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ZOLL X Series, Operator'S Manual

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ZOLL X Series Operator'S Manual Download Page 241

CPR Compression Bar Graph (Adult Only)

9650-001355-01 Rev. M

X Series Operator’s Guide

19-7

CPR Compression Bar Graph (Adult Only)

When Adult CPR electrodes are attached, the X Series unit can display a CPR compression bar 
graph next to the dashboard that is computed from the CPR sensor signals. This bar graph, 
representing depth of compression, is presented on a (AHA/ERC 2005: 0 - 2.1, AHA/ERC 
2010: 0 - 2.5) inch displacement scale with reference markers at (AHA/ERC 2005: 1.5 and 2.0, 
AHA/ERC 2010: 2.0 and 2.4) inches. The unit displays a minimum of 12 seconds of 
compression data at a rate of approximately 133 compressions per minute.

The CPR Compression Bar Graph is only available when using Adult CPR electrodes.

Summary of Contents for X Series

Page 1: ...Includes Real CPR Help and See Thru CPR X Series Operator s Guide 9650 001355 01 Rev M...

Page 2: ...rporation in the United States and or other countries All other trademarks are the property of their respective owners Masimo Rainbow SET SpCO SpMet SpHb SpOC and PVI are trademarks or registered trad...

Page 3: ...s Pacing 1 9 Non Invasive Blood Pressure Monitoring 1 10 Temperature Monitoring 1 10 SpO2 Monitoring 1 10 Respiration Monitoring 1 10 CO2 Monitoring 1 10 Invasive Pressure Monitoring 1 10 12 Lead Anal...

Page 4: ...Power Supply optional 2 15 Connecting the DC Auxiliary Power Supply to a Suitable Vehicle Power Source 2 15 Connecting AC Auxiliary Power Adapter or DC Auxiliary Power Supply 2 16 Navigating the Disp...

Page 5: ...ausing Suspending Alarms 5 6 Alarm Reminders 5 6 Alarm Options 5 7 Selecting Default Alarm Limits 5 8 Setting Alarm Limits Relative to the Patient Stat Set Option 5 8 Chapter 6 Monitoring ECG ECG Moni...

Page 6: ...Parameter Control Panel 8 13 NIBP System Messages 8 15 Chapter 9 Monitoring CO2 Overview 9 1 CO2 Monitoring Setup and Use 9 2 Selecting the CO2 Sampling Line 9 3 Connecting the CO2 Sampling Lines 9 4...

Page 7: ...ators 10 17 Patents 10 17 Chapter 11 Monitoring Invasive Pressures IBP Invasive Pressure Transducers 11 1 IBP Setup 11 2 Attaching the Invasive Pressure Transducer 11 3 Zeroing the Transducer 11 4 Rez...

Page 8: ...14 8 Fault Conditions Affecting 12 Lead Interpretive Analysis 14 11 Printing 12 Lead Waveform Traces 14 12 12 Lead Print and Display Options 14 14 Selecting 12 Lead Acquire 14 14 Specifying the Number...

Page 9: ...al Medical Protocols 16 2 Prepare Patient 16 2 1 Turn on unit 16 3 2 Press ANALYZE Button 16 4 3 Press SHOCK button 16 5 Chapter 17 Analysis CPR Protocol Defibrillation Analysis CPR Protocol Defibrill...

Page 10: ...PR Metronome 19 3 Constant Metronome Enabled 19 3 Constant Metronome Disabled 19 4 FULLY RELEASE Prompt 19 4 CPR Dashboard 19 5 CPR Rate and Depth Measurements 19 5 CPR Release Indicator Adult Only 19...

Page 11: ...missions 22 29 Configuring Clock Synchronization 22 30 Communications System Messages 22 32 Transmission Status Icons 22 32 Chapter 23 Printing Printing Patient Data 23 1 Printer Setup 23 2 Automatic...

Page 12: ...ntricular Tachycardia VT A 26 Randomized Multi Center Clinical trial for Cardioversion of Atrial Fibrillation AF A 27 Synchronized Cardioversion of Atrial Fibrillation A 29 Electromagnetic Compatibili...

Page 13: ...quickly recharges when the X Series is connected to auxiliary power In addition you can use a ZOLL SurePower Battery Charger Station to recharge and test the X Series battery Note The X Series has de...

Page 14: ...CPR feature to reduce the artifact caused by chest compressions The unit has a large colorful LCD display of numerics and waveform data that provides easy visibility from across the room and at any a...

Page 15: ...manual insert s for option s available on the X Series These insert s contain additional warnings precautions and safety related information Operator s Guide Updates An issue or revision date for this...

Page 16: ...S A customers should call ZOLL Medical Corporation 1 800 348 9011 Customers outside of the U S A should contact the nearest ZOLL authorized representative If the shipping container is damaged also no...

Page 17: ...proof type BF patient connection Defibrillator proof type CF patient connection Fusible link Equipotentiality Alternating current ac Direct current dc Auxiliary power adapter operation Caution high vo...

Page 18: ...onally damage Do not crush Do not discard in trash Recycle or dispose of properly Return to a collection site intended for waste electrical and electronic equipment WEEE Do not dispose of in unsorted...

Page 19: ...ayed on the screen for example LEAD FAULT Warning Warning statements alert you to conditions or actions that can result in personal injury or death Caution Caution statements alert you to conditions o...

Page 20: ...er with and without heart dysfunction When the pediatric patient is less than 8 years of age or weighs less than 55 lbs 25 kg use ZOLL pediatric defibrillation electrodes Do not delay therapy to deter...

Page 21: ...of age or weighs less that 55 lbs 25 Kg you must use ZOLL pediatric defibrillation electrodes Do not delay therapy to determine patient s exact age or weight ECG Monitoring The X Series is intended fo...

Page 22: ...e indicated for use on adult pediatric and neonatal patients during both no motion and motion conditions and for patients who are well or poorly perfused in hospitals hospital type facilities or in mo...

Page 23: ...pedance An adequate amount of electrolyte gel must be applied to the paddles and a force of 10 to 12 kilograms 22 to 26 4 pounds must be applied to each paddle in order to minimize this impedance If h...

Page 24: ...u must use the controls on the front panel of the unit To switch between paddles and hands free therapy electrodes remove the multifunction cable MFC or OneStep from the apex paddle and connect the ha...

Page 25: ...al charging use the ZOLL SurePower Battery Charger with the X Series battery adapter to charge the battery pack and test the battery s capacity For details refer to the SurePower II Battery Pack Guide...

