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3-1

3

Monitoring

This chapter contains information about monitoring a patient with the CodeMaster
XL+ defibrillator/monitor. This chapter also contains details of patient preparation
that apply to the synchronized cardioversion and pacing procedures described later
in this manual.

The CodeMaster XL+ can be used for either short term or long-term cardiac
monitoring. A fully charged battery pack provides a minimum of two and a half
hours of continuous monitoring. The power cord can be connected to AC power for
unlimited monitoring periods.

3

Using Leads to Monitor

The CodeMaster XL+'s monitoring functions can be used for cardiac monitoring,
elective cardioversion, and pacing (optional). Table 3-1, “Cardiac Monitoring
Configurations,” on page 3-1 details the different ECG sources that can be used for
cardiac monitoring and monitoring applications for which each is suited.

Table 3-1

Cardiac Monitoring Configurations

For this ECG
source...

Use this cable type...

In this monitoring
application...

Electrode P/N

LEADS,
LEAD I,II,III

3-Wire:
•

6 Pin - M1731A

•

8 Pin - M1733A

•

12 Pin - M1605A/
M1500A

•

ECG Normal.

•

Synchronized
Cardioversion.

•

Pacing.

14445C

LEADS,
LEAD
I,II,III,aVR,aVL
, aVF, and V

5-Wire:
•

6 Pin - M1732A

•

8 Pin - M1734A

•

12 Pin - M1625A/
M1520A

•

ECG Normal.

•

Synchronized
Cardioversion.

•

Pacing.

40493D

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Summary of Contents for CodeMaster XL+ M1722A

Page 1: ...M1722A B CodeMaster XL Defibrillator Monitor User s Guide H HP Part No M1722 91908 Printed in USA November 1994 Edition 6 E1194 ...

Page 2: ...y Before using the instrument 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 performance of the equipment if assembly operations extensions re adjustments modifications or repairs are done by persons authorized by Hewlett Packard and the electrical instal...

Page 3: ...check the device for compliance with the requirements was granted If Test and Measurement Equipment is operated with unscreened cables and or used for measurements in open set ups the user has to assure that under these operating conditions the Radio Interference Limits are still met at the border of his premises Use of accessories other than those recommended by Hewlett Packard may compromise pro...

Page 4: ...an result in damage to the equipment or loss of data Monitor On Do not confuse with 1 Joule Off Standby On Off Ground Shock hazard Caution See operating instructions Meets IEC type BF leakage current requirements and is defibrillator protected Meets IEC type CF leakage current requirements and is defibrillator protected Equipotential rear of unit adjacent to a c input Protective earth ground WARNI...

Page 5: ...v Notes contain additional information on usage TEXT represents the labels that appear on the display represents keys on the key panel represents lighted indicators on the key panel NOTE Key LIGHT ...

Page 6: ...vi ...

Page 7: ...llator 2 4 Defibrillating with Alternate Paddle Sets 2 4 Monitoring Using Leads to Monitor 3 1 Preparing the Leads for Monitoring 3 2 Preparing the Patient 3 4 Monitoring Electrodes 3 5 Monitoring 3 6 Heart Rate Alarms 3 7 Printing the Event Summary Record 3 8 Recording 3 9 Automatic Recordings 3 9 Post Shock Data 3 10 Recorder Errors 3 10 External Monitoring 3 11 Performing Synchronized Cardiover...

Page 8: ...ing Sensor Application 6 5 Connect the Sensor to the CodeMaster XL 6 6 Start Monitoring 6 7 SpO2 Readings 6 7 SpO2 Alarms 6 8 Activating SpO2 Alarms 6 8 Deactivating SpO2 Alarms 6 8 Recorder Output 6 9 Troubleshooting Troubleshooting 7 1 Troubleshooting the Defibrillator 7 2 Troubleshooting the Pacer 7 5 Troubleshooting SpO2 7 6 Performing Diagnostics 7 7 Operational Checks 7 8 Every Shift 7 9 Eve...

Page 9: ...7 Steam Sterilizing the Internal Paddles 8 7 Ethylene Oxide Sterilization 8 8 Supplies 8 8 Installation and Setup Installation A 1 Line Voltage Settings A 1 Installing and Charging the Battery A 1 Loading the Recorder Paper A 3 Connecting Paddles and Patient Cables A 3 Setup A 7 Specifications A 11 Defibrillator A 11 Monitor A 12 Thermal Array Recorder A 12 Size and Weight A 13 Battery A 13 Extern...

