal Transducers

Problem Effect on Patient Prevention See

Improper Esophageal cuts, To prevent improper insertion or “TEE Study Guidelines”
insertion or bleeding, ligament withdrawal when using a TEE transducer, on page 225
withdrawal damage, perforations never use force when inserting, removing,
or manipulating the transducer. During
insertion, lock the medial/lateral controls.
During withdrawal, release both brakes to
place both steering knobs in the
freewheeling position.
Pressure Death of esophageal Keep deflection controls in freewheeling “TEE Study Guidelines”
necrosis lining tissue mode and unplug the transducer from the on page 225
system when not imaging. Minimize the
pressure applied to deflection area and
distal tip. Do not let the distal tip displace
a tissue area for more than 5 consecutive
minutes.
Increased Esophageal burns Use the TEE preset that has been “Entering Patient
transducer established to minimize the effects of Temperature” on page
temperature temperature. For febrile patients, use the 231
Auto-Cool feature.
Improper Transient unilateral vocal Never use the transducer during any “TEE Study Guidelines”
patient position cord paralysis procedure requiring extreme neck flexion, on page 225
such as sitting craniotomies.
Nonisolated Electrical burns Only use isolated-output electrosurgical “Electrical Safety and
ESUs units (ESUs). The ESU label or service guide TEE Transducers” on
or your biomedical department should page 205
identify whether or not the ESU is isolated.
Unplug transducer from the system when
you are not imaging.
Defibrillation Electrical burns Remove the transducer from the patient “Electrical Safety and
issues before defibrillation. TEE Transducers” on
page 205

EPIQ 7 User Manual 4535 617 25341 203

Transesophageal Transducers Patient Safety During TEE Studies

Patient-Contact Parts
Latex is commonly used in sheaths marketed to help with infection control in transesophageal,
endocavity, and intraoperative imaging applications and during biopsies. Examine the packaging
to confirm latex content. Studies have shown that patients can experience allergic reactions
with natural rubber latex. See “FDA Medical Alert on Latex” on page 49.

NOTE
The ultrasound system and transducers discussed here do not contain natural rubber latex that
contacts humans. Natural rubber latex is not used on any Philips ultrasound transducers.

Preventing TEE Transducer Problems

Meticulous inspection and correct and careful operation of the TEE (transesophageal)
transducer is imperative to patient safety. The situations listed here affect safe operation as
well as the ability to service mechanical problems under the Philips one-year warranty or
service contract. Transducer repairs necessitated by misuse of the transducer are not covered
and can be very costly, often requiring complete disassembly and rebuilding of the transducer.
There are three primary areas of transducer misuse:
• Cuts and abrasions on the transducer and insulation from teeth or sharp instruments such
as scalpels, scissors, and clamps
• Improper disinfection techniques, including allowing fluid to enter the connector or
transducer handle and the use of unapproved disinfectants
• Consistently applying too much force to the control wheels of a TEE transducer, which can
break the steering mechanism
Review the following table to familiarize yourself with specific problems, to learn how to avoid
them, and to identify the sections in this manual where details are provided. Philips also
strongly recommends that you clearly post stringent protocols for TEE transducer care, based
on the information in this manual, to minimize the chance of damage.

204 EPIQ 7 User Manual 4535 617 25341

Electrical Safety and TEE Transducers Transesophageal Transducers

WARNING
For any other irregularity not listed in the following table, do not use the transducer.
Potentially serious consequences could result. Contact your Philips representative.

Preventing TEE Transducer Equipment Problems

Problem Effect on Equipment Prevention See
Current leakage Serious electrical hazards Check the transducer for cuts, frayed “Checking the TEE
insulation, kinks, or other Transducer” on page
abnormalities. 223
Biting transducer Mechanical and electrical Cover the patient's teeth with a bite “Bite Guards” on page
hazards guard (mandatory). Cover the distal tip 233
and flexible shaft with a transducer
cover (recommended, but in China and
Japan, mandatory).
Forcing deflection Steering mechanism broken Operate the deflection controls gently. “X7-2t Deflection
controls Controls” on page 211
and “S7-3t TEE
Controls” on page 218
Incorrect storage Possible damage to highly Suspend the transducer from a wall- “Transducer Storage”
sensitive elements, cuts in mounted rack and the distal tip with a on page 185
flexible shaft tip protector when not in use.
Internal exposure Severe transducer damage Never sterilize the transducer by using “Transducer Care”
to liquids that affects the image bleach, steam, heat, or ethylene oxide section
quality, the steering (EtO). Never immerse the steering
mechanism, and electrical mechanism in any disinfectant or liquid.
safety

Electrical Safety and TEE Transducers

The ultrasound system and its transducers comply with common medical device electrical
safety standards.
For electrical safety information about TEE transducers, see “Leakage Current and TEE
Transducers” on page 206 and “Reducing Risks of Using TEE Transducers” on page 206.

EPIQ 7 User Manual 4535 617 25341 205

Transesophageal Transducers Electrical Safety and TEE Transducers

For safety information on electrosurgical units, pacemakers, defibrillators, and related topics,
see “Electrical Safety” on page 29.

Leakage Current and TEE Transducers

For the TEE transducers discussed in this document, the insertion tube and tip are Type BF ,
as described in IEC 60601-1. There are no exposed conductive surfaces distal to the transducer
handle. Within the flexible shaft, all active circuits and conductors are surrounded by a chassis-
grounded shield that runs the length of the transducer.
If the outer layer of the shaft is punctured or cracked, a patient’s esophagus could be exposed
to chassis leakage current. This leakage current is not hazardous provided that the ground
connector (third wire) in the ultrasound system power cable is intact and connected to a
properly grounded wall outlet. Even if the ground connector breaks, leakage current is in
compliance with the limits noted in IEC 60601-1.
Leakage hazards are further reduced when the ultrasound system is plugged into an isolated
power outlet, which is standard in most operating rooms.

Reducing Risks of Using TEE Transducers

WARNING
Before defibrillation, if you cannot remove the transducer from the patient, always
disconnect invasive transducers that remain in contact with the patient from the system.

To reduce the possibility of electrical risks associated with use of TEE transducers, follow these
recommendations:
• Visually and tactually inspect a TEE transducer for bumps, cracks, and cuts before each TEE
exam. A small bump on the shaft surface could indicate that a strand from the ground
shield has broken and is beginning to puncture the outer layer. If you suspect a problem
with the flexible shaft, perform the electrical safety check procedure. See “TEE Leakage
Current Test” on page 234.
• Use electrosurgical units (ESUs) that have isolated outputs. Return fault/ground fault
detection circuits provide additional protection. To determine if an ESU has an isolated
output, read the label on the ESU, see the ESU service guide, or ask a biomedical engineer.

206 EPIQ 7 User Manual 4535 617 25341

TEE Deflection Control Basics Transesophageal Transducers

• Require periodic electrical safety checks to ensure that the grounding system in your area
remains intact.
• If the transducer is left in a patient during periods when imaging is not taking place, unplug
the transducer from the system to reduce the possibility of leakage current or ESU
interaction. Also make sure that the deflection control brakes are off and that the
transducer is in freewheeling mode.
• Always remove the transducer from the patient before defibrillation.

TEE Deflection Control Basics

The deflection controls on the TEE transducer move the deflection area, located between the
distal tip and flexible shaft. The deflection area bends when you operate the controls,
permitting anterior, posterior, and lateral positioning.

Deflection Control Movement

To prevent tissue damage such as pressure necrosis, gastroesophageal lacerations, bleeding,

tearing of adhesions, ligament damage, and perforation, observe the following warnings. See
“TEE Transducer References” on page 238.

WARNING
Never apply excessive force when inserting or withdrawing a TEE transducer, or when
operating the transducer deflection controls.

WARNING
Lock medial/lateral movement of the TEE transducer during insertion.

EPIQ 7 User Manual 4535 617 25341 207

Transesophageal Transducers TEE Deflection Control Basics

WARNING
Whenever the TEE transducer is not being used during a procedure, ensure that it is in
freewheeling mode and unplugged from the system.

WARNING
Do not allow the TEE transducer to remain at a maximum deflection for long periods of time.

WARNING
To prevent tissue damage, Philips recommends that the tip of the TEE transducer be
straightened and both detent brakes released before you reposition the transducer or
withdraw the transducer from the patient. In the neutral position, the tip is straight when the
indicators on the control wheels are aligned and point toward the center of the array rotation
button.

WARNING
Bite guards are mandatory; protective covers are recommended for TEE transducers, except
in China and Japan, where protective transducer covers are mandatory for TEE transducers.

WARNING
To avoid damaging gastroscope cables, be sure that the distal tip of the transducer is in the
neutral (straight) position when inserting a transducer into, or removing it from, the
transducer cover.

208 EPIQ 7 User Manual 4535 617 25341

X7-2t TEE Transducer Description Transesophageal Transducers

X7-2t TEE Transducer Description

X7-2t TEE Transducer

X7-2t TEE Transducer Features and Specifications

Features PureWave technology sensor enables high-resolution imaging and 360-degree views
of the heart, unobstructed by lungs and ribs. Capable of 2D, 3D, Harmonic imaging,
Live 3D, xPlane imaging, color Flow, steerable CW Doppler mode, and PW Doppler
mode, frequency agility, and electrocautery suppression. Tip surface constantly
monitored for patient safety. Convenient hanging ring.
Specifications • Tip: 1.5 cm (0.6 in) wide, 3.5 cm (1.4 in) long
• Shaft: 1.0 cm (0.4 in) wide, 1.0 m(3.3 ft) long

NOTE
Philips recommends that you use the X7-2t transducer only on patients weighing at least 30 kg
(66 lb), to ensure that the esophagus can comfortably accommodate the transducer.

EPIQ 7 User Manual 4535 617 25341 209

Transesophageal Transducers Using the X7-2t TEE Transducer

Using the X7-2t TEE Transducer

Philips recommends familiarizing yourself with the controls and parts of the TEE transducer
before using it in a study.
TEE Transducer Components
Component Description
Distal tip

Transducer connector

210 EPIQ 7 User Manual 4535 617 25341

Using the X7-2t TEE Transducer Transesophageal Transducers

Component Description
Transducer handle

Deflection controls

X7-2t Deflection Controls

The smaller knob controls medial/lateral movement, while the larger knob controls anterior/
posterior movement. To place the tip of the TEE transducer into the neutral position, align the
ribs on each knob with the center of the array rotation buttons (as shown below).
The knobs can be controlled by a detent brake that holds the tip position without locking it in
place. This allows the tip to straighten if it meets additional resistance. When the detent brake
actuator is rotated to the right (as shown) both knobs are in the freewheeling mode. When the
detent brake actuator is centered, the small knob (medial/lateral movement) is in the detent
mode, and when the actuator is rotated to the left, both knobs are in the detent mode.

EPIQ 7 User Manual 4535 617 25341 211

Transesophageal Transducers Using the X7-2t TEE Transducer

X7-2t Transducer Controls

Control Description
Medial/lateral control

Anterior/posterior control

Detent brake actuator

212 EPIQ 7 User Manual 4535 617 25341

Using the X7-2t TEE Transducer Transesophageal Transducers

Control Description
Image plane rotation buttons

Neutral position indicators, showing no deflection

Manipulating the X7-2t Tip

Review the warnings and caution in “Patient Safety During TEE Studies” on page 200 and “TEE
Deflection Control Basics ” on page 207 before using the transducer in a study.
1. Turn the detent brake actuator fully away from the image plane rotation buttons to put
both knobs into freewheeling mode.
2. Turn the large knob to deflect the tip in the anterior/posterior plane.
3. Turn the small knob to deflect the tip in the medial/lateral plane.
4. When the tip is positioned properly, do one of the following:
• Turn the detent brake actuator fully toward the image plane rotation buttons to put
both knobs in detent mode.
• Center the detent brake actuator to put only the small knob (medial/lateral
movement) in the detent mode.

EPIQ 7 User Manual 4535 617 25341 213

Transesophageal Transducers Using the X7-2t TEE Transducer

X7-2t Transducer Controls

Control Description
Medial/lateral control

Anterior/posterior control

Detent brake actuator

214 EPIQ 7 User Manual 4535 617 25341

Using the X7-2t TEE Transducer Transesophageal Transducers

Control Description
Image plane rotation buttons

Neutral position indicators, showing no deflection

Rotating the X7-2t Image Plane

You can rotate the image plane on the X7-2t TEE transducer to achieve a 360-degree view of
the heart. Rotation stops when you release either button.
The current degree of rotation appears in either the upper or lower part of the display,
depending on image orientation. Because the center of the image array is the pivot point, you
can achieve a 360-degree view.
• To rotate the X7-2t transducer image plane, do either of the following:
• To rotate the imaging plane toward the 180-degree position, press the image plane
rotation button that is distal to the system.
• To rotate the imaging plane toward the 0-degree position, press the button that is
proximal to the system.
• To rotate the X7-2t transducer image plane using a system control, use the Seek Angle soft
key.

EPIQ 7 User Manual 4535 617 25341 215

Transesophageal Transducers S7-3t TEE Transducer Description

S7-3t TEE Transducer Description

S7-3t TEE Transducer

S7-3t TEE Features and Specifications

Features A small transducer that enables high-resolution imaging and 360-degree views of the heart,
unobstructed by lungs and ribs. The array inside the tip can be rotated 180 degrees using a
control on the handle of the transducer. Another control on the handle sets the deflection
of the tip. This transducer is capable of color flow imaging, steerable CW and PW Doppler,
and frequency agility. Tip surface temperature is constantly monitored for patient safety.
Specifications Tip: 10.9 mm x 8.3 mm, 27 mm long (0.43 in x 0.33 in, 1.1 in long) Shaft: 7.5 mm diameter,
70 cm long (0.3 in diameter, 27.5 in long)

216 EPIQ 7 User Manual 4535 617 25341

Using the S7-3t TEE Transducer Transesophageal Transducers

Using the S7-3t TEE Transducer

Philips recommends familiarizing yourself with the controls and parts of the TEE transducer
before using it in an exam. For more information on transducer controls, see “S7-3t TEE
Controls” on page 218.

S7-3t TEE Transducer Parts

1 Distal tip
2 Flexible shaft
3 Transducer connector

EPIQ 7 User Manual 4535 617 25341 217

Transesophageal Transducers Using the S7-3t TEE Transducer

4 Transducer handle
5 Deflection and array controls

S7-3t TEE Controls

The transducer handle is designed for one-hand operation. Normally, you should operate the
transducer handle with your left hand. The thumb, first, and second fingers control the
deflection and the array rotation control wheels.
The smaller wheel on the transducer handle is for controlling the transducer tip deflection. This
wheel has a locked mode and a freewheeling mode. In the locked mode, the movement of the
deflection wheel is restrained to allow you to hold the tip in a certain position. A metallic ring
around the body of the handle, which clicks on and off, controls the lock.
The larger wheel on top is for rotating the imaging array. The array can be rotated continuously
from 0 degrees (transversal plane) through 90 degrees (longitudinal plane) to 180 degrees
(transversal plane, left/right inverted).

WARNING
Verify that the maximum deflection of the tip is 120 degrees up and 90 degrees down. If the
up/down deflection shows an unwanted amount of free play or exceeds the maximal
deflection angles, do not use the transducer. Contact Philips to readjust the steering of the
transducer. Ensuring proper deflection limits minimizes the risk of the tip folding over in the
esophagus.

WARNING
To protect the patient and the transducer, straighten the tip of the transducer and unlock the
deflection control when inserting or withdrawing the transducer. On the S7-3t, the tip is
straight when the white line on the control wheel is aligned along the shaft of the transducer
handle.

218 EPIQ 7 User Manual 4535 617 25341

Using the S7-3t TEE Transducer Transesophageal Transducers

S7-3t Controls
1 90-degree rotation indicator
2 Array control
3 Deflection control
4 Deflection lock
5 Neutral position indicators (no deflection)
Unlocked, freewheeling (white)

Locked (red)

EPIQ 7 User Manual 4535 617 25341 219

Transesophageal Transducers Using the S7-3t TEE Transducer

Manipulating the S7-3t TEE Tip

Review the warnings and caution in “Patient Safety During TEE Studies” on page 200 and “TEE
Deflection Control Basics ” on page 207 before using the transducer in a study.
1. Put the deflection control knob into freewheeling mode by sliding the deflection lock so
that the indicator is white.
2. Do one of the following:
• To deflect the tip toward the posterior, turn the smaller knob clockwise.
• To deflect the tip toward the anterior, turn the smaller knob counterclockwise.
• To set the tip in the neutral position (no deflection), turn the smaller knob so that its
white bar is in line with the center of the proximal end of the transducer handle.
3. Once the tip is positioned properly, lock the deflection control knob by sliding the deflection
lock so that the indicator is red.

Manipulating the S7-3t Transducer Tip

1 Deflection lock
2 Deflection control

220 EPIQ 7 User Manual 4535 617 25341

Using the S7-3t TEE Transducer Transesophageal Transducers

S7-3t TEE Array Rotation

You can rotate the imaging array continuously from 0 degrees (transversal plane) through 90
degrees (longitudinal plane) to 180 degrees (transversal plane, left/right inverted). Because the
transducer allows you to select all planes between 0 degrees and 180 degrees, you can scan a
conical imaging volume.
An icon shows the current degree of rotation. Depending on image orientation, the icon
appears in the upper or lower part of the display.
S7-3t Array Rotation
Short axis Angle = 0°

Long axis Angle = 90°

Short axis Angle = 180°

EPIQ 7 User Manual 4535 617 25341 221

Transesophageal Transducers Using the S7-3t TEE Transducer

Rotating the S7-3t TEE Array

CAUTION
Do not use excessive force on the array rotation control wheel at its outer positions because
this may damage the endoscope mechanism.