Page 26: ...ccurred There is no battery installed while connected to auxiliary power One or more patient monitoring parameters have failed self test NIBP SpO2 CO2 IBP or Temp The front panel button self test fail...

Page 27: ...ies products They are not a substitute for a formal patient care training course Operators should obtain formal training from an appropriate authority before using this defibrillator for patient care...

Page 28: ...to use Do not use or place the unit in service if the Ready For Use indicator at the upper right of the front panel displays a red circle with a line through it Carefully route patient cables to avoi...

Page 29: ...o not place electrodes directly over an implanted pacemaker The X Series unit detects ECG electrical signals only It does not detect a pulse effective circulatory perfusion Always verify pulse and hea...

Page 30: ...th before attempting additional shocks Improper defibrillation technique can cause skin burns To limit possible skin burns use only ZOLL defibrillation gel on paddles ensure the gel covers the entire...

Page 31: ...restricted blood flow to the skin Prolonged pacing should be avoided in these cases and periodic inspection of the underlying skin is advised There are reports of transient inhibition of spontaneous r...

Page 32: ...me instances such as obstructed airway the patient s breathing attempts may not produce any air exchange These breathing attempts can still produce chest size changes creating impedance changes which...

Page 33: ...ng can be implemented using a long FilterLine which permits placement of the monitor outside the MRI suite When using the monitor with anesthetics nitrous oxide or high concentrations of oxygen connec...

Page 34: ...such as gasoline Using the unit in such environments might cause an explosion Do not use the unit near or within standing water Electrical safety might be compromised when the defibrillator is wet Nev...

Page 35: ...ient To ensure patient safety connect the X Series only to equipment with circuits that are electrically isolated Use only high quality ECG electrodes ECG electrodes are for rhythm acquisition only yo...

Page 36: ...bles specified or supplied by ZOLL For continued safety and EMI performance use only the line cord supplied by ZOLL Electrical installation of the room or the building in which the monitor is to be us...

Page 37: ...n new location and or organization if known and different from originator s organization company name address contact name and contact phone number 4 Date when the change took effect Please address th...

Page 38: ...ZOLL Medical Corporation 4 Use Restrictions As the Purchaser you may physically transfer the products from one location to another provided that the software firmware is not copied You may not disclos...

Page 39: ...om the service representative Remove the battery pack from the unit Pack the unit with its cables and battery in the original containers if available or equivalent packaging Be sure the assigned servi...

Page 40: ...six or more alphanumeric characters The first two characters of the date of manufacture code give the last two digits of the year for example 06 appears for products manufactured in 2006 The last cha...

Page 41: ...9650 001355 01 Rev M X Series Operator s Guide 2 1 Chapter 2 Product Overview Defibrillator Controls and Indicators SHOCK 1 2 3 0 2 2 1 6 8 9 4 6 3 6 7 10 5...

Page 42: ...vicinity of the X Series unit 4 Speaker Emits R wave detection beeps and alarm tones 5 Paper Compartment Holds the paper for the printer 6 Patient connectors For details refer to Patient Cables and Co...

Page 43: ...d up and are used to indicate a patient alert equipment alert and data transfer PACER button Displays pacer settings window to start stop pacing activity or change the rate output or mode settings ANA...

Page 44: ...current alarm and pause silence the alarm audio for 90 seconds Pressing Audio Pause Silence Reset button before the Audio Pause Silence period has expired resets the alarm Ready for Use Indicator Sho...

Page 45: ...delivered energy for defibrillation and synchronized cardioversion The output current and stimulus rate for pacing Messages and prompts The image below shows the layout of parameter values waveforms...

Page 46: ...utes after exiting the defibrillation mode Icon Status Indication Action Auxiliary power adapter is connected The unit is being powered by the auxiliary power adapter No battery detected Either there...

Page 47: ...Cable Connectors on Left Side of Unit Figure 2 3 Patient Cable Connectors on Right Side of Unit Connector Description ECG For connecting 3 or 5 lead ECG cable 12 lead monitoring is optional SpO2 For c...

Page 48: ...es on page 2 10 for a list of compatible accessories Inserting Cables into Unit Plug the cable connector into the therapy input connector on the right side of the unit Push the connector in with the a...

Page 49: ...nitoring and for use with Real CPR Help See ZOLL Cables and Compatible Accessories on page 2 10 for a list of compatible accessories When connecting a OneStep electrode to the OneStep cable push the t...

Page 50: ...CG monitoring and for use with Real CPR Help See the table below for a list of compatible accessories ZOLL Cables and Compatible Accessories Cable Description Internal Paddles External Paddles Stat Pa...

Page 51: ...cannot use paddles for external transcutaneous pacing Attaching the MFC cable Attach the MFC from the X Series unit to the connector at the base of the APEX paddle If you need to detach the MFC from...

Page 52: ...e latch clicks as shown When disconnecting the OneStep electrode and OneStep cable press down the latch with your thumb as shown When attaching the OneStep cables to paddles attach the OneStep cable f...

Page 53: ...ates The user must manually adjust energy settings to pediatric levels consistent with their institution s protocols Note The X Series defibrillator also supports ZOLL autoclavable internal handles fo...

Page 54: ...ry power connector is inserted into the back of the X Series unit the auxiliary power LED on the front panel illuminates and the auxiliary power icon displays at the top of the display screen See Navi...

Page 55: ...form any unauthorized modification to the DC Auxiliary Power Supply Caution To prevent heat buildup while in use place the DC Auxiliary Power Supply in a location that allows unrestricted air circulat...

Page 56: ...uxiliary power adapter power supply grasp the connector and pull it out Navigating the Display Screen You can access the X Series functions using the quick access keys that are located on the left sid...

Page 57: ...Brightness Changes the brightness setting toggles through high contrast display white background color display black background and night vision goggle NVG friendly display IBP Displays IBP setup and...

Page 58: ...Acquisition Stops acquisition of 12 lead data Patient Information Allows you to enter information to accompany 12 lead data patient name age gender and ID Row Up Allows you to move to the previous row...

Page 59: ...the following Display the settings window while a parameter is highlighted in the main window Select options from a window Display Brightness The monitor can display in two different brightness modes...

Page 60: ...Series display screen navigate to and select the Date and Time field The Set Date And Time screen displays 2 Specify the date by navigating to the date fields Month Day and Year and adjusting as neces...