Page 10: ...ernal Paddles Selection 2 8 Switched Internal Paddles Selection 2 9 Cardiac Monitoring Configurations 3 1 3 Wire Electrode Placement 3 2 Lead Formation 3 3 5 Wire Electrode Placement 3 3 Lead Configurations 3 3 Event Summary Record Information 3 8 Automatic Recordings 3 10 External Monitoring Cables 3 11 Failure Messages 7 1 Defibrillator Messages 7 2 Pacer Messages 7 5 SpO2 Messages 7 6 Setup Men...

Page 11: ...List of Tables Contents 6 ...

Page 12: ...7 Defibrillator Control Panel 2 1 The Monitor Control Panel 3 6 The Pacer Control Panel 5 1 Positioning of the Light Emitters and Photodetector 6 2 Application of the HP M1190A Reusable Sensor 6 4 Connecting the SpO2 Sensor to the CodeMaster XL 6 6 CodeMaster XL display with SpO2 reading 6 7 Changing the Recorder Paper 8 1 Installing the Battery A 3 Connecting External Paddles Adhesive Pads or Int...

Page 13: ...s for safe use and proper care of the Hewlett Packard M1722A B CodeMaster XL defibrillator monitor Figure 1 1 The CodeMaster XL Defibrillator Monitor 1Operating Controls and Indications The following figures and tables detail the controls and indications on the CodeMaster XL defibrillator monitor ...

Page 14: ...er control Turns the instrument power on and off and selects energy level button Charges defibrillator to energy level set on Energy Select control but tons Administers shock Labelled button Changes operating mode between immediate shock normal mode and synchronized with next R wave shock Sync mode Charge button Shock buttons Sync button Energy Select power control Charg Shock Sync ...

Page 15: ...on Starts and stops the recorder When the recorder is on pressing will annotate the ECG at that point If the recorder is not on and the unit is set up to do so pressing will print an ECG strip See Appendix A for information about setting up the CodeMaster XL for recording when you press Record on Mark Record button Mark button Recor Mark Mark Mark Mark ...

Page 16: ...Alarms Prints an Event Summary record The message ES is printed at the top of the ECG strip when you print the Event Summary record The recorder must be off to print an Event Summary with this key QRS Beeper Vol ume Controls volume of QRS beeper ECG Output Provides analog 1V mV output for external monitoring Lead Select button ECG Size button HR Alarm button Review button QRS Beeper Volume ECG Out...

Page 17: ...r Operating Controls Control Description Turns pacer on or off Adjusts pacer rate ppm up or down Starts and stops pacing Adjusts pacer output current mA up or down Changes between fixed and demand pacing modes Start Stop button Output button Mode button Rate button Pacer On button Pacer Rate Start Output Mode ...

Page 18: ...2 Operating Controls Table 1 5 SpO2 Operating Controls Control Description Turns pulse oximeter on or off Activates selects and deactivates SpO2 alarms SpO2 input Connector for SpO2 sensor or sensor adaptor cable SpO2 Input SpO2 Alarm button SpO2 On Off button SpO2 On SpO2 ...

Page 19: ...Indicator PCI on Sternum pad dle IIndicates how well paddles contact patient Light Indicates that unit is in synchronized shock mode as opposed to defibrillator mode Flashes off each time an R wave is detected AC Power Indicates that unit is plugged in to AC power Battery Charge Indicates that the unit is plugged into AC power and that the battery is being charged Charge Done Paddle Contact Indica...

Page 20: ...ible Indicators Indicator Description Charge Done tone Sounds when instrument is charged and ready to deliver a shock Can be disabled in setup Auto disarm tone Sounds during the last ten seconds of the Charge Done tone Beeps intermittently until disarmed QRS beeper Sounds whenever an R wave is detected Volume controlled by front panel adjustment CRT alerts Three beeps each time a message appears o...

Page 21: ...Dangerous high voltage exists on the paddles when the defibrillator is discharged Contact with this high voltage could cause death or serious injury Avoid touching any metal surfaces on the instrument during shock Avoid connecting the patient to several devices at once because leakage current limits can be exceeded Never touch the bed the patient or any equipment connected to the patient during de...

Page 22: ... Energy Select switch is in the Off Standby position Battery charging is indicated by the light being on A fully depleted battery will recharge to 90 of full capacity in two hours and 100 capacity in 18 hours To preserve battery integrity the battery must be fully recharged each time the battery is depleted A new battery or one that has been stored for an extended period requires 24 hours of charg...

