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Preface

xii

12-Lead Electrocardiography

Indications

The American Heart Association (AHA) and the National Heart Attack Alert
Program (NHAAP) recommend prehospital 12-Lead ECG with computer
analysis and transmission to the emergency department for patients with
chest pain and possible Acute Myocardial Infarction (AMI).

The prehospital 12-Lead ECG offers paramedics and emergency physicians
significant advantages over the single lead ECG typically available in EMS.
The prehospital 12-Lead ECG not only provides a diagnostic quality ECG for
use in the detection of AMI, but also allows the knowledgeable paramedic to
determine the area of myocardial injury, anticipate associated potential
complications, and implement treatment strategies accordingly. In addition,
the prehospital 12-Lead ECG provides a baseline for serial ECG evaluations.

Contraindications

None known.

SpO

2

Monitoring

Indications

Pulse oximetry through plethmography (SpO

2

) is a measure of oxygen

saturation in arterial blood. It is indicated for use when determining a
patient’s level of hypoxemia.

Contraindications

None known.

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Summary of Contents for Codemaster 100

Page 1: ...Master 100 Portable Defibrillator Monitor with 12 Lead ECG option HP M2480B Battery Support System HP M2478A DC Power Module HP M2479A AC Power Module HP CodeMaster 100 Portable Defibrillator Monitor 3 3DUW 1R 0 3ULQWHG LQ 86 HEUXDU GLWLRQ ...

Page 2: ...photocopied reproduced or translated to another language without the prior written consent of Hewlett Packard Company Before using the HP CodeMaster 100 the battery support system or the power modules read this guide and become thoroughly familiar with the contents Responsibility of the Manufacturer Hewlett Packard only considers itself responsible for any effects on safety reliability and perform...

Page 3: ...ions to minimize the possibility of burns EMI frequency generation from electrosurgical equipment and close proximity transmitters may seriously degrade performance of the HP CodeMaster 100 Hewlett Packard assumes no liability for failures resulting from EMI between HP medical electronics and any radio frequency generating equipment at levels exceeding those established by applicable standards Fed...

Page 4: ...eference Guide M2475 97800 HP CodeMaster Series Defibrillator Monitor Pacing Application Note M1722 94920 Understanding Pulse Oximetry SpO2 Concepts M1722 93950 HP M2475B CodeMaster 100 Portable Defibrillator Monitor Service Manual M2475 90905 Sensor Guide M1722 93970 Predictive Instruments Physician s Guide M1792 93900 HP M2476B M2477B Battery Evaluation and Care M2475 92100 M3710A Carry Bag Inst...

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Page 7: ...life Caution statements describe conditions or actions that can result in damage to the equipment or loss of data Notes contain additional information on usage TEXT represents the labels that appear on the display Bold represents buttons controls on the device Bold Italic represents softkeys temporary key labels that appear on the 12 Lead display WARNING CAUTION NOTE ...

Page 8: ...yocardial infarction and other arrhythmias The HP CodeMaster 100 is used as an advanced defibrillator monitor in the pre hospital arena and as a transport defibrillator in the hospital environment It can be used with adult paddles pediatric paddles and multi function defib electrodes Multi function defib electrodes allow the user to pace monitor and defibrillate from the same electrodes Theory of ...

Page 9: ...n operating as a manual defibrillator the HP CodeMaster 100 is suitable for use by personnel trained in advanced cardiac life support In Shock Advisory Mode the HP CodeMaster 100 is suitable for use by EMS personnel with basic life support training Indications and Contraindications Defibrillation Indications Defibrillation therapy is indicated for patients that exhibit the following combination of...

Page 10: ...nts who have an implanted pacemaker The shock advisory algorithm is not designed or tested to interpret pediatric cardiac arrhythmias or administer energy at pediatric joule settings For children older than 8 years the American heart Association recommends that standard operating procedures for AEDs be followed American heart Association Textbook of Advanced Cardiac Life Support Dallas Tex AHA 199...

Page 11: ...ortive measures may be necessary Among other factors successful pacing of a patient is related to the length of time between the onset of a dysrhythmia and the initiation of pacing Rapid pacing and prompt follow up care are essential The physiologic state of the patient may affect the likelihood of successful pacing or of skeletal muscle activity The failure to successfully pace a patient is not a...

Page 12: ...ly available in EMS The prehospital 12 Lead ECG not only provides a diagnostic quality ECG for use in the detection of AMI but also allows the knowledgeable paramedic to determine the area of myocardial injury anticipate associated potential complications and implement treatment strategies accordingly In addition the prehospital 12 Lead ECG provides a baseline for serial ECG evaluations Contraindi...

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Page 15: ...y cause the equipment not to ring in response to an incoming call In most areas the sum of the REN s of all equipment on a line should not exceed five 5 0 In the unlikely event that this equipment causes harm to the telephone network the telephone company can temporarily disconnect your service The telephone com pany will try to warn you in advance of any such disconnection but if advance notice i...

Page 16: ...ed by Hewlett Packard Any repairs or alterations made by the user to this equipment or equipment malfunctions may give the telecommunications com pany cause to request the user to disconnect the equipment Users should ensure for their own protection that the electrical ground connec tions of the power utility telephone lines and internal metallic water pipe system if present are connected together...

Page 17: ...ided Although this equipment can use either loop disconnect or DTMF signaling only DTMF signaling is subject to regulatory requirements for correct operation It is therefore strongly recommended that the equipment is set to use DTMF signaling for access to public or private emergency services DTMF signaling also provides faster call set up ...

Page 18: ...Telecom Regulatory Information xviii ...

Page 19: ...lation ix Defibrillation x Noninvasive Pacing xi 12 Lead Electrocardiography xii Indications xii Contraindications xii SpO2 Monitoring xii Indications xii Contraindications xii Electromagnetic Compatibility xiii Reducing Electromagnetic Interference xiii Restrictions for Use xiv Immunity Level xiv Telecom Regulatory Information xv United States xv Canada xvi United Kingdom xvii 1 Getting Acquainte...

Page 20: ... 1 Inserting the Battery 2 2 Loading the Recorder Paper 2 3 Connecting the Paddles or Multifunction Defib Electrodes and Patient Cables 2 3 Connecting Paddles or Multifunction Defib Electrodes 2 4 ECG Input Connector 2 5 Configuring the CodeMaster 100 and 12 Lead ECG Option 2 7 Configuring the CodeMaster 100 2 8 Restoring Factory Settings 2 9 Configuring the 12 Lead Option 2 13 Navigating the Conf...

Page 21: ...Defibrillation 3 6 Defibrillating through Multifunction Defib Electrodes 3 7 Defibrillating with Anterior Posterior Paddles 3 9 4 Using Shock Advisory Mode Optional Understanding Shock Advisory Operating Controls 4 2 Using Shock Advisory Mode 4 3 Verify Patient Condition 4 4 A Select Advisory On 4 4 B Apply Defib Electrode 4 7 C Press the Analyze Button 4 10 D Follow Prompts 4 13 Shock Advised 4 1...

Page 22: ...ecording 5 10 Recording Printing ECG and Monitoring Data 5 10 Automatic Recordings 5 11 Post Shock Data 5 12 Printing the Event Summary Record 5 12 Recorder Errors 5 13 External Monitoring 5 14 6 Using the 12 Lead Option Introduction 6 1 12 Lead Keyboard and Display 6 2 Patient and Operational Safety Notes 6 6 Acquiring a 12 Lead ECG 6 8 To Acquire a 12 Lead ECG 6 9 Preparing the Patient 6 10 Chec...

Page 23: ...Summaries 6 33 HP CodeMaster 100 and 12 Lead Option Interactions 6 34 7 Performing Synchronized Cardioversion Performing Cardioversion 7 1 Monitoring During Cardioversion 7 1 Using an External Monitor 7 1 Using Paddles for Performing Synchronized Cardioversion 7 3 Applying the Paddles 7 4 Resetting the Selected Energy Level 7 5 Delivering the Synchronized Shock 7 5 Using Multifunction Defib Electr...

Page 24: ... Applying the Reusable Sensor 9 4 Troubleshooting Sensor Application 9 6 Patient Movement 9 6 Inspecting the Application Site 9 6 Circulation at Application Site 9 7 Connecting the Sensor to the Instrument 9 7 Start Monitoring 9 8 SpO2 Readings 9 9 SpO2 Alarms 9 10 Activating SpO2 Alarms 9 10 Deactivating SpO2 Alarms 9 10 Recorder Output 9 10 10 Transmitting Data from the 12 Lead Option Receiving ...

Page 25: ...ith External Power 11 8 Charging the Battery with an Auxiliary Power Module 11 8 Defibrillating with External Power 11 9 Performing Operational Checks 11 10 12 Troubleshooting CodeMaster 100 12 1 Troubleshooting the Defibrillator 12 1 If the Defibrillator does not Charge 12 3 If the Defibrillator does not Deliver a Shock 12 4 Troubleshooting the Pacer 12 5 Troubleshooting SpO2 12 6 Troubleshooting...

Page 26: ...n Functional Test 13 3 Electrode Adapter Cable Test 13 4 Quick Pacer Functionality Test 13 5 Every Week 13 6 Every Three Months 13 6 Maintaining the Defibrillator 13 7 Changing the Recorder Paper 13 7 Cleaning the Recorder Printhead 13 8 Cleaning Exterior Surfaces 13 9 Cleaning the Electrodes and Cables 13 10 Cleaning the Carry Bag M3710A 13 10 Cleaning Exterior Surfaces on the AC and DC Power Mod...

Page 27: ...tor 14 1 Equipment Classification 14 2 Monitor 14 3 External Pacer 14 3 SpO2 14 4 Measurement Range 0 to 100 14 4 Thermal Array Recorder 14 5 Size and Weight of the CodeMaster 100 without the 12 Lead Option 14 5 Advisory Mode Option C80 14 6 12 Lead Option C90 14 7 Battery 14 9 HP M2480B Battery Support System 14 10 Charging Specifications 14 10 Size and Weight 14 10 HP M2478A DC External Power Mo...

Page 28: ...xxviii ...

Page 29: ...n and troubleshooting procedures This section serves two purposes to familiarize you with the major CodeMaster 100 features and to show their respective locations on the device Figures 1 1 and 1 2 identify the main features of the HP CodeMaster 100 The HP CodeMaster 100 enables you to change from manual mode the default to Shock Advisory optional which guides you through defibrillation ...

Page 30: ...CodeMaster 100 Defibrillator Monitor with 12 Lead ECG Option Overview Top View 1 1 Recorder 12 Lead Quick change battery Defibrillator Paddles electrodes cable connector Adult Pediatric paddle Adult Pediatric paddle M2475 B0001 Monitor CRT ...

Page 31: ... HWWLQJ FTXDLQWHG 1 3 Figure 1 2 The CodeMaster 100 Defibrillator Monitor with 12 Lead ECG Option Overview Front View 1 2 SpO2 Connector ECG Connector M2475 B0002 ...

Page 32: ...Defibrillator Operating Controls The defibrillating operating controls on the HP CodeMaster 100 include Energy Select Charge Sync and Shock See Figures 1 3 and 1 4 Figure 1 3 Defibrillator Operating Controls 1 of 2 1 3 MONITOR RECORDER Load Select ECG Size HR Alarm Charge DEFIBRILLATOR ENERGY SELECT Sync Analyze Advisory On Record Mark Review Monitor On Shock Shock Charge Charge M2475 B0003 Sync ...

Page 33: ...WLQJ FTXDLQWHG Operating Controls and Indicators 1 5 Figure 1 4 Defibrillator Operating Controls 2 of 2 1 4 Charge DEFIBRILLATOR ENERGY SELECT Sync Advisory On Monitor On M2475 B0006 Energy Select Control ...

Page 34: ...llator to the energy level set on the Energy Select control Charge buttons are located on the front panel of the CodeMaster 100 and on the apex paddle Sync The Sync button changes the operating mode between immediate shock asynchronous mode and synchronized with next R wave shock Sync mode Note that the default is asynchronous mode Shock The orange Shock buttons located on both paddles administer ...

