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Pulse Oximetry

227 490 02-C

Marquette Responder® 3000

ECG

SpO2

III

15.07.1999 09:05:00

160 / 40

bpm

SpO2

etCO2

QRSPulse

Tone

OFF

semiautom.

SpO2

---

Figure 9-1.

SpO

value and plethysmogram

Warning

False Parameter Readings — Pulse oximetry is

not suitable for oxygen monitoring of fetuses

(ante-partum or sub-partu). Also this method is

not suitable for patients with carbon monoxide

poisoning.

Elevated levels of carboxyhemoglobin (CO-Hb)

and methemoglobin (Met-Hb) may affect the

measured values. Also dyes injected in the blood

stream (such as Cardiogreen) may impair meas-

urement accuracy.

Warning

No Alarm — Under certain conditions the device

may not be able to identify a signal disturbance

when monitoring the patient. In this situation

artifacts are capable of simulating a plausible

parameter reading, so that the monitor fails to

sound an alarm. In order to ensure reliable patient

monitoring the proper application of the probe

and the signal quality must be checked at regular

intervals.

9 Pulse Oximetry (SpO

)

Some Basic Facts

SpO

measurement is used to determine the

percentage of functional hemoglobin saturated

with oxygen in the patient's arterial blood. Alarm

limits can be set for monitoring of the SpO

value.

The plethysmogram waveform can be displayed on

the screen (Figure 9-1).

The device measures arterial oxygen saturation by

a method called pulse oximetry. This method is

based on the measurement of the different

absorption spectra of reduced hemoglobin and

oxyhemoglobin.

Therefore the probes consist of a light source (two

LEDs in most cases) and a photodetector on the

opposite side which collects the incident light.

After interaction with the blood and tissue, the red

and infrared light (range between 660 nm and 940

nm) from the LEDs hits the photodetector which

converts it into an electrical signal. The pulsatile

component of the signal is used to build the

plethysmogram.

Literature

UKITSCH

, M.W.; P

ETTERSON

, M.T.; T

OBLER

D.R.;P

OLOGE

, J.A.: Pulse Oximetry: Analysis of

Theory, Technology, and Practice, J. Clin. Monit. 4:

290–301 (1988)

ECIL

, W.T.; T

HORPE

, K.J.; F

IBUCH

E.E.; T

UOHY

, G.F.:

A Clinical Evaluation of the Accuracy of the Nellcor N-

100 and Ohmeda 3700 Pulse Oximeters, J. Clin. Monit.

4: 31–36 (1988)

Summary of Contents for Marquette Responder 3000

Page 1: ...Operator s Manual Version 2 227 490 02 GA e Revision C ...

Page 2: ......

Page 3: ...of the Marquette Responder 3000 58 12 Recording 61 13 Defibrillator Setup 63 14 Battery Power Operation 67 15 Test Discharge 70 16 Operation in the Vehicle Mounting Unit Mounting the AC Power Adapter 73 17 Error and System Messages 74 18 Cleaning Maintenance 75 19 Technical Specifications 78 20 Order Information 84 Appendix The Arrhythmia Detection Program 87 EC Declaration of Conformity 88 Index ...

Page 4: ...This manual is in conformity with the device specifications and standards on safety of elec tromedical equipment valid at the time of printing All rights are reserved for devices circuits techniques software programs and names appearing in this manual On request Marquette Hellige will provide a service manual The Marquette Hellige quality management system complies with the standards DIN EN ISO 90...

Page 5: ...0 30 50 100 150 200 300 360 Print Event Autoseq On Off Start Pause Dem Fix P min mA Pacer Figure 1 1 Marquette Responder 3000 The color concept for the displayed information lets you see at a glance whether the parameter reading is within the alarm limits green a technical fault is reported blue an alarm is reported red the system displays a message yellow The defibrillator has the following memor...

Page 6: ...rs The Device 1 2 3 3 2 Analyse Sync 1 2 5 7 10 20 30 50 100 150 200 300 360 Print Event Autoseq On Off Start Pause Dem Fix P min mA Pacer 1 18 19 20 21 22 23 25 24 27 28 29 30 26 31 17 2 3 4 9 10 8 7 11 13 16 15 12 14 5 6 Figure 2 1 Controls and indicators of the Marquette Responder 3000 ...