Page 23: ...been fully depleted plugging the instrument into AC will immediately restore full operation Frequent battery discharges to the low battery level will degrade battery life Battery Life The sealed lead acid battery used in the CodeMaster XL will provide optimum life when the unit is continually connected to AC power when not in use The battery operates best when it is fully charged after each use To...

Page 24: ...heck the battery capacity to determine whether to replace it The battery capacity check is described in Maintaining the Battery on page 8 3 When plugged into AC power the CodeMaster XL will function normally with no battery installed however the time required to charge the defibrillator will increase If the CodeMaster XL is operated without a battery installed clearly mark the instrument that it d...

Page 25: ... using different paddle sets for defibrillating Figure 2 1 Defibrillator Control Panel 2Defibrillating a Patient The following section describes the three steps to defibrillating a patient 1 Select Energy 2 Charge 3 Shock Shock buttons Charge button Sync button Energy Select power control ...

Page 26: ...below a Place the left Sternum paddle near the upper sternum just below the patient s right clavicle b Place the right Apex paddle on the chest just below and to the left of the patient s left nipple in the anterior axillary line 4 Rub the paddles lightly against the skin to increase contact between the patient skin and the paddles Then keep the paddles still to reduce motion artifact on the monit...

Page 27: ...patient contact as reg istered on the paddle contact indicator if supplied 2 Verify that no one is in contact with the 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...

Page 28: ...at sufficient recorder paper and electrolyte paste or defibrillator pads are available for the next use of the defibrillator Defibrillating with Alternate Paddle Sets The CodeMaster XL will defibrillate with several different pads paddles sets Adult Pediatric Anterior Anterior External Paddles External Adhesive Pads Internal Paddles Performing Pediatric Defibrillation The CodeMaster XL paddle set ...

Page 29: ...he optional pacer is installed you can switch between the pacing and defibrilla tion modes of operation quickly The defibrillator will deliver defibrillator energy levels to an open pads set The message PADS OFF appears when there is a poor pads to patient contact Check all patient connections if this message appears If possible dry off the patient s chest prior to applying the pads Avoid spreadin...

Page 30: ...ergy Select control to desired energy 7 Press 8 Wait for the Charge Done indicators 9 Press both Shock buttons at once to defibrillate The Shock buttons for external pads are on the cable connector housing Performing Internal Defibrillation You can perform internal defibrillation using one of the optional internal defibrillation paddle sets The Switchless paddle sets attach to the internal paddles...

Page 31: ...he ears of the connector to the adaptor cable Failure to correctly connect the internal paddles to the adaptor cable can result in a failure to deliver energy to the patient 5 Set the Energy Select control to the desired energy If the energy switch is set to a level greater than 50 joules 50J MAXIMUM will be displayed If is pressed the unit will only charge to 50 joules For safety and sterility wh...

Page 32: ...et the Energy Select control to the desired energy If the energy switch is set to a level greater than 50 joules 50J MAXIMUM will be displayed If is pressed the unit will only charge to 50 joules For safety and sterility when using the paddles do not touch the paddle beyond the fingerguard on the handle 5 Apply the internal paddles Table 2 1 Switchless Internal Paddles Selection HP Part Number Des...

Page 33: ...hock button on the right hand internal paddle handle Table 2 2 Switched Internal Paddles Selection HP Part Number Description M1784A Internal paddle set 7 5 cm diameter M1785A Internal paddle set 6 0 cm diameter M1786A Internal paddle set 4 5 cm diameter M1787A Internal paddle set 2 8 cm diameter Charge ...

Page 34: ...Defibrillating Defibrillating a Patient 2 10 ...

Page 35: ...eriods 3Using Leads to Monitor The CodeMaster XL s monitoring functions can be used for cardiac monitoring elective cardioversion and pacing optional Table 3 1 Cardiac Monitoring Configurations on page 3 1 details the different ECG sources that can be used for cardiac monitoring and monitoring applications for which each is suited Table 3 1 Cardiac Monitoring Configurations For this ECG source Use...

Page 36: ...ing the individual leadwires PADS Pads adaptor cable M1750A B ECG Normal Synchronized Cardioversion You can use these pads for pacing how ever you must select LEADS as the moni tor source during pac ing M1749A PADDLES Standard with instrument M1746A Emergency ECG Monitoring N A Table 3 2 3 Wire Electrode Placement Electrode Placement RA White Near right midclavicular line directly below the clavic...