Page 35: ...ting controls on the HP CodeMaster 100 that enable you to monitor a patient Refer to Figure 1 5 Refer to Chapter 5 Monitoring for more information about patient monitoring Figure 1 5 Monitor Operating Controls 1 5 Mode Start Stop Output Rate SpO2 Alarm ECG Input Pacer On MONITOR Lead Select ECG Size HR Alarm S 456 ...

Page 36: ...ion Lead Select Selects an ECG source to monitor ECG Size Changes the displayed ECG size HR Alarm Controls heart rate alarms Controls the volume of the QRS beeper ECG Output connector Located on the right side of the unit provides analog 1V mV output for external monitoring 456 ...

Page 37: ...CodeMaster 100 Refer to Figure 1 6 Figure 1 6 Recorder Operating Controls 1 6 Control Button Function Record Starts and stops the recorder Record does not enter an event into the Event Summary record Mark Annotates the ECG strip and or prints an ECG strip Mark enters the event into the Event Summary record Review Prints an Event Summary record RECORDER Record Mark Review M2475 B0005 ...

Page 38: ...t into the Event Sum mary This annotation can be configured to print on the ECG strip immediately when Mark is pressed or after a 6 second delay Refer to Chapter 2 Setup and Configuration to configure the HP CodeMaster 100 for recording when Mark is pressed When you press Review to print an Event Summary record the message ES is printed at the top of the ECG strip To print an Event Summary record ...

Page 39: ...nd Indicators 1 11 Pacer Operating Controls This section details the pacer operating controls associated with pacing Refer to Figure 1 7 Figure 1 7 Pacer Operating Controls 1 7 Mode Start Stop Output Rate SpO2 ECG Input Pacer On M2475 B0005 ...

Page 40: ...igher or lower Start Stop Starts and stops pacing Output Adjusts the pacer output current mA up or down Mode Changes between fixed and demand pacing modes Pacing does not start until you press Start Stop Pressing Pacer On enables the pacer setup function but does not start pacing Refer to Chapter 8 Pacing for more information about using the pacer NOTE ...

Page 41: ... SpO2 Operating Controls This topic details the SpO2 operating controls associated with the SpO2 feature on the HP CodeMaster 100 Refer to Figure 1 8 Figure 1 8 SpO2 Operating Controls 1 8 SpO2 On Off SpO2 Alarm SpO2 ECG Input QRS M2475 B0005 Sp02 Connector ...

Page 42: ...trols Control Button Function SpO2 On Off Starts and stops the pulse oximeter SpO2 Alarm Controls SpO2 alarms SpO2 Connector SpO2 sensors and adapter cables plug into the SpO2 input connector Chapter 9 SpO2 Monitoring contains further information about using the pulse oximeter ...

Page 43: ...ster 100 in Advisory Mode Figure 1 9 illustrates the placement of the controls Figure 1 9 Advisory Mode Operating Controls 1 9 Control Button Function Advisory On Places the CodeMaster 100 in advisory mode Analyze Starts automatic analysis of ECG waveforms Charge DEFIBRILLATOR ENERGY SELECT Sync Analyze Advisory On Monitor On Off Standby Energy Select Analyze ...

Page 44: ...perating Controls This section provides an overview of the 12 Lead portion of the CodeMaster 100 Figure 1 10 shows the keypad and operator buttons that you use to setup acquire and transmit patient data Refer to Chapter 6 Using the 12 Lead Option for more information ...

Page 45: ... Controls and Indicators 1 17 Figure 1 10 12 Lead Keyboard and Display 1 10 ID 12 Lead Send F5 F4 F3 F2 F1 Q W E R T Y U I O P 7 4 1 0 8 5 2 Filter 9 6 3 Copy A S D F G H J K L Shift Alt Z X C V B N M Stop Menu Shift M2475 B0004 ...

Page 46: ...12 Table 1 1 lists audible indicators Figure 1 11 Indicator Lights 1 11 Indicator Function Charge Done Indicates that the unit is charged and ready to use Sync Light indicates that the unit is in synchronized shock mode as opposed to defibrillator mode Flashes off each time an R wave is detected Paddle Contact Indicator PCI on the Sternum paddle indicates how well the paddles contact the patient M...

Page 47: ...19 Figure 1 12 Battery Indicator Lights 1 12 Indicator Function Battery Capacity Gauge After you press the button below the indicator the battery capacity gauge indicates the remaining battery charge Quick change battery Battery capacity gauge M2475 B0007 ...

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Page 49: ...e Monitor On position Placing the paddles in their holders and depressing both shock buttons simultaneously Waiting for the instrument to automatically disarm The unit disarms auto matically after it has been left charged for 60 seconds in the Manual mode and after 30 seconds in the Advisory Mode Do not leave the instrument turned on when it is not in use Do not discharge the defibrillator with th...

Page 50: ...ing defibrillation Keep the HP CodeMaster 100 and the immediate area clean and dry at all times to avoid creating potentially dangerous electrical paths Never open the instrument case Dangerous high voltages can be exposed Only qualified service personnel can service the instrument Do not use the defibrillator in a flammable or oxygen rich atmosphere This will cause an explosion hazard Do not rely...

Page 51: ...vides optimum performance and battery life when charged and maintained using the HP M2480B Battery Support System Figure 1 13 HP M2476B M2477B Battery 1 13 In addition to the standard M2476B 2 5 amp hour battery Hewlett Packard offers the M2477B 4 0 amp hour battery which provides more monitoring time and more charge shock cycles DWWHU FDSDFLW JDXJH ...

Page 52: ... the battery has between 80 and 100 capacity remaining Recharging a Battery To recharge the battery remove it from the defibrillator and insert it into the Battery Support System To charge the battery see Charging the Battery on page 13 14 The battery support system can recharge two batteries simultaneously Test the capacity of a new battery or one that has been stored more than one month as descr...

Page 53: ...lly depleted and the instrument shuts down there is approximately thirty minutes of monitoring and five 360 joule charge shock cycles If the battery is defective there may be significantly less monitoring time or charge capacity after the LOW BATTERY message appears than if the battery is merely depleted Recording during this time will also impact monitoring time and the number of charge shock cyc...

Page 54: ... HWWLQJ FTXDLQWHG Battery Operation 1 26 ...

Page 55: ...aster 100 The HP CodeMaster 100 is ready for operation after you perform the following tasks Insert the Battery Load Recorder Paper Seat and lock the paddles or defib electrode cable Connect the patient cable Select configuration settings for both the CodeMaster 100 and the 12 Lead option including such parameters as date and time 12 Lead keyboard to uppercase or lowercase mode 12 Lead telephone d...

Page 56: ...latch and pulling the battery out and up Perform the Battery Capacity Test on page 13 15 to charge and test the battery Insert a fully charged and tested battery into the CodeMaster 100 Figure 2 1 Insert the battery into the compartment with the connector to the inside Slide the battery into the compartment until it latches Figure 2 1 Loading the Battery into the CodeMaster 100 2 1 Quick change ba...

Page 57: ...instrument Loading the Recorder Paper The HP CodeMaster 100 recorder uses 50mm wide thermal recorder paper HP 40457C D To load the paper refer to Changing the Recorder Paper on page 13 7 Connecting the Paddles or Multifunction Defib Electrodes and Patient Cables The defibrillator has a paddles electrode adapter cable for attaching external paddles internal paddles or multifunction defib electrodes...

Page 58: ...ds the top of the connector 2 Insert the paddles electrode adapter cable plug into the cable connector on the defibrillator Figure 2 2 3 Slide the cable connector latch to the lock position to secure the plug in place To remove the paddles electrode adapter cable slide the paddle connector lock to the unlock position and pull the connector housing up and out Figure 2 2 Connecting External Paddles ...

Page 59: ... connector Connecting the Patient Cable The 3 wire 5 wire and 10 wire patient cables connect to the ECG Input connector located on the front right side of the defibrillator below the QRS volume and pacer controls The patient cable plug has 12 pins To install the patient cable Figure 2 3 1 Align the keyed cable plug with the slot in the ECG Input connector 2 Push the cable plug firmly into the ECG ...

Page 60: ...6HWXS DQG RQILJXUDWLRQ Setting Up the CodeMaster 100 2 6 Figure 2 3 Connecting a Patient Cable 2 3 LQSXW FRQQHFWRU ZLWK NH VORWV H HG SOXJ RI SDWLHQW FDEOH ...

Page 61: ...play Table 2 3 lists the selections available on the Configuration Menu A small internal battery provides back up power to store the configuration information Under normal conditions the backup battery may last for five years Extreme conditions such as prolonged high temperatures may reduce the life of the backup battery After running the Delivered Energy and Shock Button Functional Test on page 1...

Page 62: ... CRT TEST RECORDER TEST CONTROLS TEST INDICATORS TEST BATTERY TEST PACER TEST 12 LEAD 2 Select SETUP MENU 1 by pressing the and arrows on the ECG Size key until the highlight appears on SETUP MENU 1 3 Press Lead Select SETUP MENU 1 will appear with the current setup values displayed 4 Press the and arrows on the ECG Size key until the highlight appears on the value you wish to change 5 Press Lead ...

Page 63: ...Setup Diagnostic mode Restoring Factory Settings You can use the factory setting for most values by selecting RESTORE FACTORY SETTINGS from the Setup Diagnostic Menu Highlighting and selecting this setting does NOT bring up an additional menu Selecting this line will undo user configured parameters and restore factory defaults This process restores factory settings on the defibrillator monitor and...

Page 64: ...ect SETUP MENU 1 appears 4 Press ECG Size seven times to highlight Time 5 Press Lead Select 6 Press ECG Size until the hours setting contains the correct time 7 Press Lead Select 8 Press ECG Size to select minutes 9 Press Lead Select 10 Press ECG Size until the minutes setting contains the correct time 11 Press Lead Select 12 Depress both sides of the ECG Size key simultaneously to return to the S...

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Page 68: ...he desired menu line is highlighted then press F3 to display the selected item To select a field on a data entry screen press or to move the cursor down or press or to move the cursor up until the desired entry line is high lighted To save the settings exit the Configuration menu To change a field select F3 to step through the choices available To exit the Configuration menu and save your configur...

Page 69: ...en you select Configure 12 Lead from the Main Menu the Configuration Menu appears Each Configuration Menu choice is described briefly in a list then each is described in more detail in the sections that follow Default configuration settings are also listed in the tables Configuration Menu Setup ID Entry Setup 12 Lead Settings Setup ECG Filters Setup Miscellaneous Setup Transmission Setup Gateway S...

Page 70: ...tient age sex and height and weight affect the standard interpretation of the ECG For the most accurate interpretation include them in the patient ID entry At a minimum enter age and sex If you do not enter data into these fields the analysis software or 12 Lead algorithm will use default values for the analysis Setup ID Entry ID Entry Yes Name Entry Yes Age Entry Yes Years Sex Entry Yes Chest LA ...

Page 71: ...e 2 4 shows the available report formats Use F3 to change a field a Default values are shown in boldface type Table 2 4 Configurable Report Characteristics Parameter Choicesa Comments HDG RUPDW Standard DEUHUD HDG 5HSRUW RUPDW 3x4 5 5 XVWRP 5K WKP HDGV IRU 5 5 XVWRP II D95 D9 D9 9 9 9 9 9 9 II D95 D9 aVF 9 V2 C2 9 9 9 9 6HOHFW DQ OHDG 6HOHFW DQ 9 WKUHH OHDGV 3KRQH LQH Tone 3XOVH LUHFW HOO ...

Page 72: ...WLRQ Configuring the 12 Lead Option 2 18 Setup 12 Lead Settings Lead Format Standard 12 Lead Report Format 3x4 Custom Rhythm Leads for 3x4 1R II 3x4 3R Manual 3 II aVF V2 Phone Line Tone Change Format Exit F1 F2 F3 F4 F5 ...

Page 73: ...ome baseline wander suppression without distorting the ECG s ST segment The 0 05 Hz Baseline Wander filter delivers the highest fidelity signal but pro vides the least baseline wander suppression The 40 Hz Noise filter offers maximum noise suppression but reduces the fidelity of the signal The 100 Hz Noise filter provides some noise suppression while offering an accu rate signal representation The...