Page 7: ...ton to change the pacer output current 20 Button to change the pacer rate 21 Button to pause the pacer without changing the settings 22 Button to select the pacer mode fixed rate demand 23 Button to unlock left battery for removal 24 Button to turn the pacemaker on and off 25 Indicator yellow blinks with each delivered pacing pulse 26 Button to open paper compartment 27 Battery with Test button an...

Page 8: ...fibrillation of children is integrated in the paddles see Defi brillation of Children in section 4 2 Electrodes for Internal Defibrillation Electrodes for internal defibrillation consist of a contact spoon a Figure 2 3 a handle b and a counter nut c The spoon must match the size of the heart and have full contact with the myocardium There is a choice of 3 different spoon sizes The electrodes as we...

Page 9: ...e device can endan ger life Always follow the instructions given in the operator s manual When equipped with the AC power adapter do not use the defibrillator outdoors because the power adapter is not splash proof Before using the device the operator must ascertain that it is in correct working order and operating condition In particular all connectors electrodes as well as sensors and probes must...

Page 10: ...no conductive connection between the patient and bystanders exists during defi brillation The mains plug must be connected to an appropriate power supply with a non fused earthed wire If these requirements cannot be guaranteed connect the device to the ambu lance power supply or operate it on battery power Do not use multiple portable socket outlets MPSO to connect the device to the power line Dev...

Page 11: ...pment Damage Shock Hazard De vices intended for emergency application must not be exposed to low temperatures during storage and transport to avoid moisture con densation at the application site Wait until all moisture has vaporized before using the de vice Equipment Damage Exercise great care when using HF surgery equipment on the pa tient at the same as the defibrillator As a gen eral rule the d...

Page 12: ... independent Batteries are recharged by one of the following methods in the defibrillator when the defibrillator is connected to the power line or to the ambulance power supply system or by means of the separate charging unit ASU 3000 P N 701 279 01 If you prefer to operate the device mains independent ensure that the batteries are charged chapter 14 Battery Power Operation Please refer to chapter...

Page 13: ...n the standard screen display windows for heart pulse rate SpO2 and etCO2 readings including the limit values a b battery charge level c ECG lead d window for ECG SpO2 and etCO2 waveforms window indicating operating mode and defibrillation energy f date and time e menu g The color concept for the displayed information lets you see at a glance whether the parameter reading is within the alarm limit...

Page 14: ... is inserted in the vehicle mounting unit chapter 13 Defibrillator Setup In the main menu select F5 Next Menu Figure 3 4 You will see page 2 of the main menu Figure 3 5 Display the Display menu with F4 Display Figure 3 6 To flip the display press F4 Display Flip Contrast adjustment Adjust the contrast from the Display menu with F1 and F2 Adjusting Maximum Contrast Select Color Adjust the maximum c...

Page 15: ... semiautom manual Autosequence energy selection 200 J 200 J 360 J 150 to 360 J per shock Pacemaker default pacer rate 60 P min 30 to 200 P min SpO2 C LOCK C Lock ECG synchronization off on off SpO2 Integ Time SpO2 integration time 8 s 4 s 8 s 12 s DATE TIME Change clears all existing settings Date Format day mon year day mon year mon day year Entry of date and time DEVICE Display screen display Sm...

Page 16: ...hapter 17 Error and System Messages In this situation do not put the device into service In all other cases you will see the standard screen display Figure 3 7 and the device is ready for use Now verify that the defibrillation shock is correctly delivered by triggering a test discharge chapter 15 Test Discharge If the energy of the test discharge is not within the specified limits a defibrillation...

Page 17: ... pass word semiautomatic manual control not possible manual only manual control possible Operating Mode semiautomatic button To activate the manual mode simultaneously press F5 and Analyse Figure 3 9 When switched on again the defibrillator will reactivate the operating mode selected in the setup menu Date and time of the change of operating modes is stored in the event memory Operating Mode semia...

Page 18: ...reparations for and execution of defibrillation All tasks must be clearly assigned Immediately prior to the shock interrupt heart massage and artificial respiration disconnect tube connections and warn bystanders Ensure that no conductive connection between the patient and bystanders exists during defi brillation Before delivering the shock verify that the charged and selected energies are the sam...

