Sigma Instruction Manual Book One: Use of the Device

This comprehensive user guide is the definitive resource for all Sigma users. It contains both a guided guide that examines all aspects of device function and a detailed discussion of practical issues in ECT administration. Along with providing extensive training in the use of the equipment, it addresses a number of issues related to ECT practice, including stimulus dosing, electrode site preparation, and physiological monitoring. This manual includes Sigma titration charts for use in empirical dose finding and preselected dosing charts that account for gender, age, and electrode placement when recommending initial stimulus configurations. Two copies of this manual are included with the purchase of your Sigma device, and this manual is also available for purchase separately.

Second Guide to the  Twoigma Manual: Clinical Issues in the Administration of ECT

This Handbook for Book Two complements the Handbook for Book One and covers different topics. While Book One focuses on the use of the device, Book Two summarizes the current state of knowledge about ECT adverse effects, standardized assessments that can be performed to minimize risk and document clinical outcomes, informed consent, and other clinical topics. One copy is included with the purchase of Sigma equipment and this manual is also available for purchase separately.

Sigma Service Manual: Book Three

This Service Manual (Book Three) provides detailed instructions for professionals and biomedical personnel to assess the proper function and calibration of the equipment. This manual also provides device function specifications and cleaning and maintenance recommendations. Two copies are included with your Sigma device and this manual is also available for purchase separately.

Sigma Instructional DVD / USB

The Sigma instructional video comes in two formats, either a DVD or USB drive. The DVD version plays at a lower visual resolution than the USB version, but both contain the same video material: (1) Guided tour of Sigma and (2) Simulated ECT session using Aigma. The first video provides a tour of the features, including all of the device’s menus and options, supplementing the Book One User Guide. The second video shows the use of the Sigma in a simulated ECT session, including preparation of stimulation and physiological monitoring electrode sites, stimulus dosing, seizure monitoring, etc. This simulated ECT session video is particularly useful for individuals who are in ECT practice as well as residency programs.

Sigma titrations and pre-selected dosage tables

Stimulus dose titration has been widely shown to be the most accurate method for quantifying seizure threshold and determining subsequent stimulus dose. Experts sometimes prefer to administer preselected ones and avoid titration. Sigma Titration Tables and Default Dosing Tables address both approaches and are included in each Book One manual that comes with the Sigma device. These tables are also sold as a laminated set for easy access in the ECT set. Separate titration charts and pre-selected dose charts are available for one-knob and four-knob operation, so practitioners can perform titration or preset stimulus configurations whether they prefer using one knob or setting up four knobs independently. Separate tables are also available for ultra brief (0.3 ms pulse width), near ultrabrief (0.5 ms pulse width) and short (1.0 ms pulse width) parameter sets. Each table describes the stimulus parameters that deliver an electrical dose estimated at 1.5, 2.0, 2.5, and 6 times the initial seizure threshold.