Page 61: ...Daylight Saving Time If enabled the clock will be adjusted forward by 1 hour These fields only display on systems with the Clock Synchronization feature enabled For information on Clock Synchronizati...

Page 62: ...the battery so it will slide into the battery well 2 Push the battery into place Using Treatment Buttons Pressing the Treatment quick access key causes the unit to display preconfigured buttons that...

Page 63: ...s Guide 2 23 Customizing Treatment Buttons You can also customize up to 9 treatment buttons by pressing the Setup quick access key and then selecting Supervisor Log Treatment Options Highlight Define...

Page 64: ...Chapter 2 Product Overview 2 24 www zoll com 9650 001355 01 Rev M...

Page 65: ...unit also allows you to set alarm limits for each monitoring function Should a patient s vital signs measurements go outside of these limits the X Series issues an audible alarm tone and displays visu...

Page 66: ...g function Temperature The Temperature Temp meter can display temperature measurements from up to two temperature probes The X Series unit provides two separate temperature monitoring channels and if...

Page 67: ...ters of mercury mmHg You can also specify that the X Series unit display a CO2 capnogram in the waveform trace display area Pulse Oximetry SpO2 Pulse Oximetry monitoring measures the oxygen saturation...

Page 68: ...ow which displays a report listing vital signs measurements that the X Series unit logs automatically and the primary ECG waveform trace Large Numerics Display window on which large numeric displays o...

Page 69: ...tal signs measurements appear in large labeled numeric displays no waveform trace appears on this screen Press the Home Display button to redisplay the Primary Display window Note When the X Series un...

Page 70: ...y four ECG traces on startup when no other monitoring devices are attached The X Series unit can also cascade a trace onto the adjoining trace area to double the duration of the trace display On the W...

Page 71: ...to insert two more waveform traces into the window A third trace is inserted for ECG lead aVR and fourth trace for EtCO2 a capnogram Notice that when the third trace is inserted the numeric displays m...

Page 72: ...11 12 34 56 Adult 00 17 43 I II III 12 CO2 R SYNC 1 cm mV II HR bpm 80 121 79 96 NIBP mmHg 38 12 BR CO2 mmHg SpO2 97 T1 F 98 6 Pads III aVL aVF V Insert Source II I Cascade aVR 06 06 2011 12 34 56 Adu...

Page 73: ...3 I II III 12 CO2 1 cm mV aVR 1 cm mV II HR bpm 80 NIBP mmHg 121 79 96 EtCO2 mmHg 12 BR 38 SpO2 97 T1 F 98 6 Pads I II III aVR aVL aVF V SpO2 Source P1 P2 P3 Insert Cascade Remove Resp CO2 R SYNC 06 0...

Page 74: ...Chapter 3 Monitoring Overview 3 10 www zoll com 9650 001355 01 Rev M...

Page 75: ...o logs all monitored vital sign measurements when the following occurs An NIBP measurement is taken and the Trend on NIBP option is on You press the Snapshot button on the front panel A patient alarm...

Page 76: ...ormation at an interval that you specify with the exception of NIBP measurements which are logged and reported at the times they are taken The Trends status window reports the trends information at 5...

Page 77: ...rends field at the bottom of the Trends window and press Select 2 Using the navigation keys select the trend snapshot you want to print and press Select 3 Highlight Print this Trend and press Select T...

Page 78: ...and when you press To configure the display of the Trends status window press and press the Trend Settings quick access key to display the Trends Settings control panel On the Trends Settings control...

Page 79: ...d Record Additional Waveforms Always record the CO2 waveform or always record the IBP and the CO2 waveforms There is an additional waveform that can be enabled in the Waveform Recording menu This opti...

Page 80: ...Chapter 4 Trends 4 6 www zoll com 9650 001355 01 Rev M...

Page 81: ...logic monitoring functions A technical alert is monitored equipment related variable that the X Series unit can detect such as a disconnected sensor internal diagnostics failures and so on Technical a...

Page 82: ...the alarms and alerts are functioning properly verify that two alarm tones are heard and the green yellow and red LEDs are illuminated upon power up Active Alarm Alert Priority Visual Alarm Alert Indi...

Page 83: ...sage and changes the display characteristics of the monitoring function s numeric display the alarming parameter appears in red against a white background In the following example the EtCO2 measuremen...

Page 84: ...ment Alert Display When a problem with the X Series unit or an attached sensor triggers an alert in addition to sounding an equipment alert the X Series unit displays an alert message yellow backgroun...

Page 85: ...ence period has expired press the Alarm Pause Reset button Warning Do not pause silence the audible alarm if patient safety may be compromised Do not adjust alarm signal volume lower than the ambient...

Page 86: ...ss the quick access key a second time The Alarm Audio Off icon appears on the top of the display next to the message area to indicate alarm audio is paused indefinitely for this unit Note Press the qu...

Page 87: ...ess the Setup quick access key and select Supervisor Using the navigation keys select the four digits in the Supervisor passcode Press SAVE when you are finished Once you have entered your supervisor...

Page 88: ...by performing the following actions 1 Press 2 Press the Alarm quick access key 3 Press the Stat Set quick access key The X Series unit sets all parameters to a new value based on the current values as...

Page 89: ...tire range Limit Numeric 1 Limit 0 SpOC ml dL Entire range Limit Numeric 2 Limit 0 PVI Entire range Limit Numeric 5 Limit Numeric 5 PI Entire range Limit Numeric 2 Limit 0 EtCO2 mmHg Entire range Limi...

Page 90: ...Chapter 5 Alarms 5 10 www zoll com 9650 001355 01 Rev M...

Page 91: ...12 lead ECG patient cables Multi Function Pads or standard defibrillation paddles The use of an ECG patient cable and electrodes is required however to monitor ECG during pacing OneStep cables and ele...

Page 92: ...To assure protection against the effects of defibrillator discharge use only ZOLL approved accessories To avoid a shock hazard and interference from nearby electrical equipment keep electrodes and pat...

Page 93: ...epare the patient s skin for electrode application 2 Apply the electrode pads to the patient 3 Connect each lead of the ECG cable to the appropriate electrode 4 Insert the patient cable plug into the...

Page 94: ...are placed to allow defibrillation if necessary 3 Lead Electrode Placement Depending upon local usage the ECG leads are marked either RA LA and LL or R L and F The following table shows the markings...

Page 95: ...left mid clavicular line directly below clavicle LL Red Electrode F Green Electrode Place between 6th and 7th intercostal space on patient s left mid clavicular line RL Green Electrode N Black Electr...

