Philips Trim 1 Service Manual

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Chapter 1Introduction
This PageWriter Trim I, II, III, Rx Cardiograph Service Manual provides the information you 
need to successfully service the PageWriter Trim cardiographs with software version A.01.03 
and higher. The PageWriter Trim Cardiograph product family includes the following four 
product models as described in Table 1-1.
This Service Manual includes information on:
„Theory of operation
„Maintenance procedures
„Performance verification and safety testing
„Repairs
„Ordering parts and supplies
„Specifications
„Maintenance tests
„Software Installation 
„Wireless LAN Installation
„Upgrade Kit Installation
Before servicing the PageWriter Trim cardiographs, review the PageWriter Trim Instructions 
for Use located on the User Documentation CD shipped with the cardiograph, or download the 
file from the Philips InCenter site (
incenter.medical.philips.com). For information on accessing 
the InCenter site, see “Using the Philips InCenter Site” on page 1-26. This service manual 
assumes you are familiar with the controls, basic cardiograph operations, and capabilities of 
the device as described in these documents.
Table 1-1 PageWriter Trim Product Model Information
PageWriter Trim model Philips Part Number
PageWriter Trim III860286
PageWriter Trim II 860288
PageWriter Trim I860290
PageWriter Trim Rx  860297 
						

							IntroductionWho Should Use this Manual
1-2PageWriter Trim Cardiograph Service Manual
Who Should Use this Manual 
This manual is intended for users who handle preventive maintenance, periodic operational 
checks, and basic troubleshooting for PageWriter Trim cardiographs.
Before attempting to service the cardiographs, you must review the following documentation 
and training materials:
„PageWriter Trim Instructions for Use 
„PageWriter Trim Cardiograph Interactive Training Program
„This Service Manual
This PageWriter Trim Cardiograph Service Manual is intended to assist users in the safe and 
effective use of the product.
Before attempting to operate this product, read this Service Manual, and note and strictly 
observe all Warning and Cautions as described in this document.
Pay special attention to all of the safety information provided in the Safety Summary section. 
For more information, see page 1-5.
The following conventions are used in this document.
WARNINGWarning statements describe conditions or actions that may result in a potentially 
serious outcome, adverse event, or a safety hazard. Failure to follow a Warning may 
result in death or serious injury to the user or to the patient. 
CAUTIONCaution statements describe when special care is necessary for the safe and effective use of the 
product. Failure to follow a caution may result in minor to moderate personal injury or damage to the 
product or other property, a remote risk of more serious injury, or may cause environmental 
pollution. 
NOTENotes contain additional important information about a topic. 
TIPA Tip contains suggested information on using a particular feature.
Menu items and button names appear in bold no-serif font. Example: Touch the Config button.
Internal software components or file directories appear in regular no-serif font. Example: 
ECGs are stored to the 
RubyArchiveInternal directory. 
						

							IntroductionSafety Summary
PageWriter Trim Cardiograph Service Manual1-3
Safety Summary
Safety Symbols Marked on the Cardiograph 
Symbol
Name Description
 Attention See PageWriter Trim Instructions for Use for 
information.
  Type CF ECG physio isolation is type CF, defibrillator proof. 
Electrical leakage current is suitable for all patient 
applications including direct cardiac application. 
  Alternating current Indicates that the cardiograph is receiving alternating 
currents.
On/Standby Pressing the button with this symbol on it turns on the 
cardiograph or puts the cardiograph into Standby 
(power saving mode).
Electrostatic DischargeDo not touch exposed pins. Touching exposed pins can 
cause electrostatic discharge that can damage the 
cardiograph.
 Equipotential grounding post Equipotential grounding post used for establishing 
common ground between instruments.
Fuse Cardiograph contains a 1.5 amp (250V) time-delay 
fuse.
Input The connector near this symbol receives an incoming 
signal.
Serial Number The number next to this symbol is the serial number of 
the cardiograph.
Product model number The number next to this symbol is the product model 
number of the cardiograph
Entry of liquids The cardiograph is not protected against splashing 
water.
Entry of liquids The PIM (Patient Interface Module) is protected 
against splashing water. Water splashed against the 
PIM from any direction shall have no harmful effect.
AC power indicator light When lit, indicates that AC power is on. The battery is 
charging when inserted into the cardiograph.  
						

