Sensis Vibe VD12 FFR and Resting Indices Calculations Job Aid

SIEMENS Healthineers FFR and Resting Indices Calculations (Pd/Pa, dPR) Job Aid Sensis Vibe VD12 Template Effective Date: 05/27/2019 | HOOD05162003010284 1 Job Aid Effective Date: 06/26/2020 | HOOD05162003098049 Unrestricted © Siemens Healthineers, 2020 Table of Contents SIEMENS Healthineers FFR and Resting Indices (Pd/Pa, dPR) Calculations 3 FFR and Resting Indices (Pd/Pa, dPR) Calculations Workflow 6 SIEMENS Note: The product and/or features here mentioned may not be commercially available in all countries. Due to regulatory reasons their future availability cannot be guaranteed. Please contact your local Siemens Healthineers organization for further details. 2 Effective Date: 06/26/2020 | HOOD05162003098049 Unrestricted © Siemens Healthineers, 2020 Fractional Flow Reserve (FFR), Resting Pd/Pa and Diastolic SIEMENS Healthineers Pressure Ratio (dPR) Calculation .................................................................................................................................... Invasive FFR FFR is done during maximal blood flow, induced by continuous infusion of vasodilating drugs, like e.g. adenosine. Non-hyperemic Pressure Ratios (NHPR´s): Purpose: Resting Pd/Pa Identify hemodynamically Resting Pd/Pa calculates the entire cardiac cycle at rest. relevant coronary lesions to FFR guide coronary revascularization. dPR dPR calculates Pd/Pa during the diastole of the next five heart beats. iFR and the others iFR calculates Pd/Pa a specific period of the diastole. The so-called wave-free period. 3 Effective Date: 06/26/2020 | HOOD05162003098049 Unrestricted © Siemens Healthineers, 2020 Fractional Flow Reserve (FFR), Resting Pd/Pa and Diastolic SIEMENS Healthineers Pressure Ratio (dPR) Calculation FFR= Fractional Flow Reserve Pa FFR = Distal Coronary Pressure (Pd) max Proximal Coronary Pressure (Pa) Pd (During Maximum Hyperemia) Pd = distal pressure Pa = aortic pressure Pd/Pa + hyperemia = FFR • Fractional flow reserve is defined as the pressure after (distal to) a stenosis relative to the pressure before (proximal to) the stenosis. • FFR is done during maximal blood flow (hyperemia), by injecting vasodilating medication such as Adenosine or Papaverine. 4 Effective Date: 06/26/2020 | HOOD05162003098049 Unrestricted © Siemens Healthineers, 2020 FFR and Resting Indices Calculations (Pd/Pa and dPR) SIEMENS Healthineers A pre-defined setup allows for an automatic FFR, Resting Pd/Pa or dPR calculation and waveform display. HR 18 11 12-15:2 • During FFR, Resting Pd/Pa or dPR measurement, the distal 60 Review Real Time 18 11 12-15270 11/18/1858 Calculate Pressures P2_FFR 5mm (Pd) and proximal (Pa) pressure signals are measured and 127 / 69 Wonow Suppon 3 33:09 PM Pd 60 Pa 95 the value is calculated from the ratio Pd/Pa. AO 1. Rest 0.63 LCX AO 200 200 Vital Signs Editing of either calculated value is possible through the 127 / 69 LCX 200 180 180 • LCX 160 160 Resting Recording respective Event Properties dialog box. 0.63 140 140 120 120 Post Processing |Hemodynamics Heme Calculation A FFR, Resting Pd/Pa or dPR event can be manually Resting Pd/Pa 0.63 100. 