Physio Control LIFEPAK 20, Manual

Page: 56 / 227

3
M
o
nitoring
Monitoring
LIFEPAK 20e Defibrillator/Monitor Operating Instructions 3-7
©2006-2015 Physio-Control, Inc.
Smaller amplitude internal pacemaker pulses may not be distinguished clearly. For improved
detection and display of internal pacemaker pulses, turn on the internal pacemaker detector,
and/or connect the ECG cable, select an ECG lead, and print the ECG in diagnostic frequency
response.
Large amplitude pacemaker pulses may overload the QRS complex detector circuitry so that no
paced QRS complexes are counted. To help minimize ECG pickup of large unipolar pacemaker
pulses when monitoring patients with internal pacemakers, place ECG electrodes so the line
between the positive and negative electrodes is perpendicular to the line between the pacemaker
generator and the heart.
The LIFEPAK 20e defibrillator/monitor annotates internal pacemaker pulses with a hollow arrow
on the display and the printed ECG if this feature is configured or selected
ON
. False
annotations of this arrow may occur if ECG artifacts mimic internal pacer pulses. If false
annotations occur, you may deactivate the detection feature using the Options/Pacing/Internal
Pacer menu (refer to
Figure 2-7 ). Also refer to the "Pacing Setup Menu" in Table 8-9 . Patient
history and other ECG waveform data, such as wide QRS complexes, should be used to verify
the presence of an internal pacemaker.
Troubleshooting Tips for ECG Monitoring
If problems occur while monitoring the ECG, check the list of observations in Table 3-2 for aid in
troubleshooting. For basic troubleshooting problems such as no power, refer to "General
Troubleshooting Tips" in Section 7 .
Table 3-2
Troubleshooting Tips for ECG Monitoring
Observation Possible Cause Corrective Action
1 Screen blank and
ON
LED lighted.
Screen not functioning
properly. • Print ECG on recorder as backup.
• Contact service personnel for
repair.
2 Any of these
messages displayed:
CONNECT
ELECTRODES
CONNECT ECG
LEADS
ECG LEADS OFF
XX LEADS OFF
Therapy electrodes are not
connected. • Confirm therapy electrode
connections.
One or more ECG electrodes
are disconnected. • Confirm ECG electrode
connections.
ECG cable is not connected to
monitor. • Confirm ECG cable connections.
Poor electrode-to-patient
adhesion. • Reposition cable and/or lead wires
to prevent electrodes from pulling
away from patient.
• Prepare skin and replace
electrode(s).
• Select another lead.
Broken ECG cable lead wire. • Select
PADDLES
lead and use
standard paddles or therapy
electrodes for ECG monitoring.
• Check ECG cable continuity.
3 Poor ECG signal
quality. Poor electrode-skin contact. • Reposition cable and/or lead wires
to prevent electrodes from pulling
away from patient. Secure trunk
cable clasp to patient’s clothing.
• Prepare skin and replace
electrode(s).