Cadwell Sierra Summit

  • Cadwell EMG system 3-12 channel amplifier on Cephalon cart

Cadwell EMG Sierra Summit

Cadwell EMG Sierra Summit

Sierra Summit is designed for electromyography who prioritize reliability and efficiency for their EMG, NCS, EP, and Ultrasound needs.

Cadwell offers cutting-edge neuro diagnostics with forward-thinking hardware and innovative software.
The EMG system Sierra Summit is the brainchild of 40 years of research and development at Cadwell. We have responded to feature requests, new electrodiagnostic (EDX) technology, and broader learning to bring you one of our most dynamic pieces of neurophysiology diagnostic equipment. In 2018, Cadwell became the first EMG company to offer a fully integrated ultrasound for a EMG system.

Today, Cadwell is working in tandem with some of the world’s leading EDX physicians and teaching hospitals. We’re leading the charge in neurodiagnostic technology capabilities in EMG, nerve conduction, evoked potentials, ultrasound, and chemodenervation.

The Sierra Summit is a powerful tool for all of your EMG neurodiagnostic monitoring. 


  • Base Unit with dedicated keypad and knob controls
  • Dual high-power speakers with software-controlled equalizer
  • Handheld StimTroller Plus™ (3 programmable buttons, remote stim, and control)
  • 1-12 Channel Amplifier Configurations
  • EMG with spontaneous, volitional, and interference pattern modes.-Unlimited buffer storage (buffer length up to 10 minutes)-Replay with audio-Buffer length up to 10 minutes-Programmable muscle scoring-EMG snapshots within reports-Motor unit analysis (manual, suggested template, or automatic online or offline)-Interference pattern analysis (clouds)-Comparison to reference values
  • EMG Guided Injection Protocol
  • NCV (motor, sensory, mixed, inching)
  • F Wave / H Reflex •AnatomyVIEW™
  • Side-to-Side Comparisons (NCV, F, H, EP)
  • Blink Reflex
  • RNS (1 or 2 channel acquisition)
  • SEP and SEP Interleave (upper, lower, dermatomes)
  • Autonomic Studies – Heart Rate Variability (RR Interval) – Sympathetic Skin Response (SSR)
  • Programmable Study Lists
  • Tabular Data Summary View
  • QuickReport™ MS Word® based report generator
  • Auto Findings Composer (automatic comparison to norms and creation of sentences for NCV, F, H, EMG and EP findings)
  • EP Analysis (add, subtract, average, grand average, invert)
  • EMG to AVI Converter (convert EMG to video/audio files)
  • DataLAB™ (calculate user-defined relationships)
  • ASCII Output Utility (all test protocols)
  • CadLink™ Database (management of patient files and user settings)
  • Screen + video capture tools
  • Internal Calibration Signals
  • Hardware Diagnostics Suite (diagnostic routines for the amplifier, electrical stimulator, and keypad
  • Electrode Continuity Check (built into the amplifier)
  • Single Fiber and Macro EMG
  • Motor Unit Number Estimation (MUNE) – Assisted Incremental Technique – Multiple Point Stimulation Technique
  • P300
  • VEP – includes LCD calibration sensor
  • HL7 Interface for EMR connectivity

1-2 Channel EMG Amplifier

A/D Conversion: 16 bit, 100 kHz per channel.
Connection types: 1.5-mm, touchproof connector or 5-pin DIN connector.
Common Mode impedance: >1000 Mohm.
Noise: <0.6 μV rms.
CMRR at 50 or 60 Hz: >115 dB

3-12 Channel

A/D Conversion: 16 bit, 100 kHz per channel (4 non-switched EMG channels).
25 kHz per channel (8 switched EP channels).
Connection types Non-Switched Channels: 1.5 mm, touchproof or 5-pin DIN.
Switched Channels: 1.5 mm, touchproof. 4 non-switched and 8 switched channels can be utilized in any combination. The 8 switched channels can use any of the 20 inputs available on the amplifier front panel or remote input box.
Common Mode impedance: >1000 Mohm.
Noise: <0.6 μV rms.
CMRR at 50 or 60 Hz: Non-switched channels: >115 dB.
Switched channels: >90 dB

Base Unit

Field Upgradeable Firmware: Yes.
Trigger Input: 4 TTL compatible.
Rising or falling edge.
Trigger Output: 4 TTL compatible, multiple pulse durations, positive or negative polarity.
Speakers: Built-in, dual 2” high power, front-facing, 4 ohm, 7 watt, with software equalizer.
Footswitch: USB, Single pedal.
USB to PC: Dedicated high-speed connection to PC (480 Mb/sec).
Electrical Stimulator: 1 standard, 2nd optional.
Auditory Stimulator: Optional.
Equipotential Ground: Connector on back panel.
Disconnect/Reconnect: Automatic recovery after connection is lost or power is restored.
Connections: Durable, color-coded connectors with protected pins