Page 74: ...Filter status message appears in the upper right corner of the display Refer to Table 2 5 for information on configuring the Filter key a Default values are shown in boldface font NOTE Table 2 5 Configurable Filters Parameter Choicesa Comments DQGHU LOWHU 0 15 Hz 6HOHFW RQH EDVHOLQH ZDQGHU ILOWHU IRU V 1RLVH LOWHU 40 Hz 6HOHFW RQH QRLVH ILOWHU IRU HDG V URQW 3DQHO Filter H 0XVFOH UWLIDFW ILOWHU DV...

Page 75: ...is printed and transmitted with all ECGs and is displayed at the top of the Main Menu Press F1 to clear the field then type a name There are 30 character spaces available in this field Setup Miscellaneous Institution Label Hewlett Packard 12 Lead Interpretation Standard Adult Pediatric Copy Count 2 Set Keyboard lowercase 12 Lead location code 00000 12 Lead ID 0000 Erase Exit F1 F2 F3 F4 F5 ...

Page 76: ...d all entered ID fields Basic measurements are defined in Chapter 6 Using the 12 Lead Option Standard Adult Pediatric Selecting this setting prints waveform patient ID basic measurements summary and standard adult or pediatric depending on age entered computer generated diagnostic statements ACI TIPI Selecting ACI TIPI provides waveform patient ID basic measurements summary all available patient d...

Page 77: ...shift key to enter the opposite case Setting 12 Lead Location Code The 12 Lead location code identifies a specific department or EMS Service that acquired the ECG The number prints at the bottom of the report If set to zero default this field will be suppressed from the printed report This parameter can be any five digit numeric code Setting 12 Lead ID The 12 Lead ID code identifies the particular...

Page 78: ... Modem initialization string is used for modem initialization commands only and should not contain dialing information Fax initialization string is used for fax initialization commands only and should not contain dialing information Cellular initialization string is used for cellular initialization commands only and should not contain dialing information NOTE Setup Transmission Country USA Canada ...

Page 79: ...ateway The Gateway is where the ECG Manager PC gateway resides To setup the ECG Manager gateway function configure the Gateway in the Setup Gateway field You can configure the ECG Manager gateway by entering phone numbers on the Telephone Directory screen After an ECG is acquired from the patient it can be transmitted through the ECG Manager gateway by pushing the Send key Select the desired final...

Page 80: ...elephone fields Primary and Alternate The Primary field will be the first Gateway number dialed If this number fails the Alternate gateway number will be used The Alternate field can be left blank if no alternate gateway number is available Setup Gateway Telephone numbers Primary Alternate Erase Exit ...

Page 81: ...o setup the telephone directory perform the following steps 1 From the Configuration Menu press F3 to select Setup Telephone Directory 2 Press F1 The system displays the setup fields for this directory entry Setup Telephone Directory Screen 1 of 2 Name Primary Number Rcvr Type 1 2 3 4 5 6 7 8 9 Change Entry Next Exit F1 F2 F3 F4 F5 Setup Telephone Directory Entry 1 of 18 Name Telephone numbers Pri...

Page 82: ...pulse dialing with a rotary dial instead of tone with a keypad For example if you are using a pulse telephone with your modem and your house telephone system requires dialing a 9 before placing an outside call you would enter the telephone number as P9W5553334444 4 Select the transmission type by pressing F3 until the appropriate transmission type appears The transmission type will cycle through R...

Page 83: ...n until after you have selected the site for which the ECG is to be sent This automated function removes one step in the process for sending an ECG If you enter No into this field the instrument will return to the Home screen after an ECG is acquired To send an ECG you will always be required to push the Send button to enter into the telephone directory Once you are in the telephone directory sele...

Page 84: ...6HWXS DQG RQILJXUDWLRQ Configuring the 12 Lead Option 2 30 ...

Page 85: ... case of the HP CodeMaster 100 and on the quick reference card attached to the carry bag 1 Select Energy 1 Turn the Energy Select control to the desired energy level The defibrillator is now on 2 Prepare the paddles by following these steps a Remove the paddles from their holders by grasping the handles and lifting them straight up b Holding both paddles in one hand apply electrolyte medium to the...

Page 86: ...lectrodes to from a patient Avoid contact between parts of the patient s body such as exposed skin of head or limbs conductive fluids such as gel blood or saline and metal objects such as bed frame or stretcher Disconnect any other medical electronic equipment from the patient during defibrillation unless labeled as defibrillator protected 3 Apply the paddles as follows a Place the Sternum paddle ...

Page 87: ... on the instrument front panel 2 Call out Clear to alert personnel to stand away from the patient 3 Wait for the charge done indicators light and Charge Done tone When the unit is armed the monitor shows the Delivered Energy available in joules If the defibrillator does not charge refer to If the Defibrillator does not Charge on page 12 3 CHARGE DONE ...

Page 88: ... patient the monitoring cable or leads the bed rails or another potential current pathway 3 Call out Clear to alert personnel to stand away from the patient Keep hands clear of the paddle electrode edges Use your thumbs to depress the Shock buttons on the paddle handles 4 Press and briefly hold both Shock buttons labelled one on each paddle simultaneously to deliver energy to the patient If the de...

Page 89: ...and other damage Refer to the Maintenance chapter for additional information o Turn on the HP CodeMaster 100 If the instrument displays LOW BATTERY replace the battery pack with a charged battery o Perform the test described in Delivered Energy and Shock Button Functional Test on page 13 3 o Turn the Energy Select control to Off and return the HP CodeMaster 100 to its storage location o Check that...

Page 90: ...lectrodes connector receptacle Performing Pediatric Defibrillation The HP CodeMaster 100 paddle set comes with pediatric paddles To use the pediatric paddle set depress the release latch at the front of the standard external paddles while pulling forward on the adult paddle surface This action will remove the adult paddle contact surface and expose the smaller pediatric contact surface Refer to De...

Page 91: ...t The message PADS OFF appears when there is poor electrode to patient contact Check all patient connections if this message appears 1 Attach the electrode adapter cable M2472A to the paddle connector Figure 3 2 on the front of the defibrillator 2 Slide the cable connector latch to the lock position to secure the cable 3 Attach the multifunction defib electrodes to the patient as instructed on the...

Page 92: ...ADS appears on the display under the heart rate 6 Set the Energy Select control to desired energy 7 Press Charge 8 Call out Clear to alert personnel to stand away from the patient 9 Wait for the charge done indicators 10 Press both Shock buttons simultaneously to defibrillate The Shock but tons for the multifunction defib electrodes are on the cable connector housing Figure 3 2 ...

Page 93: ... Paddles The HP M2495A Anterior Posterior Paddles are similar to the anterior anterior paddles but provide a posterior electrode placed on the patient s back Refer to the packaging provided with the paddles for placement and usage guidelines OHFWURGH DGDSWHU FDEOH FRQQHFWRU KRXVLQJ 0XOWLIXQFWLRQ GHILE HOHFWURGHV DGDSWHU FDEOH 6KRFN RQQHFWRU ...

Page 94: ... HILEULOODWLQJ Defibrillating a Patient 3 10 ...

Page 95: ... advisory mode the HP CodeMaster 100 acts as a semi automatic external defibrillator When in shock advisory mode the HP CodeMaster 100 can analyze the patient s ECG rhythms advise when a shock should be administered automatically charge the defibrillator when a shock is advised prompt the user to deliver the shock provide advisory event documentation ...

Page 96: ...erating Controls The Shock Advisory mode operating controls on the HP CodeMaster 100 include the Advisory On selection on the Energy Select control and the Analyze button See Figure 4 1 Figure 4 1 Shock Advisory Mode Operating Controls 4 1 DEFIBRILLATOR ENERGY SELECT Analyze Advisory On Monitor On Off Standby Analyze ...

Page 97: ...pacemaker The advisory algorithm is not designed to detect pediatric cardiac arrhythmias or handle erratic spiking problems caused by a properly or improperly functioning pacemaker The advisory algorithm does not charge the defibrillator to energy levels appropriate for pediatric patients To use advisory mode first verify patient condition Then A Select Advisory On B Apply multifunction defib elec...

Page 98: ...e first energy setting You can configure the energy settings for the first second and third shocks by using the Setup Menu refer to Chapter 2 Setup and Configuration You must turn the Energy Select Power Control to Advisory On before analyzing the ECG Pressing Analyze has no effect unless the Energy Select Power On control is set to Advisory On In advisory mode you can use the HP CodeMaster 100 to...

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Page 100: ...monitoring lead selection leads monitoring heart rate alarms automatic recordings standard event summary generation recorder delay mode external paddles pediatric energy levels To restore these functions turn the Energy Select control to Monitor On or an energy setting If you turn the Energy Select control to Monitor On or a specific energy setting you place the HP CodeMaster 100 in manual mode an...

Page 101: ... B Apply Defib Electrode You must use the electrode adapter cable and multifunction defib electrodes in the Apex Anterior position to analyze patient cardiac rhythms when in Advisory mode You must use the electrode adapter cable and multifunction defib electrodes when in advisory mode The HP CodeMaster 100 will not analyze patient cardiac rhythms through external or internal paddle sets The messag...

Page 102: ... patient The message PADS OFF appears when there are no electrodes or there is poor electrodes to patient contact Check all patient connections if one these messages appears 1 Attach the electrode adapter cable M2472A to the paddle connector on the front of the defibrillator 2 Slide the paddle connector lock towards the front of the defibrillator to secure the cable See Figure 4 2 WARNING ...

Page 103: ...pter Cable 4 2 3 Attach the multifunction defib electrodes to the patient as instructed on the package Use the Apex Anterior electrode application shown on the package This results in the modified Lead II configuration upon which the advisory algorithm was designed and tested M2475 B0012 WARNING ...

Page 104: ...e to correctly connect the electrodes to the electrode adapter cable Incorrectly connecting the electrodes to the adapter cable can result in a failure to deliver energy to the patient C Press the Analyze Button When you place the HP CodeMaster 100 in Advisory mode the monitor displays the following message FOR ANALYSIS 200J PRESS ANALYZE SELECTED Begin analyzing the patient s ECG by pressing Anal...

Page 105: ...NALYZING ECG nnnJ DO NOT TOUCH PATIENT SELECTED where nnn is the configured setting for the energy sequence To perform accurate analysis you must not touch or move the patient during this time Stop CPR ventilation and transport Charge DEFIBRILLATOR ENERGY SELECT Sync Analyze Advisory On Monitor On Off Standby Energy Select Analyze WARNING ...

Page 106: ...ollowing messages appear on the monitor and analysis stops You can restart analysis by pressing Analyze ARTIFACT DETECTED CANNOT ANALYZE Pressing the Analyze key during analysis will stop analysis The message ANALYSIS STOPPED will be displayed momentarily and then the following message appears FOR ANALYSIS 200J PRESS ANALYZE SELECTED If the multifunction defib electrodes are not properly attached ...

Page 107: ...elect sequence for the first second and third shocks Subsequent shocks are delivered at the third shock energy level The charge done tone sounds to alert you that the defibrillator is charged and the system displays the following messages CLEAR PATIENT PRESS SHOCK BUTTONS Defibrillating a Patient 1 Verify that no one is in contact with the patient the cable or pad electrodes the bed rails or other...

Page 108: ...or by switching the Energy Select control to the Off or Monitor On positions If you disarm the defibrillator by turning the Energy Select control to Off the energy select sequence is reset to its original charge settings No Shock Advised If a non shockable rhythm is detected the message NO SHOCK ADVISED displays for about 30 seconds Continue CPR and basic life support as directed by your system s ...

Page 109: ...n nicks and other damage Refer to Chapter 13 Maintenance for additional information o Turn on the HP CodeMaster 100 If the instrument displays LOW BATTERY replace the battery pack with a charged battery o Perform the test described in Delivered Energy and Shock Button Functional Test on page 13 3 o Turn the Energy Select control to Off and return the HP CodeMaster 100 to its storage location o Che...

Page 110: ...int before the stored ECGs ECGs related to events print after the directory record The advisory event summary record which is available only in advisory mode is independent of the event summary described in Printing the Event Summary Record on page 5 12 which is available only in manual mode Passing through the 2II position on the QHUJ 6HOHFW switch more than once from Advisory Mode to Manual Mode...

Page 111: ...mmary after the instrument has been turned off or is turned to manual mode turn the Energy Select control to Advisory On and press Review The header record lists when power on occurred when the last event occurred and how many shocks were delivered The record also includes areas for you to write in the patient s name the operator s name and any comments about the event The directory lists all even...