100. • FFR AA M 80 60 entered for values measured by a non-integrated third- 40 40 Realtime 1.00 20 20 party system for final documentation. P.P. Tools O Timer 02:00 View P.P. T Choose your approach correctly. Q CH +Q Event - SpO2 . Time Due to values and corresponding indices, the acquired re 95 % Documentation Pre Cat Data Summary *** Performing Physicians Resting Papa | Rest PoPa Value : 0.63 | Pt. Pa: [AO: 95 ] [ mmHg][P2Pd: | LCX : 60 ][ mmHg ] [ (Pa-Pd) : 35[ mmá-lo ] | Duration 3:34.00 PM* Personnel Vital Sign Alarm Settings( Alarms/Type : Active(Adult | HR : On.On:45.120 [ bom ]| Sp02: OS [ % ]| Resp : Off | breaths/min ]| EICO2 3:27:16 PM Case Times Condition Changed 3:27:15 PM sult could be a false positive or false negative. Patient/Procedure Status New Condition| Name : Rest 3:27:15 PM Procedure Checklist LOC Score Pre Allergies Vital Signs Pre MVFluid Status 5 Effective Date: 06/26/2020 | HOOD05162003098049 Unrestricted © Siemens Healthineers, 2020 FFR and Resting Indices Calculations (Pd/Pa and dPR) SIEMENS Healthineers Workflow Preparing the pressure wire system: Prior to inserting into the artery, ensure that the pressure wire system is balanced to the atmospheric Connect the pressure wire system to the HemoBox pressure (“Zero“). (P1/P2 or P3/P4). Patient Applications quire Input Tools Options SENSIS VIBE Review Real Time Zero RCA LAD CX 12345678 Other 1 2/1 2/1 950 Equalize Start Rest PdsPa Start FF Balance Pressure P2_Lesion_Ly 12.5 mm/s Setup Workflow Support Lesion_Index Cx Hemodynam .. Current Condition AO 1. Rest New 200 200 [Cx -200 B 180 180 P1/P2 ECG Vital Signs 160 160 140 140 START Balance Pressure Transducers Recording 120 120 Post Proces. Signals Balancing pressure 100 100 REC mmHg 80 80 Hemo Calculation P1:AO 60 60 17 P3/P4 SpO 2 40 40 +0+ P2:LCX 55 20 20 O O P3 IP4 Tools P./P. 1 CO Balance Close NBP Ex-+1 Q Ctrl + Q Events Results Event: - Pre Cath Data Summary - Time View Performing Physicians Condition Changed 11:26:42 AM Personnel Vital Sign Alarm Settings| Alarms/Type : Active/Adult | HR : On:On:45:120 [ bpm ]| S 11:26:42 AM Case Times Condition Changed 11:05:09 AM Documentation Patient/Procedure Status Vital Sign Alarm Settings| Alarms/Type : Active/Adult | HR : On:On:45:120 [ bpm ]| S 11:05:09 AM T1/T2 EtCO 2 Microstream Procedure Checklist Condition Changed 11:03:04 AM Vital Sign Alarm Settings| Alarms/Type : Active/Adult | HR : On:On:45:120 [ bpm ]| S 11:03:04 AM LOC Score Pre Vital Sign Alarm Settings| Alarms/Type : Active/Adult | HR : On:On:45:120 [ bpm ]| S. 11:02:00 AM Allergies Condition Changed 11:01:34 AM Storage: 522:00 Lesion Index Setup Loaded 11:29:12 AM 6 Effective Date: 06/26/2020 | HOOD05162003098049 Unrestricted © Siemens Healthineers, 2020 FFR and Resting Indices Calculations (Pd/Pa and dPR) SIEMENS Healthineers Workflow Place the pressure wire system at the reference Initiate Equalize. position, so that the two sensors are reading values Accept or Reject → Accept 1 from the same site to prepare for equalization. Patient Applications Edit View Acquire Input Tools Options He TEST Real Time Zero RCA LAD CX 120 12Q 123456 Male 09/1 2/196 Equalize FR Start Balance Pressure P2_Lesion_I .. Y 12.5 mm/s Setup 100 100 Workflow Support ++Ho Lesion_Index RCA- Hemody nam ... 80 80 Current Condition 1. Rest New Thr To 1200 200 RCA~200 B 180 180 60 60 Vital Signs 160 160 140 140 START Post Proces ... 40 40 Recording AA A 1.20 120 Equalize Pressures 100 100 20 20 REC 80 Hemo Calculation 60 60 AA M. Offset is 0.11 mmHg 0 0 +0+ 40 40 1 To equalize again, click Reject. 20 20 O O Tools P /P. 1 Accept Reject H Q Ctrl + Q Events Results Event - Flowsheet Summary - Time View Personnel Vital Sign Alarm Settings| Alarms/Type : Active/Adult | HR : On:On:45:120 [ bpm ]| S .. 