Page 37: ...LA RA LL II LL RA LA III LL LA RA Table 3 4 5 Wire Electrode Placement Electrode Placement RA White Near right midclavicular line directly below clavicle LA Black Near left midclavicular line directly below clavicle LL Red Below the left pectoral muscle on the left midclavicular line RL Green Below the right pectoral muscle on the right midclavicular line V Brown As appropriate for the V lead to b...

Page 38: ...de electrodes 3 Attach disposable electrodes perform the following steps a Peel the protective backing from the electrode Be careful to keep adhesive surface free from electrolyte paste b Apply the electrodes firmly to the patient s skin pressing around the entire edge of the electrode c Attach snap on or clip on leads assuring good contact between the elec trode and the lead end Tape the lead wir...

Page 39: ...dard pads perform the following steps 1 Attach pads as instructed on the pads package 2 Attach the pads adaptor cable to the defibrillator 3 Connect the pads to the pads adaptor cable 4 PADS is the only selectable ECG source Using Paddles For an emergency evaluation you can monitor a patient s ECG through the paddles electrodes when leads are not attached to the patient Do NOT use paddles to monit...

Page 40: ...he ECG source The selected source appears in the upper right corner of the display For example PADS appears on the display when it has been selected m If the message LEADS OFF or PADS 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 will replace the normal ECG trace Lead Select button ECG ...

Page 41: ...defined limits using When HR alarms are inactive the monitor will display a bell symbol with a through it To select a pair of HR alarm limits press until the pair of limits you wish to use are displayed If you do not press the key again the displayed HR alarm limits become active and the limits are replaced by the bell symbol If the HR alarm limits are violated the HR alarm limits replace the bell...

Page 42: ... 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 The recorder must not be printing to print an Event Summary with this key After printing an event you must wait 10 seconds before printing another event To stop printing the Event Summary press or To review the Event Summary later turn the unit on and pres...

Page 43: ...and Recorder mode The lower line of the ECG strip records asynchronous events such as Shock deliv ery or Heart Rate Alarm violations Several graphic symbols are used to annotate events such as Shock HR Alarms Mark or Sync A 1 mV 200 ms calibration pulse can be printed on the ECG strip by pressing both arrows on the key simultaneously Appendix A contains a list of configuration settings in setup me...

Page 44: ...Peak Current If Post Shock Data is disabled the defibrillator will record the energy to which it was charged as the delivered energy For example if the unit was charged to 200J the delivered energy annotation on the ECG strip would be DEL 200J Table 3 7 Automatic Recordings Event Delayed mode Pre event time Delayed mode Post event time Non Delayed mode Post event time pressed 6 seconds 3 seconds 3...

Page 45: ...nal Monitoring Cables on page 3 11 The ECG output is also compatible with the interface to the HP central station ECG input 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 loc...

Page 46: ...Monitoring External Monitoring 3 12 ...

Page 47: ...onized cardioversion procedures while directly monitoring the patient through the defibrillator s pads or leads inputs If you use an external monitor as the ECG source ask your biomedical technician to verify that the monitor CodeMaster XL combination will deliver a synchronized shock within 60 ms of the peak of the R wave See the service manual for test procedure Use a 1 mV QRS complex with a QRS...

Page 48: ...ads to patient as instructed on the package 3 Connect pads to the pads adaptor cable If the PADS OFF monitor message is displayed check all patient connections 4 Select pads as the ECG source by pressing 5 Set Energy Select control to desired energy 6 Perform the procedure described inPerforming Cardioversion on page 4 1 Performing Synchronized Cardioversion To start cardioversion perform the foll...

Page 49: ...ove ECG R wave quality 4 Select the desired energy level with the Energy Select control Verifying Defibrillator Operation Before the cardioversion procedure is started verify defibrillator operation by performing the following brief test 1 Ensure that the paddles connector is attached and the paddles are in their hold ers 2 Ensure that the patient cable is connected to the ECG Input jack in the fr...

Page 50: ...ulate on the hands the paddle handles or the paddle electrodes on the chest to avoid the risk of electrical shock or burns c Gently rub the electrode surfaces together to evenly distribute the applied paste 2 Apply the paddles to the chest as follows a Place the left Sternum paddle to the right of the sternum just below the clavicle b Place the right Apex paddle on the chest just below and to the ...

Page 51: ...ve 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 countershocks are required readjust the Energy Select control as necessary and repeat the synchronized cardioversion proc...

Page 52: ...rage 3 Plug the power cord into an AC power outlet Verify that the and lights are on 4 Clean all paddles controls and cables as necessary Refer to Chapter 8 Main taining the Defibrillator for information on cleaning the defibrillator 5 Check that there are adequate recorder paper electrolyte paste and defibrillator pads for the next use BATT AC ...

