We are very excited you have chosen Ember to fulfill your training and exercise needs. If at anytime you have questions, please feel free to reach out to us at Cercacor. We are committed to doing what we can to ensure you become an advocate of Ember and Cercacor technology.
The Ember Team at Cercacor
*Equipment and software pictured in this user guide is based on information available at the time. Android App may not include all features pictured or described. Actual product offerings may vary from those shown or may be subject to availability delays or discontinuance.
Cercacor, the Cercacor logo and Ember are trademarks of Cercacor Laboratories, Inc. Apple, the Apple logo, iPhone and iPod touch are trademarks of Apple Inc., registered in the U.S. and other countries. App Store is a service mark of Apple Inc. The Bluetooth® word mark and logos are registered trademarks owned by Bluetooth SIG, Inc.
Indications for Use
Ember is intended for use by athletes or their trainers to help measure and track hemoglobin, pulse rate, perfusion index, oxygen saturation, oxygen content, respiration rate, pleth variability index, carbon monoxide or methemoglobin. It is intended to be used by individuals 13 years or older with a finger width of 22mm or less. This product is not a medical device.*
The Ember system consists of the device, sensor, and mobile app. The Ember device requires a smartphone with Bluetooth 4.0 capabilities to operate, running iOS 9.0 or newer or Android 5.0 or newer.
*This product is not intended to monitor or alleviate a physiological condition or disease state. Individuals who need a device to monitor a medical condition should contact their physician. Ember is not meant to replace laboratory measurements nor is it intended for medical use. If you want more accurate hemoglobin assessments, please use invasive methods using properly conducted Cyanmethemoglobin assay or properly conducted and calibrated Coulter Counter testing.
CREATE AN ACCOUNT (Creating an account is optional, but highly recommended)
Connecting Ember to your smartphone
If problem persists, contact firstname.lastname@example.org. Be sure to include a complete description of the problem.
Taking a Measurement
1. Begin by placing the sensor on a finger free of deformities. It is best to use the pinky (smallest) finger of your non-dominant hand. It is recommended to not use nail polish for best accuracy and repeatability of measurements. Blue or green nail polish significantly affect the accuracy of the measurement.
2. Tap to check the parameters you want included on your next measurement. Once you are ready, tap the “Start” button. The measurement time varies and can be as fast as 30 seconds. Be patient, the system will populate results as they are acquired.
For best results measuring with Ember:
3. Your measurement results will be displayed on the screen. When you tap the “Capture” button, the numbers displayed will be saved in your history. The gauge to the right of the display tells you your target range based on your age and biological sex (must have an account for gauges to be enabled). You can customize the target range based on your individual goals by accessing the “Options” tab of the app (see page 26).
When you enable the Ember by Cercacor app to track GPS location, each measurement you take will log the location and capture the outdoor climatic details where your measurement was taken.
* Please keep in mind these details are not measured by Ember but from
published data from an outdoor sensor within a similar zip code
Out of Range Results
If your results display “Low” instead of a numeric value for hemoglobin, it indicates that your value was below 10 g/dl and is too low to present a number. If you receive the phrase “High” instead of a numeric value, it indicates that your value was above 24 g/dl and is too high to present a number. If you have impurities of CO or Met then your SpO2 values may not be accurate. If SpO2 values are lower than 90% CO values may not display in some cases. If Met is greater than 2%, the value for CO will not display.
If your value has a red box around it, the value is out of your set ranges. These ranges can be adjusted to your specific needs in the “Options” tab of the App.
The default ranges displayed on your results screen can be adjusted within the “Options” tab of the Ember app.
The default values are from published sources on general population ranges based on biological sex and age.
We recommend you set your own custom ranges based on input from your trainer or your own personal goals.
Inaccurate readings can be caused by:
Note: Some of these may cause incomplete measurements see pg. 28.
If you take a measurement and receive the “Incomplete” pop-up dialogue, please check the following and try your measurement again.
Your Ember device is capable of measuring numerous parameters depending on your model or the number of parameter upgrades that you have installed.
The protein contained in red blood cells that is responsible for delivery of oxygen to the tissues. The range of hemoglobin values can vary based on your age and biological sex. For adults 18 years and over at rest, hemoglobin values can be between 12-15.5 g/dl for females and 13-17.2 g/dl for males. Tracking your Hgb first of day and Pre/Post specific activities such as workouts or hydration may help you understand the intensity of your workouts and the fluid volume shifts and/or recovery times. Additionally, you may be able to learn the extent to which elevation training increases your Hgb and how long the effect lasts after returning to sea level.