Page 19: ... the required energy level In the Autoseq position of the energy selector the defibrillator automatically sequences the preset defibrillation energy levels The level for the 3rd shock is maintained for all subsequent defibrilla tions When you set the energy selector again to Autoseq the automatic charge sequence starts over The factory set Autosequence energy levels are the values recommended by A...

Page 20: ...stored the device emits an audio signal the message Energy available appears the available energy is displayed if the available energy drops below a given level the defibrillator recharges automatically Now trigger the shock within 30 seconds To do so simultaneously press the buttons a and b on the paddles After the shock the audio signal stops and the delivered energy is displayed for approx 6 se...

Page 21: ...Defibrillation of Children Warning Damage to Myocardium Please note that chil dren require less energy for successful ventricular defibrillation than adults For the first defibrilla tion shock delivered to babies and small children select an energy of approx 2 J kg body weight For subsequent shocks the energy may be in creased to 4 J kg body weight Risk of Skin Burns The full electrode must be in ...

Page 22: ...for up to 24 hours and withstands up to 50 shocks of 360 J each Use electrodes 919 202 94 for adults and electrodes 919 202 95 for children Shave the application points this improves conductivity and makes removal of the pads easier STERNUM right sternal edge at the level of the 2nd intercostal space APEX left axillary line at the level of the 5th intercostal space Figure 4 7 Place the pads on the...

Page 23: ...lator charging and to trigger the shock correct wrong Figure 4 9 Removing the pads Before delivering the shock check that the pads are firmly seated Defibrillate the patient as described for defibrillation with paddles page 19 Be sure to charge the defibrillator with and to deliver the shock by simultaneously pressing the buttons and Figure 4 8 Carefully remove the electrodes after use Figure 4 9 ...

Page 24: ...aped electrodes are used for internal defibrillation Their contact surface must match the dimensions of the heart The spoons must make full contact with the heart There is a choice of 3 different spoon sizes You can use either two spoon electrodes or one spoon electrode and one external counter electrode for defibrillation Figure 4 10 chapter 20 Order Information Sterilize internal electrodes befo...

Page 25: ...rodes it is not possible to select a value above 50 Joules because higher energies may damage the myocardium When you set the energy selector to a value above 50 Joules you will be alerted by a message and defibrillator charging will not proceed Defibrillate the patient as described for defibrillation with paddles page 19 Be sure to charge the defibrillator with and to deliver the shock by simulta...

Page 26: ...llation command by pressing the appropriate buttons the device will wait for the next QRS complex to derive the trigger signal for actual delivery of the shock The following electrodes can be used for cardio version paddles separate ECG electrodes adhesive electrodes pads or internal electrodes separate ECG electrodes Indications Examples mitral stenosis left ventricular hypertrophy aortic stenosi...

Page 27: ... energy selector to On the monitor screen you will now see the 3 ECG leads selected in the setup menu factory defaults leads I II III Warning Shock Hazard Equipment Damage All patient signal inputs labeled with the symbol are protected against damage resulting from defibril lation and electrocautery voltages For this reason patient safety and device protection are ensured during defibrillation and...

Page 28: ...ectrode and connector Figure 4 16 Defibrillation pad application points ECG Acquisition via Defibrillation Pads Apply the defibrillation pads as shown in Figure 4 16 Turn on the device energy selector to The ECG signal is now acquired via the pads and will automatically be displayed in channel 1 unless a patient cable is connected ...

Page 29: ...ain The menu for selection of the ECG lead ap pears Figure 4 17 Using F1 select the lead to be displayed in channel 1 with F2 select the lead for chan nel 2 and with F3 select the lead for chan nel 3 with each key press the device ad vances to the next lead Press F5 Previous Menu and change the signal size with F2 1 cm mV Press F5 Next Menu for about 2 seconds to return to the main menu Activate t...

Page 30: ... conditions for use of a semiautomatic defi brillator are met unconsciousness no respiration no pulse For the same reason the user is entirely re sponsible for delivery of the defibrillation shock Do not use the anterior posterior electrode placement In the semiautomatic mode the defibrillator cannot deliver synchronized shocks For semiautomatic defibrillation do not analyze the ECG during HF surg...

Page 31: ...ar tachycardia with a deviating QRS morphology the defibrillator displays a message starts charging and informs the user when it is ready to deliver the shock The energy selector must be set to the Autoseq position where the defibrillator automatically sequences the energy levels preset for the first three shocks The factory default setting is the sequence recommended by AHA ERC 200 J 200 J 360 J ...

