Sierra software for Electrodiagnostic testing

Sierra® 4 is a modern and intuitive software for Sierra Summit. Sierra 4 offers simple setup and new diagnostic tools for EMG, nerve conduction, evoked potential, and neuromuscular ultrasound examinations.  Sierra software is completely integrated into the Summit base unit controls, the StimTroller Plus™ handheld electrical stimulator, Sierra NMUS1 neuromuscular ultrasound, the mouse, the footswitch, and auxiliary stimulators. These components can be programmed in the software to control the function of your preference.

The Sierra software user interface is customizable, flexible, and rich with features designed to improve accuracy and reduce testing time. Color themes, workspaces, protocols, techniques and reference limits can be set up to each user’s preferences.

Tests can be edited or even created on the fly during a case. You can add, delete, or rearrange sites and segments; compare to normative values or see contralateral comparisons; and sort results into a variety of tables. Neuromuscular ultrasound parameters can be predefined and stored as protocols for different anatomies, just like EMG and NCS protocols.

Want to see Sierra software in action? Contact us for a demo.

Upgrade to the latest version of Sierra software

Take advantage of Cadwell’s free software updates to access new diagnostic tools and time-saving enhancements at cadwell.support.

Sierra Protocols

Preset and custom protocols reduce testing time and ensure consistency. Auto-cursors let you place cursors on any trial with the click of a button, and test-specific functions help you easily acquire and analyze data. Whether you’re comfortable with our environment or new to Cadwell, our flexible software gives you the benefit of both classic and advanced Sierra ‘+’ protocols.

Sierra software protocol quick links

Use the buttons below to quickly jump to your protocol of interest.

Nerve Conduction Protocols | NCS & NCS+

Control intensity, pulse width, distance, nerve selection, site selection, trace selection, and more, and run an entire NCS from the palm of your hand with the StimTroller Plus™ handheld stimulator.

NCS+ Major enhancements

• Simplified setups for Tests and Reference Limits
• Improved result table management and sorting
• Improved workflow and flexibility (i.e. adding testing sites on the fly and fixing mistakes)
• Improved patient comfort: F-waves can inherit traces from Motor tests

Improve Button | F1

Reduces shock artifact, flattens the baseline and improves accuracy.

See the full story with combination tests and strategies

• Display multiple test types or even an entire strategy in the same display.
• Simultaneously display motor, sensory, F and H responses to reduce testing time, improve result analysis, and facilitate advanced test protocols.
• Integrated nerve conduction controls in the Sierra Summit base unit, handheld stimulator, mouse, and footswitch can be programmed in Sierra software to control the function of your preference.

CTS Strategy

Visible Reference Limits

Show the reference limits on traces during cursor adjustment or review.

Evoked Potential Protocols | AEP | SSEP | VEP

Sierra Summit offers a full suite of evoked potential tests that can be modified to fit the needs of your practice. Complement your other tests, including EMG and MRI scans. With Sierra EP Protocols, you can detect, confirm, and monitor problems with nervous system function.

Features:

• Scale from 1-12 channels and easily add or re-montage channels during acquisition
• Personalize views for side-by-side comparisons with a vertical or horizontal split screen
• Advanced post processing: compare, combine, average, grand average, smooth, and invert trials
• Custom cursors and calculations: latency, amplitude, inter-latency, inter-amplitude, percentages, ratios, and side-by-side comparisons
• Live Test Edit: easily adjust parameters, protocols, and channel count during acquisition

Visual (VEP) Protocols

Use any LCD monitor with Sierra Summit’s Calibration Sensor

• Pattern VEP
• Flash, ERG
• Goggle
• Trigger-In
• Trigger-Out
• Selectable Fields, Check Sizes, and Targets

NMUS+ Protocols for Neuromuscular Ultrasound

The Sierra NMUS1 Ultrasound device is completely integrated into Sierra software with the NMUS+ protocol, enabling high image quality, integrated workflow and results, and muscle quantification mode.