1. To rotate the imaging array, turn the array control (the larger wheel).
2. To rotate the array to 90 degrees, align the white bar on the side of the array control with
the center of the proximal end of the transducer handle.
3. To rotate the array to a specific setting, align a setting on the top of the array control with
the center of the proximal end of the transducer handle.

Rotating the S7-3t Imaging Array

1 Array control
2 Align settings on the control with the proximal end of the transducer handle (90° setting as shown).

222 EPIQ 7 User Manual 4535 617 25341

Checking the TEE Transducer Transesophageal Transducers

Checking the TEE Transducer

Before each TEE exam, carefully inspect the transducer and try the controls, as described in the
subordinate topics.

TEE Transducer Inspection

Carefully inspect the entire surface of the distal tip and flexible shaft for protrusions, holes,
dents, abrasions, cuts, burrs, or cracks that could be extremely hazardous to both you and your
patient.
Carefully feel the tip and shaft, and inspect the entire transducer. If you suspect an electrical
problem, follow the electrical safety check procedure described in "Electrical Safety Check for
TEE Transducers" in the "Transesophageal Transducers" section of the User Manual.
Also check for excessive flexibility in the tip, particularly in the medial/lateral direction. Do not
use the transducer if the tip is extremely flexible. If you have any questions about tip flexibility,
contact your Philips service representative.

TEE Transducer Controls Inspection

Use the deflection controls to position the tip in every possible direction, both to ensure that
the controls work properly and to get used to the feel of the TEE transducer. Make sure that
the controls operate smoothly without binding, and that you can achieve all possible positions
easily before introducing the TEE transducer into the patient.
Test the detent brakes and freewheeling mode. Remember that the controls must be in
freewheeling mode (no deflection and no brake resistance) when repositioning or withdrawing
the transducer, as well as whenever you are not imaging. See “Manipulating the X7-2t Tip” on
page 213 and “Manipulating the S7-3t TEE Tip” on page 220

Special Considerations for TEE Studies

Special considerations regarding TEE studies are advisable for patients with existing
gastroesophageal abnormalities, such as esophageal varices, hiatal hernia, tumor, diverticula,
esophageal webs and rings, fistulae, or peptic ulcers, as well as for patients who have had anti-
reflux procedures. In addition, you should do the following:
• Consider the patient’s size and ability to accommodate the transducer tip and shaft.

EPIQ 7 User Manual 4535 617 25341 223

Transesophageal Transducers Special Considerations for TEE Studies

• Check the patient’s history for gastroesophageal disease or difficulty swallowing.

• Evaluate the potential overall effects of any treatment that the patient is undergoing, such
as mediastinal radiation, chemotherapy, anticoagulation, or steroid therapy.
• Be aware that you may discover unsuspected esophageal pathology during a study. Be alert
for congenital problems with the esophagus or stomach, particularly with pediatric patients.
• When examining a patient with an above-normal temperature, use the Auto-Cool feature
and enter the patient temperature. The Auto-Cool feature is described in “TEE Temperature
Sensing” on page 228.
This list is not comprehensive. Rather, it suggests areas to investigate when considering TEE for
a particular patient.

Patient Selection for TEE Transducer Use

Although the TEE transducers can provide clinical data not available from other instruments,
you should consider which patients can safely use the TEE transducers.

WARNING
The ability of a patient to swallow or accommodate the transducer should be considered.

WARNING
You must consider any history of gastroesophageal diseases as well as the possible effects of
other therapies that the patient is undergoing. You must also consider all gastroesophageal
abnormalities or difficulty swallowing.

The following table lists the minimum patient weight recommendations when using TEE
transducers.
TEE Transducer Minimum Patient Weight Recommendations
TEE Transducer Minimum Patient Weight
S7-3t 3.5 kg (7.7 lb)
X7-2t 30 kg (66 lb)

224 EPIQ 7 User Manual 4535 617 25341

Special Considerations for TEE Studies Transesophageal Transducers

Preparing Patients for TEE Studies

These suggestions for pre-study patient preparation do not constitute an exhaustive list of all
possible factors to explore before performing transesophageal echocardiography, nor do they
imply medical protocols. Instead, they reflect basic guidelines resulting from extensive
consultation with physicians throughout the design, development, and clinical investigation
periods of Philips TEE transducers.
• Besides gathering routine background information such as current medication and allergies,
investigate any history of chronic obstructive lung disease, esophageal strictures, varices, or
bleeding.
• Thoroughly explain the procedure to the patient before the study.
• Inform the patient not to eat or drink for at least 6 hours before the study.
• Advise the patient that he or she should not plan to drive after the study, because sedatives
are often used.
• Follow institutional guidelines for obtaining patient consent for a transesophageal
echocardiography (TEE) study.
• Be sure that a recent ECG, CBC, and SMA6 are available as a baselines.

TEE Study Guidelines

During a TEE study, an assistant can provide oral and pharyngeal suctioning of the patient and
can monitor the patient’s blood pressure and general responses. For unexpected occurrences,
an emergency cart with basic life-support equipment should be ready. Throughout the study, it
is important to carefully monitor the patient’s reactions and to ensure that ventilation and vital
signs are stable.
In the operating room, do not use TEE transducers during surgical procedures requiring
extreme neck flexion, such as sitting craniotomies. The following are important guidelines for
TEE studies. (See “TEE Transducer References” on page 238.)
• Minimize the possibility of transducer tip fold-over. This problem has occurred rarely, but
its consequences can be serious. See “Tip Fold-Over” on page 226.
• Maintain a patent airway. For surgical patients, endotracheal intubation establishes a
stable, patent airway before insertion of the transducer. For patients who are awake,
carefully monitor the patient’s breathing at all times.

EPIQ 7 User Manual 4535 617 25341 225

Transesophageal Transducers Tip Fold-Over

• Minimize the possibility of pressure necrosis (tissue death). Do not let the distal tip displace
any one segment of tissue for more than 5 consecutive minutes. Also make sure the
deflection area and the distal tip are in the position of least potential pressure. Be sure that
the transducer is in a freewheeling mode and unplugged whenever you are not imaging.
• Prevent potential esophageal damage. Philips recommends that you stop TEE scanning and
unplug the transducer from the system during periods of poor perfusion, circulatory arrest,
or the hypothermic phase of open heart surgery. To discontinue scanning, unlock the
transducer connector.
• Before each TEE study, carefully inspect the transducer, as described in “Checking the TEE
Transducer” on page 223. A thorough inspection procedure is required for the safety of the
patient and yourself, and to ensure the continued correct functioning of the transducer.
• Never use excessive force when inserting, operating, or withdrawing a transducer, and
make sure the deflection area is straight during insertion and withdrawal. Forceful
insertion, manipulation, or withdrawal of a transducer can result in lacerations, bleeding,
perforation, tearing of adhesions, and ligament damage. Also be aware that the tip can fold
over, causing similar damage.
• Refrain from handling the distal tip whenever possible. If you must handle the distal tip,
grasp it on the sides. Do not touch the top or bottom. Support the transducer’s proximal
head, either by having an assistant hold the steering mechanism or by clamping the
transducer at the steering mechanism. Ensure that the clamp does not interfere with
steering, and do not clamp any part of the flexible shaft, as this will damage the transducer.

Tip Fold-Over
On rare occasions, the tip of a TEE transducer has folded over during insertion. The effects can
be serious if the situation is handled incorrectly. The esophagus can be scraped, perforated, or
otherwise damaged.

Recognizing Tip Fold-Over

The TEE transducer tip might be folded over in the patient if you encounter any of the
following:
• Resistance to advancing or removing the transducer
• An inability to turn the control knobs
• Fixation of the control knobs in the maximum flexion position
• Extreme difficulty in obtaining an image

226 EPIQ 7 User Manual 4535 617 25341

Tip Fold-Over Transesophageal Transducers

Correcting Tip Fold-Over

If you suspect the transducer tip is folded over, Philips' physician consultants recommend that
you gently try to manipulate the transducer. If the tip is neither locked nor jammed in a
doubled-over position, and you can move it forward, advance the transducer into the stomach.
Then straighten the tip and remove the transducer.
If you cannot move the tip in any direction, Philips' consultants recommend that you X-ray the
patient to evaluate the situation. You might also want to involve a gastroenterologist or
anesthesiologist.

Preventing Tip Fold-Over

The following steps can prevent the tip from folding over. This list is not exhaustive; other
factors can also be involved.

Using Correct Insertion Technique

You may find transducer insertion easier if you guide the transducer into the patient's mouth
with your fingers. You also may want to lock medial/lateral tip movement.

WARNING
All patients should wear a bite guard during a TEE exam. A bite guard protects against
dangerous transducer mechanical and electrical malfunction caused by involuntary biting.
Even anesthetized patients require bite guards to prevent damage to both their teeth and to
the transducer. For information on bite guards available from Philips, see “Bite Guards” on
page 233.

Avoid the following when inserting any TEE transducer into a patient:
• Any excessive flexion of the transducer tip, particularly in the medial/lateral direction
• Catching the tip in pharyngeal recesses
• Insertion when a patient is being uncooperative or is having a convulsion or spasm

EPIQ 7 User Manual 4535 617 25341 227

Transesophageal Transducers TEE Temperature Sensing

Reviewing Patient Esophageal Pathology

Carefully review a patient's medical history for obstructing pathologies or anatomical
irregularities before performing a TEE exam.

Ensuring Proper Transducer Maintenance

Thoroughly examine the transducer and test the controls before each exam. Be sure to check
for excessive flexibility in the tip. See “TEE Transducer Inspection” on page 223.

TEE Temperature Sensing

The transesophageal transducers contain built-in temperature sensors near the distal tip. The
sensor monitors the transducer’s temperature to prevent potential burning of esophageal
tissue. The patient’s actual temperature is required to accurately estimate the distal tip
temperature. By default the system assumes that the patient temperature is 37°C (98.6°F). You
must manually enter the actual patient temperature if it is above 37°C (98.6°F).
The Auto-Cool feature provides warning messages at two points:
• At 41.0°C (105.8°F), the TEE Auto Cool Imminent message appears.
• At 42.5°C (108.5°F), the TEE Auto Cool In Progress message appears, and the system
automatically stops scanning.

WARNING
If the patient temperature is above 37°C (98.6°F) and the Patient Temp control is set below
the actual patient temperature, then the system can overestimate the temperature of the
TEE transducer's distal tip. This can prematurely trigger the Auto-Cool feature. If the patient
temperature is at or near 37°C (98.6°F) and the Patient Temp control is set above the actual
patient temperature, then the system can underestimate the temperature of the distal tip.
This can expose patients to excessive temperatures.

228 EPIQ 7 User Manual 4535 617 25341

TEE Temperature Sensing Transesophageal Transducers

Ensuring Safe TEE Temperatures

To ensure patient safety and to avoid unnecessary interruption while scanning, follow these
suggestions:
• Ensure distal-tip-temperature accuracy by entering an accurate patient core temperature.
• Decrease the transducer temperature by using the Output Power knob before introducing a
TEE transducer to decrease acoustic output, and keep the control at the lowest possible
setting during an exam.
• Use the TEE Manual Auto-Cool safety feature to enter the patient temperature if it is above
37°C (98.6°F) as described in “Entering Patient Temperature” on page 231.
• If the transducer temperature begins to rise when you are using high-power modes such as
Live 3D, Color, Tissue Harmonic Imaging, and Doppler, temporarily switching to
fundamental 2D mode or freezing the image can help cool the transducer.

Manual Auto-Cool Feature

Use the TEE Manual Auto-Cool safety feature to enter above-normal patient temperatures.
When the temperature display is enabled, you can see both the patient temperature and the
distal tip temperature while scanning.

NOTE
The patient temperature shown on the ultrasound display is always either 37°C (98.6°F) or the
temperature that you manually enter. The system does not monitor or report the actual patient
temperature.

If the distal tip temperature reaches 41°C (105.8°F), a warning message appears and the
transducer temperature is displayed in inverse video. If the temperature reaches 42.5°C
(108.5°F), a warning appears with the patient and the transducer temperatures, and the system
stops imaging until the distal tip cools to below 42°C (107.6°F). The system shuts down if the
patient-applied part temperature of the TEE transducer exceeds 42.5°C (108.5°F), given an
entered patient temperature of 37°C (98.6°F). It resumes scanning when the temperature falls
below 42°C (107.6°F) . If the patient temperature is higher than 37°C (98.6°F), the system
shutdown temperature adjusts accordingly. You may need to restart the system by turning it
on.

EPIQ 7 User Manual 4535 617 25341 229

Transesophageal Transducers TEE Temperature Sensing

WARNING
To avoid the risk of esophageal burn for adult patients, minimize the time spent imaging at
distal tip temperatures in excess of 42°C (107.6°F). Exposure should be limited to 10 minutes
or less at 42°C (107.6°F) or higher.

WARNING
Sufficient data on thermal tolerance of the esophagus in neonate and pediatric patients does
not exist, but it is likely these patients are more vulnerable than adults. Minimize the time
spent imaging at distal tip temperatures in excess of 41°C (105.8°F).

Using the Temperature Display

Both the patient temperature (assumed or entered) and the transducer temperature appear in
the lower left corner of the display when enabled. On the display, the patient temperature is
labeled PAT T, and the transducer temperature is labeled TEE T.
A less-than sign (<) after TEE T indicates that the transducer's distal tip temperature is below
the patient temperature (PAT T) assumed by the system, which is either 37°C (98.6°F) or the
temperature you entered.

NOTE
If you want the temperature display enabled by default, turn on the temperature display and
then create a preset as described in “Creating Quick Save Presets” on page 149.

1. Connect the transducer and select a preset.

2. Swipe to the second touch screen.
3. Touch Temp Display to display or hide the temperature display.
4. Touch Temp Units to switch the temperature scale between Fahrenheit and Celsius.

230 EPIQ 7 User Manual 4535 617 25341

TEE Temperature Sensing Transesophageal Transducers

Patient Temperature
Entering a patient’s temperature enables the Auto-Cool feature to calculate tip temperature
more accurately, which can prevent unnecessary interruptions while scanning. If a patient’s
temperature is above normal, entering a temperature can avoid exposing the patient to
excessive temperatures.
Always check the patient’s temperature before inserting a TEE transducer. If it is above normal,
whether from fever or therapeutic heating from a cardiac bypass heart-lung machine, perform
the procedure in “Entering Patient Temperature” on page 231 before inserting the transducer.
Also, follow that procedure if a patient’s temperature rises during a study.
Measure the patient’s core temperature, or more specifically, the actual temperature in the
esophagus. For patients undergoing surgery, determine the temperature in the esophagus by
direct measurement or by monitoring the temperature of blood returning from the bypass
pump heat exchanger.
For closed-chest situations, rectal temperature is the best estimate of core temperature. You
can also use oral temperatures, even though they can be one degree lower than the core
temperature. If you measure an auxiliary temperature, which can be two degrees lower than
the core temperature, add one or two degrees.

Entering Patient Temperature

1. If necessary, select the TEE transducer.
2. Turn Pat Temp to enter the patient's measured temperature.

NOTE
Each time you turn off or reset the system, or enter a new patient ID, the system assumes that
the patient temperature is 37°C (98.6°F).

Resuming Imaging After Auto-Cool

If the distal tip temperature drops below 42.5°C (108.5°F), the system resumes imaging. If the
Auto-Cool message persists longer than 1 minute or an error message appears, contact your
Philips service representative.

EPIQ 7 User Manual 4535 617 25341 231

Transesophageal Transducers Patient Care After a TEE Study

The system shuts down if the patient-applied part temperature of the TEE transducer exceeds
42.5°C (108.5°F), given an entered patient temperature of 37°C (98.6°F). If the patient
temperature is higher than 37°C (98.6°F), the system shutdown temperature adjusts
accordingly. You may need to restart the system by pressing the (On/Off) control .

WARNING
The Reconnect the Transducer error message is often caused by a poorly seated transducer
connector, but it could be caused by a failure in the Auto-Cool safety logic. In the case of a
logic failure, distal tip temperatures could reach 46.5°C (115.7°F) in hyperthermic patients
(40°C to 41°C or 104°F to 106°F) before the error causes scanning to stop. At this temperature,
esophageal burns may occur (see “TEE Transducer References” on page 238).

1. Move the locking lever to the unlocked position, and pull the connector out of the
receptacle.
2. Reseat the connector in the receptacle and move the locking lever to the locked position.
3. Select the transducer and preset.
4. If the system does not resume imaging after the transducer has initialized, shut down the
system and then restart it.

Patient Care After a TEE Study

Follow your institutional guidelines for post-TEE studies. Additionally, you might want to
include the following recommendations in your guidelines as part of your post-TEE study
routine.
• Inspect the patient’s throat for any bleeding.
• Examine the patient for postural hypotension or difficulty walking.
• Instruct the patient to contact you immediately if he or she experiences any fever, chills,
chest pain, or bleeding.
• Instruct the patient not to eat or drink for at least 2 hours or until swallowing returns to
normal after anesthesia has worn off. It is especially important that the patient not ingest
hot foods or fluids during this period.
• Follow up with a call to the patient the day after the a study to make sure there are no
complications.

