Advancing medical technology to help you, help others.

Experience The Cadwell Difference – Since 1979

The benefits of owning a Cadwell system are numerous. Our development team understands
and delivers what you need. Everyone at Cadwell stands behind our products, and we all have
the same goal - to keep you as a loyal, devoted customer long into the future.

Innovative Neurodiagnostic Instruments

John Cadwell, BSEE, MD designed the first microprocessor-controlled EMG instrument. In

1979, he and his brother Carl, DDS, formed Cadwell Laboratories, Inc. and began selling
their device. Since then, Cadwell has been a leader in the development and manufacture
of innovative and reliable instruments for neurophysiology. Many of these instruments
have been providing decades of service to their owners.

Numerous patents are held by Cadwell, including those for magnetic stimulators, cable
shielding designs, neural network analysis of EEG, and database designs. Today, still
located in Kennewick, Washington, John and Carl continue ownership of the company and
come to work everyday to develop and market products ranging from EMG to EEG to PSG
to IONM instrumentation and more. Cadwell has a firm hold of its identity and a dedicated
focus on neurophysiology.

Advancing medical technology to help you, help others.

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Our Most Advanced EMG/EP Instrument (The New Standard)
The Sierra® Summit™ is the latest in a long line of successful Cadwell products. It combines the Sierra Wave’s ease of use with
innovative advancements in acquisition and stimulation technology to offer the most flexible, reliable and clinically functional
system on the market today. The Summit is offered in either a 2, 6, or 12 channel configuration and is proudly designed
and manufactured at our Kennewick, Washington facility. The Summit is built with the same lasting quality and reliability
customers have come to expect from Cadwell.

The Summit can be configured as a portable or desktop system. The portable version comes with a laptop computer and
soft-sided carrying case. The desktop version comes with a desktop PC and an LCD monitor or all-in-one PC. We offer both
lightweight and hospital-grade equipment carts to complete the system.

Sierra Summit with

laptop, two channel amplifier,
and StimTroller Plus™. Also available with
a twelve channel amplifier and second StimTroller Plus.

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 Standard Features of the Sierra Summit
• Base Unit with dedicated keypad and • EMG Guided Injection Protocol • EMG to AVI Converter (convert EMG to
knob controls (requires a computer) • NCV (motor, sensory, mixed, inching) video/audio files)
• Dual high-power speaker system • F Wave / H Reflex • DataLAB™ (calculate user-defined
with software equalizer • AnatomyVIEW™ relationships)
• Handheld StimTroller Plus™ • Side-to-Side Comparisons • ASCII Output Utility (all test protocols)
(3 programmable buttons, remote (NCV, F, H, EP) • CadLink™ Database (management of
stim and control) • Blink Reflex patient files and user settings)
• 2, 6, or 12 Channel Amplifier • RNS (1 or 2 channel acquisition) • Compatible with Sierra Wave data
configurations • SEP (upper, lower, dermatomes) files and user settings
• USB Footswitch • Autonomic Studies • Internal Calibration Signals
• EMG protocols (free run and capture - Heart Rate Variability (RR Interval) • Hardware Diagnostics Suite
mode) - Buffer Playback - Sympathetic Skin Response (SSR) (diagnostic routines for the amplifier,
with audio (up to 10 minutes) - • Programmable Study Lists electrical stimulator and keypad)
Unlimited Buffer Storage - • Tabular Data Summary View • Electrode Continuity Check (built into
Programmable Muscle Scoring - • QuickReport™ MS Word® based report amplifier)
EMG snapshots within the published generator • Comprehensive Application Help Topics
reports • Auto Findings Composer (automatic • Free Technical Phone Support
• QEMG comparison to norms and creation • Lifetime Software Upgrades
- MUP Tool of sentences for NCV, F, H, EMG and EP • Soft-sided Carrying Case
- Single Motor Unit Analysis findings) • Starter Electrode Kit
- Multi-Motor Unit Analysis • EP Analysis (add, subtract, average, • Reader Software
- Interference Pattern Analysis grand average, invert)

Sierra Summit keypad

Optional Software • VEP – includes LCD calibration sensor

• Advanced Stim/Trigger capability
• CadLink™ Server Software (centralized • HL7 Interface for EMR connectivity
data storage and administration of • Data Interface Toolkit (API for developers)
user settings for all Summit
acquisition and reader systems on Optional Hardware
the network)
• Single Fiber and Macro EMG • 2nd Electrical Stimulator
• Motor Unit Number Estimation (MUNE) • Skin Temperature Probe
- Assisted Incremental Technique • Reflex Hammer
- Multiple Point Stimulation • Trigger Out/In Interface Cable (3.5mm stereo
Technique to 2x RCA) Summit utilizes durable, color-coded
• AEP (ABR, MLR, LLR, ERG, VEMP, • Remote Input Box (for 12-channel amplifier) connectors with protected pins
ECochG) • Amp/Stim Switchbox (Injection Studies)
• P300