Page 96: ...de of the X Series unit as follows Figure 6 3 Connecting ECG Cable to X Series Unit Selecting ECG Waveforms for Display You can fit up to four waveforms on the X Series display The first waveform at t...

Page 97: ...ies unit then displays the available ECG waveform sources The following example illustrates the waveform source list that the X Series unit displays when a 5 lead ECG cable is connected to it The list...

Page 98: ...elect the trace size that appears to the right of the electrode label The default trace size is 1cm mV You can select a larger 2 0 4 0 cm mV or smaller 0 125 0 25 0 50 cm mV trace size You can also sp...

Page 99: ...er markers You can turn the Pacer Indicator ON OFF from the Setup ECG menu To turn the Pacer Indicator ON OFF 1 Press the More quick access key 2 Press the Setup quick access key 3 Use the navigation...

Page 100: ...ead Fault alarm by Pausing Suspending the alarm audio See Pausing Suspending Alarms on page 5 6 for more information System Message Cause LEAD FAULT The current ECG source lead is defective check lead...

Page 101: ...ate HR meters The Respiration and Heart Rate meters display values that the X Series unit derives from measurements taken by other X Series monitoring functions Note The respiration rate is disabled d...

Page 102: ...in chest volume However No Breath episodes with continued respiratory effort may go undetected Always monitor and set alarms for SpO2 when using impedance pneumography to monitor respiratory function...

Page 103: ...BR Alarm menu selection 4 On the RR BR Alarm Settings menu use the navigation keys to select the fields that you want to change Upper Limit Enable Lower Limit Enable Upper Limit Lower Limit 5 When you...

Page 104: ...II RA LL from which the X Series unit calculates the respiration rate Resp Lead selection is independent of ECG Lead selection CO2 Resp Sweep Speed sets the respiratory sweep speed on the display Enab...

Page 105: ...figuring Heart Rate HR Meter Alarms The X Series unit allows you to enable and disable the Heart Rate HR alarm to set alarm limits and to select a Heart Rate tone Enabling Disabling HR Alarms and Sett...

Page 106: ...limits The upper and lower limits can be ON or OFF default is OFF The following table lists the default HR alarm limits for adult pediatric and neonate patients and gives the range in which you can s...

Page 107: ...shots and Continuous Waveform printouts The following example shows an Asystole alarm event To enable or disable LTA alarms and set Extreme Brady Tachy alarm limits you can either do so through the Al...

Page 108: ...treme Tachycardia LTA alarm detection to be enabled The Extreme Bradycardia and Extreme Tachycardia LTA alarms will not activate until 20 seconds after the alarm limit threshold is crossed The followi...

Page 109: ...Control Panel Selecting the HR PR Alarm prompt displays the HR PR Alarm Settings menu on which you can enable disable Heart Rate alarms and set alarm limits RESP System Message When monitoring Respir...

Page 110: ...Chapter 7 Monitoring Respiration Resp and Heart Rate HR 7 10 www zoll com 9650 001355 01 Rev M...

Page 111: ...features of Welch Allyn s SureBP and patented Smartcuf motion tolerant technology The X Series unit must perform ECG monitoring when using Smartcuf The SureBP monitoring software allows the X Series...

Page 112: ...l uncertain about the measurement use another method Do not use NIBP without proper training Check that the correct patient mode has been selected to ensure that the initial inflation pressure is set...

Page 113: ...re requires the use of a cuff and dual lumen hose 2 If high artifact prevents an accurate measurement during cuff inflation or if you use a cuff and single lumen hose the cuff inflates to its target p...

Page 114: ...artifact weak pulses cardiac arrhythmias or other blood pressure artifacts Note For a list of system messages that may display on the X Series unit when monitoring NIBP see NIBP System Messages on pag...

Page 115: ...tient s actual blood pressure Using a cuff that is too large results in measurements lower than the patient s actual blood pressure The X Series unit uses the same definitions of Neonates Pediatrics a...

Page 116: ...umen two tube adaptor and hose You can also use a single lumen one tube hose and adaptor with the X Series unit but the unit will only measure blood pressure on cuff deflation To connect the NIBP cuff...

Page 117: ...Connecting the NIBP Cuff 9650 001355 01 Rev M X Series Operator s Guide 8 7 Attach a single lumen hose as follows Figure 8 2 Attaching Single Lumen Hose to the X Series Unit...

Page 118: ...9650 001355 01 Rev M 2 Insert the plastic connectors on the NIBP hose into the cuff hose connector and twist the connectors until they lock The connectors are the same you can insert either of the pl...

Page 119: ...nfusion causing harm to the patient Do not place cuff over a wound as this can cause further injury 4 Adjust the cuff so that the artery marker on the cuff is over the artery pointing to the hand or f...

Page 120: ...sure systolic pressure the CIT pressure must be high enough to occlude the underlying artery However setting the CIT pressure too high may unnecessarily increase the reading determination time and pat...

Page 121: ...he appropriate alarm menu selection For NIBP the alarm menu selections are NIBP Systolic Alarm NIBP Diastolic Alarm and NIBP MAPAlarm 5 On the selected NIBP alarm settings menu use the navigation keys...

Page 122: ...NIBP MAP alarms are enabled ON or disabled OFF and displays the default Upper and Lower MAP limits The upper and lower limits can be ON or OFF default is OFF The following table lists the default MAP...

Page 123: ...NIBP measurement when you press the NIBP button on the front panel To repeat the NIBP measurement you must press the NIBP key again select Manual In Automatic Mode the X Series unit takes the first of...

Page 124: ...sable Smartcuf These may include Very extreme motion artifact Certain types of arrhythmias Situations that prevent getting a ECG signal NIBP measurements can still be performed with Smartcuf disabled...

Page 125: ...ion is preventing the correct operation of the unit Check hose for kinks If using a dual lumen hose verify the correct placement of the O ring on the hose connector Eliminate kinks or replace hose if...

Page 126: ...Chapter 8 Monitoring Non Invasive Blood Pressure NIBP 8 16 www zoll com 9650 001355 01 Rev M...

Page 127: ...ed for CO2 measurements on intubated and non intubated infant pediatric and adult patients The Microstream CO2 sensor generates infrared light and beams it through the sampled breathing gases and dete...

Page 128: ...components and check connections for leaks according to standard clinical procedures Always ensure the integrity of the patient breathing circuit after insertion of the airway adapter by verifying a...