232 EPIQ 7 User Manual 4535 617 25341

TEE Accessories and Supplies Transesophageal Transducers

TEE Accessories and Supplies

Each TEE transducer comes with disposable bite guards and a disposable tip protector. Bite
guards, TEE transducer covers, tip protectors, and disposable drapes are described here. For
information on ordering TEE accessories, see “Supplies and Accessories” on page 21.

Bite Guards

WARNING
The M2203A bite guard strap contains natural rubber latex, which may cause allergic
reactions. For more information, see “FDA Medical Alert on Latex” on page 49.

CAUTION
Damage caused when patients bite or scrape a TEE transducer is not covered in the
transducer warranty or your service contract. Use bite guards to help prevent such accidents.

All patients must wear a bite guard during a TEE study. A bite guard prevents dangerous
transducer mechanical and electrical malfunctions caused by involuntary biting. Even
anesthetized patients require bite guards to prevent damage to their teeth and to the
transducer. Philips supplies disposable bite guards that are suitable for both awake and
anesthetized patients.

TEE Transducer Covers

WARNING
Transducer covers often contain natural rubber latex and talc, which may cause allergic
reactions. For more information, see “FDA Medical Alert on Latex” on page 49.

Philips recommends the use of a market-approved transducer cover during every TEE study.

EPIQ 7 User Manual 4535 617 25341 233

Transesophageal Transducers TEE Accessories and Supplies

For procedures on using transducer covers (protective sheaths), see the instructions provided
with the covers.

Tip Protectors
When not using a carrying case to transport a TEE transducer, use a tip protector on its distal
tip. The tip protector helps prevent serious damage to the transducer lens. Philips supplies tip
protectors designed for each of its TEE transducers.

Disposable Drapes
During studies in which you believe contamination of the imaging system can occur, Philips
recommends that you take universal precautions and cover the system with a disposable drape.
Consult your hospital’s rules regarding equipment use in the presence of infectious disease.

TEE Leakage Current Test

The electrical safety check described here should be performed regularly to determine if there
is a hole in a transducer’s outer insulating layer. This procedure detects liquid pathways to the
interior parts of the transducer shaft and tip by measuring third-wire leakage current. This
procedure can be performed with any commercially available safety analyzer that is designed
for hospital use.

WARNING
Only a technically qualified person should perform the leakage-test procedure.

TEE Test Background

The test procedure (see figure) involves making an AC measurement of the ultrasound system
current without a transducer. The results are then compared with the current measured when
it is forced to flow through the insulating layer of the TEE transducer. If the two currents are
nearly the same, it means there is a hole in the transducer’s outer insulating layer that must be
fixed before using the transducer.

234 EPIQ 7 User Manual 4535 617 25341

TEE Leakage Current Test Transesophageal Transducers

Electrical Safety Check for TEE Transducers

TEE Leakage Current Test

Symbol Definition
C Stray capacitance from the ultrasound system power wiring to the system grounded
metal chassis (1 to 3 MΩ reactance)

Z Impedance between the metal parts of the TEE transducer and a test electrode
placed in the bucket of saline solution (about 850 kΩ with an intact outer insulating
layer, 500 Ω with a hole in the layer)

A Microammeter to measure third-wire current, either directly from the chassis or

through Z to the test electrode

e Line power source, either 110 Vac or 220 Vac

I Current caused by e and stray capacitance, and optionally Z

EPIQ 7 User Manual 4535 617 25341 235

Transesophageal Transducers TEE Leakage Current Test

Symbol Definition
S1 Open earth lift ground switch

S2 Line polarity switch

S3 Microammeter switch

L Line mains supply

N Neutral mains supply

E Earth ground

Current I, driven by line supply e, flows through all stray capacitances between the primary
wiring and the ultrasound system’s metal chassis. Ordinarily, current then flows from the metal
chassis through S3 and back to e through a third-wire ground. When S3 is thrown in the other
position, current I is forced:
• From the chassis through the metal parts of the transducer
• Through impedance Z, produced by the insulating layer that covers the metal parts of the
transducer and the saline solution
• Through the test electrode
Saline generally presents an impedance of about 500 Ω, so Z will vary between 850 kΩ and
500 Ω, depending on whether or not there is a conductive pathway caused by a hole in the
transducer’s insulating layer.

CAUTION
Do not make a DC measurement of impedance. This could set up a voltaic cell, with the metal
of the transducer and a test electrode in the salt bath forming the two electrodes and an
electrolyte. Such a voltaic cell produces inaccurate resistance measurements.

You need the following equipment to perform the electrical safety check procedure:
• Dempsey 432HD or 232D safety analyzer or equivalent
• Philips 21110A Disinfection Basin or equivalent
• Saline solution, 9 grams (0.3 oz) of salt to 1 liter (1 qt) of tap water, or one of the tested
disinfectants listed in the “Transducer Care” section.

236 EPIQ 7 User Manual 4535 617 25341

TEE Leakage Current Test Transesophageal Transducers

Testing TEE Transducer Leakage Current

For a list of the equipment needed to perform the electrical safety test procedure, see “TEE
Test Background” on page 234.

WARNING
Only a technically qualified person should perform this procedure.

1. Gather the equipment in the preceding list.

2. Fill the basin to the fill line with saline solution.
3. Place the distal tip and shaft of the transducer into the basin.
4. Connect the transducer to the system.
5. Plug the ultrasound system’s power cord into the test receptacle on the safety analyzer.
6. Attach a lead from the safety analyzer binding post labeled RL to a metal plate submerged
in the basin.
7. On the safety analyzer, set the Leads switch to RL. Set the Line Polarity switch (S2) to
NORMAL.
8. Turn on the safety analyzer and the ultrasound system.
9. Set the Mode switch (S3) on the safety analyzer to the Case Leakage - Ground Conductor
position. Press the Lift Ground switch (S1) on the safety analyzer and record the chassis
leakage current.
10. Set the Mode switch (S3) on the safety analyzer to the ECG position. Press the Lift Ground
switch (S1) on the safety analyzer and record the patient leakage current.
The transducer fails the test if the patient leakage current recorded in step 10 is greater than
80% of the chassis leakage current recorded in step 9.
This failure indicates that there is a hole in the insulating layer of the TEE shaft. A hole enables a
conductive pathway to internal metal parts of the transducer and presents a potentially
hazardous condition to a patient undergoing external defibrillation or electrosurgery. A hole
also allows invasion of organic material, making it difficult to completely disinfect all portions of
the transducer. For these reasons, the transducer must be repaired before it is used.

EPIQ 7 User Manual 4535 617 25341 237

Transesophageal Transducers TEE Transducer References

TEE Transducer References

Cucchiara, R.F., et al. "Air Embolism in Upright Neurosurgical Patients: Detection and
Localization by Two-dimensional Transesophageal Echocardiography." Anesthesiology, 353-355,
1984.
Gussenhoven, Elma, et al. "Transesophageal Two-dimensional Echocardiography: Its Role in
Solving Clinical Problems." Journal of the American College of Cardiology, 975-979, 1986.
Radwin, Martin, et al. "Transesophageal Echocardiography: Intubation Techniques." Philips
Application Note 5091-2804E, 1992.
Urbanowitz, John H., et al. "Transesophageal Echocardiography and Its Potential for Esophageal
Damage." Anesthesiology, Vol. 72, No. 1, 1990.

238 EPIQ 7 User Manual 4535 617 25341

Operators of Endocavity Transducers Endocavity Transducers

11 Endocavity Transducers
Endocavity transducers provide high-resolution endocavity imaging for obstetric and GYN
applications. The system supports the C10-3v and the C10-4ec endocavity transducers.

WARNING
All endocavity transducers are designed to be defibrillator safe in accordance with IEC
60601-1. Nevertheless, always remove the transducer from the patient before defibrillation.

Operators of Endocavity Transducers

Philips endocavity transducers are designed for use under the guidance of physicians who are
properly trained in endocavity ultrasound imaging techniques, according to currently approved
relevant medical practices. Philips recommends that physicians operating any Philips
endocavity transducer have the following qualifications:
• Proficiency in recognizing and interpreting imaging patterns
• Thorough familiarity with the safe operation, care, and maintenance of the system and
endocavity transducers
• Thorough familiarity with the latest endocavity methods through literature and seminars

Patient Safety During Endocavity Studies

To operate an endocavity transducer, you must be under the guidance of a physician who is
properly trained in endocavity ultrasound imaging techniques, according to currently approved
relevant medical practices. You also must be thoroughly familiar with the safe operation, care,
and maintenance of the ultrasound system used with the transducer, as well as proficient at
interpreting the images generated.
To help ensure patient safety when using an endocavity transducer, observe the following
guidelines:
• Scrutinize the entire transducer before each use.
• Operate the transducer properly.

EPIQ 7 User Manual 4535 617 25341 239

Endocavity Transducers Preparing Transducers for Endocavity Use

• Do not allow water or other liquids to drip onto the transducer connector, the interior of
the system, or the keyboard.
• Use sterile ultrasound transmission gel when performing all endocavity studies.
• Protective covers are recommended for endocavity procedures; the protective covers are
mandatory in China and Japan.

WARNING
All endocavity transducers are designed to be defibrillator safe in accordance with IEC
60601-1. Nevertheless, always remove the transducer from the patient before defibrillation.

Preparing Transducers for Endocavity Use

1. Place 20 cc of sterile gel or saline into the transducer cover.
2. Carefully inspect each transducer cover before use, and discard it if you find tears or
blemishes. Also inspect each transducer cover after use. If you find a tear, the patient or the
transducer may have been contaminated.
3. Insert the transducer into the transducer cover and unfurl the transducer cover until it
covers the transducer and its cable. The cover must be unfurled far enough to maintain the
sterile field.
4. Use a sterile elastic band or clip to hold the proximal end of the transducer cover in place.
5. Ensure that wrinkles and bubbles over the face of the transducer are minimized. Check the
transducer cover for tears or damage before proceeding.
6. When operating the transducer, make sure that proper orientation is maintained to avoid
interpretation confusion.

NOTE
To achieve good acoustic contact, make sure that the imaging surface is moist.

NOTE
Imaging improves with adequate coupling between the patient surface and the transducer-
cover surface. Sterile water is a good acoustic-coupling agent during surgery.

240 EPIQ 7 User Manual 4535 617 25341

C10-3v Description Endocavity Transducers

C10-3v Description
The C10-3v transducer is described here. For more information on connecting, activating, caring
for, and maintaining transducers, see the “Transducers” and “Transducer Care” sections.

C10-3v Endocavity Transducer

Features of the C10-3v Transducer

Features Curved array designed to be easy to hold and manipulate and to provide maximum
clinician and patient comfort. Enables high resolution and contrast for gynecological,
obstetrical, urological, and fetal echo procedures.
Frequency Operating range: 3 to 10 MHz
Biopsy capable? Yes
Specifications • Length (transducer, cable, and connector): 2.5 m (8.17 ft)
• Length (handle to tip): 30 cm (12 in)
• Radius of curvature: 11.5 mm (0.45 in)

C10-4ec Description
The C10-4ec transducer is described here. For more information on connecting, activating,
caring for, and maintaining transducers, see the “Transducers” and “Transducer Care” sections.

EPIQ 7 User Manual 4535 617 25341 241

Endocavity Transducers Patient-Contact Parts

C10-4ec Endocavity Transducer

Features of the C10-4ec Transducer

Features Curved array designed to be easy to hold and manipulate and to provide maximum
clinician and patient comfort. Enables high-resolution imaging for gynecological and
obstetrical studies, and for urological procedures.
Frequency Operating range: 4 to 10 MHz
Biopsy Capable? Yes
Specifications • Length (transducer, cable, and connector): 2.6 m (8.5 ft)
• Length (handle to tip): 31.7 cm (12.5 in)
• Radius of curvature: 10 mm (0.4 in)

Patient-Contact Parts
Latex and talc are commonly used in transducer covers marketed to help with infection control
in transesophageal, endocavity, and intraoperative imaging applications and during biopsies.
Examine the packaging to confirm latex and talc content. Studies have shown that patients can
experience allergic reactions with natural rubber latex. See the “FDA Medical Alert on Latex” on
page 49.

NOTE
The ultrasound system and transducers discussed here do not contain natural rubber latex that
contacts humans. Natural rubber latex is not used on any Philips ultrasound transducers.

242 EPIQ 7 User Manual 4535 617 25341

Biopsy with Endocavity Transducers Endocavity Transducers

Biopsy with Endocavity Transducers

Endocavity transducers are biopsy capable.
For more information on the biopsy guide feature, see the “Biopsy Guides” section.

NOTE
CIVCO Medical Solutions supplies biopsy kits for Philips transducers that are biopsy capable. For
information on proper attachment of a biopsy bracket, consult the manufacturer’s instructions.

EPIQ 7 User Manual 4535 617 25341 243

Endocavity Transducers Biopsy with Endocavity Transducers

244 EPIQ 7 User Manual 4535 617 25341

Attaching and Removing a Biopsy Guide Biopsy Guides

12 Biopsy Guides
The biopsy guide feature helps you position transducers with biopsy needle-guide attachments.
The biopsy guide feature displays guidelines on the image that show the anticipated path of the
needle. You can use those guidelines to ensure that the needle or instrument is following the
correct path.
Starter kits, which include the biopsy guide or biopsy guide bracket and procedure kits, are
available from Philips. Biopsy guides and supplies are available from CIVCO Medical Solutions
(see “Supplies and Accessories” on page 21).
For detailed information about using, cleaning, and sterilizing biopsy guides and brackets, see
the instructions provided with the biopsy starter kits, guides, and brackets.

NOTE
The biopsy guides for the L12-5 50 mm, and L18-5 transducers have infinite-angle capability and
can be installed on either side of the transducer; they do not constrain the biopsy needle to a
particular path. Because the needle path is unpredictable, the Biopsy control is unavailable, and
the biopsy graphics do not appear on the display when you are using these transducers. A
biopsy with these transducers is a manual action. The C5-1 and the C9-2 also support infinite-
angle biopsy guides but the graphics should not be used.

Attaching and Removing a Biopsy Guide

Detailed information about attachment and removal of biopsy guides is provided with the
biopsy starter kits, guides, and brackets.

WARNING
Do not attempt to use the biopsy guide until you have read the instructions for selecting the
display, installing the sterile transducer cover, and verifying alignment of the biopsy guide.

EPIQ 7 User Manual 4535 617 25341 245

Biopsy Guides Biopsy Guideline Display

WARNING
Inspect all components and the transducer. Ensure that the biopsy guide you are using is the
correct one for the transducer, the system, and system software. Your Philips representative
can verify this information for you.

WARNING
Use only Philips-approved biopsy guides, transducers, covers, brackets, supplies,
components, and accessories. Other brands may not properly fit Philips transducers.
Improper installation may result in patient injury.

WARNING
Some biopsy guides must be installed over a sterile transducer cover.

WARNING
After each use, biopsy guides must be either sterilized or disposed of, depending upon the
type. See the instructions included with the biopsy guide.

WARNING
Most transducers can only be disinfected; they cannot be sterilized. Only the transducer
cover provides the sterile barrier.

Biopsy Guideline Display

WARNING
Do not attempt to use the biopsy guide until you have read the instructions for selecting the
display, installing the sterile transducer cover, and verifying alignment of the biopsy guide.

246 EPIQ 7 User Manual 4535 617 25341

Displaying the Biopsy Guideline Biopsy Guides

The system generates a biopsy guideline through the displayed real-time ultrasound image to
indicate the anticipated path of the needle. You can use that guideline to ensure that the
needle or instrument is following the correct path.
When the biopsy display is active, a biopsy guideline is displayed, entering from the left or right
side of the screen, depending on the clinical application and image presentation you have
selected. When you reverse the image presentation by touching Left/Right, the biopsy
guideline moves to the opposite side. Image presentation is defined by the location of the
orientation marker.
When depth is changed, the biopsy display redraws to reflect the new relationships at the new
depth setting.

Displaying the Biopsy Guideline

WARNING
When using a transducer with an infinite-angle biopsy guide, do not display a fixed-angle
biopsy guideline.

The biopsy guideline can have a single, fixed path or multiple paths. The system determines
which guideline to display based on the type of biopsy guide available for the transducer you
have selected.

NOTE
The following procedure applies specifically to non-intervention applications.

1. Connect the transducer.

2. Touch a preset.
3. Touch the 2D tab.
4. Touch Biopsy.

EPIQ 7 User Manual 4535 617 25341 247

Biopsy Guides Moving the Biopsy Depth Cursor

Moving the Biopsy Depth Cursor

A depth cursor appears on the biopsy guideline. The distance from the origin of the biopsy
guide to the depth cursor appears at the bottom of the imaging screen.
Rotate the trackball to move the depth cursor along the guideline. The Bx measurement value
changes to reflect the distance between the biopsy guide reference point origin and the depth
cursor.

Biopsy Depth

248 EPIQ 7 User Manual 4535 617 25341

Biopsy Guide Alignment Biopsy Guides

Biopsy Guide Alignment

Perform the alignment verification before each use of the biopsy guide. The procedure verifies
the system, transducer, and biopsy guide relationships.

WARNING
Alignment verification is necessary before performing procedures with the biopsy guide.

WARNING
Do not use the biopsy guide if the needle is not following the intended path. Contact your
Philips representative.

WARNING
The needle used for this alignment verification must not be used for the actual procedure.
Always use a new, sterile needle for each biopsy procedure.