Page 32: ... Patient in the Semiautomatic Mode We recommend to defibrillate the patient with disposable adhesive pads in this mode Thus you only have to apply two electrodes because the ECG signal can also be acquired via the pads If you are using separate ECG electrodes please refer to the end of this chapter Apply the defibrillation pads as described on page 22 Before delivering the shock check that the pad...

Page 33: ...r flutter 120 bpm ventricular fibrillation or ventricular tachycardia with a deviating QRS morphology the defibrillator displays the message Shock advised Do not touch patient Figure 5 3 and automatically begins charging You can watch the defibrillator charging When the charge level has been reached the device emits an audio signal the message Energy available appears the charged energy will be di...

Page 34: ...is algorithm does not recommend a defibrillation even though the patient is suspected to suffer from a shockable arrhythmia press Analyse again If possible apply ECG electrodes to acquire the ECG Also the device can be switched to manual defi brillation by authorized personnel Shock 198 J 17 07 1999 09 30 26 HR 161 bpm Patient Date of birth User Comments Defib Mode Selected Energy Delivered Energy...

Page 35: ...uired chapter 8 Apply the electrodes as shown in Figure 5 6 Ensure that only those leadwires are connected to the patient cable that are actually required Via the patient cable connect the electrodes to the defibrillator Turn on the device energy selector to On the monitor screen you will now see the 3 ECG leads selected in the setup menu factory defaults leads I II III Figure 5 7 The analysis alg...

Page 36: ...ers as long as the pacemaker is operating Currents exceeding 10 µA may induce ventricular fibrillation if they flow through the heart Observe the following sequence of operating steps when turning the pacemaker on and off Turning the pacemaker ON 1 Apply ECG electrodes to patient 2 Connect ECG electrodes to the device 3 Turn on the Marquette Responder 3000 energy selector to 4 Check ECG and vital ...

Page 37: ...the Marquette Responder 3000 must only be handled by persons who are trained in the use of such equipment and are capable of applying it properly Before using the device the operator is obliged to verify that it is in correct working order and operating condition It is assumed that the patient s ECG is being monitored to be able to assess the effect of pacing Furthermore at least one of the person...

Page 38: ... electrodes are connected In demand mode the pacemaker does not deliver pacing pulses as long as the patient s intrinsic heart rate exceeds the set pacing rate When the heart rate drops below the pacing rate the pacemaker starts emitting stimulation pulses This can only be ensured by continued electronic monitoring of the ECG The necessary synchronization pulses are automatically sent to the pacem...

Page 39: ...onds to the stimulation Increase the pacer current output another 5 mA to ensure continued stimulation Verify the stimulation by watching the ECG on the display You can press Start Pause to pause the stimulation and press Start Pause again to resume pacing with the same settings After therapy turn off the pacemaker before removing the pace pads carefully To turn off the pacemaker press the On Off ...

Page 40: ...e and current The selected rate remains constant and is not affected by intrinsic actions of the patient s heart This is the preferred mode for cases of cardiac arrest Check that the ECG electrodes and the pace pads are correctly applied and connected to the device Press On Off 24 Figure 6 1 to turn on the pacemaker The device defaults to the Demand mode and selects a pacer rate of 60 P min config...

Page 41: ...tion program Use silver silver chloride electrodes if possible Otherwise the polarization voltages caused by the defibrillation shock could simulate cardiac arrest If you are using only 5 electrodes apply them as shown in Figure 7 1 When working with 10 electrodes additionally apply all chest elec trodes as shown in Figure 7 2 Connect one 5 electrodes or both leadwire blocks to the patient cable F...

Page 42: ...I configurable AC line filter enabled muscle filter enabled configurable gain 1 cm mV configurable the audio alarm for heart rate and CO2 monitoring is disabled arrhythmia monitoring is enabled do not rely on this alarm alone because it will only be activated in the event of shockable arrhythmias also monitor the patient by means of the HR alarm limits These settings can be changed permanently fro...

Page 43: ...ignal is not suitable for diagnosis displayed or printed ECG The heart rate is always derived from the raw ECG signal Press F5 Next Menu Using F1 Filter enable or disable the muscle filter as appropriate The AC line filter is enabled and disabled from the setup menu Note Active filters will alter the ECG signal Switch off the filters to obtain a diagnostic ECG Enabling Disabling the QRS Beep The Q...