Page 129: ...ty use only Microstream CO2 accessories Accessory Type Part Number FilterLine Set Adult Pediatric box of 25 Intubated sampling line and airway adapter for short term monitoring 8300 0520 01 FilterLine...

Page 130: ...o connect the FilterLine or Smart CapnoLine 1 Slide open the X Series unit s CO2 inlet port cover 2 Put the fitting at the end of the sidestream tubing over the CO2 inlet port connector 3 Turn the fit...

Page 131: ...to the manufacturers instructions The gas scavenging system should comply with ISO 8835 3 1997 E Note In order to avoid moisture buildup and sampling line occlusion during nebulization or suction for...

Page 132: ...red breath WARNING The disposable Smart CapnoLine nasal and nasal oral cannula sets are intended for single patient use Do NOT reuse or sterilize any part of this product as the monitor may be damaged...

Page 133: ...and after a delay of approximately 1 minute the patient s Respiration Rate in Breaths Minute identified as BR Check that connections have been made correctly by verifying the display a proper capnogr...

Page 134: ...le CO2 alarms and set upper and lower alarm limits through the Alarms quick access key or the CO2 Parameter Control Panel To configure CO2 alarms through the Alarms quick access key 1 Press the More q...

Page 135: ...es unit in high altitude environments it is advisable to adjust EtCO2 alarm settings accordingly Setting Upper FiCO2 Limits Initially the FiCO2 Alarm menu specifies that the FiCO2 alarms are enabled O...

Page 136: ...alarm EtCO2 Breath Rate or FiCO2 On the selected alarm settings menu you can enable disable alarms and set alarm limits as described previously You can also set the CO2 sweep speed Setting the CO2 Swe...

Page 137: ...aintenance During self maintenance the CO2 module performs one or more of the following tests ambient pressure measurement auto zero and a flow test The CO2 module completes its self maintenance tests...

Page 138: ...29 and their foreign equivalents Additional patent applications pending NO IMPLIED LICENSE Possession or purchase of this device does not convey any express or implied license to the device with unaut...

Page 139: ...ter continuously and noninvasively measures the following at a peripheral site such as the foot toe or finger Oxygen saturation of arterial hemoglobin SpO2 Carboxyhemoglobin saturation SpCO Methemoglo...

Page 140: ...o as a percent normal values typically range from 95 to 100 at sea level alternating with SpCO and SpMet and SpHb SpOC PVI and PI values if available on your unit Note The monitor does not display SpC...

Page 141: ...injury follow the directions below Avoid placing the device on surfaces with visible liquid spills Do not soak or immerse the device in liquids Do not attempt to sterilize the device Use cleaning solu...

Page 142: ...elevated levels of COHb or MetHb are suspected laboratory analysis co Oximetry of a blood sample should be performed Intravascular dyes such as indocyanine green or methylene blue Externally applied...

Page 143: ...ia a laboratory blood sample should be taken to confirm the patient s condition If the Low Perfusion message is frequently displayed find a better perfused monitoring site In the interim assess the pa...

Page 144: ...nnected to the X Series unit Selecting the SpO2 Sensor When selecting the sensor consider the patient s weight the adequacy of perfusion the available sensor sites and the anticipated duration of moni...

Page 145: ...it Wrap adhesive flaps on non cable end around the digit 3 Fold cable end over top of digit so that windows are directly opposite each other Wrap adhesive securely around sides of digit Note If the se...

Page 146: ...M Figure 10 1 Plug the Sensor Connectors Together 5 Lower the clear plastic cover over the connection to secure it Figure 10 2 Lower Plastic Cover Over Cable Connection 6 See Connecting the SpO2 Senso...

Page 147: ...the sensor are parallel To ensure accurate data you must have complete coverage of the detector window Note With smaller digits the digit may not need to be pushed all the way to the stop to complete...

Page 148: ...the measurement If SpCO and SpMet or SpHb SpOC PVI and PI are installed and monitoring is on for these parameters the measurements will alternate every two seconds underneath the display Note SpHb and...

Page 149: ...larm Settings menu use the navigation keys to select the fields that you want to change The fields are Upper Limit Enable Lower Limit Enable Upper Limit Lower Limit 6 When you are finished changing va...

Page 150: ...pMet Limit Default SpMet Limit Range Adult Lower 0 Upper 10 Lower 0 98 Upper 2 100 Lower 0 Upper 3 Lower 0 98 Upper 2 100 Pediatric Lower 0 Upper 10 Lower 0 98 Upper 2 100 Lower 0 Upper 3 Lower 0 98 U...

Page 151: ...Limits The following table lists the default PI limits for adult pediatric and neonate patients and gives the range in which you can set these limits Patient Type SpOC Limit Default SpOC Limit Range...

Page 152: ...toring these parameters on the SpO2 Control Panel Specifying the SpO2 Averaging Time The Masimo SpO2 module in the X Series unit provides three different time periods over which SpO2 values are averag...

Page 153: ...ing SpHb Venous Mode If the SpHb option is installed the X Series unit allows you to specify whether to use venous mode On as the blood sample source or not Off When Off default the X Series uses arte...

Page 154: ...sensor and then reconnect it to the unit or reapply it to the patient SENSOR FAILURE The SpO2 sensor is defective Replace the sensor CABLE FAILURE The SpO2 cable is defective Replace the cable LIFE E...

Page 155: ...nt accuracy can only be evaluated in vivo by comparing pulse oximeter readings with values traceable to SpO2 measurements obtained from simultaneously sampled arterial blood using a laboratory CO oxim...

Page 156: ...Chapter 10 Pulse CO Oximetry SpO2 10 18 www zoll com 9650 001355 01 Rev M...

Page 157: ...5uV V mmHg sensitivity Each channel requires its own connector cabling and pressure transducer Invasive Pressure Transducers The X Series unit is compatible with many types of invasive pressure trans...

Page 158: ...ransducers and ensure that the transducers are connected properly Before you use the X Series unit on a new patient always turn it off for at least 2 minutes This clears the previous patient s trend v...

Page 159: ...2 Apply the transducer according to your organization s procedures Always refer the manufacturer s Directions for Use before using a transducer 3 If the transducer is a disposable unit with a separat...

Page 160: ...nnel and display the IBP channel s parameter control panel Figure 11 2 IBP Channel Parameter Control Panel 6 Select Zero Probe The unit displays the message ZEROING in the IBP Channel s numeric displa...