							IntroductionSafety Summary
1-4PageWriter Trim Cardiograph Service Manual
Global Medical Device 
Nomenclature CodeGlobal Medical Device Nomenclature Code is a 5-digit 
code providing a brief description of the device, as 
defined by EN ISO 15225.
Safety Symbols Marked on the Cardiograph (continued)
Symbol
Name Description
Safety Symbols Marked on the Cardiograph Packaging 
Symbol Description
 Keep dry.
Ambient temperature range of 0 
oC (32o.F) to 50 oC (122o F) (non-condensing) for 
transport and storage.
Atmospheric pressure range of 466 hPa to 1014 hPa for transport and storage.
Relative humidity range of 15% to 90% (non-condensing) for transport and storage.
Move and store packaging this end up.
 Fragile.
Sealed lead acid battery. Do not dispose of in trash. Follow local regulations for disposing 
of as small chemical waste. 
						

							IntroductionImportant Patient and Safety Information
PageWriter Trim Cardiograph Service Manual1-5
Important Patient and Safety Information
The PageWriter Trim cardiograph isolates all connections to the patient from electrical ground 
and all other conductive circuits in the cardiograph. This reduces the possibility of hazardous 
currents passing from the cardiograph through the patient’s heart to ground, and from other 
equipment connected to the patient passing through the leads into the cardiograph to ground. 
WARNINGFailure to follow these warnings could affect both patient and operator safety.
Symbol Description
Dispose of in accordance with the requirements of your country. 
This product consists of devices that may contain mercury, which must be recycled or 
disposed of in accordance with local, state, or federal laws. (Within this system, the 
backlight lamps in the monitor display contain mercury.)
Safety Symbols Marked on the Cardiograph Packaging (continued)
Safety and Regulatory Symbols Marked on the Cart
Symbol Name Description
Cart Transport Use care when moving the cardiograph cart. Pushing the cart 
over bumps without holding onto the cardiograph may cause the 
cart to tip.
Cart Storage Bin 
Weight LimitDo not place more than 3 kilograms or 6.6 pounds of weight 
into the cart storage bin. 
						

							IntroductionImportant Patient and Safety Information
1-6PageWriter Trim Cardiograph Service Manual
WARNINGThe Welsh bulb electrodes (available as an accessory for the cardiograph) do not meet 
the requirements of IEC 60601-2-25 for defibrillation recovery time, and cannot be 
reliably used for immediate patient diagnosis following defibrillation.
WARNINGThe PageWriter Trim I cardiograph is not recommended for diagnostic cardiograph use 
during defibrillation. It does not provide real-time data in less than 10 seconds. Reusable 
electrodes should not be used during defibrillation for diagnostic purposes as ECG 
recovery will be greater than ten seconds.
WARNINGDo not touch accessible connector pins and the patient simultaneously.
Electrical shock hazard. Keep cardiograph, Patient Interface Module (PIM) and all 
cardiograph accessories away from liquids. Do not immerse cardiograph, PIM, or other 
accessories in any liquids.
WARNINGWhen using additional peripheral equipment powered from an electrical source other 
than the cardiograph, the combination is considered to be a medical system. It is the 
responsibility of the operator to comply with IEC 60601-1-1 and test the medical system 
according to the requirements. For additional information contact Philips Medical 
Systems.
WARNINGDo not use non-medical peripherals within 1.83 meters or 6 feet of a patient unless the 
non-medical peripherals receive power from the cardiograph or from an isolation 
transformer that meets medical safety standards.
WARNINGAlways clean and disinfect reusable electrodes before patient use. Failure to properly 
clean and disinfect reusable electrodes before patient use may cause infectious materials 
to be transferred between patients. 
  CAUTIONThe Welsh bulb electrodes contain natural rubber latex which may cause allergic reactions.
„When operating the cardiograph on AC power, ensure that the cardiograph and all other 
electrical equipment connected to or near the patient are effectively grounded.
„Use only grounded power cords (three-wire power cords with grounded plugs) and 
grounded electrical outlets.
 Never adapt a grounded plug to fit an ungrounded outlet by 
removing the ground prong. Use the equipotential post when redundant earth ground is 
necessary according to IEC 60601-1-1.
„If a safe ground connection is not ensured, operate the cardiograph on battery power only. 
						

