Take a full cardiac exam on the Eko App December 01, 2022 23:28 Updated You use the full cardiac exam to perform a comprehensive cardiac assessment. The cardiac exam guides you through a four-point examination in these areas of the chest: Right Upper Sternal Border (RUSB) Left Upper Sternal Border (LUSB) Left Lower Sternal Border (LLSB) APEX The Eko analysis automatically checks for potential murmurs at every position (currently only available in the US). Results show on the cardiac exam summary screen when all four positions are complete. From this screen, you can manage the exam by sharing it, adding notes, assigning it to a patient profile, and so on. Here’s how: Pair the Eko device Start the cardiac exam Manage the exam Note If it’s your first time using the Eko App, you’ll need to take a spot check to continue on to a full cardiac exam. After that, the full cardiac exam will be directly accessible by tapping Exam on the bottom toolbar. 1. Pair the Eko device Pair the Eko CORE or DUO with the Eko App. See instructions here. 2. Start the cardiac exam The Eko App guides you through each auscultation position starting with the Right Upper Sternal Border (RUSB). Use the included visual as a placement reference. If you need to skip a position, tap Skip Position. The screenshots below show the CORE. If you’re using a DUO, the screenshots in the app will show the DUO. On the Eko App, tap Exam in the bottom toolbar. Tap Full Cardiac Exam. The Cardiac Exam screen opens. Hold the chestpiece in position as you normally would. Place the chestpiece on the patient. The CORE will listen for a signal before it starts recording. On this screen, you can tap Audio to adjust the audio settings or Placement to see a placement visual. About the audio settingsAdjust the settings as needed: Setting Description Play from Headphones Select to listen to sounds on your headphones or earbuds that are connected to your mobile device. Adjust your mobile device’s volume if needed. If there are no headphones connected to the mobile device, then the audio will play through the phone’s speakers. Tip Use high-quality headphones for optimal heart sounds as audio may play back poorly on your system speakers. Volume Boost Activated when Play from Headphones is turned on. Further amplifies the sounds through your headphones. Tap the scale to adjust the level. CORE Audio Filter Setting only shows when a CORE device is connected. Select an audio filter of Cardiac, Pulmonary, or Wide (for all use cases). DUO Audio Filter Setting only shows when a DUO device is connected. Select an audio filter of Diaphragm (Cardiac), Bellmode, Midrange (Pulmonary), or Extended. Recording begins when the CORE detects a signal for the RUSB position. Have your patient remain still and quiet to capture a high quality recording. The recording and analysis progress shows on the screen. If you need to restart the recording for the position, tap Restart. When the RUSB recording is complete, the exam automatically changes to the LUSB, then the LLSB, and finally, the APEX. When the recording is complete, the analysis results show on the cardiac exam summary screen. 3. Manage the exam You can manage details of the recording immediately after the recording is taken, on the full cardiac exam summary screen. Or, you can save the recording by tapping End Exam and add details later. If you don’t assign a patient, the recording will be saved in the unassigned recordings. The cardiac exam summary screen shows the results for each recorded position. For every recorded position, you can: View details for a position Play back a position’s recording Change the audio settings Share a position’s recording Delete a position’s recording from the exam For the entire exam, you can: Assign the exam to a patient profile Select the patient stance Add a note Share the recording summary End the exam Individual recordings Tap a recording to view the details or play it back. Tap Back to return to the summary screen. If a recording wasn’t successful, a Retry button appears that can be used to retake a recording. View details for a position The recording details screen displays: The position of the recording. The exam finding, such as if a murmur was detected or not. The heart rate in beats per minute (BPM). The visualization of the waveform. Play back the recording Tap the blue play button to see the recorded phonocardiogram and hear the recorded sounds. The recording starts to play. You can pause it by tapping the button again. Change the audio settings Tap Audio. The Audio Settings screen opens. Update the following settings as needed: Setting Description Play from Headphones Select to listen to sounds on your headphones or earbuds that are connected to your mobile device. Adjust your mobile device’s volume if needed. If there are no headphones connected to the mobile device, then the audio will play through the phone’s speakers. Tip Use high-quality headphones for optimal heart sounds as audio may play back poorly on your system speakers. Volume Boost Activated when Play from Headphones is turned on. Further amplifies the sounds through your headphones. Tap the scale to adjust the level. CORE Audio Filter Setting only shows when a CORE device is connected. Select an audio filter of Cardiac, Pulmonary, or Wide (for all use cases). DUO Audio Filter Setting only shows when a DUO device is connected. Select an audio filter of Diaphragm (Cardiac), Bellmode, Midrange (Pulmonary), or Extended. Share the position’s recording This will share all recordings taken for the exam. Tap Share to select from the sharing options on your mobile device. For detailed instructions, see Share or print a recording. Warning We strongly recommend omitting any personally identifiable patient information or protected health information (PHI). Any notes will be included when sharing a recording with others. This may violate HIPAA provisions. You are responsible for maintaining HIPPA compliance when you share patient recordings. Delete the position’s recording This will delete a position’s recording from the exam. It won’t delete the entire cardiac exam. Once a recording is deleted, it can’t be retrieved. You can take a new recording for a position after it’s deleted. Tap Delete. A confirmation message appears. Tap Delete. The recording is deleted, and a Take Recording button appears for the position if you want to retake the recording. Warning Once you end the exam, you won’t be able to delete or re-record any single position for this exam, or any previously completed exams. Entire exam You can manage these aspects of the entire cardiac exam. Assign the recording To assign the exam to a patient profile, tap Assign on the top right corner. The Assign to a Patient screen opens. If you’re assigning the recording to a patient you’ve already created, on the Existing Patients screen, find and select them using the search bar or by scrolling through the patient list. To create a new patient profile, tap New Patient and enter the patient’s information. Either the first OR last name, OR the MRN number is required. Tap Assign Patient. Note: Closing the patient profile tray or tapping I’ll Assign Later automatically saves the recording under unassigned recordings. You can always assign a patient later. The recording is assigned and the cardiac exam summary screen opens again. Select the patient stance In the Select Patient Stance section, tap the radio button for Standing, Sitting, or Supine. Add a note You can annotate the exam with freeform text. Warning We strongly recommend omitting any personally identifiable patient information or protected health information (PHI). Any notes will be included when sharing this recording with others. Tap Notes. The Summary Notes screen opens. Enter any information about the recording. Tap Done. The note is saved and appears on the Summary Notes screen. To add another note, tap Add Note at the bottom of the screen. To edit or delete a note, swipe right on the note, and select Edit on the right. Note: Notes can’t be deleted once they’ve been assigned to a patient. To close the Summary Notes screen, swipe down from the gray bar at the top. The cardiac exam summary screen appears. Share the recording summary This will share all recordings taken for the exam. Tap Share to select from sharing options on your mobile device. For detailed instructions, see Share or print a recording. Warning We strongly recommend omitting any personally identifiable patient information or protected health information (PHI). Any notes will be included when sharing a recording with others. This may violate HIPAA provisions. You are responsible for maintaining HIPPA compliance when you share patient recordings. End the exam Once you end the exam, you won’t be able to delete or re-record any single position for this exam, or any previously completed exams. Tap End Exam. The Exam home screen opens. LBL421 Rev.2.0 Date of Issue November 30, 2022