2:41:42 PM Premedication Condition Changed 2:41:42 PM Indications Vital Sign Alarm Settings| Alarms/Type : Active/Adult | HR : On:On:45:120 [ bpm ]| S. 2:40:11 PM Documentation Allergies Condition Changed 2:40:11 PM Coagulation Time Coagulation Time | ACT Type:_ | ACT Value (sec): 70 2:20:38 PM Vital Sign Alarm Settings| Alarms/Type : Active/Adult | HR : On:On:45:120 [ bpm ]| S. 2:20:17 PM EN Procedure Condition Changed 2:20:17 PM Catheter Allergies | Allergies: Aspirin | Allergy from EMR: | Allergy Code: | Coding .. 2:15:20 PM 7 Effective Date: 06/26/2020 | HOOD05162003098049 Unrestricted © Siemens Healthineers, 2020 Resting Pd/Pa Workflow SIEMENS Healthineers Patient Applications Edit View Acquire Input Tools Options He Move the pressure wire to the distal portion of the TEST Review Real Time Zero RCA LAD CX 123456 lesion Male 09/1 2/1961 Equalize Rest Pd/Pa Stop P2_Lesion_I .. y 12.5 mm/s Setup Workflow Support 1. Select the Rest Pd/Pa index Lesion_Index RCA DI RICA P Hemody nam .. Current Condition 2. Initiate Start 1. Rest New 2001 200 BCA P 200 RCA D 200 B 180 180 Vital Signs 160 160 140 140 Review Real Time Zero RCA START Post Proces ... Recording AAAAAA A 120 120 100 Equalize Rest Pd/Pa Start REC F-12 80 Hemo Calculation 60 60 1 2 40 40 20 20 0 O • Recording is automatically started. Resting Pd/Pa started. DEDE . REC 2:25:40 PM Tools P./P. 1 • Resting Pd/Pa minimum value is displayed on LIVE. O® Q Ctrl + Q Events Results Event Flowsheet Summary Time Resting 0.63 Pa/Pa View Personnel FFR | FFR : 0.63 | P1:Pa : [ RCA P : 99 ] [ mmHg ] | P2:Pd : [ RCA D : 62 ] [ mmHg ] |. 3:33:32 PM* Premedication Vital Sign Alarm Settings| Alarms/Type : Active/Adult | HR : On:On:45:120 [ bpm ]| S. 2:41:42 PM Condition Changed 2:41:42 PM FFR Indications Documentation Allergies Vital Sign Alarm Settings| Alarms/Type : Active/Adult | HR : On:On:45:120 [ bpm ]| S. 2:40:11 PM Coagulation Time Condition Changed 2:40:11 PM Realtime 0.98 Coagulation Time | ACT Type: _ | ACT Value (sec): 70 2:20:38 PM PJ/P. Procedure Vital Sign Alarm Settings| Alarms/Type : Active/Adult | HR : On:On:45:120 [ bpm ]| S 2:20:17 PM Catheter Condition Changed 2:20:17 PM Timer 00:23 8 Effective Date: 06/26/2020 | HOOD05162003098049 Unrestricted © Siemens Healthineers, 2020 Resting Pd/Pa Workflow SIEMENS Healthineers Patient Applications Edit View Acquire Input Tools Options He Initiate Stop m TEST Review Real Time Zero RCA LAD CX 123456 Male 09/1 2/1961 Calculate Pressures SAI P2_Lesion_I .. y 5 mm/s Review Real Time Ze Setup . Workflow Support ! 1 10 3:34: 15 PM Lesion_Index Pd 62 Equalize Rest Pd/Pa Stop Current Condition ! Il 10 A Pa 99 RCA D RCA P Hemody nam ... 1. Rest New ! III 10 0.63 200 RCA D 200 B 200 180 180 Recording is automatically ended. Vital Signs • 60 160 st Proces ... Resting Pd/Pa Event Properties 140 140 Review tab card is active. General | Specific 120 120 • Resting Pd/Pa 0 634 100 100 80 80 Resting Pd/Pa 0.63 60 60 1. Modify by direct input or Duration (mm:ss) 00:23 1 40 40 37 20 20 (Pa-Pd) mmHg 2. Accept calculated Resting Pd/Pa O Site Mean • Resting Pd/Pa event is created in the CaseLog: P1:Pa RCA P Enter Site 99 mmHg P2:Pd RCA D Enter Site 62 mmHg FFR | FFR : 0.63 | P1:Pa : [ RCA P : 99 ] [ mmHg ] | P2:Pd : [ RCA D : 62 ] [ mmHg ] | ... 3:33:32 PM* Result Event Vital Sign Alarm Settings| Alarms/Type : Active/Adult | HR : On:On:45:120 [ bpm ]| S .... 2:41:42 PM mary - Time Condition Changed 2:41:42 PM FFR : 0.63 | P1:Pa : [ RCA P : 99 ] [ mmHg ] | P2:Pd : [ RCA D : 62 ] [ mmHg ] |. 