Page 44: ...u semiautom 91 Figure 7 5 Buttons for modification of the HR alarm limits Monitoring Heart Rate The default heart limits are 40 and 160 bpm and the audio alarm is disabled factory default settings bell symbol in button F4 is crossed out The audio alarm can be enabled permanently from the setup menu or temporarily with F4 symbol appears The defibrillator reports an alarm condition if the HR exceeds...

Page 45: ... the heart rate of pacemaker patients only the patient s QRS complexes must be counted and pacer pulses must be rejected For this purpose the Marquette Responder 3000 has an electronic pacer pulse suppression algorithm which rejects the pacer pulses so they are not counted as QRS complexes Depending on the pacemaker model used and on the position of the electrodes the compensation pulse following ...

Page 46: ...verreading an ECG It should be made clear that a computerized analysis is not a substitute for human interpreta tion There are two reasons for this First statements of accuracy need to be viewed from a statistical perspective Although accuracy levels may be high outliers can and will exist Second a computer does not have the ability to include the entire clinical picture of the patient A person wi...

Page 47: ... and Offsets All ECG computer programs are composed of two parts one which measures the waveforms and one which does the analysis based upon those measurements The main task of computerized measurement determines the location of major reference points onsets and offsets for P QRS and T waves Consistent with the signal processing portion of the program the major wave onsets and offsets are delineat...

Page 48: ... including the measurement results and the interpretation The printed segment however is only 3 2 seconds If 12SL analysis was already performed with the defibrillator when you activate the program the previous interpretation will appear on the display In addition the full disclosure ECG of channel 1 is stored in the ECG memory Press F1 ECG Display the 12SL menu with F4 12SL Figure 8 1 Press F1 St...

Page 49: ... 9 Pulse Oximetry SpO2 Some Basic Facts SpO2 measurement is used to determine the percentage of functional hemoglobin saturated with oxygen in the patient s arterial blood Alarm limits can be set for monitoring of the SpO2 value The plethysmogram waveform can be displayed on the screen Figure 9 1 The device measures arterial oxygen saturation by a method called pulse oximetry This method is based ...

Page 50: ...ips General Tips Use only the probes listed in chapter 20 Order Information Apply the probes as described in their instructions for use Carefully observe all information and cautions given in these in structions Take care that the probe does not exert too much pressure when applied to avoid erroneous readings and blistering Inadequate oxygen supply to the skin not heat causes blisters Change the p...

Page 51: ... that the device is powered from the internal battery or from a different power circuit than the electrosurgical unit the ground pad is close to the surgical site the probe is applied as far from the surgical site the ground pad and the electrosurgical unit as possible In the presence of AC line interference When interference signals from the power line are present square waves may be displayed in...

Page 52: ...indow is blue As soon as the probe supplies a valid signal the color changes to green Figure 9 2 At the factory only a low limit of 90 is adjusted no high limit When the parameter reading drops below this value the defibrillator sounds an alarm and the window changes from green to red Enabling Disabling C Lock ECG Synchroniza tion With the factory default settings unchanged the C Lock ECG synchron...

Page 53: ...e HR Source The device can be set up to derive the heart rate from the SpO2 signal The heart rate source is selected with F4 in the SpO2 menu Figure 9 3 Adjusting Alarm Limits The alarm limits can be modified permanently from the setup menu or temporarily as described below Press F2 SpO2 etCO2 Press F2 SpO2 Alarm Limits to display the alarm limits menu Figure 9 4 Change the high limit with F1 F2 a...

Page 54: ...act that the CO2 gas in the patient s expired air absorbs infrared light at specific wavelengths The absorbed amount of light is in proportion with the amount of CO2 in the respired air A No fog membrane ensures that no condensation collects on the sensor Figure 10 2 The method used is a semi quantitative measuring method and it is assumed that the inspired air is free of CO2 etCO2 Monitoring Lite...

Page 55: ...g conditions If blood sputum or phlegm has entered the airway adapter discard the airway adapter and use a new one Do not measure the etCO2 concentration on a patient undergoing an MRI examination This could cause the sensor to give inaccurate readings High concentrations of nitrous oxide N2O or halogenated anesthetic agents can cause the sensor to give inaccurate readings The sensor may give lowe...