Page 161: ...for that IBP channel The X Series unit allows you to specify a label that identifies the channel s IBP measurement and to select a display format for the numeric display The unit displays the waveform...

Page 162: ...stolic Diastolic Alarm and mean arterial pressure Mean Alarm alarm settings On the selected Alarm Settings menu use the navigation keys to select the fields that you want to change The fields are Uppe...

Page 163: ...are enabled ON or disabled OFF and displays the default Upper and Lower MEAN limits The upper and lower limits can be ON or OFF default is OFF The following table lists the default MEAN alarm limits...

Page 164: ...e unit display one of the following labels to identify the IBP channel In the following example source labels are specified for all three IBP channels Source Label Description Source Label Description...

Page 165: ...ANSDUCER The IBP probe is not compatible See the Appendix B Accessories for a list of ZOLL approved IBP probes CHECK PROBE The IBP probed has become disconnected ZERO PROBE The IBP probe is connected...

Page 166: ...Chapter 11 Monitoring Invasive Pressures IBP 11 10 www zoll com 9650 001355 01 Rev M...

Page 167: ...When both channels are in use the unit displays each channel s temperature successively followed by the difference between the temperatures labeled T Temperature Monitoring Setup To monitor temperatur...

Page 168: ...ion and use of metal jacketed temperature probes that come in contact with conductive objects or clinical personnel during electrocautery may cause burns at the point of contact between the patient an...

Page 169: ...e fields are Upper Limit Enable Lower Limit Enable Upper Limit Lower Limit 5 When you are finished changing values on the alarm menu navigate to the Backarrow key to exit the menu Setting Upper and Lo...

Page 170: ...is OFF The following table lists the default Temperature limits for adult pediatric and neonate patients and gives the range in which you can set these limits Patient Type Temperature Limit Default Te...

Page 171: ...ne of the following labels for each temperature channel If you don t select a label the Temperature channels appear with the default labels of T1 and T2 Source Label Description ART Arterial temperatu...

Page 172: ...lf test when initially powered on and also performs system tests automatically every 10 seconds while this function is active System Message Cause CHECK PROBE The temperature probe is disconnected Che...

Page 173: ...Adult Basic Life Support and Use of Automated External Defibrillators 1 2 3 4 If your local protocol requires a different procedure follow that protocol The AED Mode is Supervisor configurable and whe...

Page 174: ...irst mode of analyzing is automatic the other mode of analyzing is user activated analysis and is initiated by pressing the ANALYZE button Automatic and user activated analysis of a patient s ECG can...

Page 175: ...f the therapy electrodes are not making good contact with the patient The message SHORT DETECTED is displayed if a short circuit exists between the therapy electrodes Note Since analysis is only done...

Page 176: ...nt and connected to the X Series unit the ATTACH PADS message and voice prompt will be issued Energy Select The default energy selections for adult patients are Shock 1 120 joules Shock 2 150 joules S...

Page 177: ...stop the rescue cycle While the rescue cycle is paused ECG analysis continues in the background The trends log alarm monitoring and 12 lead features are only accessible when the rescue cycle is paused...

Page 178: ...ockable the unit displays the SHOCK ADVISED and PRESS SHOCK messages The defibrillator automatically prompts the operator to shock the patient at the preconfigured energy level and the SHOCK button il...

Page 179: ...been delivered The delivered energy level and the shock number 1 are displayed in the panel at the bottom of the screen Perform CPR Begin chest compressions and rescue breathing per local protocol as...

Page 180: ...ges The display messages and voice prompts that can occur during AED operation are described below ATTACH PADS If the unit is powered on without therapy pads connected to the patient the ATTACH PADS m...

Page 181: ...announced during the CPR interval after a No Shock Advised analysis result STOP CPR After performing CPR for the configured period the unit will issue a STOP CPR prompt while it restarts ECG analysis...

Page 182: ...e Note If the unit has not been configured to enter a pass code the message Exit to Manual Mode is displayed Use the navigation keys to select Yes to enter the Manual mode of operation If you do not p...

Page 183: ...how to use the X Series unit to monitor 12 Lead ECG for adult and pediatric patients and how to display 12 Lead ECG Interpretive Analysis information for adult patients X Series 12 Lead ECG Monitoring...

Page 184: ...es may become polarized during defibrillator discharge causing the ECG waveform to briefly go off screen ZOLL Medical Corporation recommends the use of high quality silver silver chloride Ag AgCl elec...

Page 185: ...unit uses the name that you enter in the Patient Info panel to label the 12 lead ECG monitoring snapshots that it saves To enter patient information use the navigation keys to highlight and select a...

Page 186: ...front panel to decrease or increase the default value 45 then press Select To change Patient Gender use the navigation keys on the front panel to toggle between the default value M male and F female t...

Page 187: ...lead wires are marked with certain labels Refer to the following table for labels and color codes for the different lead sets 1 American Heart Association 2 International Electrotechnical Commission...

Page 188: ...ody of the sternum 3 Locate the second intercostal space on the patient s right side lateral to and just below the Angle of Louis 4 Move your finger down two more intercostal spaces to the fourth inte...

Page 189: ...ows Figure 14 2 Connecting the 12 Lead ECG Cable Observing the 12 Lead Waveform Traces To observe the 12 Lead waveform traces press The screen displays all twelve waveform traces with the size display...

Page 190: ...nder ensures that the highest degree of ECG analysis is obtained If you do not enter the patient s age or gender the X Series uses the default age 45 years and default gender male See Entering Patient...

Page 191: ...12 Lead Interpretive Analysis information In the example above the interpretive statement STEMI indicates the occurrence of ST Elevation Myocardial Infarction The interpretive statements that the X S...

Page 192: ...is 14 10 www zoll com 9650 001355 01 Rev M To display Analysis Page 2 press the 12 Lead Review Next quick access key Analysis Page 2 displays the identifying information that has been entered for the...

Page 193: ...terpretive Analysis if it detects one of the following fault conditions when attempting to acquire 12 Lead data A pacer signal is present A lead fault is detected in the ECG cable An invalid cable is...

Page 194: ...can print the 12 Lead ECG traces for review and analysis Press to collect 10 seconds of 12 Lead data for print Press the Print quick access key to print a 12 lead snapshot which begins with a header t...

Page 195: ...lead snapshots are stored the oldest snapshot in the log is overwritten by subsequent snapshots Note that if a patient data log is full you will not be able to store12 lead snapshots The 12 lead snaps...