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Page 113: ...ng Advisory Event Memory The instrument retains event information after you turn the instrument off Memory clears when the HP CodeMaster 100 is turned on placed in Advisory Mode and Analyze pressed or a new ECG strip is recorded see Table 4 2 Advisory Event Summary Record Information Memory does not clear if the HP CodeMaster 100 is simply turned on or if the instrument is used in manual mode This...

Page 114: ...factory default settings for a sequence of 200 200 and 360 Joules to a sequence of 200 300 and 360 Joules The energy level for the third shock and all subse quent shocks will be 360 Joules Post Shock Data On Off When operating in Advisory mode the following settings cannot be changed Charge done tone always sounds CRT alert tones always sounds Alert tone volume always at the maximum volume Recorde...

Page 115: ... pacing procedures The HP CodeMaster 100 can be used for either short term or long term cardiac monitoring A fully charged HP M2476B 2 5 amp hour NiCd battery provides a minimum of two hours of continuous monitoring A fully charged HP M2477B 4 0 amp hour NiCd battery provides a minimum of three hours of continuous monitoring time Not intended for use with internal electrodes CAUTION ...

Page 116: ...llator is configured for a 3 wire cable the choices are always I II III aVR aVL aVF V when config ured for a 5 wire cable 2 The actual V lead shown is dependent upon electrode placement 3 V1 with 12 Lead only will be displayed when the V lead is selected When multifunction defib electrodes are used to pace on demand an alternate ECG source must be used for monitoring and Lead Select should be set ...

Page 117: ... 5 wire 10 wire 3 Wire Patient Cable Table 5 2 describes typical lead wire placement using the 3 wire patient cable Table 5 3 shows how the individual leads are formed using the individual leadwires Table 5 2 3 Wire Electrode Placement Electrode Placement 5 KLWH 1HDU ULJKW PLGFODYLFXODU OLQH GLUHFWO EHORZ WKH FODYLFOH ODFN 1HDU WKH OHIW PLGFODYLFXODU OLQH GLUHFWO EHORZ WKH FODYLFOH 5HG HORZ WKH OH...

Page 118: ...nt 5 KLWH 1HDU ULJKW PLGFODYLFXODU OLQH GLUHFWO EHORZ FODYLFOH ODFN 1HDU OHIW PLGFODYLFXODU OLQH GLUHFWO EHORZ FODYLFOH 5HG HORZ WKH OHIW SHFWRUDO PXVFOH RQ WKH OHIW PLGFODYLFXODU OLQH 5 UHHQ HORZ WKH ULJKW SHFWRUDO PXVFOH RQ WKH ULJKW PLGFODYLFXODU OLQH 9 URZQ V DSSURSULDWH IRU WKH 9 OHDG WR EH PRQLWRUHG 9 9 1RWH WKDW IRU WKH ZLUH SDWLHQW FDEOH DOO 9 9 OHDGV DUH PRQLWRUHG RQ WKH HDG GLVSOD DQG WK...

Page 119: ...ride electrodes Be sure that the electrodes or lead wire tips do not come in contact with any other conductive materials including earth grounded materials especially when connecting or disconnecting electrodes to from a patient 3 Attach disposable monitoring electrodes by performing the following steps a Peel the protective backing from the electrode Be careful to keep adhesive surface free from ...

Page 120: ...CG monitoring electrodes Do not mix reusable and disposable electrodes Be careful to correctly align the cable plug when connecting the patient ECG leads cable to the HP CodeMaster 100 Correctly orient the cable plug key with the connector slot If the ECG leads cable falls out or is incorrectly connected the message LEADS OFF appears on the display NOTE ...

Page 121: ...2472A to the defibrillator 3 Connect the defib electrodes to the electrode adapter cable The elec trodes are correctly connected when the locking ring is twisted locking the ears of the connector to the adapter cable 4 Use the Lead Select button to select PADS as the ECG source Using Paddles For an emergency evaluation you can monitor a patient s ECG through the paddles electrodes when leads are n...

Page 122: ...DS OFF appears on the display inspect the electrodes patient cable leadwires and associated connections If the selected ECG source is not connected a dashed line replaces the normal ECG trace 4 Ensure that the ECG size has been automatically adjusted for optimal size If you wish to reduce the ECG size press ECG Size The gain bar along the left side of the display represents 1 mV of signal amplitud...

Page 123: ...ecome active and the limits are replaced by the bell symbol If the heart rate alarm limits are violated the heart rate alarm limits replace the bell symbol and the violated limit is highlighted Pressing HR Alarm at this point will turn off the heart rate alarms If the heart rate alarms are active and you wish to review the limits press HR Alarm The currently active pair of heart rate alarm limits ...

Page 124: ...de The lower line of the ECG strip records asynchronous events such as Shock delivery or Heart Rate Alarm violations Several graphic symbols are used to annotate events such as Shock Heart Rate Alarms Mark or Sync You can print a 1 mV 200 ms calibration pulse on the ECG strip by pressing both arrows on the ECG Size key simultaneously Table 2 2 on page 2 12 contains a list of configuration settings...

Page 125: ... defined in Table 5 6 All event summaries except for shock advisory are 3 seconds pre and 8 seconds post events If in delayed mode each event prints with a 6 second pre event strip prior to the event Table 5 6 Automatic Recordings Event Delayed mode Post event time Non Delayed mode Post event time Mark SUHVVHG VHFRQGV VHFRQGV KDUJH 8QWLO 6KRFN RU LVDUP HYHQW 8QWLO 6KRFN RU LVDUP HYHQW 6KRFNLQJ WKH...

Page 126: ...art rate alarm violations SpO2 alarm violations and mark events Each event record includes date of event heart rate SpO2 reading ECG source and size setting as shown in Table 5 7 The time annotated on the ECG strip is within 8 seconds of the recorded event The message ES is printed at the top of the ECG strip when you print the Event Summary record To print the Event Summary on the recorder press ...

Page 127: ...turn later to review event information such as code statistics Turn the defibrillator off between uses to ensure that Event Summary records are patient specific Recorder Errors The message CHECK RECORDER appears on the screen if an error occurs while recording If this message appears check the recorder paper supply This message may also appear if the recorder door is open NOTE ...

Page 128: ...ation Center and other HP central stations Do not use the ECG output to synchronize another defibrillator The ECG In to ECG Out delay is 35 milliseconds The connection of external equipment may increase leakage currents Always request that local safety personnel verify that multiple connected equipment comply with local regulatory standards before putting such equipment into service Table 5 8 Exte...

Page 129: ...ad acquisition and printing for on site interpretation preview display to scroll through all l2 leads computerized ECG analysis or interpretation internal modem US Canada and UK and combined landline cellular for ECG transmission RS 232 port for use with external modem phone directory with auto dial with storage of up to 18 transmission sites storage of up to 30 ECGs backlit LCD display shared pat...

Page 130: ...ead Keyboard and Display 6 2 612 Lead Keyboard and Display This section discusses the 12 Lead keyboard and provides detailed descriptions of all the function keys Refer to Figure 6 1 for an illustration of the 12 Lead keyboard ...

Page 131: ...ad Keyboard and Display 6 3 Figure 6 1 12 Lead Keyboard and Front Panel 6 1 ID 12 Lead Send F5 F4 F3 F2 F1 Q W E R T Y U I O P 7 4 1 0 8 5 2 Filter 9 6 3 Copy A S D F G H J K L Shift Alt Z X C V B N M Stop Menu Shift M2475 B0004 ...

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Page 133: ...8VLQJ WKH HDG 2SWLRQ 12 Lead Keyboard and Display 6 5 Figure 6 2 Characters by Language 6 2 ...

Page 134: ... flammable anesthetics It is not intended for use in explosive environments Do not use the HP CodeMaster 100 with 12 Lead in the presence of electrosurgical or diathermy instruments Do not touch the patient or patient cable during defibrillation Death or injury may occur from the electrical shock delivered by the defibrillator Be sure that the electrodes or connectors do not come in contact with a...

Page 135: ...other telecommunications equipment may increase leakage currents beyond levels that are acceptable in a patient care environment Always request that local safety personnel verify that multiple connected equipment comply with local requlatory standards before putting such equipment into service WARNING ...

Page 136: ... 6Acquiring a 12 Lead ECG This section describes how to prepare the patient for an ECG check the signal quality of the patient leads enter patient ID and printed report information record an ECG change the report format understand the printed report ...

Page 137: ...l leads 5 Press the ID key and enter patient ID information 6 Press the 12 Lead key to obtain an ECG If you are using HP ACI TIPI or TPI the system prompts you for any missing information required for HP ACI TIPI or TPI See Using HP ACI TIPI on page 6 18 and Using HP TPI on page 6 19 The status messages Acquiring ECG Processing Analyzing Storing ECG and Printing are displayed Wait for the report t...

Page 138: ...tercostal space at right sternal margin V2 C2 Fourth intercostal space at left sternal margin V3 C3 Midway between V2 and V4 V4 C4 Fifth intercostal space at left midclavicular line V5 C5 Same level as V4 on anterior axillary line V6 C6 Same level as V4 at left midaxillary line RA R Inside of arm between wrist and elbow LA L Inside of arm between wrist and elbow RL N Inside of calf between knee an...

Page 139: ...ient by performing the following steps 1 Reassure and relax the patient 2 Make sure the electrode site is not covered by hair or clothing Prepare the skin to ensure good contact between the skin and the electrode by gently cleaning and abrading the surface of the skin with dry gauze 3 Place electrodes on the patient 4 Attach each lead wire to the correct electrode 5 The upper left corner of the sc...

Page 140: ...ECG Trace After application of a defibrillator pulse reconnecting one or more leads or any other time the ECG signal is off center during ECG acquisition traces can be quickly restored by pressing the Stop key Table 6 2 Leads Off Labels Designator AHA IEC Meaning 5 1 5LJKW OHJ HOHFWURGH QRW FRQQHFWHG or RQO ULJKW OHJ HOHFWURGH LV FRQQHFWHG DQG DOO RWKHU OLPE HOHFWURGHV DUH QRW FRQQHFWHG 5 5 5LJKW ...

Page 141: ...ing that at least one of the electrodes associated with the lead is not connected The dotted line is known as a leads off trace Use the leads off labels see Table 6 2 to determine which electrodes are off As you connect the electrodes to the patient the lead waveforms are displayed on the screen The ECG traces are updated by the erase bar that moves across the screen Table 6 3 Lead Groups Group Le...

Page 142: ...isplayed for you to review or change if necessary 2 Type the ID number and press or The next line requests the patient s name 3 Type the patient s name and press the or The next line requests the patient s age It also allows you to change the age units Years Year of Birth Months Weeks Days or Hours 4 Type the patient s age Press F3 until the screen displays the age units you want to use Press or T...

Page 143: ...haracter to the left of the cursor You can stop entering patient ID information at any time by pressing F5 or Stop Reviewing and Changing Patient ID To review and change the current patient ID information 1 Press the ID key The message New Patient displays 2 Press The current patient ID screen displays and you can change any field No Edit Old ID ...

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Page 145: ...17 To obtain high fidelity ECG tracings suitable for manual interpretation of the ST segment use the 0 05 Hz or 0 15 Hz bandwidth filter selections The 0 5 Hz baseline wander filter should not be used for manual interpretation of the ST segment NOTE ...

Page 146: ...demographics and ECG information If you have configured HP ACI TIPI as your interpretation option when you press the 12 Lead key the system displays the HP ACI TIPI Data Entry screen as follows This screen only appears if you have not pressed the ID key and entered all necessary fields required for HP ACI TIPI The system acquires the ECG and prints a report with the HP ACI TIPI probability ACI TIP...

Page 147: ...rpretation option when you press the 12 Lead key the system displays the HP TPI Data Entry screen as follows This screen only appears if you have not pressed the ID key and entered all necessary fields required for HP TPI The system acquires the ECG and prints a report with the HP TPI probability If the patient does not meet the HP TPI criteria the HP CodeMaster 100 will print the standard interpr...