							IntroductionImportant Patient and Safety Information
PageWriter Trim Cardiograph Service Manual1-7
„The use of equipment that applies high frequency voltages to the patient (including 
electrosurgical equipment and some respiration transducers) is not supported and may 
produce undesired results. Disconnect the patient data cable from the cardiograph, or detach 
the leads from the patient prior to performing any procedure that uses high frequency 
surgical equipment. 
„Do not perform ST analysis on the R/T ECG screen display or on Rhythm reports when the 
0.5 Hz Baseline Wander filter is applied. 
„If abnormal ECG data appears on the printed report, and the abnormal data does not have a 
physiological origin, perform the printer diagnostic test to assess printer performance.
„When printing a Rhythm report, there may be a slight delay before the Rhythm report 
begins to print on the cardiograph. Rhythm printing is not completed in real-time.
„Pace pulse tick marks will not print on an Auto ECG that uses simultaneous acquisition.
„Periodically inspect the patient data cable, lead wires, and AC power cord for any worn or 
cracked insulation to ensure that no inner conductive material is exposed. Discard worn 
accessories and replace them only with Philips Medical Systems accessories (see page 1-
20).
„Keep the patient data cable away from power cords and any other electrical equipment. 
Failure to do so can result in AC power line frequency interference on the ECG trace.
„The Philips Medical Systems patient data cable (supplied with cardiograph) is an integral 
part of the cardiograph safety features. Use of any other patient data cable may compromise 
defibrillation protection, degrade cardiograph performance, and may result in distorted 
ECG data. 
„Only qualified personnel may service the cardiograph or may open the cardiograph housing 
to access internal cardiograph components. Do not open any covers on the cardiograph. 
There are no internal cardiograph components that are serviced by the operator.
„Do not use this cardiograph near flammable anesthetics. It is not intended for use in 
explosive environments or in operating rooms.
„Do not touch the patient, the patient data cable, any unused patient leads, or the cardiograph 
during defibrillation. Death or injury may occur from the electrical shock delivered by the 
defibrillator.
„Always use electrode gel with reusable electrodes during defibrillation as ECG recovery 
will be greater than 10 seconds. Philips Medical Systems recommends the use of disposable 
electrodes at all times.
„Ensure that the electrodes or lead wires do not come in contact with any other conductive 
materials (including earth-grounded materials) especially when connecting or 
disconnecting electrodes to or from a patient.
„Connecting multiple medical electrical equipment to the same patient may pose a safety 
hazard due to the summation of leakage currents. Any combination of instruments should 
be evaluated by local safety personnel before being put into service. 
						

							IntroductionImportant Patient and Safety Information
1-8PageWriter Trim Cardiograph Service Manual
„Portable medical equipment such as X-rays and MRI may produce electromagnetic 
interference that produces noise in the ECG signal. Move the cardiograph away from these 
potential sources of electromagnetic interference.
„Do not pull on the paper while an ECG report is being printed. This can cause distortion of 
the waveform and can lead to potential misdiagnosis.
„Only use the Philips Medical Systems AC power cord supplied with the cardiograph. 
Periodically inspect the AC power cord and AC power connector (rear of cardiograph, see 
page 1-15) to ensure that both are in a safe and operable condition. If the AC power cord or 
AC power connector is not in a safe or operable condition, operate the cardiograph on 
battery power and contact Philips Medical Systems for service.
„The cardiograph has been safety tested with the recommended accessories, peripherals, and 
leads, and no hazard was found when the cardiograph is operated with cardiac pacemakers 
or other stimulators.
„Do not connect any equipment or accessories to the cardiograph that are not manufactured 
or approved by Philips Medical Systems or that are not IEC 60601-1 approved. The 
operation or use of non-approved equipment or accessories with the cardiograph is not 
tested or supported, and cardiograph operation and safety are not guaranteed.
„The list of cables and other accessories with which Philips claims compliance with the 
emissions and immunity requirements of IEC standard 60601-1-2 are listed in “Supplies 
and Ordering Information” on page 1-20.
„Only install Philips Medical Systems software on the cardiograph. The installation or use of 
software not approved by Philips Medical Systems is strictly prohibited and cardiograph 
safety and performance are not guaranteed. 
„Only use Philips Medical Systems replacement parts and supplies with the cardiograph. The 
use of non-approved replacement parts and supplies with the cardiograph is strictly 
prohibited. Cardiograph safety and performance are not guaranteed when non-approved 
replacement parts and supplies are used with the cardiograph.
„Manual measurements of ECG intervals and magnitudes should be performed on printed 
ECG reports only. Do not make manual measurements of ECG intervals and magnitudes on 
the R/T ECG display since these ECG representations are scaled.
„Only use patient electrodes that are approved by Philips Medical Systems. The use of non-
approved patient electrodes may degrade cardiograph performance. 
„The Philips Medical Systems warranty is applicable only if you use Philips Medical 
Systems approved accessories and replacement parts. See “Supplies and Ordering 
Information” on page 1-20 for more information.
„Before using the Patient Cable Arm with the cardiograph cart, properly install the counter 
weight on the cardiograph base.
„Only use the shielded LAN cable provided with the PageWriter Trim cardiograph, Philips 
part number 989803138021. Do not use any other LAN cables with the PageWriter Trim 
cardiograph. Use of unapproved LAN cables may result in radiated emissions that exceed 
the limit specified by CISPR11 Class B.  
						