3:33:32 PM Sign Alarm Settings| Alarms/Type : Active/Adult | HR : On:On:45:120 [ bpm ]| S. 2:41:42 PM lition Changed Resting Pd/Pa value Resting 0.63 2:41:42 PM Sign Alarm Settings| Alarms/Type : Active/Adult | HR : On:On:45:120 [ bpm ]| S. 2:40:11 PM • Pd/P. 2 lition Changed 2:40:11 PM lulation Time | ACT Type:_ | ACT Value (sec): 70 2:20:38 PM is displayed on LIVE I Print FFR Sign Alarm Settings| Alarms/Type : Active/Adult | HR : On:On:45:120 [ bpm ]| S. 2:20:17 PM OK Cancel lition Changed 2:20:17 PM Realtime 0.98 Pd/Pa 9 Effective Date: 06/26/2020 | HOOD05162003098049 Timer 00:23 Unrestricted © Siemens Healthineers, 2020 FFR Workflow SIEMENS Healthineers Move the pressure wire to the distal portion of the lesion. Patient Applications Edit View Acquire Input Tools Options He Inject vasodilating medication and document. TEST Review Real Time Zero RCA LAD CX 123456 1 Male 09/1 2/1961 Equalize FFR Stop P2_Lesion_I .. 12.5 mm/s Setup Workflow Support 1. Select the FFR index Lesion_Index ROAD ACAPA Hemodynam .. Current Condition 1. Rest New 1200 200 B 2. Initiate Start RCA b 208 180 180 Vital Signs 160 160 Review Real Time Zero RCA 140 140 START 120 Post Proces ... Recording AAAAAAAA 120 100 Ago Equalize FFR Start REC ~12 80 Hemo Calculation 60 1 2 60 40 40 20 20 O O • Recording is automatically started. FFR started. DEDAL REC 2:31:51 PM SAI Tools P./P. 1 • Current Pd/Pa value is displayed on LIVE. Q Ctrl + Q Events Results Event - Resting P.P. Flowsheet Summary Time View Personnel Vital Sign Alarm Settings| Alarms/Type : Active/Adult | HR : On:On:45:120 [ bpm ]| S 2:41:42 PM 0.63 Premedication Condition Changed 2:41:42 PM FFR Indications Vital Sign Alarm Settings| Alarms/Type : Active/Adult | HR : On:On:45:120 [ bpm ]| S 2:40:11 PM Documentation Allergies Condition Changed 2:40:11 PM Coagulation Time | ACT Type: _ |ACT Value (sec): 70 2:20:38 PM Realtime 0.63 Coagulation Time Vital Sign Alarm Settings| Alarms/Type : Active/Adult | HR : On:On:45:120 [ bpm ]| S 2:20:17 PM P.P. Procedure Condition Changed 2:20:17 PM Catheter Allergies | Allergies: Aspirin | Allergy from EMR: | Allergy Code: Coding .... 2:15:20 PM Timer 00:13 10 Effective Date: 06/26/2020 | HOOD05162003098049 Unrestricted © Siemens Healthineers, 2020 FFR Workflow SIEMENS Healthineers Initiate Stop Patient Applications Edit View Acquire Input Tools Options He m TEST Review Real Time Zero RCA LAD CX 123456 Pressures SAI P2_Lesion_I .. y 5 mm/s Review Real Time Zero Male 09/1 2/1 961 Calculate Setup . Workflow Support 3:33:23 PM Lesion_Index Pd 62 Pa 99 RCA D RCA P Hemody nam. Equalize FFR Stop Current Condition 1. Rest New 0.63 BCA 200 RCA D 200 B 200 180 180 Vital Signs 160 160 Recording is automatically ended. st Proces ... • FFR Event Properties x 140 140 Review tab card is active. General Specific 120 120 • LEER O 85 A A A A 100 100 80 80 FFR 0.63 60 60 Duration (mm:ss) 00:16 40 1. Modify or 1 40 (Pa-Pd) 37 20 20 mmHg O 2. Accept calculated FFR Site Mean FFR event is created in the CaseLog: P1:Pa RCA P Enter Site 99 mmHg • FFR | FFR : 0.63 | P1:Pa : [ RCA P : 99 ] [ mmHg ] | P2:Pd : [ RCA D : 62 ] [ mmHg ] | ... 3:33:32 PM* P2:Pd RCA D Enter Site 62 mmHg Vital Sign Alarm Settings| Alarms/Type : Active/Adult | HR : On:On:45:120 [ bpm ]| S .... 