WARNING
To assist in an accurate projection of the needle, use a straight, new needle for each
alignment procedure.

Preparation for Alignment Verification

Assemble the following items before performing the alignment verification:
• Transducer
• Biopsy guide or bracket (The bracket is not disposable. The type of bracket you use depends
upon the transducer you are using. For the correct bracket, contact CIVCO Medical
Solutions; see “Supplies and Accessories” on page 21.)
• Needle guide (Contact CIVCO for the needle guide that fits your biopsy guide bracket.)
• Sterile procedure kit (disposable)
• New, straight, biopsy needle

EPIQ 7 User Manual 4535 617 25341 249

Biopsy Guides Biopsy Guide Alignment

• Beaker of water (or water bath)

Verifying the Biopsy Guide Alignment

WARNING
If the needle enters from the unexpected side of the display or cannot be seen, verify that the
biopsy guide is correctly mounted on the transducer and that the orientation of the
transducer is correct. If the needle is still not following the expected path along the guideline,
do not use the biopsy guide. Contact your Philips representative.

1. Attach the biopsy guide. Although some transducers require the use of a second transducer
cover for biopsy procedures, a second transducer cover is unnecessary for this alignment
verification.
2. Connect the transducer to the system, and select the appropriate applications and preset.
3. Set the system depth for the procedure to be performed.
4. Display the biopsy guideline.
5. Without changing the position of the biopsy depth cursor, note the default depth shown at
the bottom of the display.
6. Immerse the transducer no more than 6 mm (0.25 in) into the water bath.

250 EPIQ 7 User Manual 4535 617 25341

Biopsy Guide Alignment Biopsy Guides

Immersing the Transducer

7. Select a new, straight needle that matches the needle-gauge size on the biopsy guide clip
you are using (if applicable), select the guide channel on the biopsy guide (A, B, and so on),
and use the Biopsy soft key to select the matching biopsy angle setting.
8. Insert the straight, new needle into the biopsy guide.
9. Move the needle down into the water bath until its ultrasound image is visible on the video
display.
10. Verify that the needle, as seen on the video display, falls along the guideline along the
entire depth of the guideline display. The biopsy guideline is intended only to provide an
indication of the expected path of the needle. Actual position must be verified by
identifying the echoes from the needle.
11. Remove the needle from the biopsy guide.
12. From the tip of the needle, measure a distance equal to the value noted in step 5. Mark this
point on the needle.
13. Immerse the transducer no more than 6 mm (0.25 in) into the water bath.

EPIQ 7 User Manual 4535 617 25341 251

Biopsy Guides Performing a Biopsy Procedure

14. Insert the needle into a guide channel that corresponds to the size of the needle and the
angle you selected. Continue sliding the needle in until the mark on the needle aligns with
the origin on the biopsy guide. (The origin is the point at which the needle enters the biopsy
guide.)
15. Move the biopsy depth cursor to the tip of the needle, as seen on the display, and verify
that the displayed depth is within 4 mm (0.16 in) of the value noted in step 5.
16. Confirm that the needle is visible along its expected path. If so, then the biopsy guide is
properly aligned.

Performing a Biopsy Procedure

WARNING
Before the biopsy procedure, perform alignment verification at the selected depth, to ensure
that the biopsy guide and the needle have been installed properly.

WARNING
Use a straight, new, sterile needle for each procedure.

WARNING
Do not perform the biopsy guide procedure if the needle is not visible

WARNING
The biopsy guideline is intended only to provide an indication of the expected path of the
needle. Actual position must be verified by identifying the echoes from the needle.

WARNING
If the needle is not following the expected path, discontinue the procedure and contact your
Philips representative.

252 EPIQ 7 User Manual 4535 617 25341

Performing a Biopsy Procedure Biopsy Guides

WARNING
Thin needles can bend when entering tissue. Actual position must be verified by identifying
the echoes from the needle.

WARNING
Reverberation or other tissue artifacts may produce false needle images, which can cause
confusion in locating the actual needle image. Ensure the needle path is along the guideline,
and that you are not using a false needle image to locate the needle.

WARNING
When using a transducer with an infinite-angle biopsy guide, do not display a fixed-angle
biopsy guideline.

WARNING
Philips does not recommend anatomical survey of the prostate with the biopsy guide
attached.

1. Install the transducer cover and the biopsy guide according to the instructions provided
with the biopsy guide.
2. Select a new, straight needle that matches the needle-gauge size on the biopsy guide clip
you are using (if applicable), and select the guide channel on the biopsy guide.
3. Set the system imaging controls for the biopsy procedure.
4. Touch a preset.
5. Touch the 2D tab.
6. Touch Biopsy.
7. Orient the transducer to match image presentation. Use the orientation marker .
8. If necessary, apply sterile acoustic coupling gel to the patient.
9. Begin scanning the patient. Position the transducer so that the puncture target is
intersected by the guideline on the display.
10. Do one of the following:
• For guides with a single angle, insert the needle into the needle guide groove closest to
the transducer.

EPIQ 7 User Manual 4535 617 25341 253

Biopsy Guides Biopsy Guide Maintenance

• For guides with multiple angles, insert the needle into the needle guide groove that
corresponds to the angle you previously selected.
11. Perform the puncture by sliding the needle through the groove in the guide until the
needle, as shown on the display, intercepts the target.
12. If you are using a biopsy guide bracket and procedure kit, you can remove the transducer
from the patient while the needle is still inserted in the patient: Separate the needle from
the biopsy guide by pulling the tab up so that the clip snaps out of the needle guide,
allowing the clip (still attached to the needle) and needle to separate from the biopsy guide
(still attached to the transducer).
13. Remove the biopsy guide after use.

Biopsy Guide Maintenance

WARNING
The biopsy procedure kit components are disposable and must not be reused.

For information and instructions on cleaning, disinfecting, and sterilizing the biopsy guide, see
the instructions provided with the biopsy guide.

254 EPIQ 7 User Manual 4535 617 25341

Transducer Care Safety Transducer Care

13 Transducer Care
This section contains information on cleaning, disinfecting, and sterilizing transducers that are
compatible with your ultrasound system.
For information on the gels that are safe to use with your system's transducers, see
“Ultrasound Transmission Gels” on page 184.
These instructions are intended to assist in effective cleaning, disinfection, and sterilization. In
addition, these instructions will help avoid damage, which could void your warranty, during
cleaning, disinfection, and sterilization.

Transducer Care Safety

Observe the following warnings and cautions when using disinfectants. More specific warnings
and cautions are included within the various procedures in this section and on the labels of the
cleaning or disinfection solutions.

WARNING
Disinfectants listed in this manual are recommended because of their chemical compatibility
with product materials, not their biological effectiveness. For the biological effectiveness of a
disinfectant, see the guidelines and recommendations of the disinfectant manufacturer, the
U.S. Food and Drug Administration, and the U.S. Centers for Disease Control.

WARNING
The level of disinfection required for a device is dictated by the type of tissue it will contact
during use. Ensure the disinfectant type is appropriate for the type of transducer and the
transducer application. For information on the levels of disinfection requirements, see
“Choosing the Correct Transducer-Care Method” on page 257. Also, see the disinfectant label
instructions and the recommendations of the Association for Professionals in Infection
Control, the U.S. Food and Drug Administration, and the U.S. Centers for Disease Control.

EPIQ 7 User Manual 4535 617 25341 255

Transducer Care Transducer Care Safety

WARNING
Sterile transducer covers with sterile ultrasound transmission gel are required for
intraoperative and biopsy procedures, and protective covers are recommended for
transrectal and intravaginal procedures, but in China and Japan, the covers are mandatory.
Philips recommends the use of qualified covers.

WARNING
Bite guards are mandatory for TEE transducers. See “Bite Guards” on page 233.

WARNING
In intraoperative applications, sterilized transducers should be used with sterile gel and a
sterile transducer cover.

For information on ordering transducer covers, contact CIVCO Medical Solutions (see “Supplies
and Accessories” on page 21).

Latex Product Alert

Philips ultrasound systems and transducers do not contain natural rubber latex that contacts
humans. Natural rubber latex is not used on any ultrasound transducer, including transthoracic,
intraoperative, and transesophageal echocardiography (TEE) transducers. It also is not used on
Philips ECG cables for the products in this manual.

WARNING
Transducer covers can contain natural rubber latex, which may cause allergic reactions in
some individuals.

WARNING
The M2203A bite guard strap contains natural rubber latex, which may cause allergic
reactions.

256 EPIQ 7 User Manual 4535 617 25341

Transducer Care Safety Transducer Care

For information on allergic reactions to latex-containing medical devices, see “FDA Medical
Alert on Latex” on page 49.

Transmissible Spongiform Encephalopathy

WARNING
If a sterile transducer cover becomes compromised during an intraoperative application
involving a patient with transmissible spongiform encephalopathy, such as Creutzfeldt-Jakob
disease, follow the guidelines of the U.S. Centers for Disease Control and this document from
the World Health Organization: WHO/CDS/ APH/2000/3, WHO Infection Control Guidelines
for Transmissible Spongiform Encephalopathies. The transducers for your system cannot be
decontaminated using a heat process.

Choosing the Correct Transducer-Care Method

To choose an appropriate care method for your transducer, you first must determine the
transducer's classification, based on its use.
Care Methods by Transducer Type
Transducer Use Example Classification Care Method
Contacts intact skin Curved, linear, xMatrix, and Noncritical Low-level disinfection (see
sector transducers “Transducer, Cable, and Connector
Cleaning” on page 258)
Contacts mucous Endocavity and Semi-critical High-level disinfection (see
membranes transesophageal (TEE) “Transducer, Cable, and Connector
Cleaning” on page 258 and
“Transducer Disinfection” on page
263)
Enters otherwise Intraoperative Critical Sterilization (see “Transducer, Cable,
sterile tissue and Connector Cleaning” on page 258
and “Transducer Sterilization” on page
273)

EPIQ 7 User Manual 4535 617 25341 257

Transducer Care Transducer, Cable, and Connector Cleaning

The care method for your transducer determines the appropriate disinfectant for your
transducer. For details about compatible disinfectants, see “Disinfectants Compatibility” on
page 276.

Transducer, Cable, and Connector Cleaning

These general cleaning (low-level disinfection) instructions are indicated for all transducers and
cables. It is important that you clean the transducer and cable according to the following
procedures.

WARNING
Always use protective eyewear and gloves when cleaning and disinfecting any equipment.

WARNING
If a premixed solution is used, be sure to observe the solution expiration date.

WARNING
Transducers must be cleaned after each use. Cleaning the transducer is an essential step
before effective disinfection or sterilization. Be sure to follow the manufacturer’s instructions
when using disinfectants.

CAUTION
Attempting to disinfect a cable or connector by using a method other than the one included
here can damage the device and voids the warranty.

CAUTION
Do not allow sharp objects, such as scalpels or cauterizing knives, to touch transducers or
cables.

258 EPIQ 7 User Manual 4535 617 25341

Transducer, Cable, and Connector Cleaning Transducer Care

CAUTION
When handling a transducer, do not bump the transducer on hard surfaces.

CAUTION
Do not use a surgeon’s brush when cleaning transducers. Even the use of soft brushes can
damage transducers.

CAUTION
Do not use a brush on the connector label.

CAUTION
During cleaning, disinfection, and sterilization, orient the parts of the transducer, connector,
or cable that must remain dry higher than the wet parts until all parts are dry. This will help
keep liquid from entering unsealed areas of the transducer.

CAUTION
Do not allow any type of fluid to enter the connector. Ensure that fluid does not enter
through the strain relief, through the connector, through the electrical contacts, or through
the areas surrounding the locking-lever shaft and the strain relief. Fluid in the connector may
void the device warranty.

CAUTION
You can use an alcohol solution for disinfection on the connector only. Ensure the solution is
only 70% alcohol or less. Solutions of more than 70% alcohol can cause product damage.

CAUTION
Do not use any alcohol or alcohol-based products on the cable or strain relief.

EPIQ 7 User Manual 4535 617 25341 259

Transducer Care Transducer, Cable, and Connector Cleaning

CAUTION
Avoid disinfectant contact with the connector label.

CAUTION
Be sure to use the proper concentration of enzymatic cleaner and rinse thoroughly.

CAUTION
Do not use paper products or products that are abrasive when cleaning the transducer. They
damage the soft lens of the transducer.

CAUTION
Before storing transducers, ensure that they are thoroughly dry. If it is necessary to dry the
transducer lens after cleaning, use a soft cloth and a blotting motion, instead of a wiping
motion.

Cleaning a Transducer

NOTE
All imaging transducers are rated at a minimum IPX7 in accordance with IEC529. This rating
indicates that the device is protected against the effects of immersion. Continuous wave
(nonimaging) transducers are rated IPX1. This rating indicates that the device is protected
against the effects of vertically falling water. For all TEE transducers, the control module is rated
IPX1, while the endoscope is rated IPX7, in accordance with IEC529.

Before cleaning a transducer, read the warnings and cautions in “Transducer, Cable, and
Connector Cleaning” on page 258 and “Transducer Care Safety” on page 255.
1. After every patient study, use a moist cloth to remove the ultrasound transmission gel from
the transducer.

260 EPIQ 7 User Manual 4535 617 25341

Transducer, Cable, and Connector Cleaning Transducer Care

2. Disconnect the transducer from the system, and remove any accessories attached to or
covering the transducer.
3. To remove all organic matter and other residue, use a pre-cleaner or detergent to assist in
removing protein residuals. Enzymatic cleaners must be diluted prior to use per the
manufacturer’s instructions for dilution. Enzymatic cleaners are generically approved for
use.
4. When cleaning the lens, use a blotting motion rather than a wiping motion.
5. To remove remaining particulate and cleaning residue, rinse thoroughly with water up to
the immersion point shown in “Disinfecting Non-TEE Transducers by Immersion” on page
268 and “Disinfecting TEE Transducers by Immersion” on page 270.
6. Optional: Wipe with a dry cloth. To dry the lens, use a soft cloth and a blotting motion
instead of a wiping motion.

NOTE
If you use cleaning wipes, it may be unnecessary to rinse the transducer with water. Always
follow the product label recommendations.

Cleaning and Disinfecting Cables and Connectors

Before cleaning the cables and connectors, read the warnings and cautions in “Transducer,
Cable, and Connector Cleaning” on page 258 and “Transducer Care Safety” on page 255.
The cables and connectors of all transducers can be disinfected using a recommended wipe or
spray disinfectant.

CAUTION
Do not bend or crimp the gastroscope or cable.

1. Disconnect the device from the system.

2. Push the connector cover, if available, onto the connector to protect against fluid splashing
onto the contacts.
3. Orient the device and the connector so they are both facing up (strain reliefs on the
bottom).

EPIQ 7 User Manual 4535 617 25341 261

Transducer Care Transducer, Cable, and Connector Cleaning

4. Use a soft cloth lightly dampened in a mild soap or detergent solution to clean the cable,
the strain reliefs, and the connector. A soft-bristled brush can be used to clean only the
metal surfaces of the connector.
5. Mix the disinfection solution compatible with your cable (see “Disinfectants and Cleaning
Solutions Compatibility Table” on page 278) according to label instructions for solution
strength.
6. Wipe or spray the cable, strain relief, and connector with the disinfectant, following
disinfectant label instructions for wipe durations, solution strengths, and duration of
disinfectant contact with the cable. Ensure that the solution strength and duration of
contact are appropriate for the intended clinical use of the device. Ensure that the
disinfectant solution does not enter the device or the connector or come into contact with
the connector label.
7. Air dry or towel dry with a sterile cloth according to the instructions on the disinfectant
label.
8. Examine the device and cable for damage such as cracks, splitting, sharp edges, or
projections. If damage is evident, discontinue use of the device and contact your Philips
representative.

262 EPIQ 7 User Manual 4535 617 25341

Transducer Disinfection Transducer Care

Cleaning Cables and Connectors

1 Transducer strain relief
2 Electrical contacts
3 Connector strain relief

Transducer Disinfection
To disinfect transducers, you can use either an immersion method or a wipe method with a
disinfectant recommended by Philips Ultrasound. Use the method that is biologically
appropriate, as described in “Choosing the Correct Transducer-Care Method” on page 257.

WARNING
Always use protective eyewear and gloves when cleaning and disinfecting any equipment.

EPIQ 7 User Manual 4535 617 25341 263

Transducer Care Transducer Disinfection

Isopropyl Alcohol Restrictions

The use of 70% isopropyl alcohol (rubbing alcohol) and alcohol-based products on transducers
is restricted. Isopropyl alcohol can cause damage to parts of the transducer. This damage is not
covered by the warranty or your service contract.

CAUTION
Wipe only the distal tip of the transducer up to 2.5 cm (1 in) from the strain relief/housing
joint with an isopropyl alcohol solution.

CAUTION
Do not use isopropyl alcohol on the strain relief/housing joint, the strain relief, or the cable.

CAUTION
Do not use isopropyl alcohol on TEE transducers, except for the handle.

Disinfecting Transducers Using a Wipe or Spray Method

This topic provides instructions on using the wipe or spray method.

CAUTION
The use of 70% isopropyl alcohol (rubbing alcohol) on transducers is restricted. Wipe only the
distal tip of the transducer up to 2.5 cm (1 in) from the strain relief/housing joint with an
isopropyl alcohol solution. Do not use isopropyl alcohol on the strain relief/housing joint, the
strain relief, or the cable. Do not use isopropyl alcohol on TEE transducers, except for the
handle. Isopropyl alcohol can cause damage to these parts of the transducer. This damage is
not covered by the warranty or your service contract.