Page 53: ...dhesive pads The patient can be paced and defibrillated through the same set of pads While pacing avoid touching the gelled area of the pacing pads or the patient to prevent electrical shock Use only HP recommended pads M1749A with the external pacer option The CodeMaster XL delivers pacer pulses through a low impedance multifunction pad The CodeMaster XL does not pace effectively with high impeda...

Page 54: ...r toward the front of the defibrillator to lock the connec tor in place 6 Attach the pads to the pads adaptor cable and turn the twist lock 7 Turn the Energy Select control to the Monitor On position m If the message NO PADDLES is displayed check that the pads adaptor cable connector is properly seated and latched m If the message PADS OFF is displayed check the pads connection to the patient and ...

Page 55: ...nts heart rate is lower than the selected pacer rate m When in Fixed mode the pacer will deliver pacer pulses at the selected pacer rate Use Demand pacing mode whenever possible Use Fixed pacing mode Asynchronous for cases when reliably monitoring the patient is impractical For example use Fixed mode when there is motion artifact or other ECG noise that makes R wave detection unreliable 12 Press t...

Page 56: ...tach the pad and press HR meters and HR alarms function during pacing but they can be unreliable The HR meter attempts to count QRS activity in both Demand and Fixed pacing modes Observe the patient closely while pacing Do not rely on HR alarms or the indicated Heart Rate as a measure of the patient s health Defibrillation During Pacing If the patient must be defibrillated during pacing perform th...

Page 57: ...Pacing Optional Using the Pacer 5 5 After the shock the pacer remains off Resume pacing if it is required ...

Page 58: ...Pacing Optional Using the Pacer 5 6 ...

Page 59: ...Message Possible Solutions DEFIB FAILURE Use a back up defibrillator and call service MONITOR FAILURE Use a back up defibrillator and call service If there is no alternative try to use the defibrillator without the monitor Use Charge Done indi cators to verify defibrillator functionality SYSTEM FAILURE Use a back up defibrillator and call service If there is no alternative try to use the defibrill...

Page 60: ... mode Defibrillator is in sync mode and PADDLES is selected Select PADS or LEAD I II or III instead of PADDLES Defibrillator is in defib mode and PADDLES is selected when leads are attached to the patient Select PADS or LEAD I II or III instead of PADDLES Defibrillator is in defib mode PADDLES is the ECG source when attaching leads to the patient Select PADS or LEAD I II or III instead of PADDLES ...

Page 61: ... and use a backup defibrillator 4 Press to print an event summary and keep any ECG strips from the defibrillator for later evaluation 5 Alert appropriate service personnel If the Defibrillator does not Deliver a Shock If the defibrillator does not deliver a shock perform the following steps DEFIB DIS ARMED CodeMaster XL has internally dis charged energy and is now dis armed CHECK RECORDER The reco...

Page 62: ...e defibrillator This includes con nections to the pads paddles adaptor cable if one is being used Also check for worn or broken areas along the cables 3 Press 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 Moni tor On or Off Standby position and use a back up defibrillator 6 Press to print an eve...

Page 63: ...eliver the required current 1 Stop the pacer 2 Change the pads and check the pads adaptor cable for proper connec tion 3 Restart the pacer STOP PACER An attempt was made to change pac ing mode while pacing Stop the pacer before you change the pacing mode NO PADS Pacer is on and one of the following occurs No pads adaptor attached Paddles attached Internal paddles attached Attach pads for pacing PA...

Page 64: ...n t derive measurement because The sensor is not on the patient No pulse is detected The sensor is incorrectly positioned The sensor is defective Check the patient for a pulse Reapply the sensor and make sure it is correctly positioned If it doesn t work replace the sensor SPO2 NOISY SIGNAL Irregular pulse patterns Patient motion Reapply sensor Consider using a different sensor site SPO2 LIGHT INT...

Page 65: ...that Date Time HR heart rate PADDLES ECG source and AUTOGAIN ECG gain mode are noted on the ECG strip b Press and verify that the mark t symbol is printed It will be delayed 6 seconds if the recorder is in the delayed mode c Press to stop the recorder 6 Press Verify that the configured alarm limits appear briefly then are replaced by the bell symbol bell in the upper right of the display With no E...

Page 66: ...ars The message LEADS OFF should now appear indi cating that one or more leads are not connected 15 Turn the Energy Select control to Off Standby The defibrillator is ready for use if it passes the above checklist A more extensive test of defibrillator monitor functionality can be performed using the diagnostic service mode described in the M1722 M1723 CodeMaster XL Series Defibrillator Monitor Se...