Page 148: ...wlett Packard predictive instrument evaluation is not a substitute for the physician s decision process Just as cardiologists may disagree on ECG interpretations they may also at times disagree with an interpretation given by the HP predictive instruments evaluation Configuring the Contents of the Report The 12 Lead option prints a report that can include a summary of all 12 leads interpretation s...

Page 149: ...size gain through the ECG main screen To change the report lead format 1 Press Stop 2 Use the F2 softkey to toggle through the available formats Press F4 to change the size The ECG Report Figure 6 4 shows a sample report with all the fields identified in Table 6 5 Note that some fields must be selected in order to properly interpret analyze the acquired ECG Figure 6 4 illustrates a two page report...

Page 150: ...8VLQJ WKH HDG 2SWLRQ Setting Up the Printed Report 6 22 Figure 6 4 The ECG Report 6 4 0 4 3 6 5 2 7 8 ...

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Page 152: ...easurements in degrees These are representative values for the dominant beat pattern in the ECG Table 6 6 Basic Measurements Item Description Units 5 7 HDUW UDWH EHDWV SHU PLQXWH 35 35 LQWHUYDO PLOOLVHFRQGV 456 456 GXUDWLRQ PLOOLVHFRQGV 47 47 LQWHUYDO PLOOLVHFRQGV 47 47 LQWHUYDO FRUUHFWHG IRU UDWH PLOOLVHFRQGV 3 URQWDO 3 D LV GHJUHHV 456 URQWDO PHDQ 456 D LV GHJUHHV 7 URQWDO 7 D LV GHJUHHV ...

Page 153: ...e shows how the height of the calibration pulse indicates ECG sensitivity Report Examples The following figures illustrate ECG report formats with standard adult interpretation Table 6 7 Calibration Signals ECG Size mm mV Calibration Pulse Display Label Limb Leads V leads V1 V6 12 Lead ô9 ô9 ô9 ...

Page 154: ...8VLQJ WKH HDG 2SWLRQ Setting Up the Printed Report 6 26 Figure 6 5 A Standard 3x4 ECG 3x4 6 5 ...

Page 155: ...8VLQJ WKH HDG 2SWLRQ Setting Up the Printed Report 6 27 Figure 6 6 3x4 ECG with One Rhythm Strip 3x4 1R 6 6 ...

Page 156: ...8VLQJ WKH HDG 2SWLRQ Setting Up the Printed Report 6 28 Figure 6 7 An Auto 3x4 ECG with Three Rhythm Strips 3x4 3R 6 7 ...

Page 157: ...powers on the initialization screen briefly appears as follows The system displays a message requesting that you attach the 12 Lead patient cable Hewlett Packard CodeMaster 100 12 Lead M2475 English 1989 1998 Hewlett Packard Co Attach the HP 12 Lead ECG cable to take a 12 Lead 3x4 1 0 Pulse Format Size Line ...

Page 158: ...stem displays the Main Menu From the Main Menu you can perform several functions This section describes how to use each entry on the Main Menu I II III 3x4 1 0 Pulse Format Size Line Send ECGs Manage Stored ECGs Print the Log of ECGs Stored Print the Configuration Configure the 12 Lead Event Summaries Select Exit Hewlett Packard 12 Lead 04 53 44 Wed 23 Apr 1997 Main Menu F1 F2 F3 F4 F5 ...

Page 159: ...r which you want the ECG to be sent and push the Send soft key If more than one ECG is to be sent simply highlight a desired ECG as described above and then push the Select soft key to select that ECG Once an ECG has been selected a will appear next to it indicating that it has been selected Additional ECGs can be selected in the same manner After ECGs have been selected choose the Send soft key A...

Page 160: ... more stored ECG s You can select more than one ECG at a time Simply highlight a desired ECG as above and then push the Select soft key to select that ECG Once an ECG has been selected a will appear next to it indicating that it has been selected Additional ECGs can be selected in the same manner After ECGs have been selected choose the soft key function that you want for managing the ECGs Manage ...

Page 161: ...can be printed on the printer The printed ECG Log report includes the date time ID Patient Name and ECG report format Print the Configuration When you select this entry the system will print the current configuration Send Event Summaries This functionality will transmit the Event Summary to an event summary host ...

Page 162: ...es manual to shock advisory changing the battery To resume transmitting after the unit is reset select the ECG from the Send ECGs Menu and press Send The 12 Lead option does not operate while the HP CodeMaster 100 is set to Shock Advisory mode Low Battery information from the HP CodeMaster 100 displays on the 12 Lead screen When the language option is changed in SETUP MENU 1 on the HP Code Master ...

Page 163: ...sing an External Monitor Whenever possible Hewlett Packard recommends that you perform synchronized cardioversion procedures while directly monitoring the patient through the multifunction defib electrodes or ECG leads inputs If you use an external monitor as the ECG source ask your biomedical technician to verify that the CodeMaster 100 defibrillator and external monitor combination will deliver ...

Page 164: ...or and connects to the HP CodeMaster 100 ECG Input for monitoring To use an external monitor perform the following steps 1 Select Lead I or Lead II on the HP CodeMaster 100 2 Plug the cable into the external monitor ECG Output jack and plug the input end of the cable into the ECG input plug on the HP CodeMaster 100 Using ECG electrodes with the HP CodeMaster 100 Use a patient cable connected to th...

Page 165: ...k in paddles ECG mode leads mode is recommended Artifact induced by moving the paddles may resemble an R wave and trigger defibrillator shock You can perform cardioversion in Autogain mode Always inspect the displayed ECG before delivering the counter shock Verify that an R wave marker indi cating shock point appears only with each R wave If a marker dot does not appear or if a marker dot is viewe...

Page 166: ... discharge and may cause damage to the surface of the paddles 2 Apply the paddles to the chest as follows a Place the Sternum paddle to the right of the sternum just below the clavicle b Place the Apex paddle on the chest just below and to the left of the left nip ple in the anterior axillary line 3 Rub the paddles lightly against the skin to distribute the electrolyte medium and increase the cont...

Page 167: ...le and that a marker dot appears only with each R wave of the cardiac cycle 2 Briefly adjust paddle pressure and placement to optimize contact as registered on the paddle contact indicator 3 Depress both Shock buttons one on each paddle until shock occurs The defibrillator will shock with the next detected R wave 4 If additional counter shocks are required readjust the Energy Select control and re...

Page 168: ...ach the electrode adapter cable M2472A to the defibrillator 2 Attach the multifunction defib electrodes to the patient as instructed on the elec trode package 3 Connect the electrode cable connector to the electrode adapter cable The elec trodes are correctly connected when the locking ring is twisted locking the ears of the connector to the adapter cable 4 Turn the Energy Select control to Monito...

Page 169: ...it for the Charge Done indicators If you must disarm the charged defibrillator if counter shock is not needed turn the Energy Select control to Monitor On Any stored energy will be discharged internally and the available energy on the display will return to 0 Resetting the Selected Energy Level To increase or decrease the selected energy level after you press Charge move the Energy Select control ...

Page 170: ...Summary Record on page 5 12 After you use the defibrillator perform the following steps to prepare the defibrillator for its next use o Clean all paddles controls and cables Visually check the patient cables paddles paddles cables and electrode adapter cables for wear insulation nicks and other damage Refer to the Chapter 13 Maintenance for additional information o Turn on the HP CodeMaster 100 If...

Page 171: ...g is a technique of electrically stimulating the heart externally through a set of electrodes Pacing is required when the heart s own conduction system slows dangerously The HP CodeMaster 100 with the pacer can perform external transcutaneous pacing The pacer provides demand synchronous and fixed asynchronous pacing modes The patient is connected to the pacer by multifunction defib electrodes The ...

Page 172: ...ffectively with high impedance pace only electrodes Do not use the same defib electrodes for more than eight hours of continuous pacing 8Using the Pacer To use the pacer perform the following steps 1 Apply the multifunction defib electrodes as instructed on the package 2 Attach the ECG monitoring electrodes as instructed in Preparing the Leads for Monitoring on page 5 3 3 Attach the patient cable ...

Page 173: ...de when it is turned on At this point no pacer pulses are being delivered to the patient The pacer must be started before the pacer pulses are delivered at the selected rate ppm and output mA If the pacing mode is ON and the configuration settings are altered the user can move in and out of pacing provided the defibrillator is not shut off and the settings will not revert back to the factory defau...

Page 174: ...r ECG noise that makes R wave detection unreliable 12 Press Start Stop to start pacing The monitor displays the message PACING as well as the selected mode rate and output The pacer will not start pacing if there is a problem with either the multifunction defib electrode connections or the ECG monitoring electrode connections If there is a problem with the multifunction defib electrode connection ...

Page 175: ...vering pulses and the messages PACER STOP and LEADS OFF will appear To resume pacing reattach the lead and press Start Stop Pacing in fixed mode does not require ECG leads to be attached for the pacer to deliver pulses If a multifunction defib electrode comes off during pacing the pacer will stop delivering pulses and the messages PACER STOP and PADS OFF will appear To resume pacing reattach the e...

Page 176: ...d and fixed pacing modes Observe the patient closely while pacing Do not rely on heart rate alarms or the indicated heart rate as a measure of the patient s perfusion status If the battery runs out during pacing and you replace it with a charged battery the instrument may no longer be in pacing mode To resume pacing press Pacer On and Start Stop WARNING NOTE ...

Page 177: ... charging The pacer status messages will be cleared and replaced with the defibrillator delivered energy display 3 Call out Clear to alert personnel to stand away from the patient 4 Wait for the Charge Done Indicators 5 Simultaneously press and briefly hold both Shock buttons located on the cable connector The shock will be delivered through the multifunction defib electrodes After the shock the p...

Page 178: ...3DFLQJ Using the Pacer 8 8 ...

Page 179: ...f sensor application For more detailed information refer to Understanding Pulse Oximetry Guide You can use the SpO2 monitor with sensors made by other manufacturers as well as with Hewlett Packard sensors For a list of approved sensors see the Sensor Guide 9Understanding Pulse Oximetry This section provides a brief description of SpO2 SaO2 and SpO2 Hewlett Packard is adopting the convention of ref...

Page 180: ... used for measuring SpO2 uses LEDs light emitting diodes to transmit red and infrared light through suitable peripheral areas of the body typically the foot in neonates or the finger in adults The oxygen saturation is gauged by measuring the redness of the blood in the arterial pulse A photodetector positioned opposite the light emitter compares light absorption before and after pulsation to provi...

Page 181: ...in SpO2 Operating Controls on page 1 13 9Patient Monitor Using SpO2 Sensor Types There are three types of sensors Disposable LVSRVDEOH VHQVRUV VKRXOG EH XVHG RQFH RQO DQG WKHQ GLVFDUGHG RZHYHU WKH FDQ EH UHORFDWHG WR D GLIIHUHQW DSSOLFDWLRQ VLWH RQ WKH SDWLHQW LI WKH ILUVW ORFDWLRQ GRHV QRW JLYH WKH GHVLUHG UHVXOWV LVSRVDEOH VHQVRUV PXVW QRW EH UHXVHG RQ GLIIHUHQW SDWLHQWV Semi Disposable 6HPL GLV...

Page 182: ... Patient Hewlett Packard supports the use of many sensors Use the Sensor Guide to find the sensor which is best for your case Follow the manufacturer s guidelines for applying and using the sensor Applying the Reusable Sensor Push the sensor over the fingertip so the cable lies on the back of the hand Secure the cable to the wrist with the wrist strap supplied Make sure the finger is not pinched i...

Page 183: ...ation reddening blistering or pressure necrosis particularly on neonates and on patients with impaired perfusion and varying or immature skin morphology Specific attention must be given to sensor site inspection for changes in skin quality proper optical path alignment and attachment Check the application site at regular intervals at least every two hours and change the site if any compromise in s...

Page 184: ...ely affect the performance of the sensor You may have to replace the sensor to ensure good adhesion or you may have to choose another application site Inspecting the Application Site Inspect the SpO2 sensor site at least once every 2 hours to ensure adhesion skin integrity and correct alignment of the light emitter and photodetector Should alterations of skin integrity occur remove the sensor and ...

Page 185: ...lso cause venous pulsations Only use adhesive wraps recommended by Hewlett Packard Avoid placing the SpO2 sensor on any extremity with an arterial catheter blood pressure cuff or intravascular venous infusion line Connecting the Sensor to the Instrument When you have applied the sensor to the patient plug the disposable and semi disposable sensors into the connector cable and plug this cable into ...