264 EPIQ 7 User Manual 4535 617 25341

Transducer Disinfection Transducer Care

NOTE
Transducers can be disinfected using the wipe method only if the product labeling of the
compatible disinfectant you are using indicates it can be used with a wipe method.

Restricted Use of Isopropyl Alcohol to Clean Transducers

1 Cable
2 Strain relief
3 Strain relief/housing joint
4 Housing
5 2.5 cm (1 in) between housing and strain relief/housing joint
6 You can use alcohol in this area of non-TEE transducers
7 Do not use alcohol in this area

1. Clean the transducer and cable according to the procedures in “Transducer, Cable, and
Connector Cleaning” on page 258.
2. After cleaning, wipe or spray the transducer and cable with a low-level disinfectant. Allow
for the manufacturer’s recommended contact time. For a list of compatible disinfectants,
see “Disinfectants Compatibility” on page 276.

EPIQ 7 User Manual 4535 617 25341 265

Transducer Care Transducer Disinfection

NOTE
If you use cleaning wipes, it may be unnecessary to rinse the transducer with water. Always
follow your product label recommendations.

3. Examine the device and cable for damage such as cracks, splitting, sharp edges, or
projections. If damage is evident, discontinue use of the device and contact your Philips
representative.

Transducer Disinfection by Immersion

Methods for disinfecting transesophageal (TEE) and non-TEE transducers differ. Observe the
following warnings and cautions and then see the procedure for your transducer. For non-TEE
transducers, see “Disinfecting Non-TEE Transducers by Immersion” on page 268. For TEE
transducers, see “Disinfecting TEE Transducers by Immersion” on page 270 or “Disinfecting TEE
Transducers with an AER” on page 273.

WARNING
If a premixed disinfectant is used, be sure to observe the expiration date.

NOTE
All imaging transducers are rated at a minimum IPX7 in accordance with IEC529. This rating
indicates that the device is protected against the effects of immersion. Continuous wave
(nonimaging) transducers are rated IPX1. This rating indicates that the device is protected
against the effects of vertically falling water. For all TEE transducers, the control module is rated
IPX1, while the endoscope is rated IPX7, in accordance with IEC529.

CAUTION
Using non-recommended disinfectants, using incorrect solution strengths, or immersing a
transducer deeper or longer than recommended can damage or discolor the transducer and
voids the transducer warranty.

266 EPIQ 7 User Manual 4535 617 25341

Transducer Disinfection Transducer Care

CAUTION
Do not immerse transducers longer than the minimum time needed for your level of
disinfection. For information on the levels of disinfection requirements, see “Choosing the
Correct Transducer-Care Method” on page 257.

Minimizing the Effects of Residual Disinfectant

If you use an OPA-based disinfectant, residual solution may remain on your transducers if you
do not carefully follow the manufacturer’s instructions.

WARNING
Residual OPA on TEE transducers may cause temporary staining of the mouth and lip area
and irritation or chemical burns of the mouth, throat, esophagus, and stomach.

To minimize the effects from residual OPA, or any other disinfectant, Philips recommends the
following:

WARNING
Follow the disinfectant manufacturer’s instructions very carefully. For example, the
manufacturer of Cidex OPA recommends soaking transducers three times in fresh water.

WARNING
Use a protective transducer cover during endocavity and TEE studies.

WARNING
Use a sterile protective transducer cover with sterile ultrasound transmission gel during
intraoperative and biopsy studies.

EPIQ 7 User Manual 4535 617 25341 267

Transducer Care Transducer Disinfection

WARNING
Limit the time that transducers are soaked in the disinfectant solution to the minimum time
recommended by the disinfectant manufacturer (for example, the manufacturer of Cidex OPA
recommends a minimum of 12 minutes).

Disinfecting Non-TEE Transducers by Immersion

Before performing this procedure, read the warnings and cautions in “Transducer Disinfection
by Immersion” on page 266, “Transducer Care Safety” on page 255, and “Minimizing the Effects
of Residual Disinfectant” on page 267.
Methods for disinfecting transesophageal (TEE) and non-TEE transducers differ. For TEE
transducers, see “Disinfecting TEE Transducers by Immersion” on page 270 or “Disinfecting TEE
Transducers with an AER” on page 273.
1. Clean the transducer and cable according to the procedures in “Transducer, Cable, and
Connector Cleaning” on page 258.
2. Mix the disinfection solution compatible with your transducer (see “Disinfectants and
Cleaning Solutions Compatibility Table” on page 278) according to label instructions for
solution strength.
3. Immerse the transducer into the appropriate disinfectant for your transducer as shown in
the illustration. Follow the instructions on the disinfectant label for the duration of
transducer immersion. Do not immerse transducers longer than the minimum time needed
for your level of disinfection.
4. Using the instructions on the disinfectant label, rinse the transducer up to the point of
immersion, and then air dry or towel dry with a sterile cloth.
5. Examine the transducer for damage, such as cracks, splitting, fluid leaks, or sharp edges or
projections. If damage is evident, discontinue use of the transducer and contact your Philips
representative.

268 EPIQ 7 User Manual 4535 617 25341

Transducer Disinfection Transducer Care

Immersing Transducers
1 Immerse this section only, up to 5.1 cm (2 in) from the connector’s strain relief.
2 Maximum allowable immersion depth; you are not required to immerse to this depth if it is unnecessary.

Cautions for TEE Transducer Disinfection

Obey the following safety precautions when disinfecting TEE transducers.

CAUTION
Never sterilize the transducer with autoclave, gamma-radiation, gas, steam, or heat
sterilization techniques. Severe damage will result. Avoidable transducer damage is not
covered by the warranty or service contract.

CAUTION
Do not bend the shaft into a circle with a diameter of less than 0.30 m (1 ft).

CAUTION
Do not use bleach on the transducer and shaft.

EPIQ 7 User Manual 4535 617 25341 269

Transducer Care Transducer Disinfection

CAUTION
Do not use isopropyl alcohol-based products on the transducer and shaft.

CAUTION
Do not soak the transducer for extended periods of time. Limit the time that transducers are
soaked in disinfectant solution to the minimum time recommended by the disinfectant
manufacturer.

CAUTION
Do not rinse or immerse the control housing, cable, connector, or the portion of the cable
near the connector.

CAUTION
Do not immerse or rinse the steering mechanism.

CAUTION
Follow the recommendations of the disinfectant manufacturer.

CAUTION
The transducer steering mechanism is unsealed. If disinfectant or other fluid enters the
steering mechanism, it corrodes the gears and electrical connections. Avoidable transducer
damage is not covered by the warranty or service contract.

Disinfecting TEE Transducers by Immersion

Before performing this procedure, read the cautions and warnings in “Transducer Disinfection
by Immersion” on page 266, “Transducer Care Safety” on page 255, and “Minimizing the Effects
of Residual Disinfectant” on page 267.
Disinfection by immersion is the accepted method of infection control for transesophageal
transducers. Philips recommends that a protective transducer cover be used during studies.

270 EPIQ 7 User Manual 4535 617 25341

Transducer Disinfection Transducer Care

Upon receiving your new transducer, disinfect it before performing the first study. Clean and
disinfect the transducer immediately after each use to protect patients and personnel from a
variety of pathogens. Establish and clearly post a cleaning procedure that includes the following
steps.
Methods for disinfecting transesophageal (TEE) and non-TEE transducers differ. For non-TEE
transducers, see “Disinfecting Non-TEE Transducers by Immersion” on page 268.
1. Disconnect the transducer from the system.
2. Clean the transducer and flexible shaft using any of the following: enzymatic cleaner, mild
soap solution, or an approved wipe. Follow the manufacturer's instructions for use.
3. Use water to rinse the distal tip and flexible shaft thoroughly.
4. Immerse the distal tip and flexible shaft into the appropriate disinfectant as shown in the
illustration.
5. Remove the tip and shaft from the disinfectant and thoroughly rinse with water according
to the instructions from the disinfectant manufacturer.
6. Check the transducer for any residual organic material. If any is present, remove it and
disinfect the transducer again.
7. Gently dry the distal tip and flexible shaft with a sterile cloth or pad, or allow it to air dry.
8. Lightly wipe only the steering mechanism and handle with a pad moistened with rubbing
alcohol (70% isopropyl alcohol), or use approved cleaners as directed on the handle and
steering mechanism.
9. Hang the transducer on a wall-mounted rack, and let it air dry.

EPIQ 7 User Manual 4535 617 25341 271

Transducer Care Transducer Disinfection

Immersing TEE Transducers

1 Immerse this section only, up to 5.1 cm (2 in) from the handle’s strain relief.
2 Maximum allowable immersion depth; you are not required to immerse to this depth if it is unnecessary.

272 EPIQ 7 User Manual 4535 617 25341

Transducer Disinfection Transducer Care

Disinfecting TEE Transducers with an AER

Before performing this procedure, read the cautions and warnings in “Transducer Disinfection
by Immersion” on page 266, “Transducer Care Safety” on page 255, “Cautions for TEE
Transducer Disinfection” on page 269, and “Minimizing the Effects of Residual Disinfectant” on
page 267.
The automated endoscopy reprocessor (AER) disinfector can be used only with those
transducers listed that are listed as compatible in the “Disinfectants and Cleaning Solutions
Compatibility Table” on page 278 or in the results of a compatible-solution search on the
Transducer Care website:
www.healthcare.philips.com/us_en/products/ultrasound/Transducers/transducer_care/
index.wpd
Methods for disinfecting transesophageal (TEE) and non-TEE transducers differ. For non-TEE
transducers, see “Disinfecting Non-TEE Transducers by Immersion” on page 268.
1. Disconnect the transducer from the system.
2. Follow the manufacturers' instructions for disinfection.

Transducer Sterilization
Sterilization is required if the transducer enters otherwise sterile tissue without a sterile cover.
If you use a sterile cover, you should sterilize but you can disinfect (high-level disinfection). For
information about disinfecting a transducer, see “Transducer Disinfection” on page 263.

WARNING
Always use protective eyewear and gloves when cleaning, disinfecting, or sterilizing any
equipment.

WARNING
In intraoperative applications, sterilized transducers should be used with sterile gel and a
sterile transducer cover.

EPIQ 7 User Manual 4535 617 25341 273

Transducer Care Transducer Sterilization

WARNING
Sterile transducer covers are disposable and must not be reused.

WARNING
If a premixed solution is used, be sure to observe the solution expiration date.

CAUTION
Transducers must be cleaned after each use. Cleaning the transducer is an essential step
before effective disinfection or sterilization. Be sure to follow the manufacturer’s instructions
when using disinfectants.

CAUTION
Use only liquid solutions to sterilize transducers. Using autoclave, gas (EtO), or other methods
not approved by Philips will damage your transducer and void your warranty.

CAUTION
Do not allow sharp objects, such as scalpels and cauterizing knives, to touch transducers or
cables.

CAUTION
When handling a transducer, do not bump the transducer on hard surfaces.

CAUTION
Ensure the solution strength and duration of contact are appropriate for sterilization. Be sure
to follow the manufacturer’s instructions.

274 EPIQ 7 User Manual 4535 617 25341

Transducer Sterilization Transducer Care

Sterilizing Transducers by Immersion

The main difference between sterilization by immersion and disinfection by immersion is the
length of time the transducer is immersed. To determine if your transducer requires
sterilization or high-level disinfection, see “Choosing the Correct Transducer-Care Method” on
page 257.
1. Clean the transducer and cable according to the procedures in “Transducer, Cable, and
Connector Cleaning” on page 258.
2. Mix the sterilization solution compatible with your transducer according to label
instructions for solution strength.
3. Immerse the transducer in the sterilization solution as shown in the illustration.
4. Follow the instructions on the sterilization label for the duration of transducer immersion
required for sterilization.
5. Remove the transducer from the sterilization solution after the recommended sterilization
time has elapsed.
6. Using the instructions on the sterilization label, rinse the transducer in sterile water up to
the point of immersion, and then air dry or towel dry with a sterile cloth.
7. Examine the transducer for damage, such as cracks, splitting, fluid leaks, or sharp edges or
projections. If damage is evident, discontinue use of the transducer, and contact your
Philips representative.

EPIQ 7 User Manual 4535 617 25341 275

Transducer Care Disinfectants Compatibility

Immersing Transducers
1 Immerse this section only, up to 5.1 cm (2 in) from the connector’s strain relief.
2 Maximum allowable immersion depth; you are not required to immerse to this depth if it is unnecessary.

Disinfectants Compatibility
Read this information before performing disinfection and sterilization procedures. It discusses
recommended disinfectants and choosing an appropriate disinfectant for the required level of
disinfection. You must check “Disinfectants and Cleaning Solutions Compatibility Table” on page
278 for the chemical compatibility of disinfectants and cleaners with specific transducers. In
addition, the table indicates if a device can be sprayed or wiped only, or if it can be soaked.

276 EPIQ 7 User Manual 4535 617 25341

Disinfectants Compatibility Transducer Care

WARNING
Not all disinfectants are effective against all types of contamination. Ensure the disinfectant
type is appropriate for the type of transducer and that the solution strength and time of
contact are appropriate for the intended clinical use.

WARNING
Disinfectants listed in this section are recommended because of their chemical compatibility
with product materials, not their biological effectiveness. For the biological effectiveness of a
disinfectant, see the guidelines and recommendations of the disinfectant manufacturer, the
Association for Professionals in Infection Control, the U.S. Food and Drug Administration, and
the U.S. Centers for Disease Control.

WARNING
If a premixed solution is used, be sure to observe the solution expiration date.

WARNING
Always use protective eyewear and gloves when cleaning and disinfecting any equipment.

CAUTION
Using a non-recommended disinfection solution, using an incorrect solution strength, or
immersing a transducer deeper or longer than recommended can damage the device and
voids the warranty.

Disinfectant Types

WARNING
The level of disinfection required for a device is dictated by the type of tissue it will contact
during use. Ensure the disinfectant type is appropriate for the type of transducer and the
transducer application. For information on the levels of disinfection requirements, see

EPIQ 7 User Manual 4535 617 25341 277

Transducer Care Disinfectants Compatibility

“Choosing the Correct Transducer-Care Method” on page 257. For more information, see the
disinfectant label instructions and the recommendations of the Association for Professionals
in Infection Control, the U.S. Food and Drug Administration, and the U.S. Centers for Disease
Control.

CAUTION
If you use an isopropyl alcohol-based product for disinfection, ensure the solution is only 70%
alcohol or less. Solutions of more than 70% alcohol can cause product damage. Do not use
alcohol on the transducer’s strain relief or cable, or on TEE transducers (except the handle).

See “Disinfectants Compatibility” on page 276 for standard industry recommendations on

disinfection, for information that can help you choose an appropriate disinfectant for the
required level of disinfection, and for transducer-specific instructions.

Factors Affecting Disinfectant Efficiency

The following factors will affect the efficiency of a disinfectant solution:
• Number and location of microorganisms
• Innate resistance of microorganisms
• Concentration and potency of disinfectants
• Physical and chemical factors
• Organic and inorganic matter
• Duration of exposure
• Biofilms

Disinfectants and Cleaning Solutions Compatibility Table

The following table lists the disinfectants and cleaning solutions that are compatible with the
transducers available for your ultrasound system.

CAUTION
Do not use hydrogen-peroxide products on Doppler transducers.

278 EPIQ 7 User Manual 4535 617 25341

Disinfectants Compatibility Transducer Care

CAUTION
Isopropyl alcohol (IPA) products are approved for use on the transducer only and only if the
IPA content does not exceed 70%. Do not use IPA-based products on the connector cable and
strain relief. All other product types listed here can be used on the transducer and cable.

NOTE
TEE transducers require unique methods for disinfection. See “Disinfecting TEE Transducers by
Immersion” on page 270 or “Disinfecting TEE Transducers with an AER” on page 273.

Based on material compatibility testing and product use profile and active ingredients, Philips
has approved for use the following types of low-level disinfectants used as a spray or wipe for
surface (skin contact) and transvaginal or transrectal probes:
• Sodium hypochlorite based (for example 10% household bleach solution with active sodium
hypochlorite at approximately 0.6%)
• Quaternary ammonium (QUAT) based (for example, products that contain n-alkyl (x)benzyl
ammonium chloride solution where (x) can be any organic functional group such as ethyl
and methyl, and so on; concentration at use should be less than 0.5% total for all QUATs
listed)
• Accelerated hydrogen peroxide based, except on Doppler transducers (D2cwc, D2tcd, and
D5cwc)
• Activated hydrogen peroxide based, except on Doppler transducers (D2cwc, D2tcd, and
D5cwc)
• Alcohol or alcohol plus QUAT based (product alcohol content cannot exceed 70%)
Products not specifically listed in the following table but with similar active ingredients, as
indicated above, and marketed for medical use may be used. Because of the large number of
products available, it is impossible to have an all-inclusive list. If you are unsure of the suitability
of a particular product, please contact your Philips representative for assistance.
For more information:
• Philips Ultrasound Transducer Care website (www.healthcare.philips.com/us/products/
ultrasound/transducers/transducer_care/)
• In North America, call Philips at 800-722-9377.
• Outside North America, contact your local Philips representative.