Page 56: ...tical position Although the No fog membrane prevents moisture condensation on the window liquid secretions could soil the window Connect the sensor to the defibrillator yellow connector right The CO2 measurement begins as soon as the sensor is connected During the short self test the parameter window is blue As soon as the sensor supplies a valid reading the color changes to green Check that the i...

Page 57: ... s Press F5 Next Menu Figure 10 7 Press F2 Assign Channel Waveform Figure 10 8 Press F3 Figure 10 9 repeatedly until etCO2 is displayed Figure 10 10 When the etCO2 measurement is disabled a sawtooth signal is displayed which can be replaced with an ECG lead During the automatic sensor calibration process a calibration pulse is superimposed on the capnogram a Figure 10 10 Cleaning the Sensor Use a ...

Page 58: ... memories an event memory an ECG memory a trend memory a 12SL memory optional Event Memory The event memory stores up to 250 events annotated with date time and parameter readings e g HR which document the operating proce dures e g device on off alarms defibrillation shocks events Event When the event memory is full the device updates the information automatically by saving new events and deleting...

Page 59: ...p Events whose ECG strips are older than 180 minutes are still listed in the event memory if they are among the most recent 250 events but the ECG strip is no longer available When you attempt to print this event the message No ECG Data will be displayed Printing the ECG Press F5 Next Menu in the main menu to display page 2 Figure 11 2 Display the memory menu with F3 Memory Figure 11 3 Display the...

Page 60: ...2 values of the past 4 hours The trend data too are automatically updated The stored data can be printed out in the form of graphic trends You can choose between a 1 hour and a 4 hour trend window Press F5 Next Menu in the main menu to display page 2 Figure 11 7 Display the memory menu with F3 Memory Figure 11 8 Display the trend menu with F2 Trend Figure 11 9 In the trend menu Figure 11 9 select ...

Page 61: ...display Print Menu Press Print for approx 2 seconds to display the print menu The display shown in Figure 12 1 will appear With F1 Contin Printout you can start and stop a continuous recording With F2 Hardcopy you can print a hardcopy of the screen display With F3 14 s you can print a 14 second ECG strip With F4 Auto Printout you initiate an automatic synchronized recording of all leads 12 stan da...

Page 62: ...leeve of the previous paper roll Insert the spindle in the new roll and place the roll into the device as shown in Figure 12 3 Pull a length of paper approx 15 cm from the compartment and close the door Figure 12 4 The paper compartment door must click into place audibly on both sides The last 3 meters of the roll paper are marked Insert a new paper roll in time to ensure that all alarm recordings...

Page 63: ...e activated each time the defibrillator is switched on Simultaneously press F1 and F5 to display the configuration menu if the password function is enabled you will be prompted to enter the password see Password below You will see the setup menu as shown in Figure 13 1 For a complete list of the parameters of each menu item please refer to table 1 on page 15 The operating steps are always the same...

Page 64: ...button semiautomatic password When choosing semiautomatic password the defibrillator requests a 3 digit password which can be entered with F1 F2 and F3 factory set password 111 Autosequence entry of the energy levels for the 1st 2nd and 3rd defibrillation shock Pacemaker default pacer rate Date Time Date format either DD MM YYYY day month year or MM DD YYYY month day year Note Date and time are sa...

Page 65: ...ibrillator setup choose For setup ON In this case you will have to enter the code combination before you can display the setup menu Changing the Password Using F1 or F2 position the bar cursor on PASSWORD and confirm the selec tion with F3 ENTER The password menu will be displayed The bar cursor highlights the menu item Password Confirm the command with F4 The menu for entry of the password will b...

Page 66: ...s For activation of optional program modules Figure 13 6 The defibrillator serial number has already been entered We need to know this number when you order optional program modules Then you will be given the option code number When you enter this number and exit the configuration menu with Save EXIT the defibrillator will automatically restart and activate the new program module s ECG I 20 01 199...

Page 67: ...ing ambulance power supply power line The batteries recharge when you place the defibrillator in the vehicle mounting unit wall mount unit or connect the defibrillator to the power line units with AC power adapter The two indicators Figure 14 1 light up when the batteries are charging Charging will take approx 4 hours per battery the batteries are recharged one after the other The defibrillator ca...

