Exhibit 4-48. Treadmill test stage 2 – (12 through 18 years)12- through 18-Year-Olds:
Throughout this stage, monitor the BP monitor for the SP’s heart rate. Watch the
continuum bar to confirm that the SP’s heart rate is below 90 percent of PMHR. If the SPs heart rate is above the 90 percent range, determine if the SP is OK by
observing his or her color, breathing and gait for signs of severe fatigue and ask how
he or she is doing. Ask for the RPE. You do not have to record the RPE unless it is at the end of the
stage. If the SP looks OK, does not ask to stop, and RPE is not greater than 17,
continue with the test. Continue to monitor very closely for signs of exhaustion and stop the test if the SP’s
symptoms warrant ending the test. At 2 minutes 30 seconds into Stage 2 the ISIS system will give the auditory message:“Get RPE Assessment.” Get the SP’s assessment of RPE and enter the number in the appropriate field below
Stage 2. The BP monitor will automatically measure BP and HR. These values will be
captured by the ISIS system. At approximately 2 minutes 40 seconds into Stage 2 the
ISIS system will give the auditory message:“Check heart rate on monitor.”