2:41:42 PM Results Event Condition Changed 2:41:42 PM mary -Time Sign Alarm Settings| Alarms/Type : Active/Adult | HR : On:On:45:120 [ bpm ]| S 2:41:42 PM lition Changed 2:41:42 PM Resting Sign Alarm Settings| Alarms/Type : Active/Adult | HR : On:On:45:120 [ bpm ]| S 2:40:11 PM Pd/Pa lition Changed 2:40:11 PM • FFR value is displayed on LIVE. 2 [ulation Time | ACT Type: _ | ACT Value (sec): 70 2:20:38 PM FFR 0.63 Print Sign Alarm Settings| Alarms/Type : Active/Adult | HR : On:On:45:120 [ bpm ]| S 2:20:17 PM lition Changed 2:20:17 PM OK Cancel gies | Allergies: Aspirin | Allergy from EMR: | Allergy Code: | Coding. 2:15:20 PM Realtime 0.63 Pa/Pa 11 Effective Date: 06/26/2020 | HOOD05162003098049 imer 00:13 Unrestricted © Siemens Healthineers, 2020 dPR Workflow SIEMENS Healthineers Patient Applications Edit View Acquire Input Tools Options Help Move the pressure wire to the distal portion of the lesion Test Patient Review Real Time 123456 Male 01/14/1953 Equalize CPR Calculating P2_Lesion_L.y 12.5 mm/s . Setup Workflow Support TT Ho 1. Select the dPR index. HEMO_Lesion_Index Hemodynam .. Current Condition TIN40 A LEX AD 2. Initiate Calculate. 3. Post Angioplasty Now 200 200 AO, 200 [CX 200 B 180 180 Vital Signs 160 160 START 140 140 Post Proces .. Review Real Time Recording 120 120 100 100 REC 80 Equalize dPR Calculate Hemo Calculation 60 160 40 40 1 2 20 20 O O • Recording is automatically started. Tools P /P. 1 Calculating dPR. U * * REC 4:27:02 PM Ò Q Ctrl + Q Events Results Event: Pre Cath Data Summary Time View Performing Physicians Condition Changed 4:24:45 PM Personnel Vital Sign Alarm Settings| Alarms/Type : Active/Adult | HR : On:On:45:120 [ bpm ]| S. 4:24:45 PM Case Times FFR | FFR : 0.61 | P1:Pa : [ AO : 99 ] [ mmHg ] | P2:Pd : [ LCX : 61 ][ mmHg ] | (Pa- 4:22:45 PM Documentation Patient/Procedure Status Vital Sign Alarm Settings| Alarms/Type : Active/Adult | HR : On:On:45:120 [ bpm ]| S 4:19:41 PM Procedure Checklist Condition Changed 4:19:41 PM LOC Score Pre Systolic Area Index | Exp. Pressures : RV ( 24/ 1 / 1 ) [ mmHg ] , LV ( 119/ 0/7) [ m. 4:16:38 PM Condition Changed 4:15:48 PM Allergies Vital Sign Alarm Settings| Alarms/Type : Active/Adult | HR : On:On:45:120 [ bpm ]| S. 4:14:11 PM 12 Effective Date: 06/26/2020 | HOOD05162003098049 Unrestricted © Siemens Healthineers, 2020 dPR Workflow SIEMENS Healthineers After 5 beats have been analyzed, the calculation is Patient Applications Edit View Acquire Input Tools Options Help Test Patient Review Real Time complete: 123456 Male 01/14/1953 Calculate Pressures P2_Lesion_I .. y IVS 5 mm/s . Setup Workflow Support ! 1 10 MLML 4:27:08 PM HEMO_Lesion_Index • Recording is automatically ended. ! II 10MAL LCX AO Hemodynam. Current Condition Review tab card is active. 3. Post Angioplasty New ! III 10 • AO, 200 B 200 200 LCX 200 180 180 Vital Signs 160 160 dPR Event Properties X 140 140 st Proces ... Modify or General 120 120 1. Specific 100 100 80 Accept calculated dPR. 80 2. dPR 0.80 60 60 Duration (mm:ss) 00:00 dPR event is created in the CaseLog. 1 40 40 • (Pa-Pd) 11 mmHg 20 20 0 O Events Results Event: Site Summary Mean Time P1:Pa AO Enter Site 81 mmHg dPR | dPR Value : 0.8 | P1:Pa : [ AO : 81 ] [ mmHg ] | P2:Pd : [ LCX : 70 ] [ mmHg ] | .. 4:27:09 PM* Vital Sign Alarm Settings| Alarms/Type : Active/Adult | HR : On:On:45:120 [ bpm ]| S 4:24:45 PM P2:Pd LCX Enter Site 70 mmHg Result Event: - • dPR value is displayed on LIVE. mary Time dPR 0.8 lition Changed 4:24:45 PM Sign Alarm Settings| Alarms/Type : Active/Adult | HR : On:On:45:120 [ bpm ]| S. 4:24:45 PM | FFR : 0.61 | P1:Pa : [ AO : 99 ] [ mmHg ] | P2:Pd : [ LCX : 61 ] [ mmHg ] | (Pa -... 