Page 186: ...rce the SpO2 connector into the ECG input socket Start Monitoring Turn the defibrillator on if necessary by turning the Energy Select control to Monitor On Press SpO2 On Off to display the SpO2 reading in the upper right corner of the display MONITOR RECORDER Lead Select ECG Size HR Alarm Record Mark Review M2475 B0013 ECG Input Sp02 Input S S CAUTION ...

Page 187: ... the patient has a very low signal the pulse amplitude indicator does not vary through its full range If the signal is noisy the pulse amplitude indicator does not vary rhythmically with the pulse The pulse rate is derived from the pulse oximeter It should correlate closely with the patient s heart rate Figure 9 4 CodeMaster 100 Display with SpO2 Reading 9 4 6S2 UHDGLQJ 3XOVH DPSOLWXGH LQGLFDWRU 3...

Page 188: ...imit set press SpO2 alarm If the SpO2 level falls below the low alarm limit an alarm sounds and the violated limit is highlighted SpO2 alarms are automatically turned off when you press Charge Deactivating SpO2 Alarms Press SpO2 alarm The symbol to the right of the SpO2 display indicates that the alarms are off Recorder Output After an alarm event the recorder prints a strip The bottom of the stri...

Page 189: ...ions Rear View of CodeMaster 100 with the 12 Lead Option 10 1 The connection of an external modem or other telecommunications equipment may increase leakage currents beyond levels that are acceptable in a patient care environment Always request that local safety personnel verify that multiple connected equipment comply with local requlatory standards before putting such equipment into service This...

Page 190: ...ateway or receiving station which receives prints stores and forwards 12 Lead ECGs This is the recommended platform for receiving and printing 12 Lead ECGs acquired and transmitted from the CodeMaster 100 defibrillator monitor with 12 Lead option Transmitting to a Fax Machine You can send ECGs directly to standard fax machines Transmitting directly to a fax machine does not require a special recei...

Page 191: ...ne jack is a standard phone cable and not provided with the HP CodeMaster 100 Table 10 1 lists the landline communications capabilities Table 10 1 Landline Communications Capabilities Sent From Via Destination 3 RGH0DVWHU HDG LUHFWO ZLWK DQGOLQH D 0DFKLQH 3 RGH0DVWHU HDG LUHFWO 3 3DJH ULWHU L SL L 3 RGH0DVWHU HDG LUHFWO 3 7UDFH0DVWHU 0DQDJHU 6 VWHP 3 RGH0DVWHU HDG 0DQDJHU 5HFHLYLQJ 6WDWLRQ DQG DWH...

Page 192: ...y for units used outside of North America and the UK The internal modem will not work with a digital phone system or a digital Public Branch Exchange PBX Figure 10 2 illustrates a standard landline connection using the internal modem Figure 10 3 shows the HP CodeMaster 100 connecting to a landline connection using an external modem Table 10 2 Direct CommunicationsCcapabilities Sent From Via Destin...

Page 193: ...0 2 10 2 Internal Modem Example 1 Transmit Receiving Site Standard Phone System Example 2 Example 3 Example 4 RJ11C Landline Connection Personal Computer running ECG Manager M1765A or Event Summary Host HP TraceMaster ECG Management System M1730B HP PageWriter XLi Cardiograph M1700A Fax Machine CodeMaster 100 with 12 Lead Option ...

Page 194: ... Transmit Receiving Site Standard Phone System Example 2 Example 3 Example 4 Personal Computer running ECG Manager M1765A or Event Summary Host HP TraceMaster ECG Management System M1730B HP PageWriter XLi Cardiograph M1700A Fax Machine Landline Connection with External Modem RS232 Port External Modem RJ11C CodeMaster 100 with 12 Lead Option ...

Page 195: ...tandard cellular communication connections Use only a Data Interface Adapter to connect the portable cellular phone to either the internal or external modem This cellular Data Interface Adapter provides an RJ11C connection from the modem to the cellular phone creates and translates the necessary signals for cellular communication Table 10 3 Cellular Communications Capabilities Sent From Via Destin...

Page 196: ...10 4 Standard Cellular Connection Internal Modem 10 4 Cellular Internal Modem RJ11C Transmit Receiving Site Cellular Data Interface Adapter RJ11C Adapter Cellular Bag Phone 3 watt Personal Computer running ECG Manager M1765A or Event Summary Host CodeMaster 100 with 12 Lead Option ...

Page 197: ...our local cellular communication service provider Cellular service is not reliable in all areas Check with your local cellular service provider for details of coverage area Transmit Receiving Site Personal Computer running ECG Manager M1765A or Event Sum mary Host Cellular Data Interface Adapter RJ11C Adapter CodeMaster 100 with 12 Lead Option Cellular Bag Phone 3 watt Cellular External Modem NOTE...

Page 198: ...will take you to the Telephone Directory screen Once in the Telephone Directory use the Arrow button on the key pad to highlight the destination for which you want to send the ECG and press the Send softkey or the Send button on the keypad again If Auto Send Acquired ECG has been enabled then you will automatically be taken to the Telephone Directory after the ECG has been acquired and printed Sel...

Page 199: ... to transmit the ECG 5 The system displays a message indicating successful transmission and then returns to the home display If the ECG does not transmit the system displays the Send ECGs screen If the system does not transmit the ECG successfully refer to the section Iden tifying Transmission Problems on page 12 17 Press the STOP key to halt the transmission process For configuration information ...

Page 200: ...ory screen appears 4 Press F2 or Send to transmit the event summary The HP CodeMaster 100 transmits the event summary and indicates that it is executing the dialing sequence The system then confirms the number it is dial ing and that the sequence is being sent 5 The system displays a message indicating successful transmission and then returns to the home display If the event summary does not trans...

Page 201: ...10 13 If the system does not transmit the event summary successfully refer to the sec tion Identifying Transmission Problems on page 12 17 Press the STOP key to halt the transmission process For configuration information refer to Chapter 2 Setup and Configuration NOTE ...

Page 202: ...7UDQVPLWWLQJ DWD IURP WKH HDG 2SWLRQ Transmitting an Event Summary 10 14 ...

Page 203: ... Using the AC Power Module To use the AC power module 3OXJ WKH 3RZHU 0RGXOH SRZHU FRUG LQWR DQ SRZHU VRXUFH 9HULI WKDW WKH SRZHU LQGLFDWRU OLJKWV XS WR VKRZ WKDW SRZHU LV VXSSOLHG WR WKH PRGXOH 6HH LJXUH RQQHFW WKH 3RZHU 0RGXOH GHILEULOODWRU LQWHUIDFH FDEOH WR WKH 3 RGH0DVWHU 7R GR VR SRVLWLRQ WKH FDEOH ZLWK WKH UHG GRW RQ WKH FRQQHFWRU IDFLQJ GRZQ DQG LQVHUW WKH FRQQHFWRU LQWR WKH YROW UHFHSWDFOH...

Page 204: ...H QGLFDWRUV 11 1 Charging Indicator The charging indicator appears when the battery is installed in the HP CodeMaster 100 and the battery is being charged Power Indicator The power indicator lights up when power is supplied to the AC Power Module SRZHU LQGLFDWRU FKDUJLQJ LQGLFDWRU ...

Page 205: ...ce for the HP CodeMaster 100 This module is designed specifically for emergency vehicles with 12 Volt electrical systems With this module your vehicle s 12 Volt system can power the HP CodeMaster 100 saving the defibrillator monitor battery for remote use Additionally the HP CodeMaster 100 battery is recharged when it is attached to the external power module ...

Page 206: ...HG WR WKH H WHUQDO SRZHU PRGXOH 7KH FKDUJLQJ LQGLFDWRU DSSHDUV ZKHQ WKH EDWWHU LV LQVWDOOHG LQ WKH 3 RGH0DVWHU HILEULOODWRU DQG WKH EDWWHU LV EHLQJ FKDUJHG FFHVV WKH IXVH WKURXJK WKH IXVH KROGHU R QRW GLVFRQQHFW WKH 3 0 HILEULOODWRU 0RQLWRU FRQQHFWRU FDEOH XQGHU QRUPDO XVH 7KLV FRQQHFWLRQ SUHYHQWV GDPDJH LQ FDVH RX IRUJHW WR GLVFRQQHFW WKH GHILEULOODWRU IURP H WHUQDO SRZHU EHIRUH PRYLQJ LW ...

Page 207: ...upplies power to the external power module should be protected by a fuse between 10 amps and 20 amps This allows sufficient power to operate the External Power Module and still provides electrical protection in case of faulty or defective wiring to the External Power Module The power module attempts to draw power from the vehicle 12 Volt system whenever the defibrillator monitor is on and whenever...

Page 208: ...er input Verify that the power indicator on the external power module and the external power indicator on the HP CodeMaster 100 both appear 2 Install a battery in the HP CodeMaster 100 and verify that the charging indicator appears on the External Power Module 3 Remove the battery and turn the Energy Select Monitor On control on the HP CodeMaster 100 to 360J Press Charge and verify that the defibr...

Page 209: ... indicators on the HP CodeMaster 100 see Figure 11 4 Figure 11 4 RGH0DVWHU WHUQDO 3RZHU QGLFDWRUV 11 4 3UHVV WKH EDWWHU FDSDFLW JDXJH WR VKRZ WKH FKDUJH OHYHO RI WKH EDWWHU 7KH H WHUQDO SRZHU LQGLFDWRU OLJKW DSSHDUV ZKHQHYHU WKH 3RZHU 0RGXOH LV VXSSO LQJ SRZHU 7KH GHILEULOODWRU LQWHUIDFH FDEOH RI WKH 3RZHU 0RGXOH DWWDFKHV WR WKH H WHUQDO SRZHU LQSXW ...

Page 210: ...dule appears when the battery is charging The indicator may disappear briefly after you turn the defibrillator off When you charge the defibrillator the battery does not charge so the indicator disappears until the defibrillator is charged 7KH 3RZHU 0RGXOH FKDUJHV WKH EDWWHU PRUH TXLFNO LI WKH GHILEULOODWRU LV LQ 2II PRGH I RX WXUQ WKH QHUJ 6HOHFW 3RZHU RQWURO WR 0RQLWRU 2Q RU WR DQ HQHUJ OHYHO WK...

Page 211: ...ating with External Power I D EDWWHU LV LQVWDOOHG LQ WKH 3 RGH0DVWHU HQHUJ WR FKDUJH WKH GHILEULOODWRU FRPHV IURP WKH EDWWHU I WKH EDWWHU LV GHSOHWHG QRW IXQFWLRQLQJ RU QRW SUHVHQW WKH 3RZHU 0RGXOH SURYLGHV HQHUJ IRU GHILEULOODWLRQ 7KH 3RZHU 0RGXOH LV QRW LQWHQGHG WR HOLPLQDWH WKH EDWWHU KRZHYHU OWKRXJK RX FDQ RSHUDWH WKH GHILEULOODWRU ZLWK WKH 3RZHU 0RGXOH DQG ZLWKRXW D EDWWHU LQ WKH GHILEULOODWR...

Page 212: ...HQFH 8QSOXJ WKH 3RZHU 0RGXOH 7XUQ RQ WKH 3 RGH0DVWHU I LW GLVSOD V WKH 2 77 5 PHVVDJH UHSODFH WKH EDWWHU ZLWK D FKDUJHG EDWWHU 7XUQ RII WKH GHILEULOODWRU 3OXJ LQ WKH 3RZHU 0RGXOH 0DNH VXUH WKDW WKH SRZHU LQGLFDWRU RQ WKH 3RZHU 0RGXOH DSSHDUV DQG WKDW WKH LQGLFDWRU RQ WKH RGH0DVWHU DSSHDUV 5HPRYH WKH EDWWHU IURP WKH 3 RGH0DVWHU 0DNH VXUH WKDW WKH FKDUJ LQJ LQGLFDWRU OLJKW JRHV RXW RQ WKH 3RZHU 0RGX...

