EXERCISE TOLERANCE TEST (ETT) TEMPLATE QUICKSTART GUIDE

Transcription

1 EXERCISE TOLERANCE TEST (ETT) TEMPLATE QUICKSTART GUIDE This ETT Automated Word Template is a free resource provided by NuclearCardiologyReports.com to the worldwide cardiology community. You are free to use it to produce patient reports and to recommend it to others. We do request 2 things: Instead of giving it to others, please have them download the latest installation file from If you find yourself in need of a Nuclear Cardiology Reporting solution, please keep us in mind. This template will produce very complete, concise, and well-laid-out ETT final reports for your referring MDs. It is quite intuitive with a few minutes experience. Word 2007 or newer is required. HOW TO GET FAMILIAR WITH HOW IT WORKS: 1. If you have 6 minutes and 32 seconds, go to and watch the Free ETT Template Video 2. PRINT THIS DOCUMENT (in COLOR if at all possible) Page 1 of 11

2 3. START EXPERIMENTING WITH THE STARTER FILES IN YOUR DOWNLOAD: Before you start experimenting, you have to enable macros in Word. This is easy. Macros are the VBA programming in the templates which provide the Automation feature. You may also have to enable editing. (See the yellow bar below) (Simply click the Enable Editing button) When you enable Word to run all macros (the programming contained in the templates), you will be warned that enabling macros could allow malicious software to run on your PC. This is true- but no more so than running any other software on your PC. There are no known issues of our software harming anybody s computer. Page 2 of 11

3 TO ENABLE MACROS IN WORD 2010 DO THIS: Page 3 of 11

4 TO ENABLE MACROS IN WORD 2007, DO THIS: Page 4 of 11

5 1 ST QUICK EXPERIMENT WITH YOUR FREE ETT TEMPLATE: Refer to the color-coded, already-filled-in, color-coded Stress Worksheet at the end of this PDF for patient John Doe. Open the folder named COLOR CODED & FILLED IN- BEGIN EXPERIMENTING HERE o Open the word file named ETT TEMPLATE JOHN DOE COLOR CODED.docm Study the color-coded-correlation between the Stress Worksheet and the ETT Word Template- observe what data goes where, etc. o Also, hover your mouse through the FINDINGS paragraph to discover other dropdowns whose values are set at a certain default value, but may be easily changed on a patient-by-patient basis. You will see the dropdowns highlight in gray when you hover over them. Now, press the Report Automation tab at the top of the ribbon of Word: Then, press one of the 3 Section Processing Buttons outlined in red above. Page 5 of 11

6 You will observe these things happen as you press these buttons: The section processing programs will alert you IF you omit any required report elements, or IF you make logically inconsistent choices You can go back and fix omissions / mistakes and press the buttons again The programs will offer to save the report as: PATIENTNAME DATEOFSTUDY ETT.docm e.g. DOE, JOHN A 03_12_2014 ETT.docm The programs will allow you to navigate to a folder to save your report in After the patient report saves (or you opt not to save it), you will see that: The extra dropdowns disappear and the sentences in the FINDINGS paragraph flow smoothly. Exception: The extra History and Indications dropdowns are still there-- invisibly on a space value if you want to go back and add / change your choices. The SUMMARY section automatically populates according to the values you entered in the DEMOGRAPHICS section (age) and in the FINDINGS paragraph. Page 6 of 11

7 MORE COLOR-CODED EXPERIMENTS WITH YOUR FREE ETT TEMPLATE: Go to the folder named COLOR CODED BLANK- CONTINUE EXPERIMENTING Now: PRINT (in color) the ETT WORKSHEET COLOR CODED.PDF, and Open the ETT EMPLATE COLOR CODED (BLANK).docm on your PC Enter real or hypothetical data (with a pen) on the color coded worksheet Enter the data from your color coded worksheet into the color coded ETT Template Press the relevant Section Processing Buttons on the Report Automation tab of the ribbon and observe how the programming functions The error checking and error messages will keep you on track Once you are happy with your final report, save it as PDF and archive it. To save the final report as a PDF, simply click Save As in the Word menu, and choose to save it as file type PDF. Page 7 of 11