4:22:45 PM FFR Sign Alarm Settings| Alarms/Type : Active/Adult | HR : On:On:45:120 [ bpm ]| S. 4:19:41 PM 2 lition Changed 4:19:41 PM Print lic Area Index | Exp. Pressures : RV ( 24 / 1 / 1 ) [ mmHg ] , LV ( 119 / 0 / 7 ) [ m .. 4:16:38 PM lition Changed 4:15:48 PM Realtime 0.86 OK Cancel Sign Alarm Settings| Alarms/Type : Active/Adult | HR : On:On:45:120 [ bpm ]| S. 4:14:11 PM Pa/P. Storage: 143:36 4:27:08 PM - dPR 4:27:14 PM Timer 13 Effective Date: 06/26/2020 | HOOD05162003098049 Unrestricted © Siemens Healthineers, 2020 FFR and Resting Indices Calculations (Pd/Pa and dPR) SIEMENS Healthineers Workflow Manually adding FFR, Resting Pd/Pa or dPR values from another 1 source. Acquire Input Tools Options 02 Saturation Summary Time Review Cardiac Output Manual Resting Pd/Pa | Rest Pd/Pa Value : 0.87 | P1:Pa : _ | P2:Pd: 3:04:08 PM 1. Select FFR, Resting Pd/Pa or dPR from the Input Menu. qualize HB 02 Consumption 2 • The event is created in the CaseLog. Vital Signs FFR Resting Pd/Pa dPR 2. Double click on the event, the dialog opens to: Condition Manual Resting Pd/Pa Event Properties General | Specific Site • Enter the Resting Pd/Pa value in the text field. 2 Normal Resting Pd/Pa Congenital • Enter site of arterial calculation and Resting Pd/Pa value . @ Coronary Site Peripheral Not Defined P1:Pa Enter Site P2:P Enter Site 1. Click on Enter Site for setting the Pa and Pd. The Site dialog opens, choose the site from the Site Tree. 3 • • Click OK. • The event is updated in the CaseLog. Print OK Cancel OK Cance 14 Effective Date: 06/26/2020 | HOOD05162003098049 Unrestricted © Siemens Healthineers, 2020 SIEMENS Healthineers Please note that the learning material is for training purposes only! For the proper use of the software or hardware, please always use the Operator Manual or Instructions for Use (hereinafter collectively “Operator Manual”) issued by Siemens Healthineers. This material is to be used as training material only and shall by no means substitute the Operator Manual. Any material used in this training will not be updated on a regular basis and does not necessarily reflect the latest version of the software and hardware available at the time of the training. The Operator's Manual shall be used as your main reference, in particular for relevant safety information like warnings and cautions. Note: Some functions shown in this material are optional and might not be part of your system. Certain products, product related claims or functionalities (hereinafter collectively “Functionality”) may not (yet) be commercially available in your country. Due to regulatory requirements, the future availability of said Functionalities in any specific country is not guaranteed. Please contact your local Siemens Healthineers sales representative for the most current information. The reproduction, transmission or distribution of this training or its contents is not permitted without express written authority. Offenders will be liable for damages. All names and data of patients, parameters and configuration dependent designations are fictional and examples only. All rights, including rights created by patent grant or registration of a utility model or design, are reserved. Copyright © Siemens Healthcare GmbH Global Siemens Healthineers Headquarters Henkestr. 127 91052 Erlangen, Germany Phone: +49 9131 84 siemens.com/healthineers 15 Effective Date: 06/26/2020 | HOOD05162003098049 Unrestricted © Siemens Healthineers, 2020