Page 68: ...ecial battery maintenance program see next section To ensure that the Marquette Responder 3000 will always function in an emergency it must not be disconnected from an external power source for more than 48 hours mains or ambulance power supply Reconnect the defibrillator to the external power source immediately after use or recharge the batteries with the separate charging unit The batteries cann...

Page 69: ...nce power system Connect the device to the power supply system Turn on the defibrillator with the energy selector position Simultaneously press F1 and F5 to display the setup menu Press F1 to position the bar cursor on BATTERY and confirm the selection with F3 ENTER Press F4 to select the Battery Mainte nance ON option and confirm the selection with F5 Previous Menu Set the energy selector to Off ...

Page 70: ...ator from semiauto matic to manual operation Simultaneously press F5 and Analyse Figure 15 1 When the defibrillator is set up for Semiau tom Button it will immediately activate the manual mode When the defibrillator is set up for Semiau tom Password the screen for entry of the password appears Figure 15 2 Enter the password 3 digit number with F1 F2 F3 The factory set password is 111 also refer to...

Page 71: ...defibrillator the test discharge is only possible with a suitable simulator a test discharge with internal spoons is not possible Set the energy selector to 360 J The selected energy will be displayed Figure 15 4 Initiate defibrillator charging by pressing the Charge Shock button on the right paddle Figure 15 5 or by pressing on the con trol panel Figure 15 6 when using adhesive pads When the sele...

Page 72: ... signal stops and the delivered energy is displayed for about 6 seconds According to the requirements of the IEC AAMI standards this value must be between 306 and 414 Joules At the same time the defibrillator prints a 14 second ECG strip incl history of 4 seconds if this function is enabled If the discharge circuit is interrupted electrodes not properly inserted in their compartments cable defect ...

Page 73: ...top In the vehicle mounting unit the defibrillator display is upside down Therefore you can flip the display see chapter 3 section Display Flip Figure 16 1 Vehicle mounting unit Mounting the AC Power Adapter The AC power adapter is screwed to the rear of the Marquette Responder 3000 Remove the two legs a Figure 16 2 and the screws b on the underside Attach the AC power adapter and secure it with t...

Page 74: ...ergencies only defibrillation possible all time related data e g heart rate may be erroneous press one of the function keys adjust time if error message recurs notify service Battery battery almost depleted charge battery HR etC alarm violation of alarm limit Electrode high ECG or defibrillation electrode impedance reapply electrode Check selector energy selector is not indexing properly defibrill...

Page 75: ... Cleaning Maintenance Cleaning Disinfection and Steriliza tion Electrodes Device Discard all disposable items immediately after use to prevent that they are reused The paddles and their leads can be cleaned and disinfected by wiping them down with a gaze pad moistened with a cleaning solution or disinfectant Before using the paddles again however make sure that they are completely dry The device s...

Page 76: ... ate position Now fix the contact paddle by screwing the counter nut 2 tight against the handle 3 External Counter Electrode for Internal Defibrillation Disconnect the electrode from its lead before cleaning or sterilizing it Figure 18 2 Clean the electrode by rubbing it down with a cloth moistened with soap water Use a disin fectant for disinfection Do not immerse the electrode in the liquid Low ...

Page 77: ...ire regular mainte nance To ensure functional and operational safety of the Marquette Responder 3000 Technical Inspections should be carried out on an annual basis These checks should be performed by persons with adequate training and experience The checks can be carried out by Marquette Hellige within the framework of a service contract The nature and scope of these checks are ex plained in the c...

Page 78: ... indicating charge done capacitor charging time for energy setting of 360 J on line power and when inserted in vehicle mounting unit typically 9 s with fully charged battery typically 6 s with partially discharged battery typically 7 s max 10 s Defibrillation Shock capacitor discharge via induction coil Lown Edmark exponential pulse shape monophase damped sinusoidal halfwave pulse duration for an ...

Page 79: ...ohm load resis tance max twice within 15 minutes 3 digit display of the delivered energy warning on LCD when discharge circuit is interrupted e g defibrillation electrode not applied automatic power on self test with error message Synchronization with ECG signal of either polarity minimum ECG amplitude for reliable triggering approx 0 50 mV and QRS width of 80 ms indicated by yellow LED SYNC marke...