Page 196: ...ead option to display the 12 Lead parameter control panel Selecting 12 Lead Acquire When enabled the unit automatically prints the 12 Lead report when you press By default this feature is not enabled...

Page 197: ...es Note The display and the recording present the waveform according to the filter setting Diagnostic or Filtered Diagnostic but the 12 Lead Interpretive Analysis is always performed using a diagnosti...

Page 198: ...Chapter 14 12 Lead ECG Interpretive Analysis 14 16 www zoll com 9650 001355 01 Rev M...

Page 199: ...ddle handles When defibrillating with paddles use your thumbs to operate the SHOCK buttons in order to avoid inadvertent operator shock No portion of the hands should be near the paddle plates Be sure...

Page 200: ...ted either on the front of the unit or on the STERNUM paddle Note The initial defibrillator pad external paddle energy selection can be set in Defib Pacer default settings in the Setup Supervisor menu...

Page 201: ...right just below the clavicle Place the APEX paddle on the chest wall just below and to the left of the patient s left nipple along the anterior axillary line Rub the paddles against the skin to maxi...

Page 202: ...g tone sounds indicating that the unit is charging The energy range bar graph on the right side of the display highlights the charge level until it reaches the selected energy When the unit is fully c...

Page 203: ...ously press and hold both SHOCK buttons one on each paddle until energy is delivered to the patient Note The front panel SHOCK button is inactive when using external paddles Pressing this button inste...

Page 204: ...the therapy electrodes are making good contact with the patient s skin and are not covering any part of the ECG electrodes Therapy Electrode Application Warning Poor adherence and or air under the th...

Page 205: ...t the desired energy level These buttons are located on the front panel of the unit Note The initial defibrillator pad external paddle energy selection can be set in Defib Pacer default settings in th...

Page 206: ...ss the CHARGE button again to charge the unit to the newly selected energy level A charging message displays at the bottom of the screen and a distinctive charging tone sounds indicating that the unit...

Page 207: ...the defibrillator is not discharged within 60 seconds after reaching the selected energy level the unit automatically disarms itself If additional countershocks are needed follow steps 1 through 3 of...

Page 208: ...on on the handle set if present and verify that there is an audible click and that the button springs back upon release Verify that the defibrillator window displays the message APPLY PADDLES TO PATIE...

Page 209: ...h the ECG R wave to avoid the induction of ventricular fibrillation In this case a synchronizing SYNC circuit within the defibrillator detects the patient s R waves When the SHOCK button or buttons if...

Page 210: ...lation Procedure with Paddles on page 15 1 for preparing paddles applying paddles charging the defibrillator and delivering a shock Note however that synchronized discharge with paddles as an ECG sour...

Page 211: ...after you have pressed the CHARGE button use the defibrillator Energy Select arrows on the front panel or sternum panel Caution Changing the selected energy while the unit is charging or charged caus...

Page 212: ...will discharge with the next detected R wave The delivered energy level is displayed at the bottom of the screen and the shock number 1 displays at the top of the screen Note If at any time you want...

Page 213: ...otocol and patient condition The advisory function can be activated only when The unit is configured for Single Analysis The unit is on and in manual mode Hands free therapy electrodes are properly co...

Page 214: ...or shave it to ensure proper adhesion of the electrodes Attach hands free therapy electrodes according to instructions on the electrode packaging and as described in Therapy Electrode Application on p...

Page 215: ...ill revert back to AED operation If Unit is in Manual Mode No additional steps are necessary to proceed If no hands free therapy electrodes have been attached to the patient and connected to the X Ser...

Page 216: ...er there is a shockable rhythm If the analysis detects a shockable rhythm the unit prompts the operator to shock the patient at the preconfigured energy level If the analysis does not detect a shockab...

Page 217: ...tal objects such as a bed frame as unwanted pathways for defibrillation current may result Press and hold the SHOCK button on the front panel until energy is delivered to the patient The delivered ene...

Page 218: ...Chapter 16 Advisory Defibrillation 16 6 www zoll com 9650 001355 01 Rev M...

Page 219: ...continues through the CPR interval and then halts and waits for the pads to be reattached If you press the Energy Select Up Down arrow keys or CHARGE button while in Analysis CPR Protocol mode the uni...

Page 220: ...eathing Absence of pulse Begin CPR Following Local Medical Protocols Request additional assistance Prepare Patient Remove all clothing covering the patient s chest Dry chest if necessary If the patien...

Page 221: ...s to enter the Manual mode of operation If you do not press Yes within 10 seconds the unit will revert back to AED operation If Unit is in Manual Mode No additional steps are necessary to proceed If n...

Page 222: ...bottom of the screen while the patient s ECG is analyzed Once the analysis is completed the unit indicates whether or not a shock is advised Note You can terminate the Analysis CPR Protocol mode and r...

Page 223: ...preconfigured energy level and the SHOCK button illuminates A continuous tone sounds for 20 or 50 seconds depending on configuration followed by a higher pitch tone for 10 seconds You must deliver the...

Page 224: ...Chapter 17 Analysis CPR Protocol Defibrillation 17 6 www zoll com 9650 001355 01 Rev M...

Page 225: ...pecific recommendations Prolonged pacing in excess of 30 minutes particularly in adolescent child and infant pediatric patients or adults with severely restricted blood flow may cause burns Periodic i...

Page 226: ...es are detected a pacing pulse is delivered to the patient In the demand mode the pacer supplies the required number of pacing pulses to maintain the patient s heart rate at approximately the rate sel...

Page 227: ...rely to the patient 2 Roll the pad smoothly from the applied edge to the other being careful not to trap any air pockets between the gel and skin 3 Ensure that hands free therapy electrodes are making...

Page 228: ...and by 10 ppm for rates above 100 Note The initial pacing rate can be set in Defib Pacer Default settings in the Supervisor Setup menu 6 Turn On Pacer Use the arrow keys to navigate to Start Pacer th...

Page 229: ...r artifacts Mechanical capture is assessed by palpation of the peripheral pulse To avoid mistaking muscular response to pacing stimuli for arterial pulsations use ONLY the following locations for palp...

Page 230: ...ectrodes according to instructions on the electrode packaging Connect these therapy electrodes to the MFC Therapy Electrode Application WARNING Poor adherence and or air under the therapy electrodes c...

Page 231: ...s to navigate to Rate press the Select button then use the arrow keys and the Select button to set the Pacer Rate to a value 10 20 ppm higher than the patient s intrinsic heart rate If no intrinsic ra...