							IntroductionThe PageWriter Trim Cardiograph
PageWriter Trim Cardiograph Service Manual1-9
„The combined maximum weight that can be placed on the cardiograph cart shelf and the top 
surface of the cart cannot exceed 20 kg (44 lbs). Do not place more than the specified 
weight on the cardiograph top surface and shelf. 
„Do not connect any device to the RS-232 port on the rear of the cardiograph when the 
patient data cable is connected to a patient.
„There are no cardiograph parts that can be sterilized. 
„The cardiograph is not intended for direct, or invasive cardiac monitoring purposes.
„Excessive, repetitive use of the cardiograph keyboard and the cardiograph Trim Knob may 
result in a risk of developing carpal tunnel syndrome.
„Ensure that the patient data cable is tucked away from the cardiograph cart wheels when 
transporting the cardiograph. Ensure that the patient data cable does not present a hazard 
when pushing the cardiograph cart. 
„For information on the standard IEC 60601-2-51, please see the document on the 
PageWriter Trim Cardiograph User Documentation CD, or go to the Philips InCenter web 
site (
incenter.medical.philips.com). For information on using the Philips InCenter site, see 
page 1-26.
„The combined maximum weight that can be placed on the cardiograph cart shelf and the top 
surface of the cart cannot exceed 20 kilograms (44 pounds). Do not place more than the 
specified weight on the cardiograph top surface and shelf.
„Ensure that the patient data cable is tucked away from the cardiograph cart wheels when 
transporting the cardiograph. Ensure that the patient data cable does not present a hazard 
when pushing the cardiograph cart.
The PageWriter Trim Cardiograph
Intended Use
The intended use of the cardiograph is to acquire multi-channel ECG signals from adult and 
pediatric patients from body surface ECG electrodes and to record, display, analyze, and store 
these ECG signals for review by the user. The cardiograph is to be used in healthcare facilities 
by trained healthcare professionals. Analysis of the ECG signals is accomplished with 
algorithms that provide measurements, data presentations, graphical presentations, and 
interpretations for review by the user.
The interpreted ECG with measurements and interpretive statements is offered to the clinician 
on an advisory basis only. It is to be used in conjunction with the clinicians knowledge of the 
patient, the results of the physical examination, the ECG tracings, and other clinical findings. 
A qualified physician is asked to overread and validate (or change) the computer-generated 
ECG interpretation. 
						

							IntroductionThe Philips 12-Lead Algorithm
1-10PageWriter Trim Cardiograph Service Manual
Indications for Use
The cardiograph is to be used where the clinician decides to evaluate the electrocardiogram of 
adult and pediatric patients as part of decisions regarding possible diagnosis, potential 
treatment, effectiveness of treatment, or to rule out causes for symptoms.
The Philips 12-Lead Algorithm 
The PageWriter Trim Cardiograph software uses the Philips 12-Lead Algorithm. The 
algorithm in the software analyzes the morphology and rhythm on each of the 12 leads and 
summarizes the results. The set of summarized measurements is then analyzed by the 
clinically-proven ECG Analysis Program.
12-lead Reports may include or exclude ECG measurements, reasons, or analysis statements.
Intended Use
The intended use of the Philips 12-Lead Algorithm is to analyze multi-channel ECG signals 
from adult and pediatric patients with algorithms that provide measurements, data 
presentations, graphical presentations, and interpretations for review by the user.
The interpreted ECG with measurements and interpretive statements is offered to the clinician 
on an advisory basis only. It is to be used in conjunction with the clinicians knowledge of the 
patient, the results of the physical examination, the ECG tracings, and other clinical findings. 
A qualified physician is asked to overread and validate (or change) the computer-generated 
ECG interpretation.
Indications for Use
The Philips 12-Lead Algorithm is to be used where the clinician decides to evaluate the 
electrocardiogram of adult and pediatric patients as part of decisions regarding possible 
diagnosis, potential treatment, effectiveness of treatment, or to rule out causes for symptoms.
Features and Capabilities
The Philips PageWriter Trim family of cardiographs includes four product models: 
PageWriter Trim Rx, PageWriter Trim III, PageWriter Trim II, and PageWriter Trim I. Each 
cardiograph is designed to be economical, interpretive, and lightweight, and includes a remote 
digital patient module. The cardiograph contains the controls, the printer, and all the 
processing circuitry. 
The features of the PageWriter Trim cardiographs include:
„Battery or AC operated
„Remote digital acquisition module with replaceable patient leads 
„Capability for up to 12 leads