Electrical Stimulator

Number: 1 or 2.
Type: Hand-held, constant-current electrical stimulator with stimulus intensity dial, single,repetitive, store, polarity, and three user programmable buttons on handle.
Includes high flex-life cable.
Pulse duration: 50 to 1000 μs width, adjustable in 50-μs increments.
Pulse shape: Monophasic or Biphasic.
Pulse types: Single, Pair, Train, Dual, Dual Train, Triple.
Repetition rates: 0.1 to 200 pps depending on stimulus type and sweep speed.
Probes: 2 removable stainless steel, 2.5 or 1.5 cm center-to-center spacing.
Probe positions: Adjustable+45 to -90 degrees without removing probe tips.
Electrical range: 0 to 100 mA, 400 V maximum voltage.
Resolution: 0.03 mA.
Safety features: Over current fault detection, High impedance detection.
Isolation: Type BF.

Auditory Stimulator

Transducer: Sennheiser HDA 280 headphones (37-ohm), Insert earphones (10-ohm) and Bone transducer (10-ohm)
Presentation: Left, right, or bilateral.
Intensity units: nHL/SPL.
Intensity increments: 1, 2, 5, or 10 dB.
Stimulus types: Click, Tone Burst, Tone Pip 202, Tone Pip 212.
Stimulus polarity: Rarefaction, condensation, or alternating polarity.
Repetition rates: 0.1 to 90 pps depending on stimulus type and sweep speed.
Clicks: 50, 100, 200, 500 or 1000 μs square wave.
Tone Frequencies: 250, 500, 750, 1k, 1.5k, 2k, 3k, 4k, 6k, 8k Hz.
Tone Burst: 4 to 100 ms rise/fall, 4 to 2000 ms plateau.
Tone Pip: 1 to 40 cycles rise/fall, 0 to 500 cycles plateau.
Tone Envelope: None, Linear, Gaussian, Hanning, Blackman.
Decibel range: -10 to 107 dB nHL (140 pSPL) depending on stimulus type, frequency and transducer.
White noise masking: Contralateral masking from 0 to 80 dB below stimulus level.


Visual Stimulator

LCD Monitor: LCD monitor for black and white, pattern-reversal checkerboard stimulation.
Features center fixation target, independent quadrant and half-field stimulation.
Square sizes: 1, 2, 4, 8, 16, 32, 64 or 128 checks.
Combination of Sierra Summit and monitor must meet requirements of EN60601-1-1.
Connection Type: SVGA, HDMI, DVI, or Display Port from Laptop or Desktop PC.
VEP Calibration Sensor: Included with VEP software (for automatic calibration of LCD video delay).
LED Goggles: Red flash, 5 ms duration. Left, right or bilateral presentation.

Integrated EMG Cart

The features and ergonomics of Cadwell’s new EMG Cart were designed to seamlessly combine EMG and Ultrasound into an integrated examination. The cart conveniently accommodates ultrasound probes and gel alongside EMG supplies and accessories.


Integrated EMG and Ultrasound Controls

Directly from the Sierra Base Unit:

  • Adjust image settings
  • Record and review snapshots and videos
  • Switch between B, M, Doppler and Comparisons modes


Integrated Settings

Pre-define structures in the Sierra Summit with specific image presets. Save time with labeling. Improve clarity of specific structures.


Integrated Workflow 

Switch between US and EMG or NCS with the push of a button. Include imaging sites in your NCS and EMG study lists.


Integrated Reports

Include US images and measurements in your EMG report. Store everything in the same locations.


Concurrent Use

Use ultrasound simultaneously with any NCS or EMG protocol. 

  • Hear, see and stimulate for more accurate injections and needle guidance.
  • Combine imaging with any nerve study and create a new and unique protocol.
Cadwell EMG Ultrasound curvilinear probe

Ultrasound allows visual guidance of peripheral joint, tendon, and nerve injections

  • Visualize the needle and the soft tissue target in real time
  • Improve needle placement
  • Identify and avoid neurovascular structures
  • Identify and avoid visceral structures
  • Improve accuracy, even in routine procedures
Cadwell EMG Ultrasound Probe

Integrated ultrasound gives real-time neuromuscular visualization

  • Dynamic visualization 
  • Ability to see moving tissue
  • Ability to see vascular flow with Doppler imaging
  • Protect target and surrounding soft tissue structures in diagnostic and therapeutic needle guidance procedures
  • Enhance safety and accuracy in needle procedures
Cadwell EMG Ultrasound Probe 2

Provide safe, portable and low-cost diagnostic imaging

  • No ionizing radiation
  • Can be used with metallic implants
  • No claustrophobia, as with other imaging modalities
  • No restrictions or known adverse effects
  • Instant feedback of results
B Mode Median Nerve Long Axis
B Mode: Median Nerve Long Axis
M Mode: Diaphragm with Phrenic Nerve Stim
M Mode: Diaphragm with Phrenic Nerve Stim
B Mode: Median Nerve Cross-Section
B Mode: Median Nerve Cross-Section
Needle Injection with PDI Doppler
 Needle Injection with PDI Doppler