Page 67: ...ay have a broken wire o Check that the and lights go off when the unit is unplugged o Perform the Delivered Energy and Shock Button Functional Test which follows o If your instrument has the external pacing option perform the Quick Pacer Functionality Test as described in Quick Pacer Functionality Test on page 7 11 Delivered Energy and Shock Button Functional Test To check the instrument with the ...

Page 68: ... both Shock buttons Verify that the defibrillator does not dis charge 7 Press again to remove the defibrillator from sync mode 8 With the paddles in their holders press and briefly hold both Shock buttons at once 9 The recorder will print a test report To check the instrument with the pads adaptor cable perform the following steps 1 Connect the Test Load M1781A to the Pads Adaptor Cable M1750A B 2...

Page 69: ...o 30mA by pressing Adjust the pacer rate to 60ppm by pressing 5 Start the pacer by pressing and start the recorder by pressing 6 Verify that the pacer pulses are shown on the recorder strip approximately every five large boxes if the recorder is in delay mode it will take several seconds before the pacer pulses appear Allow the pacer to run for 10 12 seconds 7 Turn the pacer off by pressing and st...

Page 70: ... or discoloration on the electrode surfaces Polish or replace as required o Ensure that the cable connector and electrodes have no cracks in the insulation Every Three Months Have the cable set tested for electrical continuity every three months Every Six Months See the M1722 M1723 CodeMaster XL Series Service Manual for extensive electrical operational and safety tests to be performed by a qualif...

Page 71: ... monitor 8Changing the Recorder Paper Figure 8 1 Changing the Recorder Paper To change the recorder paper perform the following steps 1 Slide the recorder door to the right of the defibrillator as shown in Figure 8 1 on page 8 1 The paper platen will tilt up 2 Pull up on the plastic removal tag to remove the empty or low paper roll ...

Page 72: ...close over the platen roller 8Cleaning the Recorder Printhead If the ECG strip has light or varying density printing clean the printhead to remove any possible buildup of paper residue 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...

Page 73: ... power some current is drawn from the battery to maintain memory and startup logic If the battery is to be stored for extended periods more than one month without AC power observe the caution in Appendix A Installing and Charging the Battery This battery was selected because it provides optimum performance and battery life over a wide range of operating conditions The life expectancy of this batte...

Page 74: ...rify that the and lights are on 2 Verify that there is recorder paper in the recorder 3 Depress while turning the Energy Select control from Off Standby to Monitor On While pressing turn the Energy Select con trol from the Off position to the Monitor On position The Setup Diagnostic Ser vice menu will appear in a moment 4 Press to highlight the Test Battery diagnostic test 5 Unplug the instrument ...

Page 75: ... the two battery compartment quarter turn screws counter clockwise 4 Lift out the battery door 5 Disconnect the battery connector and remove the battery 6 Connect the new battery and slide it into the compartment 7 Replace the battery door and secure it by turning the two retaining screws a quarter turn clockwise 8 Perform the Battery Capacity Check above before placing instrument in service 8Clea...

Page 76: ...nsitive to rough handling and subject to scratching o Do not steam sterilize the monitoring leads submerge them for prolonged periods or heat them above 50ºC If metallic surfaces become oxidized clean them with a very light abrasive toothpaste Do not use highly abrasive cleaners such as steel wool or silver polish o Do not steam or gas sterilize the external paddle set 8Cleaning and Sterilizing th...

Page 77: ... of these paddles is limited replace them when functionality or appearance is questionable When using the sterilization procedures described in this guide the paddles will withstand approximately 200 sterilization cycles This will vary depending on the equipment and the process used Steam Sterilizing the Internal Paddles Prevacuum Sterilization Flash Sterilization Gravity Sterilization Preparation...

Page 78: ...L 12 88 EtO Exposure Time 1 hour 45 minutes Aeration Time 18 hours M1758A Battery assembly M1731A Patient cable 6 pin 3 wire AHA M1732A Patient cable 5 wire 6 pin AHA M1733A Patient cable 8 pin 3 wire AHA M1734A Patient cable 5 wire 8 pin AHA M1735A Patient cable 8 pin 3 wire IEC M1736A Patient cable 5 wire 8 pin IEC M1500A Trunk cable 3 wire 12 pin AHA M1605A Lead set 3 wire AHA M1510A Trunk cabl...