EPIQ 7 User Manual 4535 617 25341 279

Transducer Care Disinfectants Compatibility

Disinfectants and Cleaning Solutions Compatibility Table Legend

Origin (Country Code) Application Definitions Special Instructions
AU = Australia T = Approved for use on the transducer 1. Soak or per product instructions
CA = Canada C = Approved for use on the cable --
DE = Germany H =Approved for use on the handle housing --
ES = Spain N = Not approved for use --
FR = France -- --
UK = United Kingdom -- --
US = United States -- --

Disinfectants and Cleaning Solutions Compatibility

Solution Origin Qualified Active C5-1 D2cwc L12-3 S5-1 S7-3t V6-2 X5-1 X6-1 X7-2t
Use Ingredients C8-5 D2tcd L12-5 50 S8-3
C9-2 D5cwc L15-7io S12-4
C10-3v L18-5
C10-4ec
70% Isopropyl All Spray/ Alcohol T T T T H T T T H
Alcohol Wipe
AbcoCide US Soak1 Glutaraldehyde T,C N T,C T,C T T,C T,C T,C T
AbcoCide 28 US Soak1 Glutaraldehyde T,C N T,C T,C T T,C T,C T,C T
Accel Wipes CA Wipe Hydrogen T,C N T,C T,C N T,C T,C T,C T,C,H
Peroxide
Aidal AU Soak1 Glutaraldehyde T,C N T,C T,C T T,C T,C T,C T
Aidal Plus AU Soak1 Glutaraldehyde T,C N T,C T,C T T,C T,C T,C T
Alkaspray FR Spray/ Alcohol, T T T T H T T T H
Wipe Alkylamine
Ampholysine FR Spray/ Biguanide/ T,C T,C T,C T,C T,C T,C T,C T,C T,C
Basique Wipe Quat.
Ammonia
Aniosept Activ FR Soak1 Peracetic Acid T,C N T,C T,C N T,C T,C T,C T
Anioxyde 1000 FR Soak1 Peracetic Acid T,C N T,C T,C N T,C T,C T,C T
Antigermix AE1 FR AE1 UV-C N N N N N N N N T
System

280 EPIQ 7 User Manual 4535 617 25341

Disinfectants Compatibility Transducer Care

Solution Origin Qualified Active C5-1 D2cwc L12-3 S5-1 S7-3t V6-2 X5-1 X6-1 X7-2t
Use Ingredients C8-5 D2tcd L12-5 50 S8-3
C9-2 D5cwc L15-7io S12-4
C10-3v L18-5
C10-4ec
Antigermix S1 FR S1 UV-C T,C N T,C T,C N N T,C T,C N
System
Banicide US Soak1 Glutaraldehyde T,C N T,C T,C T T,C T,C T,C T
Bleach (10% All Spray/ Sodium T,C T,C T,C T,C C T,C T,C T,C C
solution of Wipe Hypochlorite
5.25% Bleach)
CaviWipes US Wipe Alcohol, Quat. T T T T H T T T H
Ammonia
Cidex US Soak1 Glutaraldehyde T,C N T,C T,C T T,C T,C T,C T
Cidex 7 US Soak1 Glutaraldehyde T,C N T,C T,C T T,C T,C T,C T
Cidex OPA US Soak 1
Ortho-phthal T,C N T,C T,C T T,C T,C T,C T
aldehyde
Cidex PAE 14J FR Soak1 Glutaraldehyde T,C N T,C T,C T T,C T,C T,C T
Cidex Plus US Soak1 Glutaraldehyde T,C N T,C T,C T T,C T,C T,C T
Cleanisept DE Spray/ Quat. T,C T,C T,C T,C T,C,H T,C T,C T,C T,C,H
Wipes Wipe Ammonia
Descoton Extra DE Soak1 Glutaraldehyde T,C N T,C T,C T T,C T,C T,C T
Dispatch US Spray/ Sodium T,C T,C T,C T,C C T,C T,C T,C C
Wipe Hypochlorite
Endo FC FR Soak1 Glutaraldehyde T,C N T,C T,C T T,C T,C T,C T
Endosporine FR Soak1 Glutaraldehyde T,C N T,C T,C T T,C T,C T,C T
Enzol US Pre- Enzymes T,C N T,C T,C T T,C T,C T,C T
cleaner
Epizyme Rapid AU Pre- Enzymes T,C N T,C T,C T T,C T,C T,C T
cleaner
Gigasept FF DE Soak1 Succinic T,C N T,C T,C T T,C T,C T,C T
(neu) dialdehyde
Gigasept PAA DE Soak1 Peracetic T,C N T,C T,C N T,C T,C T,C T

EPIQ 7 User Manual 4535 617 25341 281

Transducer Care Disinfectants Compatibility

Solution Origin Qualified Active C5-1 D2cwc L12-3 S5-1 S7-3t V6-2 X5-1 X6-1 X7-2t
Use Ingredients C8-5 D2tcd L12-5 50 S8-3
C9-2 D5cwc L15-7io S12-4
C10-3v L18-5
C10-4ec
Incidin DE Spray/ Alcohol T T T T H T T T H
Wipe
Incidur Spray DE Spray/ Alcohol, Quat. T T T T H T T T H
Wipe Aldehyde
Instruzyme FR Pre- Enzymes, Quat. T,C N T,C N T T,C N T,C T
cleaner Ammonia,
Biguanide
Klenzyme US Pre- Enzymes T,C N T,C T,C T T,C T,C T,C T
cleaner
Kohrsolin DE Soak1 Glutaraldehyde T,C N T,C T,C T T,C T,C T,C T
Korsolex Basic FR Soak 1
Aldehyde T,C N T,C T,C T T,C T,C T,C T
Releasing
Korsolex Extra FR Soak1 Aldehydes/ T,C N T,C T,C T T,C T,C T,C T
Quaternary
Ammonium
Korsolex PAE FR Soak1 Glutaraldehyde T,C N T,C T,C T T,C T,C T,C T
MaxiCide Plus US Soak1 Glutaraldehyde T,C N T,C T,C T T,C T,C T,C T
MedDis UK Soak 1
Quat. T,C N T,C T,C T T,C T,C T,C T
Ammonia,
Sulfamic Acid
Medistel UK Soak1 Quat. T,C N T,C T,C T T,C T,C T,C T
Ammonia,
Sulfamic Acid
MetriCide US Soak1 Glutaraldehyde T,C N T,C T,C T T,C T,C T,C T
MetriCide 28 US Soak 1
Glutaraldehyde T,C N T,C T,C T T,C T,C T,C T
MetriCide OPA US Soak1 Ortho- T,C N T,C T,C T T,C T,C T,C T
Plus phthalaldehyde
MetriCide Plus US Soak1 Glutaraldehyde T,C N T,C T,C T T,C T,C T,C T
30

282 EPIQ 7 User Manual 4535 617 25341

Disinfectants Compatibility Transducer Care

Solution Origin Qualified Active C5-1 D2cwc L12-3 S5-1 S7-3t V6-2 X5-1 X6-1 X7-2t
Use Ingredients C8-5 D2tcd L12-5 50 S8-3
C9-2 D5cwc L15-7io S12-4
C10-3v L18-5
C10-4ec
MetriZyme US Pre- Enzymes T,C N T,C T,C T T,C T,C T,C T
cleaner
Mikrozid PAA DE Wipe Peracetic Acid T,C N T,C T,C N T,C T,C T,C T
Mild Soap All Pre- Surfactants/ T,C T,C T,C T,C T,C T,C T,C T,C T,C
Solution cleaner Soap
Milton AU Spray/ Sodium T,C T,C T,C T,C C T,C T,C T,C C
Wipe Hypochlorite
NDP Med SP Soak1 N- T,C N T,C T,C T T,C T,C T,C T
Concentrated Duopropenide,
Plus Alkylamine
Omnicide 14NS US Soak1 Glutaraldehyde T,C N T,C T,C T T,C T,C T,C T
Omnicide 28 US Soak1 Glutaraldehyde T,C N T,C T,C T T,C T,C T,C T
Opti-Cide 3 US Spray/ Alcohol, Quat. T T T T H T T T H
Wipe Ammonia
Oxivir US Wipe Hydrogen T,C N T,C T,C N T,C T,C T,C T,C,H
Peroxide
Peracetic Acid UK Soak1 Peracetic Acid T,C N T,C T,C N T,C T,C T,C T
OCS
PeraSafe UK Soak1 Peracetic Acid T,C N T,C T,C T T,C T,C T,C T
Powder
Perastel UK Soak1 Peracetic Acid T,C N T,C T,C N T,C T,C T,C T
(formerly
Perascope)
PerCept Wipes CA Wipe Hydrogen T,C N T,C T,C T,C,H T,C T,C T,C T,C,H
Peroxide
Phagocide D FR Soak1 Glutaraldehyde T,C N T,C T,C T T,C T,C T,C T
Phagozyme ND FR Pre- Enzymes, Quat. T,C N T,C N T T,C N T,C T
cleaner Ammonium
Pro-Cide US Soak1 Glutaraldehyde T,C N T,C T,C T T,C T,C T,C T

EPIQ 7 User Manual 4535 617 25341 283

Transducer Care Disinfectants Compatibility

Solution Origin Qualified Active C5-1 D2cwc L12-3 S5-1 S7-3t V6-2 X5-1 X6-1 X7-2t
Use Ingredients C8-5 D2tcd L12-5 50 S8-3
C9-2 D5cwc L15-7io S12-4
C10-3v L18-5
C10-4ec
Pro-Cide 14NS US Soak1 Glutaraldehyde T,C N T,C T,C T T,C T,C T,C T
Pro-Cide 28 US Soak 1
Glutaraldehyde T,C N T,C T,C T T,C T,C T,C T
Pro-Cide NS US Soak1 Glutaraldehyde T,C N T,C T,C T T,C T,C T,C T
Pro-Cide Plus US Soak 1
Glutaraldehyde T,C N T,C T,C T T,C T,C T,C T
Prolystica 2X US Pre- Enzymes T,C N T,C T,C T T,C T,C T,C T
cleaner
Protex US Spray/ Quat. ammonia T,C T,C T,C T,C T,C,H T,C T,C T,C T,C,H
Disinfectant Wipe
Spray
PSS Select 14 US Soak1 Glutaraldehyde T,C N T,C T,C T T,C T,C T,C T
Day
PSS Select 28 US Soak1 Glutaraldehyde T,C N T,C T,C T T,C T,C T,C T
Day
PSS Select Plus US Soak1 Glutaraldehyde T,C N T,C T,C T T,C T,C T,C T
Quaternary All Spray/ Quat. T,C T,C T,C T,C C T,C T,C T,C C
Ammonium Wipe Ammonia
Rapicide US Soak1 Glutaraldehyde T,C N T,C T,C T T,C T,C T,C T
Resert XL HLD US Soak Hydrogen T,C N T,C T,C N T,C T,C T,C N
Peroxide
Rivascop FR Spray/ Quat. T,C T,C T,C T,C T,C,H T,C T,C T,C T,C,H
Wipe Ammonia
Salvanios pH FR Spray/ Quat. T,C T,C T,C T,C T,C,H T,C T,C T,C T,C,H
10 Wipe Ammonia
Sani-Cloth US Wipe Quat. T,C T,C T,C T,C T,C,H T,C T,C T,C T,C,H
Active Ammonia
Sani-Cloth AF US Wipe Quat. T,C T,C T,C T,C T,C,H T,C T,C T,C T,C,H
Ammonia
Sani-Cloth AF3 US Wipe Quat. T,C T,C T,C T,C T,C,H T,C T,C T,C T,C,H
Ammonia

284 EPIQ 7 User Manual 4535 617 25341

Disinfectants Compatibility Transducer Care

Solution Origin Qualified Active C5-1 D2cwc L12-3 S5-1 S7-3t V6-2 X5-1 X6-1 X7-2t
Use Ingredients C8-5 D2tcd L12-5 50 S8-3
C9-2 D5cwc L15-7io S12-4
C10-3v L18-5
C10-4ec
Sani-Cloth US Wipe Sodium T,C T,C T,C T,C C T,C T,C T,C C
Bleach Hypochlorite
Sani-Cloth Plus US Wipe Alcohol, Quat. T T T T H T T T H
Ammonia
SDS 14 NS US Soak1 Glutaraldehyde T,C N T,C T,C T T,C T,C T,C T
SDS 28 US Soak 1
Glutaraldehyde T,C N T,C T,C T T,C T,C T,C T
Sekucid N FR Soak1 Glutaraldehyde T,C N T,C T,C T T,C T,C T,C T
Sekusept Aktiv DE Soak 1
Peracetic Acid T,C N T,C T,C T T,C T,C T,C T
Sekusept Easy DE Soak1 Peracetic Acid T,C N T,C T,C T T,C T,C T,C T
Sekusept Plus DE Soak 1
Glucoprotamin T,C N T,C N T T,C N T,C T
Steranios 2% FR Soak1 Glutaraldehyde T,C N T,C T,C T T,C T,C T,C T
TD-5 US TD-100 Glutaraldehyde N N N N T N N N T
Reproces
sor
T-Spray US Spray/ Quat. T,C T,C T,C T,C T,C,H T,C T,C T,C T,C,H
Wipe Ammonia
T-Spray II US Spray/ Quat. T,C T,C T,C T,C T,C,H T,C T,C T,C T,C,H
Wipe Ammonia
Tristel Duo UK Foam/ Chlorine T,C N T,C T,C N N T,C T,C N
Wipe Dioxide
Tristel Fuse for UK Stella Chlorine T,C N T,C T,C T N T,C T,C T
Instruments System Dioxide
Tristel UK Wipe Chlorine T,C T,C T,C T,C T N T,C T,C T
Sporicidal Dioxide
Wipes
Trophon EPR AU Trophon Hydrogen T,C N T,C T,C N T,C T,C T,C N
EPR Peroxide
Reproces
sor

EPIQ 7 User Manual 4535 617 25341 285

Transducer Care Disinfectants Compatibility

Solution Origin Qualified Active C5-1 D2cwc L12-3 S5-1 S7-3t V6-2 X5-1 X6-1 X7-2t
Use Ingredients C8-5 D2tcd L12-5 50 S8-3
C9-2 D5cwc L15-7io S12-4
C10-3v L18-5
C10-4ec
Vaposeptol FR Spray/ Alcohol, T T T T H T T T H
Wipe Biguanide
Vespore US Soak1 Glutaraldehyde T,C N T,C T,C T T,C T,C T,C T
Virox 5 RTU CA Wipe Hydrogen T,C N T,C T,C T,C,H T,C T,C T,C T,C,H
Peroxide
Wavicide -01 US Soak1 Glutaraldehyde T,C N T,C T,C T T,C T,C T,C T
Wip'Anios FR Wipe Alohol, Quat. T T T T H T T T H
Ammonia

286 EPIQ 7 User Manual 4535 617 25341

Cleaning and Maintaining the System System Maintenance

14 System Maintenance
Maintenance should be performed regularly and as needed.
Because the system is a piece of medical equipment that contains several circuit boards,
extensive service diagnostics, and complex operating software, Philips recommends that only
trained personnel service the system.

Cleaning and Maintaining the System

It is important to clean and maintain the ultrasound system and peripherals. Thorough cleaning
is particularly important for pieces of peripheral equipment, because they contain
electromechanical devices. If exposed to constant and excessive environmental dust and
humidity, these devices will suffer in both performance and reliability.
It is essential to clean the transducers used with your ultrasound system. The cleaning
procedures vary for the different types of transducers and their uses.
For detailed instructions on how to clean and maintain each type of transducer used with the
system, including disinfectant compatibility, see the “Transducer Care” section.

Cleaning the System and ECG Equipment

Use this method to clean the system and the ECG cables, leads, and electrodes. You can use a
mild soap solution. If the equipment has come in contact with blood or infectious material,
clean the equipment with a 70% solution of isopropyl alcohol. For instructions on disinfecting
system surfaces, see “Disinfecting System Surfaces” on page 290.

WARNING
Always use protective eyewear and gloves when cleaning and disinfecting any equipment.

CAUTION
Attempting to disinfect a cable or connector by using a method other than the one included
here can damage the device and voids the warranty.

EPIQ 7 User Manual 4535 617 25341 287

System Maintenance Cleaning and Maintaining the System

CAUTION
Orient the parts that must remain dry higher than the wet parts until all parts are dry.

Use the following procedure to clean the display; the system control panel; all the external
surfaces of the system and the cart; and the ECG trunk cables, leads, and electrodes.
1. Before cleaning, turn off the system and unplug the power cord from the power source.
2. Wipe with a soft cloth moistened with soap and water.

CAUTION
Do not spill or spray liquid on the controls, into the system cabinet, or into the transducer
connection receptacle.

3. Remove any solid matter around the keys or the controls with a cotton swab or toothpick to
ensure that solids are not pushed into the cabinet.
4. If blood or other infectious material comes in contact with the system or any cable other
than a transducer cable, wipe with a 70% solution of isopropyl alcohol.

CAUTION
If blood or other infectious material comes in contact with a transducer or transducer cable,
do not wipe with isopropyl alcohol until you have read the “Transducer Care” section for
specific cleaning guidelines. Isopropyl alcohol should not be used on some parts of the
transducer and should never be used on any parts of the transducer cable. Additional
cleaning agents are also available for transducers.

CAUTION
Do not use strong solvents, common cleaning products, or abrasive cleansers, which will
damage the system surfaces.

CAUTION
Do not touch the displays with sharp objects or use paper towels to clean them, which may
damage them.