Pulse Rate (Pr)
The number of beats your heart takes per minute (bpm) as detected from the pulsation at your finger tip. At rest values range between 50-85 bpm however fit individuals typically have lower resting heart rates. This is because their heart is more efficient and effective with each beat that it requires fewer beats per every minute. Tracking your pulse rate first of day and pre and post workout is a great benefit of using Ember to get an understanding of the intensity of your workouts as well as the impact over time to your fitness level on your first of day pulse rate.
Perfusion Index (PI)
The strength of blood flow/circulation at your finger tip measured as a percentage (%). Values for PI range from 1-20%.
Oxygen Saturation (SpO2 )
The amount of hemoglobin that is saturated with oxygen expressed as a percentage (%). At rest you should be greater than 95% oxygen saturated and after an intense workout you may go less than 85%. The lower your SpO2 the less effective your muscles and tissues are for performance. Tracking your SpO2 with specific activities throughout the day with Ember may help you understand the quality of your oxygen exchange.
Oxygen Content (OC)
The total amount of oxygen bound to hemoglobin. This value is derived from your hemoglobin and oxygen saturation levels in millilitres per decilitre of oxygen (ml/dl). At rest values can range between 15.2 - 23 ml/dl. By tracking this number with Ember, you may discover that you have better endurance and performance when your OC is trending higher.
Respiration Rate (RR)
The number of respiratory cycles you complete per minute (rpm). A respiratory cycle is the entire inhalation (breathing in) and exhalation (breathing out) from your lungs. Values can range from 15-20 respiratory cycles at rest. Tracking your RR multiple times per day with Ember may help you understand the impact exercise has on your respiratory cycle and provide feedback on how effective your breathing becomes over time.
Pleth Variability Index (PVI)
A measure of the dynamic changes in the perfusion index that occur during the respiratory cycle. In mechanically ventilated patients PVI has been correlated as an indicator for how well patients respond to fluids. If you track PVI multiple times per day we are excited to hear from you how this helps your training, planning or wellness. It is suggested to establish your baseline PVI by measuring it over several days, at the same time, in the same body position, at the same breathing rate and depth of breathing. An ideal time to measure PVI is in the morning before you get out of bed. An increase in PVI compared to your baseline PVI may indicate increased dehydration, increased breathing effort, or other factors. A decrease in PVI compared to your baseline PVI value may indicate greater levels of hydration, decreased breathing effort, or other factors. Multiple factors other than hydration and breathing effort can affect PVI, including breathing rate, depth of breathing, body position, body movement, vascular tone, blood flow to the finger, and cardiovascular abnormalities.
Carbon Monoxide (CO)
A measure of the percentage (%) of hemoglobin that is bound to Carbon Monoxide in arterial blood and unable to bind oxygen. Non-smokers should have less than 2.3% while heavy smokers (> 2 packs a day) may be as high as 9%. CO levels as low as 4% can cause significant reduction in exercise performance. Tracking your CO values can help you see how changes in location or behavior can help minimize CO exposure and maximize your body’s oxygen-carrying capacity.
A measure of the percent (%) of hemoglobin that is in the oxidized state (Met) in arterial blood and unable to bind oxygen. Met values can normally range between 1 – 1.5 %. Met can accumulate as a result of diet high in nitrates or nitrites or strenuous exercise. Tracking your Met values can help you see how changes in diet or exercise routine can help minimize Met and maximize your body’s oxygen-carrying capacity.
Each Ember device comes preloaded with 200 measurement credits. Credits are required to measure Hemoglobin (Hgb), Oxygen Content (OC), Carbon Monoxide (CO) and Methemoglobin (Met). All other parameters do not require credits. Hgb and OC require 1 credit while CO and Met require 2 credits. If you do not have anymore credits these parameters will not display and will be dashed out in light grey.
Credits are smart device specific so if you are buying credits they are only applicable on that specific iOS or Android device and they cannot be transferred or replaced if your device is lost, damaged, or stolen.
Depending on the Ember model you have, you may need to unlock parameters to enable more measurement values. If you would like your Ember to measure additional parameters unlock codes can be purchased online at www.cercacor.com.
When you purchase an unlock code, Cercacor’s tech support team will contact you to unlock the additional parameters. The unlocked parameters are specific to your Ember sensor and not your iOS and Android smart device. This means that the new measurement parameters once unlocked are available anywhere that your Ember sensor is used. As long as the iOS or Android smart device has sufficient measurement credits then Hemoglobin and oxygen content will display as well if you have CO and Met credits those will display.