The NMUS+ Protocol supports the NMUS1 Ultrasound Scanner and Probes with full integration in Sierra 4 software and Sierra Summit hardware. The workflow complements NCS and EMG with unique features for nerve and muscle quantification. NMUS+ with the Sierra NMUS1™ ultrasound scanner offer great image quality and simple reporting with imaging and data tables. This new ultrasound protocol requires upgrading to the new Sierra NMUS1 ultrasound scanner and probe(s), and also requires a computer with a Thunderbolt connection.

• B-Mode: Measurements: distance, area, circumference, volume and angle
• CFD-Mode
• M-Mode
• PW-Mode
• Q-Mode: our cutting-edge proprietary technology that offers a dual stream of B-Mode and RF data that can be used for researching ultrasonic quantification of muscle and nerve tissue. Measurements include: mean echo intensity (EI) and mean echo intensity compensated for signal attenuation (EIc).

Cine

Sierra NMUS+ Right Wirst Cine 5

Single Fiber EMG Protocol | SFEMG+

SFEMG+ protocol gives you real-time jitter analysis with automatic triggering and peak detection. All live data is saved, so you can easily perform edits and refine the results at any time. SFEMG+ protocol enables hands-free recording, automatic peak detection and triggering, real-time analysis with live results and normative data for standard concentric needles. You can exclude traces and refine results in seconds. Sierra software can be programmed to control SFEMG settings and functions with integrated controls on the Summit base unit, the StimTroller Plus handheld stimulator, the mouse, and the footswitch.

Major SFEMG+ enhancements

• Workflow and efficiency improvements
• More intuitive results tables and histogram
• Better peak analysis
• Docking and auto-hiding windows offers better workspace flexibility

MUNIX+ Protocol

New MUNIX + Protocol

• This new protocol combines motor NCV and surface EMG to derive a motor unit number index (MUNIX) of a muscle, which can be used to track disease progression in motor neuron diseases, including amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease)
• MUNIX+ Protocol is part of the MUNE license

MEP+ and Triple Stim Protocol

MEP+

• Use magnetic stimulation for motor evoked potentials
• Commonly used internationally, MEP+ is growing in use in the United States, specifically in Gastroenterology and teaching hospitals

Electrodiagnostic Reports

Efficiently and effectively reviewing and communicating diagnostic results is a top priority. Sierra software is designed with many timesaving and intuitive reporting features specifically focused on helping physicians manage their many responsibilities.

Optimize your post-exam workflow

• Leave the exam room and finish your diagnosis and reporting in your office or from any computer connected with CadLink®
• Have an identical user experience from any computer with synchronized settings and role-based user management
• Remotely view tests that are being acquired by a technician or resident
• Easily access previous studies, including EEG and IONM cases and compare with recent results
• Anonymize and export data in multiple formats for publications, presentations, or research

Reviewing and reporting features

• Tab Data Summary View: See all test results and waveforms with the click of a button, and complete your report without switching screens. Adjust cursors, replay buffers, and edit the muscle scoring table.
• CadCapture™: Anonymize and export data in multiple formats for publications, presentations, or research, and create training videos and lectures with CadCapture video and screen capture.
• Auto-Findings Composer: Automatically generate findings paragraphs based on reference values, and compare your NCS and EP results with normative data, instantly summarizing your findings in paragraphs or bullet points. Personalized wording and language give you full control of how your results are communicated.
• QuickReport™: Complete your report while you are performing the examination with custom templates and selections accessible during patient entry, acquisition, and review. Create a personalized report with just a few mouse clicks.
• Custom Reports: Several professional report templates are included with the Sierra Summit, however you have full control to modify or create your own report templates. Ultrasound images and measurements can also be included.
• Anatomy View™: Anatomical images illustrating results can be included within the report to better communicate neurodiagnostic findings.
• EMR Integration and Data Management: Reports can be automatically sent to the patient’s EMR as embedded data or as an attachment when using CadLink with HL7. Reports can also be emailed, printed, or saved locally or to a remote server. Multiple formats are available including .pdf, .docx, and .rtf.