288 EPIQ 7 User Manual 4535 617 25341

Cleaning and Maintaining the System System Maintenance

5. Remove dust from the monitor screen and touch screen with a soft, lint-free cloth. A micro-
fiber cloth is recommended. Clean the monitor screen and touch screen using a liquid
screen cleaner specifically designed for LCDs. Spray the liquid onto the cleaning cloth or
spray sparingly onto the displays. You can also use pre-moistened screen wipes. Dry the
displays with a soft, lint-free cloth.

CAUTION
When cleaning the system control panel, monitor screen, touch screen, and keyboard, take
care not to get any solution inside the housings. Also take care not to scratch the face of the
monitor while cleaning it.

CAUTION
Do not use cleaners containing bleach on the touch screen. It may damage the surface.

6. Remove any residue with a cloth moistened with sterile water.

7. Be sure to dry the equipment to prevent potential corrosion.

Disinfectants for System Surfaces

The exterior surfaces of the system can be disinfected using a compatible disinfectant with a
wipe method.
System surfaces include the monitor screen, the touch screens, and plastic and painted
surfaces. The following products can be used on system surfaces:
• Mild soap solution
• 70% isopropyl alcohol (IPA)
• T-Spray II (quaternary ammonium-based)
• Opti-Cide 3 (quaternary ammonium/isopropyl alcohol-based)
• Sani-Cloth HB (quaternary ammonium-based)
• Sani-Cloth Plus (quaternary ammonium/isopropyl alcohol-based)
• 0.5% Accelerated hydrogen peroxide
Other products that are based on quaternary ammonium compounds (QUAT) or QUAT/
isopropyl alcohol can also be used in disinfecting system surfaces.

EPIQ 7 User Manual 4535 617 25341 289

System Maintenance Cleaning and Maintaining the System

Disinfecting System Surfaces

WARNING
Always use protective eyewear and gloves when cleaning and disinfecting any equipment.

CAUTION
Use only compatible disinfectants on system surfaces.

CAUTION
If you use an isopropyl alcohol solution for disinfection, ensure the solution is only 70%
alcohol or less. Solutions of more than 70% alcohol can cause product damage.

Before performing this procedure, read “Disinfectants for System Surfaces” on page 289.
1. Turn off the system and disconnect the system power cord from the wall outlet.
2. Use a soft cloth lightly dampened in a mild soap or detergent solution to clean exterior
surfaces on the system.
3. Mix the disinfection solution compatible with your system according to label instructions
for solution strength.

CAUTION
Do not spray disinfectant directly on system surfaces. When wiping, do not allow disinfectant
to pool or run on system surfaces. In either case, disinfectant may leak into the system,
damaging the system and voiding the warranty. Wipe only with a cloth or applicator that is
lightly dampened.

4. Wipe system surfaces with the disinfectant, following disinfectant label instructions for
wipe durations, solution strengths, and disinfectant contact duration. Ensure the solution
strength and duration of contact are appropriate for the intended clinical application.

290 EPIQ 7 User Manual 4535 617 25341

Cleaning and Maintaining the System System Maintenance

5. Air dry or towel dry with a sterile cloth according to the instructions on the disinfectant
label.
6. Because the system is a piece of medical equipment that contains several circuit boards,
extensive service diagnostics, and complex operating software, Philips recommends that
only trained personnel service the system.

System Control Panel Maintenance

The system control panel and other outer surfaces are most likely to be affected by liquid spills
and other materials such as excessive amounts of gel. These materials may seep into electrical
components under the panel and cause intermittent failures. During preventive maintenance,
look for such potential problems including loose knobs and worn controls.
Regularly clean the outside of the system as described in “Cleaning the System and ECG
Equipment” on page 287.

Cleaning the Trackball

Cleaning the trackball regularly prolongs its useful life and prevents service calls.
1. With your fingers, unscrew the ring around the trackball.
2. Lift the trackball out of the mounting area.
3. Clean the trackball and the mounting area with a lint-free cloth or a small brush.
4. Place the ball back on the mounting area.
5. With your fingers, screw the ring back on.

Cleaning the System Air Filter

The system air filters should be inspected every week and cleaned as needed. The air filter is
located in a slot at the bottom left side of the system. If you decide to clean the air filters with
soap and water, you may want to install a spare filter while the other filter is drying. Additional
air filters can be ordered from Philips.

WARNING
Before performing maintenance or cleaning, always turn off the system, and then disconnect
the system from the wall outlet.

EPIQ 7 User Manual 4535 617 25341 291

System Maintenance Cleaning and Maintaining the System

CAUTION
Turn off power before you remove the air filter. Do not turn on power without the air filter
installed.

CAUTION
Ensure that air filter is dry before installing it. Installing a wet or damp air filter can damage
the system.

1. Locate the air filter handle at the bottom of the left side of the system.
2. Pull the air filter handle straight out, until the filter is completely removed from the system.
3. Inspect the filter. Depending on the condition of the air filter, vacuum or rinse the filter with
water to clean it. If the filter is worn out, or cannot be cleaned, replace it with a spare.
4. To reinstall the filter, slide the filter into place at the bottom of the left side of the system.

292 EPIQ 7 User Manual 4535 617 25341

Cleaning and Maintaining the System System Maintenance

Removing the System Air Filter

Specifying and Resetting the Air Filter Maintenance Status

1. Press Support.
2. In Philips SupportConnect, click Test/Utilities.
3. Click Check Filter Status.
4. To change the cleaning interval for the air filter, under Filter Cleaning, type the number of
days in Interval.
5. To reset the interval after cleaning the filter, under Filter Cleaned, click Done.
6. To exit SupportConnect, touch Close.

Transducer Maintenance
Transducers require proper care, cleaning, and handling. Reasonable care includes inspection,
cleaning, and disinfection or sterilization, as necessary.

EPIQ 7 User Manual 4535 617 25341 293

System Maintenance Printer and DVD Recorder Maintenance

Inspect the transducer cable, case, and lens before each use. Check for cracks or other damage
that jeopardizes the integrity of the transducer. Report any damage to your Philips customer
service representative, and discontinue use of the transducer.
For all information on transducer cleaning and disinfection, see the “Transducer Care” section.
For all information about the use of acoustic coupling gels, see “Ultrasound Transmission Gels”
on page 184.

CAUTION
Some ultrasound coupling gels, as well as some solutions for precleaning, disinfecting, and
sterilizing can damage a transducer. Before using a gel or solution on a transducer, see
“Ultrasound Transmission Gels” on page 184 or the “Transducer Care” section. You can also
contact your local Philips representative. For contact information, see “Customer Service” on
page 22.

If you encounter poor image quality or transducer problems, see “Troubleshooting” on page
295.

Printer and DVD Recorder Maintenance

Before performing any maintenance on a device, observe the following warnings and cautions:

WARNING
If the device is internal to the system, turn off the system and disconnect the system from the
wall outlet. If the device is external to the system, disconnect the device from the wall outlet.

CAUTION
Do not scratch the roller or allow dirt and dust to contact the roller of a printer.

CAUTION
Do not use strong solvents such as thinner or acetone, or abrasive cleaners, because those
will damage a device cabinet.

294 EPIQ 7 User Manual 4535 617 25341

Troubleshooting System Maintenance

CAUTION
Do not unplug the system from the wall outlet until the system is completely off. If you
unplug your system before the shutdown message appears, you will have to wait longer than
usual to use your system the next time you turn it on. You may also corrupt files, which can
result in an inoperative system or the loss of patient data.

Periodically clean the external surfaces of a device with a soft cloth. Difficult stains may be
removed with a cloth lightly dampened with a mild detergent solution.

Troubleshooting
If you encounter difficulty in the operation of the system, use the information here to help
correct the problem. If the problem is not covered here, contact your Philips representative.
The troubleshooting table contains a list of symptoms and the actions to take to correct the
problems.
Troubleshooting
Symptoms Corrective Action
The system does not power up. The monitor indicator 1. Verify the power connections.
light is off. 2. Check the circuit breaker on the back of the system.
No image displays on the monitor. 1. After power up, the system takes about 20 seconds to
initialize. During this time the monitor is blank.
2. After 20 seconds, adjust the monitor brightness.
3. Check the monitor cables and connections.
No audio comes from the system speakers. Adjust the volume to ensure that the speakers are not
muted.
An error message is displayed. Run the system test (see “Testing the System” on page
297).
An error message indicates that the system is above 1. Click Continue. The system will power down
normal operating temperature. automatically in 30 minutes.
2. With power off, check for obstructed air filters (see
“Cleaning the System Air Filter” on page 291).

EPIQ 7 User Manual 4535 617 25341 295

System Maintenance Error Messages

Error Messages
The system displays error messages in response to operating or error conditions detected by
the system.
The error messages must be noted and reported to your Philips representative, who may ask
you to run the system test (see “Testing the System” on page 297).

Test Patterns
Two sets of test patterns are available for testing the image quality of the system, peripheral
devices, review stations, or a PACS.
• The original set of test patterns (labeled Test Patterns) includes images intended for a
variety of tests. Unlike the TG-18 test patterns, however, these test patterns are not tied to
a unified standard.
• The newest set of test patterns was created by the American Association of Physicists in
Medicine Task Group 18 (TG-18). The TG-18 test patterns on the system were adapted for
the 1024 x 768 pixel image area of the 54.6-cm (21.5-in) system monitor. For information
on using these test patterns, read IEC publication 61223-3-6 (62B/588/CD).

Transferring the Test Patterns

The test patterns are stored on a separate part of the system hard drive. You must transfer the
test patterns to a different part of the hard drive before you can view them. The transferred
test patterns remain unless you delete them.
1. Press Review.
2. Select Test Imgs from the Source menu.
3. Select TG18 Test Patterns or Test Patterns from the exam selection list.
4. Click Send To HD. A status message indicates that the transfer is in progress.

Using the Test Patterns

1. Press Review.
2. On the Source menu, select Hard Drive.
3. Select TG18 Test Patterns or Test Patterns from the exam selection list.
4. Click Display Exams and do any of the following:

296 EPIQ 7 User Manual 4535 617 25341

Testing the System System Maintenance

• To send a test pattern to a local printer, double-click a test pattern to display it full-
screen, and touch Alt Print.
• To send a test pattern to a DICOM printer or archive server, click a test pattern
number to select it, click Send To, select a device, and click OK.

Testing the System

The system test is a comprehensive test of the system operational status. This test includes
numerous subtests. If a subtest fails, the system completes the remaining subtests. The system
test displays only a pass-fail result on the system monitor. If the system test fails, notify your
Philips service representative.
Run the system test any time a system error is displayed, or if you suspect problems with the
system. If an error message is displayed during the test, restart the system with the (On/
Off) control.

NOTE
The system test can take several minutes to run.

1. Turn on the system.

2. Disconnect all transducers from the system.
3. Press Support.
4. In Philips SupportConnect, click the Test/Utilities tab.
5. Under Navigator, click System Test.
6. In the System Test area, click Run. The system displays a message when the test is
complete, indicating whether the test passed or failed.
7. If the test fails, contact your Philips service representative for instructions about how to
export the log files.
8. Restart the system as explained in “Turning the System On and Off” on page 113.

For Assistance
If you are unable to correct a problem, call your local Philips representative.

EPIQ 7 User Manual 4535 617 25341 297

System Maintenance For Assistance

298 EPIQ 7 User Manual 4535 617 25341

Specifications

15 Specifications
Philips reserves the right to change specifications contained herein or discontinue manufacture
at any time without prior notice. Current specifications are supplied with each system
purchased or are available from your Philips representative.

Dimensions
• Width: 59.2 cm (23.3 in)
• Height (with fully extended monitor): 188.6 cm (74.25 in)
• Height (with monitor folded down): 125.7 cm (49.5 in)
• Depth (Maximum extension): 111.8 cm (44 in)
• Depth (Minimum extension): 79.4 cm (31.25 in)
• Weight: 102 kg (225 lb)

Gray Shades
255 in 2D, M-mode, and Doppler

Scan Lines
Up to 1,024 scan lines, depending on transducer and mode

Monitor
• 54.6 cm (21.5 in) flat-panel monitor on a tilt/swivel arm
• 128 hues of color available
• 24-bit color

Input Signals
• Four transducer receptacles
• Pencil probe receptacle
• Physio pulse, phono, auxiliary 1, and auxiliary 2
• High- and low-level ECG

EPIQ 7 User Manual 4535 617 25341 299

Specifications

Output Signals
• External printer
• USB serial data
• Video: S-Video, and Digital DisplayPort
• Physio analog signal

Data Connections
• Ethernet network (Gigabit, 10Base-T, and 100Base-T)
• Wireless network (IEEE 802.11 b/g)
• USB 3.0 devices at USB 2.0 speeds
• Digital Navigation Link (DNL)

Modality Interface
DICOM standard. DICOM conformance statements for Philips products are available at this
website:
www.healthcare.philips.com/us/about/connectivity/dicom_conformance_main.wpd

Physio
• ECG amplitude range between 0.15 mV and 5.0 mV
• Duration of the QRS wave between 40 ms and 120 ms
• Lower Frequency Cut-off: 0.70 Hz ±10%
• Upper Frequency Cut-off: 17 Hz ±10%
• Nominal Input Amplitude: ±5 mV peak
• Minimum QRS Wave Amplitude: 0.05 mV

Peripherals
• Black-and-white image printer
• Foot switch
• Color image printer
• DVD recorder
• Report printer
• External monitor

300 EPIQ 7 User Manual 4535 617 25341

Specifications

Electrical Parameters
AC Voltage
• AC voltage 100-240 V~
• 50 or 60 Hz
• 600 VA
Power must be available through a grounded outlet.
In the United States, power must be available through a grounded, hospital-grade outlet.

Languages
Localized user interface (including international symbols on key caps) and Help:
Danish German Spanish
Dutch Italian Swedish
French Norwegian

Localized documentation, other than Help:

Bulgarian Greek Norwegian
Chinese, Traditional and Simplified Hungarian Polish
Czech Indonesian Portuguese (Brazilian)
Danish Italian Romanian
Dutch Japanese Russian
Estonian Kazakh Slovak
Finnish Korean Spanish
French Latvian Swedish
German Lithuanian Turkish

Pressure Limits
• Operating: 525 mmHg to 795 mmHg (700 hPa to 1,060 hPa)
• Storage: 427 mmHg to 795 mmHg (570 hPa to 1,060 hPa)

Humidity Limits
• Operating: 15% to 80%
• Storage: 15% to 95%

EPIQ 7 User Manual 4535 617 25341 301

Specifications Safety and Regulatory Requirements

Temperature Limits
• High operating temperature: 40°C (104°F) between 1060 hPa and 795 hPa (795 mmHg to
596 mmHg), linearly decreasing to 35°C (95°F) at 700 hPa (525 mmHg)
• Low operating temperature: 10°C (50°F) from 700 hPa to 1060 hPa (525 mmHg to
795 mmHg)
• Storage temperature range: -20°C to 60°C (-4°F to 140°F)

Safety and Regulatory Requirements

Classification
• Class I equipment with Type BF and Type CF applied parts
• Ordinary Equipment/Continuous Operation
• Non-AP/APG

Electromechanical Safety Standards Met

The system complies with the requirements of IEC 60601-1 Medical Electrical Equipment,
General Requirements for Safety, including all applicable collateral and particular standards, as
well as all applicable national deviations.

Compliance
Philips products comply with relevant international and national standards and laws.
Information on compliance will be supplied by your local Philips representative, or the
manufacturer, on request.