Page 80: ...ferred to ground reference 3 kV static detection of pacing pulses pulse duration dp approx 0 1 ms 2 0 ms pace marker independent of polarity pulse amplitude ap 10 to 700 mV reverse current pulse a0 1 mV time constant t0 25 to 100 ms overall error 20 typical Signal Transmission signal input amplification signal sampling AD conversion digital processing display and recorder adjustable gain 0 5 1 2 c...

Page 81: ...e for reliable triggering 0 3 mV for an ECG signal with a QRS dura tion of 80 ms QRS trigger according to AAMI EC 13 T wave suppression up to 1 mV response time to HR changes approx 5 s Alarm System electronic release of alarm when the heart rate violates one of the set alarm limits after condition exists for 10 seconds audio signal sounds can be disabled message HR Alarm alarm recording is initia...

Page 82: ...orts including the ECG 1 and 4 hour trends for ECG and etCO2 storage of the most recent 250 actions e g device on off alarms defibrillation energy including date and time Pacemaker Operating Modes Demand Fix pacer rate 30 to 200 P min 5 pacer current 0 to 200 mA 10 for 500 Ω pulse width 20 ms pulse shape monophase square wave pulse SpO2 saturation 0 to 100 in increments of 1 rate 0 to 250 P min in...

Page 83: ...er consumption during defibrillator charging 130 W during monitor operation 27 W during battery charging 14 W Operational readiness 4 seconds incl automatic self test Operating position any horizontal with AC power adapter Type of Protection protected against splashing water Marquette Responder IPX 4 batteries inserted cables connected AC power adapter IPX 1 Environment Operation operation under t...

Page 84: ...2 recorder Options 205 108 01 AC power adapter 384 018 86 Upgrade kit semiautomatic 384 018 90 Upgrade kit 12SL Accessories ECG 412931 002 Patient trunk cable 5 lead cable 3 6 m IEC MultiLink 412931 001 Patient trunk cable 5 lead cable 3 6 m AHA MultiLink 416035 002 Patient trunk cable 10 lead cable 3 6 m IEC MultiLink 416035 001 Patient trunk cable 10 lead cable 3 6 m AHA MultiLink 384 018 10 Set...

Page 85: ...01 Connecting cable for defibrilla tion electrodes 919 202 94 95 Internal defibrillation 217 308 01 Pair of defib electrodes for internal defibrillation w o contact insert 384 013 19 Contact inserts 2 internal for adults 384 013 20 Contact inserts 2 internal for children 384 013 21 Contact inserts 2 internal for babies 919 202 36 External counter electrode for internal defibrillation etCO2 220 106...

Page 86: ...perator s Manual 931 099 56 Carrying bag no labeling 919 062 00 Power cord EURO 919 201 81 Power cord US 919 203 37 Power cord UK 401855 107 Power cord CH 303 446 31 Rechargeable battery 2 Ah 701 279 01 Battery Station ASU 3000 202 317 01 Vehicle mounting unit with 12 V DC power supply 202 317 02 Vehicle mounting unit with 12 V DC power supply US version 223 425 01 Adapter cable 12 V 919 200 37 Po...

Page 87: ...s a trade off between the two Massachusetts Institute of Technology American Heart Association Association for the Advancement of Medical Instrumen tation The consensus opinion published by AAMI TIR 2 1987 is that specificity should be as high as possible even at the sacrifice of some sensitivity This approach minimizes the likelihood of shocking a non shockable rhythm However this does mean that ...

Page 88: ...EC Declaration of Conformity 88 Marquette Responder 3000 227 490 02 C ...

Page 89: ...space volume 55 Defibrillating the patient in the semiautomatic mode 32 Defibrillation of children 21 Defibrillation pads application 22 Demand mode 38 Disinfection 75 Display flip 14 Disposable defibrillation pads 22 Disposal of the device 77 E ECG acquisition via separate ECG electrodes 35 ECG display 41 ECG memory 59 ECG signal size 42 Electrode for internal defibrillation 8 EMC requirements 11...

Page 90: ...n etCO2 55 Sawtooth signal 13 Selecting the HR source 53 Semiautomatic defibrillation 30 31 Setup 14 Setup menu 63 Shock counter 21 Specifications 78 SpO2 measurement 49 SpO2 measurement begin 52 Spoon electrode insertion 24 76 Sterilization 75 Switching from semiautomatic to manual defibrillation 17 70 Symbols used on the device explanation 7 Synchronization pulses 38 Synchronized defibrillation ...

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