Page 213: ...MONITOR FAILURE 8VH D EDFN XS GHILEULOODWRU DQG FDOO VHUYLFH I WKHUH LV QR DOWHUQDWLYH WU WR XVH WKH GHILEULOODWRU ZLWKRXW WKH PRQLWRU 8VH KDUJH RQH LQGLFDWRUV WR YHULI GHILEULOODWRU IXQFWLRQDOLW SYSTEM FAILURE 8VH D EDFN XS GHILEULOODWRU DQG FDOO VHUYLFH I WKHUH LV QR DOWHUQDWLYH WU WR XVH WKH GHILEULOODWRU 8VH KDUJH RQH LQGLFDWRUV WR YHULI GHILEULOODWRU IXQFWLRQDOLW Table 12 2 Defibrillator Mess...

Page 214: ...U III LQVWHDG RI PAD DLES 50J MAXIMUM QWHUQDO SDGGOHV DUH DWWDFKHG DQG WKH Energy Select FRQWURO KDV EHHQ WXUQHG SDVW MRXOHV RGH0DVWHU GHILEULOODWRU PRQL WRU ZLOO FKDUJH WR MRXOHV LOW BATTERY DWWHU YROWDJH LV EHORZ WKH ORZ EDWWHU WKUHVKROG QVWDOO D FKDUJHG EDWWHU SETUP LOST 7KH LQWHUQDO EDWWHU ZKLFK EDFNV XS WKH FRQ ILJXUDWLRQ PHPRU KDV GHSOHWHG DOO IRU VHUYLFH DEFIB DISARMED RGH0DVWHU GHILEULOODW...

Page 215: ...rn the Energy Select con trol to Off and use a backup defibrillator 4 Press Review to print an event summary and keep any ECG strips from the defibrillator for later evaluation 5 Alert HP service personnel CHECK BATTERY 7KH EDWWHU SDFN LV QRW IXOO LQVHUWHG LQWR WKH GHILEULOODWRU RU LW LV IDXOW 5HLQVHUW WKH EDWWHU SDFN PDNLQJ VXUH LW ODWFKHV I WKH PHVVDJH UHDSSHDUV SHUIRUP D EDWWHU FDSDFLW WHVW CHE...

Page 216: ...IB DISARMED verify proper connections from the patient to the defibrilla tor This includes connections to the pads paddles adapter cable if one is being used Also check for worn or broken areas along the cables 3 Press Charge again wait for the Charge Done indicators 4 Press the Shock buttons again 5 If the unit remains unable to shock turn the Energy Select control to the Monitor On or Off positi...

Page 217: ...WRS WKH SDFHU KDQJH WKH SDGV DQG FKHFN WKH SDGV DGDSWHU FDEOH IRU SURSHU FRQQHFWLRQ 5HVWDUW WKH SDFHU STOP PACER Q DWWHPSW ZDV PDGH WR FKDQJH SDFLQJ PRGH ZKLOH SDFLQJ 6WRS WKH SDFHU EHIRUH RX FKDQJH WKH SDFLQJ PRGH NO PADS 3DFHU LV RQ DQG RQH RI WKH IROORZLQJ RFFXUV 1R HOHFWURGH DGDSWHU DWWDFKHG 3DGGOHV DWWDFKHG QWHUQDO SDGGOHV DWWDFKHG WWDFK HOHFWURGHV IRU SDFLQJ PADS OFF OHFWURGH DGDSWHU FDEOH L...

Page 218: ...ZHHQ 3 RGH0DVWHU SRUWDEOH GHILEULOODWRU PRQLWRU DQG WKH VHQVRU FDEOH RU DGDSWHU FDEOH DVKHV DSSHDU RQ GLVSOD LQVWHDG RI 6S2 UHDGLQJ DQ W GHULYH PHDVXUHPHQW EHFDXVH 7KH VHQVRU LV QRW RQ WKH SDWLHQW 1R SXOVH LV GHWHFWHG 7KH VHQVRU LV LQFRUUHFWO SRVLWLRQHG 7KH VHQVRU LV GHIHFWLYH KHFN WKH SDWLHQW IRU D SXOVH 5HDSSO WKH VHQVRU DQG PDNH VXUH LW LV FRUUHFWO SRVLWLRQHG I LW GRHVQ W ZRUN UHSODFH WKH VHQVR...

Page 219: ...QW IRU SRRU SHUIX VLRQ 5HDSSO GLVSRVDEOH DQG VHPL GLVSRVDEOH VHQVRUV 5HDGMXVW UHXVDEOH VHQVRUV RQVLGHU XVLQJ D GLIIHUHQW VHQVRU VLWH SpO2 perfusion read ing is high or erratic 0 5 QYHVWLJDWH WKH VRXUFH RI WKH LQWHU IHUHQFH 5HPRYH WKH GHYLFH RU UHOR FDWH WKH SDWLHQW Table 12 4 SpO2 Messages Message Cause Possible Solutions ...

Page 220: ...DUH QRW DWWDFKHG WR WKH HOHFWURGH DGDSWHU FDEOH RU GHILE HOHFWURGHV DUH QRW DWWDFKHG WR WKH SDWLHQW KHFN HOHFWURGH FRQQHFWLRQV ARTIFACT DETECTED DO NOT TOUCH PATIENT FHVVLYH QRLVH ZDV GHWHFWHG E WKH DGYLVRU DOJRULWKP GXULQJ DQDO VLV R QRW WRXFK PRYH SHUIRUP 35 YHQWLODWH RU WUDQVSRUW WKH SDWLHQW ZKLOH WKH DGYLVRU DOJRULWKP LV DQDO LQJ FDUGLDF UK WKPV 5HSHDW DQDO VLV PADS OFF 7KH HOHFWURGH DGDSWHU F...

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Page 223: ...2 PADDLES ECG source and AUTOGAIN ECG gain mode are noted on the ECG strip b Press Mark and verify that the mark symbol is printed It will be delayed 6 seconds if the recorder is in the delayed mode c Press Record to stop the recorder 5 Press HR Alarm Verify that the configured alarm limits appear briefly then are replaced by the bell symbol in the upper right of the display With no ECG signal an ...

Page 224: ...ync mode 12 Verify that the messages SYNC and USE LEADS appear on the display 13 Press Lead Select once to select Lead I and verify that the message USE LEADS no longer appears The message LEADS OFF should now appear indicating that one or more leads are not connected 14 Turn the Energy Select control to Off The defibrillator is ready for use if it passes the above checklist A more extensive test ...

Page 225: ...hapter tells how to solve basic ECG problems Checking ECG Technique Many problems in taking an ECG may be related to electrode application Review Preparing the Patient on page 6 10 to ensure the patient leads are prop erly attached to the patient Refer to Checking Signal Quality on page 6 12 for information about ensuring a good recording by using the preview screen ...

Page 226: ...KHU HOHFWULFDO HTXLSPHQW DZD IURP SDWLHQW 8QSOXJ HOHFWULF EHG DQGHULQJ DVHOLQH 3DWLHQW PRYHPHQW OHFWURGH PRYHPHQW 3RRU HOHFWURGH FRQWDFW DQG VNLQ SUHSDUDWLRQ 5HVSLUDWRU LQWHUIHUHQFH 5HDVVXUH DQG UHOD WKH SDWLHQW H VXUH WKDW WKH OHDG ZLUHV DUH QRW SXOOLQJ RQ WKH HOHF WURGHV 5HDSSO HOHFWURGHV 3UHVV WKH Filter NH LI LW LV FRQILJXUHG IRU DVHOLQH DQGHU 0RYH OHDG ZLUHV DZD IURP DUHDV ZLWK WKH JUHDWHVW U...

Page 227: ...WKH HOHFWURGH VLWH 5HDSSO HOHFWURGHV KHFN H SLUDWLRQ GDWH RQ GLVSRVDEOH HOHFWURGHV 5HSODFH IDXOW SDWLHQW FDEOH IWHU SRZHULQJ RQ WKH XQLW RU GXULQJ QRUPDO RSHUDWLRQ WKH PHVVDJH WWDFK WKH 3 HDG FDEOH WR WDNH D HDG GLVSOD V 7KH FDEOH LVQ W SURSHUO FRQQHFWHG WWDFK WKH HDG FDEOH WR WKH GHYLFH Table 12 7 ECG Problems and Solutions Continued Problem Cause Possible Solutions Table 12 8 Recorder Problems a...

Page 228: ...his effect by using an integrating type A D converter sampling all leadwires simultaneously oversampling the signals processing the oversampled signals with appropriate digital signal processing techniques Identifying Storage Problems The following table shows symptoms and solutions to problems that can occur when storing an ECG Table 12 9 Storage Problems and Solutions Message Likely Cause Possib...

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Page 231: ... call your HP regional office 7KH 0DQDJHU JDWHZD FDQ RQO UHFHLYH RQH 7KH ILUVW KDV EHHQ VXFFHVVIXOO VHQW 7KH DWHZD LV OLPLWHG WR UHFHLYLQJ RQH DXWR IRUZDUGHG 6HOHFW RQH DW D WLPH IRU WUDQVPLVVLRQ IURP WKH 6HQG V VFUHHQ Table 12 10 Transmission Problems and Solutions Continued Message Likely Cause Possible Solutions ...

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Page 233: ...p com go medsupplies 12Service For telephone assistance call the Response Center nearest to you or visit our website at www hp com mpgcsd United States 800 548 8833 Canada East 800 361 9790 Canada Central 800 268 1221 Canada West 800 268 1221 Australia 131147 Belgium 32 2 778 35 31 France 0803 35 34 33 Germany 0130 4730 Italy 0292 122999 Netherlands 0 20 547 6333 United Kingdom 44 344 366333 ...

Page 234: ...7URXEOHVKRRWLQJ Service 12 22 ...

Page 235: ...battery o Check for adequate thermal paper in the recorder o Check for ECG leads electrodes and adequate electrolyte medium If you have an external power module perform these additional checks every shift o Unplug the AC or DC external power module Turn on the HP CodeMaster 100 If it displays the LOW BATTERY message replace the battery with a charged battery Turn off the defibrillator o Plug in th...

Page 236: ...t cables paddles cables and pads adapter cables for wear insulation nicks and other damage o Perform the Delivered Energy and Shock Button Functional Test on page 13 3 o Perform the Electrode Adapter Cable Test on page 13 4 o Perform the Quick Pacer Functionality Test on page 13 5 o Make sure that a battery is charging in the battery support system If you have the advisory option o Turn the Energy...

Page 237: ...trode edges Use your thumbs to depress the Shock buttons on the paddle handles 4 With the paddles in their holders grasp the paddle handles and press the Apex paddle Shock button Verify that the defibrillator does not discharge 5 Release the Apex paddle Shock button then press the Sternum paddle Shock button Verify that the defibrillator does not discharge 6 Press Sync to place the defibrillator i...

Page 238: ...one indicators 4 Press the left Shock button on the pads adapter cable connector housing Verify that the defibrillator does not discharge 5 Release the left Shock button and press the right Shock button on the pads adapter cable connector housing Verify that the defibrillator does not discharge 6 Press Sync to place the defibrillator in sync mode 7 Press and hold both Shock buttons Verify that the...

Page 239: ...During the test only ignore the LEADS OFF warning message if it occurs 3 Put the pacer into the Fixed Mode of operation by pressing Mode 4 Adjust the current to 30 mA by pressing Output Adjust the pacer rate to 60 pulses per minute by pressing Rate 5 Start the pacer by pressing Start Stop on the pacer keypad and start the recorder by pressing Record on the recorder keypad 6 Verify that pacer pulse...

Page 240: ... indication the paddle set is old and must be replaced o Check for pitting or discoloration on the electrode surfaces Replace as required o Ensure that the cable connector and electrodes have no cracks in the insulation Every Three Months Perform the following checks every three months o Have the cable set tested for electrical continuity every three months o Perform a battery capacity test using ...

Page 241: ...1 The paper platen will tilt up 2 Pull up on the plastic removal tag to remove the empty or low paper roll Figure 13 1 Changing the Recorder Paper 13 1 3 Place a new roll of recorder paper HP 40457C D in the recorder so that the paper unrolls from the top of the roll and the grid faces down as it comes out of the recorder 4 Pull the end of the paper past the recorder platen 5 While holding the rec...