302 EPIQ 7 User Manual 4535 617 25341

Index

16 Index
Numerics Allergic reactions to latex, 49
2D distance measurement, 168 Analysis, 167
3D Analysis applications, 86
acoustic artifacts, 181 Applications
imaging options, 85 analysis, 86
clinical, 86
A
Applications, clinical, 86, 152
Accessories, 21
Artifacts, 179, 181
Accessories, electromagnetic compliance, 73
Assistance, 22, 297
Acoustic artifacts, 179, 181
Audience, intended, 15
Acoustic coupling medium, 184, 255
Audio, troubleshooting, 295
Acoustic output limits, 50
Auto Freeze function, 140
Acoustic output measurement, 60, 63
Auto-Cool, 228, 229, 231
Acoustic output tables, 18, 54, 63
Acquisition status, 129 B
Adjusting Battery indicators, 132
control panel, 121 Battery operating time, 130
monitor, 116 Biological safety, 46
Air filter, cleaning, 291 Biopsy
ALARA principle endocavity, 243
applying, 50 guideline display, 247
education program, 50 maintaining guides, 254
example, 50 procedure, 252
related guidance documents, 60 safety precautions, 46, 245
Alcohol, restricted use on transducers, 264 Biopsy guides, 245

EPIQ 7 User Manual 4535 617 25341 303

Index

alignment verification, 249 Cautions, described, 27

attaching, 245 CD, loading and ejecting, 144
Biopsy needle, releasing, 252 CD, User Information, 17
Bite guards, 233 Changing setups, 151
Body markers CIVCO Medical Solutions, 21
displaying, 161 Cleaning
Brakes air filter, 291
S7-3t transducer, 220 cables, 258
system, 115 control panel, 291
wheel, 34, 99 ECG equipment, 287
X7-2t transducer, 213 printers, 294
system surfaces, 287
C
system, cables, and connectors, 287
C10-3v transducer, 241
trackball, 291
C10-4ec transducer, 241
transducers, 258
Cables
Cleaning solutions, 277, 278
approved for electromagnetic
Clinical applications, 86, 174
compliance, 72
Comments
cleaning, 258, 287
customer, 21
cleaning and disinfecting, 261
Compatibility
protecting from damage, 34, 36, 106,
261, 287 disinfectants, 276
Calculations, 167 gels, 184
Capabilities, system, 83 media, 143
Capillary rupture, 46 product, 37
Capturing Compliance, electromagnetic
images, 165 approved accessories, 73
loops, 165 approved cables, 72

304 EPIQ 7 User Manual 4535 617 25341

Index

approved transducers, 73 receiver controls, 50

Components, system, 88 Conventions
Condensation, 36 product, 18
Configuring system, 18
local printers, 104 user information, 19
Connecting an external DVD recorder, 105 Covers
Connecting an external monitor, 105 TEE transducer, 233
Connecting an external printer, 103 transducer, 46, 101, 183, 255
Connecting devices, 101 Creutzfeldt-Jakob disease, 257
Connectivity options, 85 Custom procedure
Connectors creating, 152
cleaning, 287 selecting, 153
cleaning and disinfecting, 261 Customer comments, 21
Control panel Customer service, 22
adjustments, 121 Customizing the system, 147
cleaning, 291
D
Depth control, 122
Data connections specifications, 299
Controls
Data ports, 93
control panel, 18, 119
Data security, 88, 133
S7-3t transducer, 220
Data storage, 93, 143
TEE transducers, 207, 215, 221, 222
Date and time, setting, 114
touch screen, 19
Default transducer and preset, 148, 174
trackball, 126
Defibrillation, electrical safety, 30, 33
X7-2t transducer, 211, 213
Deflection controls
Controls affecting MI and TI
S7-3t transducer, 220
direct controls, 50
TEE transducer, 207
indirect controls, 50

EPIQ 7 User Manual 4535 617 25341 305

Index

X7-2t transducer, 211, 213 Distance measurements

Depth M-mode, 169
biopsy guide and distance relationships, performing, 168
250 Doppler
control settings, 122 measuring velocity, 169
moving biopsy depth cursor, 248 velocity on live image, 169
Device class, 29 Doppler velocity minus sign, 151
Devices, connecting, 101 DVD
DICOM viewer, 146 erase, 144
Dimensions, system, 299 image acquisition and review, 84
Disinfectants, 278 loading and ejecting, 144
compatibility, 276 media compatibility, 143
factors affecting efficiency, 278 using, 144
safety, 255 DVD drive, 93, 143
types, 277 DVD drive status, 130
Disinfecting DVD recorder
cables and connectors, 261 connecting, 105
system surfaces, 289 status, 130
TEE transducers, 270 using, 162
transducers, 266, 268, 270
Disinfection E

by immersion, 266 ECG

with wipes and sprays, 264 equipment, cleaning, 287

Display dimming, 119 receptacles, 98, 143

Display, avoiding damage, 36 signal requirements, 70

Disposable drape, 192, 234 Ejecting a CD, 144

Disposal of system, 22 Ejecting a DVD, 144

306 EPIQ 7 User Manual 4535 617 25341

Index

Electrical parameters, 299 starting, 139

Electrical safety, 29 Endocavity studies, 239
Electrical safety tests Endocavity transducers
TEE transducer, 237 biopsy guides, 243
TEE transducers diagram, 234 C10-3v, 241
Electrical safety, intraoperative transducers, C10-4ec, 241
192 operator qualifications, 239
Electromagnetic compatibility, 68 overview, 239
Electromagnetic compliance patient safety, 239
approved accessories, 73 patient-contact parts, 242
approved cables, 72 preparing for imaging, 240
approved transducers, 73 transducer covers, 240
Electromagnetic emissions Equipment protection, 36
defined, 68 Erase DVD, 144
environment, 71 Error messages, 46, 296
Electromagnetic immunity ESD precautions, 70
defined, 68 Exams
system environment, 74 ending, 170
Electromagnetic interference entering patient data, 156
avoiding, 81 new, 155
distance to transmitters, 79 Explosion hazard, 16, 29
types, 77 External monitor port, 95
Electromagnetism, 32 External printers, 102, 103
Electrostatic discharge (ESD), 70
Electrosurgical units (ESUs), 32 F

Emergency studies False needle image, 252

about, 138 Fire hazard, 31

EPIQ 7 User Manual 4535 617 25341 307

Index

Fire safety, 34 High level disinfection, 263

Foot switch HIPAA, 84
connecting, 105 Humidity limits, 299
warning, 65
I
Freezing an inactive system, 140
Icons
Full screen image view, 165
battery indicators, 132
G imaging display, 135
Gain control, ECG, 143 status icons, 129
Gels trackball, 126
compatibility, 184 IEC symbols, 38
endocavity studies, 240 Image review, 164
intraoperative studies, 189 Image title, adding, 161
recommendations, 184 Image updating, inconsistent, 46
Glutaraldehyde exposure, 66 Images
Gray shades specification, 299 acquiring, 84, 165
capturing, 165
H
false needle, 252
Hard drive, 93
troubleshooting the display of, 295
Hazards
Imaging
electrical shock, 29, 30, 31
acoustic artifacts, 179, 181
explosion, 16, 29
display, 135
fire, 31
options, 85
IEC symbols, 38
Imaging display
Help, 18
image area, 136
Hiding Doppler minus sign, 151
patient bar, 136
Hiding Doppler signs, 151
tools and icons, 138
Hiding, patient name/ID, 157

308 EPIQ 7 User Manual 4535 617 25341

Index

Indications for use, 176 Isopropyl alcohol restrictions, 264

Indices, 54
K
Infection control, 66
Keyboard
Input signals, 299
retractable, 128
Inspection, 223
touch screen, 128
Intended audience, 15
Intended use, 15 L
Interference, 77, 81 L15-7io transducer, 190
Intraoperative applications, 183, 255, 273 Labeled measurements, 169
Intraoperative transducers, 187 Labels
accessories, 192 adding, 159, 161
checking the transducer, 190 image title, 161
description, 190 Languages, 299
disposable drape, 192, 234 Latex
electrical safety, 192 allergic reactions, 49
intended uses, 187, 188 bite guards, 46
L15-7io, 190 in Philips products, 256
leakage current testing, 193, 196, 197 patient-contact parts, 189, 204, 242
misuse, common problems, 190 sensitivity, 189, 204, 242
operator qualifications, 187 transducer covers, 46
patient safety, 188 Leakage current, 31
patient-contact parts, 189, 204 intraoperative transducers, 193, 196, 197
preparing for imaging, 191 TEE transducers, 204, 206
transducer covers, 191 Live images
iSCAN printing, 163
status, 129 Loading
Isolation transformers, 31, 101 CDs, 144

EPIQ 7 User Manual 4535 617 25341 309

Index

DVDs, 144 QLAB software, 86

Lock, S7-3t transducer, 220 tools, 83
Lock, X7-2t transducer, 213 types, 83
Logging off of the system, 133, 134 unlabeled, 170
Logging on to the system, 133 Measure-then-label method, 170
Loops Mechanical index (MI), 54
acquiring, 165 controls affecting, 58
capturing, 165 display, 54
Low level disinfection, 258 display precision and accuracy, 54
on-screen, 54
M
Mechanical safety, 34
Maintenance
Media compatibility, 143
printer, 294
Medical Ultrasound Safety, 18
system, 287
Messages, error, 46, 296
transducers, 178, 293
MI, 54
Matrix transducers, 177
MI and TI accuracy estimates, 54
Measurement tools, 83
Microphone status, 129
unlabeled, 170
M-mode
Measurements, 167
distance, 169
acoustic, 60
measurements, 169
biopsy depth, 250
Modality interface specification, 299
biopsy depth cursor, 248
Modality Worklist
distance, 168
searching for exams, 157
Doppler distance (velocity), 169
selecting patient, 156
labeled, obtaining, 169
Monitor
live Doppler velocity, 169
adjustments, 116
M-mode, 169
description, 90

310 EPIQ 7 User Manual 4535 617 25341

Index

external, connecting, 105 system, 84, 152

precautions when positioning, 34 Ordering supplies and accessories, 21
specifications, 299 Output display, 54
troubleshooting, 295 Output signals, 299
Moving the biopsy depth cursor, 248 Output tables, acoustic, 18, 54, 63
Moving the system Overview, system, 83
confined spaces, 111
P
safety precautions, 34, 106
Pacemakers, 30
setting up after, 112
Passing system to others, 22
Multiple-angle biopsy guides, 252
Password protection, 88
N Passwords, 133
Needle guides, 245 Patient contact temperature, 173
Network Patient data
status, 130 creating a custom procedure, 152
status icon, 130 entering, 156
Network Packet Capture (NPC) status, 129 hiding name and ID, 157
Network ports, 95 protecting, 84, 88
Network status, 130 security, 84
selecting a custom procedure, 153
O
setups, 152, 153
On/Off control, system power, 39, 113
Patient ID, hiding, 157
Operating notes, 17
Patient name, hiding, 157
Operating temperature, 36, 299
Patient temperature
Operator safety, 65
entering, 231
Options
overview, 231
connectivity, 85
Perchlorate information, 22
imaging, 85

EPIQ 7 User Manual 4535 617 25341 311

Index

PercuNav, 88 Preventricular contractions, 46

Peripherals Printers
bay, 95 adding, 104
specifications, 299 configuring, 104
Philips contact information, 22 maintaining, 294
Phono (ECG) port, 95 supported models, 102
Physio, 143 types, 163
receptacles, 98 Printing
Physio specifications, 300 about, 163
Physio trace status, 129 live images, 163
Positioning system in confined spaces, 111 status, 130
Power Problems, correcting, 295
peripherals, 30, 101 Procedure setup, 152
troubleshooting, 295 Product compatibility, 37
Power (On/Off) control, 92 Product conventions, 18
Power management, 130 Protection against system damage, 36
Presets Protocols, Stress Echo, 87
clinical applications, 148
Q
copying, 149
QLAB Advanced Quantification Software
creating, 149
options, 86
deleting, 149
Quick Save presets, 148
loading, 150
overview, 147 R
Quick Save, 148 Radio-frequency emissions, 69
selecting, 143 Receptacles
setting default, 148, 174 ECG, 98
Pressure limits, 299 physio, 98

312 EPIQ 7 User Manual 4535 617 25341

Index

transducer, 96, 140, 173 acoustic output and measurement, 60

Recording ALARA principle, 50
DVD recorder, 162 basic, 27
status, 130 biological, 46
Recycling information, WEEE, 22 biopsy, 46, 245
Regulatory requirements, 302 defibrillators, 33
Releasing biopsy needles, 252 electrical, 29
Remote User status, 129 electromagnetic emissions and
Repetitive strain injury, 65 immunity, 68

Report printers, 102 electrosurgical units, 32

Restrictions for use, 81 endocavity studies, 239

Review endocavity transducers, 239

image view, 165 equipment protection, 36

measuring in, 164 fire, 34

navigating, 165 general warnings, 16

overview, 164 guidance documents, 60

starting, 164 intraoperative studies, 188

thumbnail view, 165 mechanical, 34

mechanical index, 54
S medical ultrasound, 18
S7-3t transducer moving the system, 34, 106
array rotation, 221, 222 operator, 65
deflection controls, 218 output display, 54
description, 216 pacemakers, 30
manipulating the tip, 220 patient, intraoperative transducers, 188
using, 217 symbols, 38
Safety, 27 TEE transducers, 200

EPIQ 7 User Manual 4535 617 25341 313

Index

thermal index, 54 gray shades, 299

Safety requirements, 302 humidity limits, 299
Scan lines specification, 299 input signals, 299
Security languages, 299
data, 84, 88 modality interface, 299
logging on, 133 monitor, 299
Selecting objects, 18 output signals, 299
Selecting presets, 143 peripherals, 299
Selecting transducers, 142, 158, 173 physio, 300
Send on Demand pressure limits, 299
status, 129 safety requirements, 302
Separation distance, 79 scan lines, 299
Service, customer, 22 temperature limits, 299
Settings Spongiform encephalopathy, 257
customizing, 147 Starter kits, ordering biopsy, 245
Setups Static shock, 70
changing, 151 Status icons, 129
overview, 150 Steering locks, system wheels, 99, 115
Shock hazards, electrical, 29 Sterilization, transducers, 273
Single-angle biopsy guides, 252 Storage temperature, 299
Sleep Mode, 130, 131 Storage, data, 93, 143
Solutions, cleaning, 277 Storing transducers, 185
Solvents, 36 daily and long-term, 186
Specifications for transport, 185
data connections, 299 Stress Echocardiography, 87
dimensions, 299 Supplies, 21
electrical parameters, 299 Surfaces, disinfecting system, 289

314 EPIQ 7 User Manual 4535 617 25341

Index

Symbols about, 199

definitions, 38 accessories, 233
warning, 17 Auto-Cool, 229, 231
System cleaning, 287, 290 avoiding problems, 204
System conventions, 18 bite guards, 233
System error messages, 296 controls, 207, 213, 215, 220, 221, 222
System maintenance, 287 controls inspection, 223
System options correcting tip fold-over, 227
about, 152 covers, 233
lists, 84 disinfecting by immersion, 270
System setups disinfecting in automated disinfector,
changing, 151 273

overview, 150 disposable drape, 192, 234

System testing, 297 electrical safety, 205

System upgrades, 21 electrical safety test, 234, 237

ensuring safe temperatures, 229
T entering patient temperature, 231
Tables, acoustic output, 18, 63 inspection, 223
Technical support, 297 leakage current, 204, 206
TEE studies operator qualifications, 199
avoiding esophageal damage, 225 patient care, 232
guidelines, 225 patient safety, 200
patient care, 232 patient temperature, 231
patient selection, 224 patient-contact parts, 189, 204
preparing patients, 225 recognizing tip fold-over, 226
special considerations, 223 reducing risks, 206
TEE transducers references, 238

EPIQ 7 User Manual 4535 617 25341 315

Index

S7-3t, 216, 217 on-screen, 54

S7-3t deflection controls, 218 using appropriate for application, 54
supplies, 233 Thumbnail view, 165
temperature sensing, 228, 229 TI, 54
tip fold-over, 226 TI and MI values, 58
tip protector, 234 Time and date, setting, 114
X7-2t, 209, 210 Tip fold-over, 226
Temperature limits, 299 correcting, 227
Temperature sensing, 228 recognizing, 226
Temperature, Auto-Cool, 229 Tip protector, TEE transducer, 234
Temporary ID Tools, measurement, 83
overview, 139 unlabeled, 170
using, 139 Touch screen, 122
Test patterns controls, 124
about, 296 layout, 123
transferring, 296 Trackball
using, 296 annotation, 159
Testing leakage current controls, 18, 126, 159
intraoperative transducers, 193, 196, 197 icon, 126
TEE transducers, 206, 237 Trackball, cleaning, 291
Testing the system, 297 Transducer connectors, cleaning, 287
Text entry, 18 Transducer maintenance, 178, 293
Thermal index (TI), 54 Transducers
controls affecting, 58 affecting TI and MI values, 58
display precision and accuracy, 54 care, 178, 255, 293
displays, 54 cleaning, 255
modes of operation, 54 cleaning procedures, 258

316 EPIQ 7 User Manual 4535 617 25341

Index

clinical applications, 174 using, 173

connecting, 142, 158, 173 Transesophageal transducers, 199
covers, 46, 183, 255 Transferring the system to other users, 22
disinfectants compatibility, 276 Transformers, isolation, 31, 101
disinfecting, 255, 263 Transmissible spongiform encephalopathy,
disinfecting by immersion, 266 257

disinfecting with wipes and sprays, 264 Transporting the system

electrical safety, 30 safety precautions, 106

electromagnetic compliance, 73 setting up after, 112

endocavity, 239 Troubleshooting, 295

gels compatibility, 184 Turning the system on and off, 113

immersing for disinfection, 268

U
indications for use, 176
U.S. Health Insurance Portability and
inspecting for damage, 30, 245 Accountability Act (HIPAA), 84
intraoperative, 187 Ultrasonic bioeffects, related documentation,
isopropyl alcohol, 264 60

isopropyl alcohol restrictions, 264 Ultrasound transmission gel

maintenance, 178, 293 compatibility, 184

matrix array, 177 endocavity studies, 240

receptacles, 96, 140, 173 intraoperative studies, 189

selecting, 142, 158, 173 recommended, 184

setting default, 148, 174 Upgrades, system, 21

sterilizing, 255, 273 USB devices

storage, daily and long-term, 186 location, 145

storage, for transport, 185 overview, 143

storing, 185 warnings and cautions, 145

transesophageal, 199 USB ports, 95

EPIQ 7 User Manual 4535 617 25341 317

Index

User information X
about, 15 X7-2t transducer
components, 17 controls, 211, 213
conventions, 19 description, 209
User Information CD, 17 manipulating tip, 213
parts, 210
V
rotating image plane, 215
Verifying biopsy guide alignment, 249, 250
xMatrix array transducers, 177, 178, 209, 210
Video monitor, 90
Voltage precautions, 36
Volume control, troubleshooting, 295

W
Warning symbols, 17, 38
Warnings
described, 27
general, 16, 27
Waste Electrical and Electronic Equipment,
European Union Directive, 22
Website, Philips, 22
WEEE recycling information, 22
Wheel brakes, 34, 99
Wheels, 34, 106
Worklist
searching for exams, 157
selecting patient, 156

318 EPIQ 7 User Manual 4535 617 25341