8 You will likely have questions about exactly how the section processing programs work, how to manage your files, how to customize your template, how to insert signatures electronically, how integrate this system with the rest of your IT environment, etc. To get answers, go to and watch the concise video tutorials: o How to use the Demographics Section o How to use the Stress Sections o How to Use the File Management System o How to Integrate Your Reports with Other Medical Records o How to Affix an Electronic Signature o How to Set Up Your Lab s Header and Footer o How to Customize Your Demographics Section o How to Create and Edit Dropdowns These videos were produced for our SPECT MPI Reporting System, but the principles and specifics are applicable to the Free ETT Reporter Page 8 of 11

9 BEGIN USING YOUR ETT TEMPLATE ON ACTUAL PATIENTS: Once you are comfortable, go to the FOR EVERYDAY USE folder and begin using the EXERCISE TOLERANCE TEST TEMPLATE.docm file to create actual patient reports. NOTE: the EXERCISE TOLERANCE TEST TEMPLATE.docm file is read-only and should remain read-only so that you do not accidently save patient data by mistake in your blank Template which will be used for future patients. You may temporarily turn off the read-only attribute to customize your template: Right-click on the file, choose Properties and uncheck Read-only box shown below. Open the template and make your customizations, and save the file. Then re-check the read-only attribute to keep the template blank for future patients. Page 9 of 11

10 If you like the way this ETT Template functions, please keep us in mind for your SPECT MPI reporting needs. This template is identical to our SPECT MPI template except that it lacks the User Interface and programming which the Nuclear Interpreting MDs use to interpret images. See below: may have. Please feel free to with any questions you Sincerely, Jim McGee, BS CNMT, NCT, RT(R)(N) Founder & CEO NuclearCardiologyReports.com, LLC 1 (520) Page 10 of 11

11 We hope you enjoy your experience with our Free ETT Template. It requires Windows XP or above, and Word 2007 or above. It has not been tested on all platforms, and currently there is one known issue of slow program execution with Intel Core i3 processors. We are trying to resolve this. There are no known program errors which would cause inaccurate reports or other problems. As always, proof-read your final reports before transmittal. No guarantees or warranties are stated or implied respecting the performance of this software. Developer assumes no responsibility for problems incurred resulting from use of product. Page 11 of 11

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13 EXERCISE TOLERANCE TEST FINAL REPORT Patient Name: DOE, JOHN A Gender: M Date of Study: 3/3/2014 Date of birth: 1/1/1950 Age: 64 Medical Record #: Ordering Physician: JOE INTERNIST, MD History: CAD, DOE, Abn ECG, Chest Pain, Hypertension Indications: Assessment of anginal equivalent (DOE), Chest pain Medication(s): Statins, Anti-hypertensive(s) Recent medication(s) which might affect test: None EXERCISE TOLERANCE TEST FINDINGS: The patient exercised on a treadmill utilizing the Bruce protocol; they completed 10 minutes & 27 seconds, achieving approximately 12.9 METS. Baseline heart rate was measured at 72 bpm, and increased to 138 bpm at peak exercise; which is 88% of the maximum predicted heart rate. The heart rate response was normal. Baseline blood pressure was 120/80 mmhg and increased to 166/94 mmhg at peak exercise, which is a physiologic response to exercise. Resting ECG demonstrated normal sinus rhythm w/ PVCs with non-specific ST-T abnormalities, late r-wave progression. During exercise, the ECG showed no additional arrythmia. At peak stress, the ECG revealed horizontal ST-T depression of 2 mm. There was T-wave inversion during stress. During exercise, the patient developed chest pain level 4 of 10, dyspnea. The reason for exercise termination was fatigue, dyspnea, patient's request. Symptomatology resolved during standard recovery period. SUMMARY: IMPRESSION: Positive minutes on Bruce protocol; achieved 12.9 METS at 88% of maximum predicted heart rate Chest pain level 4 of 10 Exercise ST-T changes noted Dyspnea Blood pressure response was physiologic Stopped for fatigue, dyspnea, patient's request John Hancock, MD Date of Final Report: 3/3/2014 Interpreting MD cc: DAVID SPECIALIST, MD 123 Main St NY, New York ph: (202) fax: (202)