A very exciting feature about the Ember device is the ability to review your historical data in different ways. The more you participate, by measuring frequently and choosing activities associated with each measurement, the more powerful your graphs become. We recommend you measure 3 times per day using these activities: First of day, Pre Workout, and Post Workout.
Explore and enjoy graphs by using pinch to zoom, pan and even rotate your device to take advantage of landscape view. Graphs can be shared via SMS, email, and popular social networking sites to share your progress with friends, coaches, trainers, and teammates.
Every time you take a measurement, the app will ask you to associate an activity. By using the same finger, same posture, same time of day, and associating the measurement to a specific activity you will have a more powerful and precise historical review of your data. Consistency is important to get reliable trends in hemoglobin.
We recommend measuring the first thing every day before you get out of bed. We also recommend measuring 5 minutes before a workout and then within 1 minute after you workout for the best comparison of exercise on your baseline.
If you want to create specific custom activities you can do so in the “Options” tab. New activities can be General or they can be a Pre/Post combination.
Pre/Post activities are designed for measurements where you want to track your Ember results before and after a sport or training activity.
For example you may want to track how swimming impacts your hemoglobin. Pre/Post combinations are available to be viewed within the Daily Ranges graph to see comparisons throughout the day while General activities cannot. All other graphs support filtering of General or filtering of Pre/Post custom activities.
The available choices for General and Pre/Post custom activity icons.
Inputting Perceived Values
Take the time to assign a numeric value for your First of Day, Post Workout, or Post Hydration to allow Ember to plot those values versus your measured parameters.
Your state of pain can have an impact your parameters. After each measurement on Ember tap the pain button and add if your level of pain from “No pain” to the “Worst” pain. By tracking your levels of pain, you can review over time on the multi-parameter graph if an increase in pain level is increasing your pulse rate or other parameters.
You can also review pain levels over an entire year to find out if you have more pain during a specific season.
Emotions and Feelings
Your emotions can have an impact on your sympathetic nervous system and thus affect your parameters. By tracking your emotional state, you may gain insight into what training plans or recovery techniques are best suited to achieve the emotional state you desire. Spin the wheel to find the feeling that best represents you after each Ember measurement.
Use the multi-parameter graph to see how your parameters respond during trends in emotional states or review an entire year of emotions on the seasonal graph to see if you spent more time happy or sad.
Emotional states and feelings
All measurements are stored locally on your iOS or Android device. We recommend you create a Cercacor account so that your data is safely backed up and stored in the cloud automatically when your phone is connected to the Internet.
Since your physiology is affected by environmental factors, your measurements will automatically capture various details based on your location, for example, the weather and elevation.
The outer surface of the device can be cleaned with a soft cloth dampened with a mild detergent and warm water solution or isopropyl alcohol.
For more information on Regulatory and Safety Notices open the “Options” tab in the Ember app and then go to “Regulatory”section.
The accuracy of Ember in measuring Hgb has been shown in controlled studies to be 1 gram per deciliter (g/dl) at one standard deviation. This means that under the specific controlled conditions of those studies, 68% of the Hgb values measured on the Ember device fell within +/- 1 g/dl when compared to a calibrated and properly used invasive laboratory reference method used to measure Hgb. The protocols for the accuracy testing of the device are available from Cercacor. Please note that such testing isolates, as well as possible, the accuracy of the device from other sources of error.
Usability and repeatability are separate measures from accuracy, but are frequently confused with accuracy, and the error contribution from these other measures can create an impression about device accuracy that does not reflect actual device accuracy.
An internal study was conducted to evaluate the effectiveness of non-invasive Hgb to detect changes in Hgb and the precision of measurements from the device. The trend accuracy in this study, defined as its ability to detect changes in Hgb values was shown to be +/- 0.7 g/dl at one standard deviation. The precision, defined as the closeness of two or more measurements to one another, was shown to be +/- 0.4 g/dl at one standard deviation. This was a controlled study designed to isolate measurement of the trend accuracy of the device, rather than measures of usability and repeatability.
The accuracy of Ember in measuring pulse rate in the range of 25 – 240 beats per minute is +/- 3 beats per minute at one standard deviation, under no motion condition. This accuracy is for plus or minus one standard deviation, which encompasses 68% of the measurements. This accuracy was measured using bench top testing against a BioTek Index 2 simulator. This does not reflect testing on people or in a user setting.