Sierra Summit rear panel

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Cart Configurations
Point-of-Care
Shown here is a 2-channel Sierra Summit with a laptop computer on the lightweight Point-
of-Care cart. A printer can be placed on the shelf and supplies stored in the bin. Mounting
brackets for an amplifier arm are located on either side of the top shelf. The articulated
arm holds the amplifier, StimTroller Plus and also provides a convenient needle holder. The
placement of the stimulator and needle holder can be reversed. Snap-on cable covers on
the arm protect the amplifier and stimulator cables while providing a clean appearance.
The top shelf height is adjustable via hydraulic lever for use while standing or
sitting. Options include a pull-out keyboard shelf, footswitch holder and an
additional storage bin.

Amplifer bracket with

2 channel amplifier,
stimulator and needle
holder

Narrow Trolley
Shown here is a 12-channel Sierra Summit with a low profile PC on the
Narrow Trolley cart. This cart features a foam handle and large locking
wheels for easy manuevering. Cable management is provided inside the
trolley’s twin legs. The PC and a printer can both be placed on the large
bottom shelf. The middle shelf holds the Sierra Summit base unit, while
the top shelf remains free and can be used as a convenient writing
surface. The LCD monitor mounts on a sturdy, adjustable pole on
the rear of the top shelf. An optional isolation transformer can be
installed on the basement shelf. Other options include a pull-
out keyboard/mouse tray, storage drawer and an accessory bag
which mounts on the back of the cart.

Don’t need a cart? The Sierra Summit, amplifier,

StimTroller Plus and cables all fit into our custom
carrying case. For even greater
portability, upgrade to the wheeled
carrying case.

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 Multi-Modality Configuration
Maximize your diagnostic offerings by configuring Easy III EEG and
Sierra Summit EMG/EP software on the same PC. Pictured here are
the 12-channel Sierra Summit and 32-channel Easy III amplifiers on a
Narrow Trolley cart. An all-in-one computer frees up the bottom shelf
for a large printer or additional storage space.

Hardware Diagnostics
The Sierra Summit includes a comprehensive hardware
diagnostic suite. Reduce troubleshooting time by easily
verifying the proper performance of the amplifier, electrical
stimulators and base unit keypad. You can save or print the
test results for your maintenance notebook. Calibration
signals, with four voltages and two frequency settings, are also
available in all test protocols.

NCV Test Protocol

EMG Test Protocol

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Amplifiers
Cadwell has long been recognized as producing some of the world’s finest
neurophysiologic amplifiers; and the Sierra Summit amplifiers are no exception.
Either 2-, 6-, or 12-channel configurations are available. The same amplifier is utilized for
the 6-channel configuration, with the maximum number of channels limited by software.
Each amplifier features fast artifact recovery and very low noise. Analog-to-digital
conversion is done inside the amplifier, eliminating the amplifier cable as a potential
noise source. Each amplifier has superb RF immunity and excellent signal quality.
Temperature measurement, impedance, on/off switch and calibration signals are built-
in. The 12-channel amplifier has four non-switched and eight switched channels. The
eight switched channels can use any of the 20 inputs available in the modified
head pattern on the amplifier or optional remote input box. All 12 channels
can be used simultaneously for data acquisition.

A unique electrode continuity check

(Electrode Check) is built into each
amplifier, so you can easily confirm if
one of your electrode leads is good
or bad.

StimTroller Plus™ Programmable Button 3 Removable/Adjustable Angle

Programmable Stimulator and Test Controller Stimulator Probes
The StimTroller Plus reduces test time by providing
Quick Connect Area
commonly used functions on the remote handheld stimulator.
A typical study can be performed without having to reach back Polarity Indicator
to the base unit keypad or mouse. Three programmable buttons
allow customization to suit your technique.
Functions include:
• Single or repetitive • Playback of EMG buffer Reverse Polarity Button
pulse delivery • Probes can be removed to connect
• Polarity reversal standard bar and ring electrodes.
Angle Single Stim / Hold for Repetitive
Or leave probes in and use our Adjust
• Intensity adjust Button Intensity Adjust / Distance Wheel
Quick Connect Adapter. Other
• Trace storage probe styles include:
• Distance entry - Small diameter, round tip Store
• Next test - Large diameter, pointed tip
- Felt pad tip
• Start/stop EMG - Large diameter, round tip (shown here)
acquisition
• Adjustable stimulus probe angle
• Store EMG snapshot and width for easier and faster
• EMG gain control access to all stimulus locations
Programmable Buttons 1 and 2
• Move back and forth • Three programmable buttons can be
within EMG buffer assigned test specific functions.