14 NAME: EXERCISE TOLERANCE TEST WORKSHEET DOB: DATE OF STUDY: GENDER: M F PATIENT ID#: History / Indications: Abn ECG Angina/Unstab A-Fib A-Flut CAD CardMyop C.P. CHF Old MI Fatigue A.Stenos D.M. Dysp DOE Chol B.P. LBBB RBBB Palpit. Smoker ExSmok +Ca + Sync PVD Hx of: PCI CABG Fam Hx of: CAD CHF 85% = RESTING: Stage 1/minute 1: Stage 2/minute 2: Stage 3/minute 3: Stage 4/minute 4: Stage 5/minute 5: Stage 6/minute 6: Stage 7/minute 7: PEAK: Recovery: 1min: 3 min: 5 min: HR BP EKG SYMPTOMS Notes: IMPRESSION: Inadequate Negative Equivocal Positive Positive by Symptoms Positive by ECG criteria EXERCISE TIME: METS: HRRESP: Normal Blunted Accentuated BPRESP: Physiologic Hypotensive Hypertensive Initials: (REST) RHYTHM: NSR S.Brady S.Tach AV seq. paced Junc. Rhyt SVT PACs A-flutter A-Fib V paced A paced PVCs (REST) PATTERN: no sig abn LAD LAHB Δ wave LVH RBBB LBBB WPW inc RBBB inc LBBB IWMI old AWMI-old LWMI-old inf Q-waves ant Q-waves lat Q-waves IVCD T-wave def late r-wave prog early repolar V-paced early r-wave prog non spec ST-T changes RBBB & LAHB (STRESS) ARRHYTH: none PACs PVCs A-Fib SVT non-sus V-Tach V-Tach Trans A-Fib 1 st AV-block 2 nd AV-block 3 rd AV-block STDELTA: no dx ST-T Δ s ST dep horiz ST dep ST dep ST elev flat to ST dep flat to ST dep STΔmm: T-wave flattening T-wave inv WHYTERM: arrhythmia chest pain claudication dyspnea ECG Δ s fatigue hypotension hypertension pt s request leg fatigue

15 NAME: EXERCISE TOLERANCE TEST WORKSHEET DOB: DATE OF STUDY: GENDER: M F PATIENT ID#: History / Indications: Abn ECG Angina/Unstab A-Fib A-Flut CAD CardMyop C.P. CHF Old MI Fatigue A.Stenos D.M. Dysp DOE Chol B.P. LBBB RBBB Palpit. Smoker ExSmok +Ca + Sync PVD Hx of: PCI CABG Fam Hx of: CAD CHF 85% = RESTING: Stage 1/minute 1: Stage 2/minute 2: Stage 3/minute 3: Stage 4/minute 4: Stage 5/minute 5: Stage 6/minute 6: Stage 7/minute 7: PEAK: Recovery: 1min: 3 min: 5 min: HR BP EKG SYMPTOMS Notes: IMPRESSION: Inadequate Negative Equivocal Positive Positive by Symptoms Positive by ECG criteria EXERCISE TIME: METS: HRRESP: Normal Blunted Accentuated BPRESP: Physiologic Hypotensive Hypertensive Initials: (REST) RHYTHM: NSR S.Brady S.Tach AV seq. paced Junc. Rhyt SVT PACs A-flutter A-Fib V paced A paced PVCs (REST) PATTERN: no sig abn LAD LAHB Δ wave LVH RBBB LBBB WPW inc RBBB inc LBBB IWMI old AWMI-old LWMI-old inf Q-waves ant Q-waves lat Q-waves IVCD T-wave def late r-wave prog early repolar V-paced early r-wave prog non spec ST-T changes RBBB & LAHB (STRESS) ARRHYTH: none PACs PVCs A-Fib SVT non-sus V-Tach V-Tach Trans A-Fib 1 st AV-block 2 nd AV-block 3 rd AV-block STDELTA: no dx ST-T Δ s ST dep horiz ST dep ST dep ST elev flat to ST dep flat to ST dep STΔmm: T-wave flattening T-wave inv WHYTERM: arrhythmia chest pain claudication dyspnea ECG Δ s fatigue hypotension hypertension pt s request leg fatigue