Page 79: ...41A Switchless Internal paddle set 7 5cm diameter M1742A Switchless Internal paddle set 6 0cm diameter M1743A Switchless Internal paddle set 4 5cm diameter M1744A Switchless Internal paddle set 2 8cm diameter M1784A Switched Internal paddle set 7 5 cm diameter M1785A Switched Internal paddle set 6 0 cm diameter M1786A Switched Internal paddle set 4 5 cm diameter M1787A Switched Internal paddle set...

Page 80: ...e Redux Paper Cases Wall Mount Kit M1749A Defibrillation pacing pads M1750A Pads adaptor M1750B Pads adaptor yellow M1781A Pads adaptor test load 651 1008 050 Redux 40457C D Recorder paper M1778A Carry case M1779A Accessory pouch M1722 80001 Wall mount hardware ...

Page 81: ...ly three wire power cords with three pronged grounded plugs Make sure that the outlet accepts the three pronged plugs and is grounded Never adapt a three pronged plug to fit a two pronged outlet Installing and Charging the Battery To install the battery refer to the battery replacement procedure in Replacing the Battery page 8 5 After installing the battery connect the power cord to the back of th...

Page 82: ... will be stored for longer than one month without AC power first charge the battery for 48 hours then remove the battery from the unit Note on the instrument that the battery has been removed Store the battery in a cool dry location Recharge a stored battery for at least 24 hours every six months This will ensure that the battery does not completely discharge while in storage The battery s shelf l...

Page 83: ...ch wide thermal paper HP 40457C D To load the paper refer to the procedure in Changing the Recorder Paper page 7 1 Connecting Paddles and Patient Cables The defibrillator has a paddles connector for attaching pads paddles sets and an ECG Input connector for attaching leads Paddles Connector Battery Battery compartment Battery plug Battery ...

Page 84: ...or adhesive pads to the defibrillator perform the following steps 1 Slide the paddle connector lock on the paddles plug to the unlock position To do this push the lock towards the top of the connector 2 Insert the paddles pads adaptor cable plug into the paddles connector on the defibrillator as shown in Figure 7 1 on page 7 1 3 Slide the paddle connector lock to the lock position to latch the plu...

Page 85: ...n purchased with the instrument For each connector option several different patient cables can be used for various ECG sources and applications Refer to Table 3 1 Cardiac Monitoring Configurations on page 3 1 for a list of available patient cables and lead sets and their part numbers Push the lock in the direction indicated by the arrow to move the lock to the lock position shown Connector lock Pa...

Page 86: ...nt cable make sure that the pin count of the patient cable plug matches the pin count of the ECG Input connector To install the patient cable 1 Align the keyed cable plug with the slot in the ECG Input connector See Figure 1 3 on page A 7 2 Push the cable plug firmly into the ECG Input connector When a lead is selected for monitoring the message LEADS OFF appears on the display if the patient cabl...

Page 87: ...Master XL you must use the setup menus Table 1 1 Setup Menu 1 Settings on page A 9 and Table 1 2 Setup Menu 2 Settings on page A 10 list the choices you can make on the setup menus Perform the following steps to configure the CodeMaster XL ECG Input connector with key slot Keyed plug of patient cable ...

Page 88: ...will appear with the current setup values displayed 4 Press or until the highlight appears on the value you wish to change 5 Press 6 Press or to scroll through the available choices for this parameter 7 When the choice you want is displayed press to set your choice 8 Press or until the highlight appears on the next value you wish to change 9 Repeat steps 5 through 8 until you are finished configur...

Page 89: ...ngs for all setup values To clear the SETUP LOST message go to setup menu 1 or setup menu 2 The Setup Lost condition will be cleared when you view the setup menus You do not have to change the values if you want to keep the factory settings Table 1 1 Setup Menu 1 Settings on page A 9 and Table 1 2 Setup Menu 2 Settings on page A 10 show configurable parameters on the instrument Table 1 1 Setup Men...

Page 90: ... Table 1 2 Setup Menu 2 Settings Setting Choices Description Recorder Delay Delay 6s No Delay Printout is delayed 6 seconds or immediate Recorder BW Monitor Diagnostic Bandwidth recorder only Record on Mark ON OFF Records during mark Record on Charge ON OFF Records during charge Record on Shock ON OFF Records during discharge Record on Alarms ON OFF Records during alarms Post Shock Data ON OFF ON ...

Page 91: ...le indicates quality of defibrillator paddle contact before discharge Paddles Standard paddles are anterior anterior adult and pediatric 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 audib...