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 User Interface
Clean, reliable and fast best describe the Sierra Summit user interface. Use either the custom keypad with its function keys and soft
knobs, or the mouse - whichever is most convenient for you. Combined with the StimTroller Plus and programmable footswitch,
you have all the controls you need without having to drill down through seemingly endless menus.

Advanced features are available from the pull-down menus at the top of the screen or by accessing the context menu (mouse
right-click) over each window. A plug-and-play USB communication interface to the Summit base unit provides compatibility and
upgradeability in a rapidly changing PC environment.

F key and soft knob functionality are specifically tailored for each test
protocol to maximize ease of use and facilitate rapid data acquisition

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 Software

Standard EMG protocol includes both Live and Capture data acquisition modes with easily accessible muscle scoring table and
audio equalizer controls, allowing you to fine tune the audio signal to your listening preference. Up to 10 minute Live EMG Buffer
with unlimited storage and playback. Full-screen or raster displays. Manual MUP tool and single Motor Unit Analysis for quick
documentation of interesting motor unit potentials.

Spontaneous or Stimulated Single Fiber Analysis using either

real-time peak latency detection or voltage crossing. Records
up to 100 consecutive discharges and displays #blocks, MCD,
IPI, and frequency. Review and editing can be done real-time or
offline. A Fiber Density calculator is included.

Interference Pattern Analysis: Quantifies the electromyographic

interference pattern and displays the results on color-coded Multi-MUP Analysis: Signal decomposition and template
plots. Analysis includes Amplitude vs. Turns, Envelope vs. Activity, matching is used to extract, identify, and sort motor unit action
and Number of Short Segments vs. Activity. Normative reference potentials from an epoch of EMG. Typically 1 to 6 motor units
“clouds” provided for several muscles. IPA provides a basis for can be extracted from one 10 second epoch. Includes flexible
classifying the interference pattern as normal, neuropathic, or editing features and summary display of all acquired MUPs. Can
myopathic. Can be performed real-time or offline. be performed real-time or offline.

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 Automatic cursor placement and Left vs. Right comparisons in NCV, F, H, and Evoked Potential test protocols. Live Monitor window
facilitates identification of artifacts or poor electrode connections. On-line comparison to reference data and identification of
abnormal values. Unlimited number of traces displayed per test protocol.

Unique Tab Data Summary View provides quick and

convenient review on all acquired traces and tabular results.
Adjust cursor positions, change distance measurements, and
easily review and playback stored EMG without having to return
to the specific test protocol. Cadwell’s unique Auto Findings
Composer compares the patient’s values to your norms and
creates findings sentences for NCV, F, H, EMG, and EP’s.

AnatomyVIEW feature displays the EMG muscle scoring and

NCV results on a 3D color-coded anatomical model. Green
Repetitive Nerve Stimulation by manual or automatic delivery indicates normal findings and varying levels of yellow-orange-
of programmable stimulus trains. Results include comparison of red indicate abnormal results. The models can be rotated and
both amplitude and area for all responses in the train. Supports resized quickly using the mouse. This graphic can be included
stimulation frequency up to 50 Hz and 1 or 2 channel recording. in reports.

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Evoked Potentials include somatosensory, auditory, and visual modalities with display and storage of unlimited number of waveforms.
Auto-cursors for marking important waveform features with automatic side-to-side comparison and highlighting of abnormal values.
Normal or Odd/Even averaging modes. Adjustable artifact rejection and support for third-party stimulators via Trigger In/Out.

Cadwell’s industry leading Report Generator utilizes Microsoft

Word® and includes customizable modules for entry of patient
history, physical exam, impressions, and more, without having
to type at the keyboard. Reports include tabulated data,
waveforms, anatomical displays, and results of Auto Findings
Composer. Templates can be customized to suit your individual
needs.

Autonomic Studies include RR interval and Sympathetic Skin Advanced Studies include Macro EMG, MUNE (motor unit
Response. RR Interval includes automatic or manual calculation number estimation) and multiple stimulus configurations
of max/min ratio and support for normal and deep breathing, utilizing the two independent electrical stimulators with
valsalva maneuver, and 30:15 ratio. adjustable train lengths and delays.