Page 242: ...due To clean the printhead perform the following steps 1 Slide the recorder door to the right of the defibrillator The paper platen will tilt up 2 Remove the paper roll 3 Clean the printhead surface above the brush with rubbing alcohol and a cotton swab 4 Re install the paper roll 5 While holding the recorder door open to the right press the platen down over the paper 6 Allow the door to close ove...

Page 243: ... and free of dust and dirt Clean the paddles thoroughly to prevent build up of dried electrolyte medium Do not allow any fluids to penetrate the instrument case Avoid pouring fluid on the unit while cleaning Do not use abrasive cleaners or strong solvents such as acetone or ace tone based compounds Clean the display screen carefully It is especially sensitive to rough handling and subject to scrat...

Page 244: ... the patient cable with alcohol Alcohol can cause the plastic to become brittle and may cause the cable to fail prematurely Do not autoclave the cable or use ultrasonic cleaners Do not immerse the patient cable Do not use abrasive materials to clean metal surfaces scratches on them can cause artifacts on the ECG Do not wet the connectors especially the 12 pin connector Inspect disposable electrode...

Page 245: ... charge HP M2476B M2477B battery packs You should also use only the HP M2480B battery support system to discharge recondition and perform a capacity test on these batteries It is recommended that you charge batteries at room temperature 10 30 C Be sure to alternate batteries between the HP CodeMaster 100 and the battery support system Install a freshly charged battery pack in the HP CodeMaster 100...

Page 246: ... storage batteries begin to loose their charge This occurs in all batteries including the NiCd batteries M2476B M2477B used in the HP CodeMaster 100 Starting with a fully charged battery greater than 50 battery capacity will remain after 25 days The discharge rate can be increased due to the age of the battery and the environment in which it is stored You will get the best battery performance if y...

Page 247: ...als because this can cause a fire hazard New Batteries To assure optimal performance of a new battery all newly purchased batteries should be capacity tested in the M2480B charger prior to being put into service Accomplish this by placing the battery in the charger and performing the Battery Capacity Test on page 13 15 Battery Life Recommended battery pack replacement After two years of service Af...

Page 248: ...e battery pack if the temperature of the battery is not between 10 C and 40 C If it is outside these temperatures the battery support system allows the battery to warm up or cool down before charging A flashing indicator indicates a problem with the charging bay next to the indicator Notify service personnel and do not use that charging bay The other charging bay is not affected and you can contin...

Page 249: ...ing the battery takes approximately 24 hours Battery capacity testing is complete when the PASS indicator appears 3 Record the date of the test on the bottom of the battery If the indicator appears the battery did not pass the test Remove the battery from service immediately and notify service personnel The battery support system will automatically charge and recondition batteries during the capac...

Page 250: ...t system M2478A M2479A DC external power module AC external power module M1500A Trunk cable 3 wire 12 pin AAMI M1510A Trunk cable 3 wire 12 pin IEC M1605A Lead set 3 wire AAMI M1615A Lead set 3 wire IEC M1520A Trunk cable 5 wire 12 pin AAMI M1530A Trunk cable 5 wire 12 pin IEC M1625A Lead set 5 wire AAMI M1635A Lead set 5 wire IEC M3714A Patient cable 10 wire 12 pin AAMI M3715A Patient cable 10 wi...

Page 251: ...20 4464 Australia New Zealand 8120 1703 United Kingdom Ireland 8120 2957 Denmark 8120 1692 Italy 8120 5213 North America 8120 2296 Switzerland 8120 4600 South Africa M2471A Anterior anterior paddle set black PCI transport a M3501A Multifunction adhesive electrode pads adult AAMI M3502A Multifunction adhesive electrode pads adult IEC M3503A Multifunction adhesive electrode pads pediatric IEC M3504A...

Page 252: ...0DLQWHQDQFH CodeMaster 100 13 18 Monitoring Electrodes Paper Cases M2202A Adult snap electrodes 40457C D Recorder paper M3710A Carry case for 12 Lead option ...

Page 253: ...istant anterior anterior adult and pediatric with PCI Contact indicator External paddles are water resistant Adult electrodes 83 cm sq slide off to expose pediatric electrodes 21 cm sq Paddle cord is 10 ft 3 m Full range of internal paddles available Synchronizer SYNC message appears on monitor and is annotated periodically on recorder while in synchronous mode An audible beep sounds with each det...

Page 254: ...nment listed above Equipment Classification internally powered degree of protection against ingress of liquids IPX4 defibrillator pads and paddles dry connected not suitable for use in the presence of a flammable anesthetic mixture with air or nitrous oxide mode of operation continuous patient applied parts classification Type BF defibrillator paddles Type CF SpO2 and ECG NOTE ...

Page 255: ... Display Size and Type 5 inch 12 7 cm diagonal CRT for 4 seconds of ECG data on screen non fade fixed trace Scrolling trace is selectable Sweep Speed Fixed trace 25 mm sec nominal Scrolling trace 28 5 mm sec nominal Frequency Response 0 5 to 40 Hz Heart Rate Display Digital readout on monitor from 15 to 300 BPM Heart Rate Alarms Three configurable pairs of high and low heart rate alarm limits from...

Page 256: ...ats SpO2 alarm limits range 100 90 100 85 100 80 SpO2 alarm delay ten seconds after value drops below the low alarm setting INOP alerts Triggered by disconnected sensor noisy signal light interference or low signal Pulse rate measurement range 30 to 300 bpm 2 resolution 1 bpm Pulse amplitude indicator Indicates pulsatile activity Maximum operating temperature 35 C ...

Page 257: ...Paper Size 50 mm by 30 m 100 ft Recorder Mode Automatically documents events and ECG during defibrillation episodes The recorder can be configured to run in either real time or with a six second delay Frequency Response CodeMaster 100 without the 12 Lead option 0 5 to 40 Hz CodeMaster 100 with the 12 Lead option 0 05 to 150 Hz selectable Size and Weight of the CodeMaster 100 without the 12 Lead Op...

Page 258: ...360J and 200J 300J 360J Analysis Control Push button on front panel Charge Time Less than 5 seconds to 360 joules with battery present Armed Indicators Charge done tone and available energy indicated on display Advisory Event Summary Stores approximately 200 events and 50 ECG strips Data retained after instrument turned off Waveform Damped sinusoidal Lown ...

Page 259: ...raphic Devices by methods A D and E Filters Noise Filter On Off capability Power line filter always enabled Configurable baseline wander noise and artifact filters Storage Capacity 30 ECGs Type 2 MB of non removable flash memory Transmission of 12 Lead ECGs to HP ECG Manager PC Based Receiving Station Software Internal cellular landline modem with RJ11C connector US Canada UK only RS232 Port for e...

Page 260: ...th configurable rhythm strips Size and Weight Dimensions 7 25 in H by 13 75 in W by 15 13 in D 18 5 cm H by 34 9 cm W by 38 4 cm D Weight 23 5lb 10 65 kg Includes paddles standard 2 5 Ah battery and recorder paper Additional Standard Accessories 12 Lead Patient Cable Starter kit of electrodes Soft Carrying Case ...

Page 261: ... H by 2 96 in W by 7 25 in D 85 mm H by 75 mm W by 184 mm D Battery weight 2 7 lb 1 22 kg Battery storage Range of 30 to 50 C Should not be stored above 35 C for extended periods of time HP M2477B 4 0 amp hour battery Type Rechargeable nickel cadmium battery 4 0 Ah 12 V nominal Capacity M2475B Standard 4000 mAH 4 hours ECG monitoring or 75 full energy discharges or 3 hours combined ECG monitoring ...

Page 262: ...rs Capacity test time Approximately 24 hours Recommended battery charging temperature 10 to 30 C Environmental operating conditions 0 to 55 C 15 to 95 relative humidity noncondensing for 24 hours at 40 C 15 000 ft altitude Storage conditions 20 to 70 C 90 relative humidity noncondensing for 24 hours at 65 C 15 000 ft altitude Size and Weight Dimensions 5 1 in H by 14 6 in W by 12 5 in D 13 0 cm H ...

Page 263: ...tery charging output 12 V DC 1 0 A 12 W 90 0 mA 1 1 W trickle Instrument operation output 12 V DC 1 0 A 12 W 7 A 85 W maximum Charge time With defibrillator monitor turned to Off Standby typically four hours HP M2476B 2 5 Ah Battery typically six hours HP M2477B 4 0 Ah Battery Recommended charging temperature 5 C to 35 C Environmental operating conditions 0 C to 55 C 5 to 90 relative humidity non ...

Page 264: ...LFDOO IRXU KRXUV 3 0 K DWWHU W SLFDOO VL KRXUV 3 0 K DWWHU 5HFRPPHQGHG FKDUJLQJ WHPSHUDWXUH WR QYLURQPHQWDO RSHUDWLQJ FRQGLWLRQV WR WR UHODWLYH KXPLGLW QRQ FRQGHQVLQJ IW DOWLWXGH K3D 7UDQVSRUW DQG VWRUDJH WR WR UHODWLYH KXPLGLW LQFOXGLQJ FRQGHQVDWLRQ IW DOWLWXGH K3D TXLSPHQW FODVVLILFDWLRQ ODVVLILFDWLRQ ZLWK UHVSHFW WR SURWHFWLRQ IURP HOHFWULF VKRFN ODVV HJUHH RI SURWHFWLRQ DJDLQVW LQJUHVV RI OLTX...

Page 265: ...1 automatic disarm 1 21 automatic recordings 5 11 B backup battery 2 7 baseline wander filter 2 19 battery capacity test 13 6 13 11 13 15 charging 13 14 disposal 13 13 maintenance 13 11 13 15 monitoring time 5 1 operating time 13 13 operation 1 23 part numbers 13 16 replacing 1 23 specifications 1 24 14 9 battery capacity gauge location 1 23 using 1 24 battery support system specifications 14 10 u...

Page 266: ...fibrillator 2 6 connecting to external monitor 7 2 connector 2 4 ECG output 5 14 ECG problems AC interference 12 14 identifying 12 14 12 15 intermittent waveform 12 15 jittery waveform 12 15 muscle artifact 12 14 respiratory interference 12 14 tremor 12 14 ECG size adjusting 5 8 ECG source automatic analysis 4 4 ECG strip light printing 13 8 ECG trace 2 12 electrode part numbers 5 2 energy deliver...

Page 267: ...ds 5 7 13 17 M1749B multifunction adhesive pads 5 7 13 17 M1749C multifunction adhesive pads 5 7 13 17 M1749D multifunction adhesive pads 5 7 13 17 M1781A test load 13 4 13 5 M1782A external monitoring cable 5 14 M1783A external monitoring cable 5 14 M1900B connector cable 9 4 M2471A anterior anterior paddles 5 2 13 17 M2472A pads adapter cable 5 2 8 2 13 17 M2476B battery 1 23 13 11 13 16 M2477B ...

Page 268: ...CG source 3 8 using for synchronized cardioversion 7 6 pads adapter cable testing 13 4 using for monitoring 5 2 PADS OFF 3 8 8 3 12 5 part numbers supplies 13 16 patient cable 3 wire 5 3 5 wire 5 4 5 5 and abrasives 13 10 and autoclaving 13 10 and isopropyl alcohol 13 10 and ultrasonic cleaners 13 10 configuring 2 12 connecting 2 3 2 5 2 6 immersing 13 10 part numbers 13 16 testing 13 6 patient ID...

Page 269: ...ode 2 9 setup diagnostic menu 2 9 shift checks 13 1 shock buttons defibrillating with during pacing 8 7 defibrillating with using external adhesive pads 3 8 defibrillating with using paddles 3 4 disarming defibrillator 1 21 performing synchronized cardioversion using exter nal adhesive pads 7 7 performing synchronized cardioversion using paddles 7 5 testing 13 3 to 13 4 shock hazard v 6 6 shocking...

Page 270: ...r functionality 13 5 pads adapter cable 13 4 time 2 10 2 11 tones 1 20 4 5 TPI 2 22 transmission 2 24 transmission problems 12 17 transmission setup 2 13 transmitting event summaries 10 1 transmitting 12 Lead ECG 10 10 transmitting event summary 10 12 troubleshooting 12 1 to 12 7 U understanding reports 6 20 upper alarm limits 2 11 USE LEADS 12 2 Using 7 2 V verifying defibrillator operation 13 1 ...

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