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Friday 30 September 2016
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CorScreen: portable ECG monitors for your practice’s medical staff

In the busy environment of a modern GP surgery, your medical team require reliable, user-friendly equipment. CorScreen® is a portable electrocardiogram system for the measurement, recording and assessment of cardiac activity. Practice nurse Helen Lewis, who trialled the product for several weeks, explains how it works and how it can benefit practices

Electrocardiogram (ECG) is routinely used in primary care and is seen as one of the most useful investigations in contemporary medicine. It is essential for the identification of disorders of the cardiac rhythm, extremely useful for the diagnosis of abnormalities of the heart, and a helpful clue in generalised disorders such as electrolyte disturbances.1
With this in mind, practice nurses and GPs require the correct equipment in terms of usability and reliability to complete ECG recordings to enable interpretation of the results to be a true reflection of the patient's condition.

CorScreen
CorScreen is a portable ECG system that allows the practitioner to record either a 3/6-lead ECG via a 4-pin cable or a full 12-lead ECG using a 10-pin cable. The equipment's small size allows it to be desktop-based for easy access, and coupled with an approximate weight of 5 kg allows for easy transportation if required.

The appearance of CorScreen is that of a fax machine with a keyboard facility for information input. The ergonomic swivel-mounted colour LCD allows the user to adjust the screen if required. CorScreen does not require specialist ECG paper as reports can either be printed directly onto A4 sheets or transferred onto a computer.

CorScreen allows the user to connect a memory card that can be used for archiving ECG reports for later interpretation. Several portals at the rear allow the user to connect CorScreen directly to a computer along with an ECG amplifier.

CorScreen has the added function of spirometry, which allows for instant identification of patients with asthma and chronic obstructive pulmonary disease.

The fact that CorScreen is effectively two machines in one reduces not only the cost of purchasing separate machines but also any storage issues. This will not cause confusion as when the spirometry device is installed it is not possible to record an ECG.

Set-up
Having never used CorScreen before, I found the set-up to be simple and straightforward. The on/off switch is located at the back of the CorScreen and a blue LED light flashes on the front left lower side of the keyboard when switched on.

A welcome screen appears followed by the "patient input data screen" a few seconds later. If you wish to carry out an ECG it is not possible to bypass this section. The keyboard can be used in exactly the same way as any PC keyboard and function keys 1–6, located at the top of the keyboard, correspond to the icon tool bar on the display screen.

The screen and menu bars allow the user to navigate easily around the menus and the "information key", which is located on the top righthand side of the keyboard, gives the user a brief description of the selectable functions in the menu bar.

The initial screen requires the user to input the patient's details – ID, surname and forename, gender, date of birth, height and weight. There is also a yes/no/unknown option for pacemakers, although it should be noted that automatic interpretation of the ECG is not possible for pacemaker patients.

The patient ID can be inputted using figures and numbers, which is useful to maintain patient confidentiality should the information be interpreted elsewhere. There is also a delete function, so that any information that is inputted incorrectly can be altered later. The CorScreen can be configured to a number of different options, and once the configuration is set there is no need to reset every time the device is operational.

Trial
CorScreen is a user-friendly device that doesn't require laborious hours of manual reading before operation. A key feature is the information button, which enables the user to navigate around the set up and gives a brief description of each part of the menu.
I was impressed by CorScreen's compactness and ease of use. Each patient's ECG is recorded and can be saved under a unique identification number, which prevents confidentiality issues.

In practice I explained the use of the equipment to the patient, and recorded their details including height and weight (this can be bypassed for a "quick ECG" by simply pressing the "measure" button F6).

Once the patient's details were stored, an automatic electrode check began and a model appeared on the screen indicating that the leads and electrodes were connected. When the electrodes are connected correctly, green markers appear on the screen, backed up by green lights on the electrodes themselves. I initially had some difficulty getting a good connection between some of the electrodes and the skin, but after a bit of adjustment I managed to achieve the "green light" and the process could begin. The ECG will not commence until all the electrodes are illuminated green.

Once the ECG recording begins, the screen changes to allow the clinician to view the ECG in progress, although the screen can be altered to reflect the type of ECG measurement (for the purposes of this trial, the full 12-lead ECG measurement was displayed).

It is possible to add a comment onto the screen to aid the ECG interpretation – eg, should the patient sneeze or cough this is obviously going to have an effect on the display pattern. The keys F1–F6 at the bottom of the screen enable the user to adapt the ECG while in progress. A unique feature is the "view" button, which allows magnification of the ECG to obtain more detail of the reading as it occurs.

Finally, a full report was printed onto A4 paper giving the patient's details along with measurements, rhythm and specific findings in terms of QRS-T formation.

A useful feature of the CorScreen is its ability to save an ECG recording directly into the patient's notes. With previous equipment I've used, the ECG had to be printed off and then scanned into the patient's notes, which is obviously a time-consuming and costly process. The ECG can also be stored onto a USB memory stick and viewed by specialist practitioners.
 
Conclusion
I found the CorScreen to be a useable and efficient piece of equipment. It is small and practical enough for easy storage and light enough to be transported to house-bound patients who require ECG recordings. It is not a labour-intensive machine and does not require hours of training before operation.

A busy GP surgery requires equipment that is user-friendly and gives accurate and easily interpreted ECG results. The CorScreen achieves all of these with relative ease.

REFERENCE
1. Houghton AR, Gray D. Making Sense of the ECG: a Hands-On Guide. London: Hodder Arnold; 2003.

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