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 CadLink™ Database

Designed for easy setup and operation in either the private practice or large neurodiagnostic laboratory setting, the CadLink
database organizes, manages and secures your patient files and customized user settings. View your patient records in multiple ways
- alphabetically, by day, by month, by year, by physician - whichever is convenient. Complex searches can be accomplished using the
advanced search capabilities. Import supplementary documentation, such as symptom drawings, pictures or patient history forms and
save them with the record. CadLink supports multiple users; each with their own test settings and report templates.

Networking
Add the CadLink Central Server module and you can seamlessly network multiple Sierra Summits and Reader stations. Patient
records are available from any acquisition or review station on the network. Complete the exam and then finish the report later in the
comfort of your office. The receptionist can also be included on the network so that patient information can be input at check-in or
final edits can be made to reports. Change a test setting or report template on one Sierra Summit and it is automatically available to
all systems on the network.

Exam Room 1 Reception

Server

Reader station in
Exam Room 2 physician’s office

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Your Time is Valuable
Here Are Three Reasons the Sierra Summit Will Save You Time
1. Reduced Testing Time
• Perform NCV, F/H tests without touching
the keypad.
Select nerves, acquire traces, store traces, and enter
distances using programmable buttons on the StimTroller Plus.

• Easier access to stim locations.

Angle of stimulus probes is adjustable and the
polarity of the probes is reversible. And with our
Quick Connect Adapter, you don’t need to
remove the probes to attach a bar or ring electrode.

• Eliminate the time of moving between screens.

Study lists allow you to perform a complete study from
one screen, saving button pushes and time.

• Adapts to your testing style.

Most functions can be performed using button pushes or the
mouse. You decide which makes you more efficient.
2. Rapid Review of Results
• One button push displays all data.
Numbers and waveforms from every
test are available from one screen. Click
on a test to review the waveforms or
adjust cursors.

• Faster data review.

Abnormal findings
(based on your
normal values) are

automatically
highlighted but can
be adjusted if needed for each patient.

• Eliminates the time it takes to write a

summary paragraph.
Auto Findings Composer writes the
summary of findings paragraph for you
based on the highlighted values you
have determined to be abnormal in
both NCV and EP tests, and even
summarizes your EMG scoring for Finding shown here in bulleted format.
the report. Numbered or paragraph formats also available.

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 3. Your Personalized Reports without Typing
• Unique Reports.
We will design templates in your own style, not
ours. Templates can be designed for EMG/
NCV testing only or even more complex full
consultation reports.

• Eliminate dictation or typing.

Your custom report templates will allow you to
generate reports simply by using the mouse and
selecting from a list of choices.
Use the mouse to
• Easily email reports.
make selections
All results and findings are automatically
transferred to Microsoft Word, and are saved in
*.doc, *.docx, or *.pdf format.

• EMR friendly.
Easy integration with patient’s electronic The Carpal Tunnel Impression template has been selected.

medical record. Sierra Summit is network ready

and has an optional HL7 Interface.

Easily insert your

office header
and logo.

This entire section

was created without
using the keyboard.

All result tables can be included with

abnormal values highlighted.
Waveforms optionally included.

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Cadwell Customer Support
Cadwell is focused on making you a satisfied, loyal customer for years to come. Our
telephone support is second to none. We answer every call during business hours
with a real person. Our in-house employee technicians are trained professionals.
Our web-based support program allows our technicians to troubleshoot real-time
– as if they were in your office. Our flexible service contracts will meet your specific
needs. Just ask.

Supplies and Accessories - www.estore.cadwell.com

Cadwell has a complete range of quality, reliable supplies as well. From Monopolar and Concentric to Injectable and Single
Fiber needles; disposable and reusable surface electrodes for NCV, EMG and EP. We are your one-stop source for everything
neurophysiology related.

Quick Connect Shielded Interconnect

Adapter Cable

Cadwell Disposable Patient Pak Refills

and Starter Kits
(Improved Hydrogel)

Stim Probe
Ambu® Neuroline Disposable Extension
Monopolar Needle Electrodes
With Detached Lead Wire

15
909 N. Kellogg St. · Kennewick, WA 99336
(800) 245-3001 · (509) 735-6481 ph · (509) 783-6503 fx
www.cadwell.com · [email protected]

© 2013 Cadwell. All rights reserved. PN# 190272-937 Rev. 00

The information contained in this document is subject to change without notice. This document contains trademarks that belong to Cadwell Laboratories, Inc. and other companies, respectively.