Page 92: ...c monitors EC13 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 25 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 20 to 280 BPM ECG Output 1V mV P...

Page 93: ...tery and recorder paper Battery Type Rechargeable sealed lead acid battery 4 Ah 12 V nominal Charge Time 2 hours to 90 of full capacity 18 hours to 100 capacity Repeated charging to less than 100 will reduce useful life of battery Capacity 2 1 2 hours monitoring or fifty 50 full energy discharges or 1 hour monitoring and recording Battery Indicators Illuminated LED indicates battery is charging LO...

Page 94: ... deviation 65 80 2 5 80 100 1 5 resolution 1 Averaging 8 beats 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 1 resolution 1 bpm Pulse amplitude indicator Indicates pulsatile activity ...

Page 95: ...il P O Box CH 1217 Meyrin 2 Geneva Switzerland Tel 22 838 111 France Hewlett Packard France S A Parc d activite du Bois Briard 2 avenue du Lac F 91040 Evry Cedex Tel 1 60 77 83 83 Austria Eastern Europe Yugoslavia Hewlett Packard Ges m b H Lieblgasse 1 P O Box 72 A 1222 Vienna Tel 222 25 00 0 Germany Hewlett Packard GmbH Hewlett Packard Strasse D 6380 Bad Homburg Tel 0 61 72 400 0 Belgium Hewlett ...

Page 96: ...terndalen 16 18 N 1345 Osteras Tel 2 24 60 90 Sweden Hewlett Packard Sverige AB Skalholtsgatan 9 Kista Box 19 S 163 93 Spanga Tel 8 750 20 00 Denmark Hewlett Packard A S Kongevejen 25 DK 3460 Birkerod Tel 2 81 66 40 United Kingdom Hewlett Packard Limited Harman House No 1 George Street Uxbridge Middlesex UB8 1YH Tel 895 720 20 Finland Hewlett Packard OY Piispankalliontie 17 02200 Espoo Tel 0 887 2...

Page 97: ... SaO2 and SpO2 Hewlett Packard is adopting the convention of referring to the SpO2 parameter Previously it was referred to as SaO2 SaO2 is the term used to indicate the oxygen saturation of arterial blood SpO2 is the term used to indicate the oxygen saturation of arterial blood as measured by pulse oximetry 6Application Notes The pulse oximetry method used for measuring SpO2 uses LEDs light emitti...

Page 98: ...tor o The patient must have at least a minimum pulse o The light emitter and the photodetector must be opposite each other 6Using SpO2 to Monitor a Patient There are three types of sensors Disposable Disposable sensors should be used once only and then discarded However they can be relocated to a different application site on the patient if the first location does not give the desired results Disp...

Page 99: ...sensor to the identified location 5 Connect the sensor to the monitor To connect sensors from other manufacturers you need the HP M1900B Connector Cable Apply the Sensor to the Patient HP 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 Semi Disposable Semi disposable sensors ...

Page 100: ... in the correct position inaccurate readings result In extreme cases the instrument displays dashes instead of an SpO2 reading When correctly positioned the end of the finger just touches the end of the sensor When non HP SpO2 sensors are used application must be consistent with the manufacturer s own guidelines Prolonged continuous monitoring may increase the risk of undesirable changes in skin c...

Page 101: ...y 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 reapply at another recommended site Avoid application of the sensor to edematous or fragile tissue Check circ...

Page 102: ...sposable and semi disposable sensors into the connector cable and plug this cable into the SpO2 socket on the lower right of the CodeMaster XL Plug the HP M1190A sensor directly into the SpO2 socket of the CodeMaster XL The plug is keyed and is color coded blue to distinguish it from the white ECG socket Figure 6 3 Connecting the SpO2 Sensor to the CodeMaster XL Do not force the SpO2 connector int...

Page 103: ...aster XL display with SpO2 reading The pulse amplitude indicator shows the quality of the SpO2 signal Since it is derived from the patient s plethysmograph signal it varies with the pulse of the patient If 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 puls...

Page 104: ... option Stop when you see the alarm you would like to choose and after three seconds that alarm will take effect A symbol replaces the limits to show that the alarm is active To review the limit set press the button 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 Deactivating SpO2 Alarms...

Page 105: ... alarm event the recorder prints a strip The bottom of the strip shows the alarm violation and the top of the strip shows the SpO2 reading You may print an event summary record which contains SpO2 information as described in Printing the Event Summary Record page 3 8 ...

Page 106: ...SpO2 Monitoring Optional SpO2 Alarms 6 10 ...

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