Page 232: ...tion of electrical capture should only be performed by viewing the ECG trace on the X Series display with its ECG connection directly attached to the patient Use of other ECG monitoring devices might...

Page 233: ...w all instructions on electrode packaging Pace Fault The X Series unit may display the following messages when pacing System Message Description PAUSED The pacer has paused pacing the patient PACING T...

Page 234: ...Chapter 18 External Pacing 18 10 www zoll com 9650 001355 01 Rev M...

Page 235: ...edback is provided varies with respect to the operational mode and user configuration but is derived from compression rate and depth measurements When applied according to package instructions ZOLL CP...

Page 236: ...rescuer to see a close approximation of the patient s underlying ECG rhythm while performing CPR we describe See Thru CPR in Chapter 20 The CPR features that the X Series unit provides differ dependi...

Page 237: ...ions per minute The CPR metronome can be configured to operate in all modes AED Manual and Analysis CPR Protocol or in AED mode only The CPR metronome can also be disabled for all modes When activated...

Page 238: ...en the CPR metronome is active FULLY RELEASE Prompt The X Series unit can be configured to display the text prompt FULLY RELEASE which instructs rescuers to lift fully release their hands from the pat...

Page 239: ...R electrodes are attached If the unit detects that CPR performance is consistently below the AHA ERC recommended compression rate the unit displays the rate measurement in yellow needs improvement Lik...

Page 240: ...dicator will only partially fill to indicate the need for more rigorous efforts Following the cessation of compressions the indicator s fill level gradually decreases until a hollow outline is display...

Page 241: ...is computed from the CPR sensor signals This bar graph representing depth of compression is presented on a AHA ERC 2005 0 2 1 AHA ERC 2010 0 2 5 inch displacement scale with reference markers at AHA...

Page 242: ...Chapter 19 Real CPR Help 19 8 www zoll com 9650 001355 01 Rev M...

Page 243: ...nce is invalid ZOLL OneStep CPR electrodes OneStep Complete electrodes or CPR D padz are no longer detected The See Thru CPR filter will not remove all CPR artifact Always stop CPR to verify the patie...

Page 244: ...filtering artifacts a rescuer should always follow the standard procedure of stopping CPR to assess the patient s ECG rhythm before determining treatment Using See Thru CPR To use See Thru CPR The X...

Page 245: ...includes ECG signal with CPR artifact ECG signal after the See Thru CPR filter has removed CPR artifact Indication of the period during which See Thru CPR is active CPR signal to show when CPR activi...

Page 246: ...001355 01 Rev M The following figure shows a patient in VF which during compressions is slightly more difficult to discern When viewing this ECG it is possible to view the underlying rhythm as the fi...

Page 247: ...ression artifact leaks through to distort this signal When the CPR filter turns on the PEA is still not obvious because of the left over ripples from the CPR signal About 14 seconds into this chart th...

Page 248: ...Chapter 20 See Thru CPR 20 6 www zoll com 9650 001355 01 Rev M The following figure shows a patient with an organized rhythm where See Thru CPR effectively filters out artifact created by CPR...

Page 249: ...device Note Before deleting log files from the X Series view the files on a personal computer to verify that they have been successfully transferred Note Data transfers will not be successful if the...

Page 250: ...pter Log Capacity Indicator The Log quick access key has an indicator bar which shows an approximation of the current level of data storage in the log When data storage reaches its capacity the unit p...

Page 251: ...t is a report that shows all of the treatment events related to a patient such as defibrillation pacer events alarm events and treatment snapshots It is helpful to print out this report at the end of...

Page 252: ...to select Transfer from the Transfer the Log menu 6 The green LED on the top of the device turns on while data is transferred to the USB device Note Wait for the log transfer to complete and for the g...

Page 253: ...g the log during patient treatment results in the loss of all patient data and events recorded prior to clearing the log To clear the log 1 Press 2 Press 3 Press the Clear Log quick access key 3 Use t...

Page 254: ...Chapter 21 Patient Data 21 6 www zoll com 9650 001355 01 Rev M...

Page 255: ...nt snapshots and 12 lead snapshots and analysis Note Full disclosure cases can also be automatically retrieved from the X Series unit using ZOLL RescueNet or ePCR software or saved to a USB device You...

Page 256: ...requested Not connected Wireless connectivity is inactive If a WiFi access point is selected this icon indicates the selected network cannot connect due to incorrect configuration or weak no signal s...

Page 257: ...ccess the Wireless menu where you can Select preconfigured WiFi access points View connection details View Bluetooth paired devices View or update 12 Lead distribution lists Set up a temporary WiFi ac...

Page 258: ...M The Wireless Menu The Wireless menu has the following options WiFi Access Point View Configure Paired Devices View Distribution List and Update Distribution List Use the navigation keys to navigate...

Page 259: ...s Point profiles To make an Access Point Profile active 1 Use the navigation keys to highlight and select WiFi Access Point The Select Access Point Profile dialog box displays with a list of available...

Page 260: ...y Access Point Profile In the wireless menu use the navigation keys to highlight and select WiFi Access Point You can now view preconfigured Access Point Profiles Use the navigation keys to highlight...

Page 261: ...elect either DHCP or Static IP If you select Static IP use the numeric keypad to enter values for the IP Address Subnet Mask Default Gateway Preferred DNS Server and Alternate DNS Server SSID Use the...

Page 262: ...Use the navigation keys to select the authentication type The unit supports three types of Wi Fi authentication WPA PSK Wi Fi Protected Access Pre shared key WPA2 PSK Wi Fi Protected Access II Pre sha...

Page 263: ...ty The CA certificate is also optional Other options on the screen will be greyed out Note The X Series unit only supports PEAPv0 v1 MSCHAPV2 TLS Transport Layer Security If TLS is selected you must s...

Page 264: ...ces To pair a new device use the navigation keys and select New The unit will then scan for nearby Bluetooth devices that are in discoverable mode Use the navigation keys to select the desired device...

Page 265: ...NAP profiles only Contact your local ZOLL Medical Corporation sales representative for a list of approved devices Changing the PIN It may be necessary to change the PIN on the X Series unit check you...

Page 266: ...ke a 12 lead snapshot see Chapter 14 12 Lead ECG Interpretive Analysis for more information about acquiring 12 lead data 3 Press the 12 lead review next quick access key A list of snapshots appears se...

Page 267: ...se The Case Selection dialog box displays with a list of up to 150 most recent cases 3 Use the navigation keys to select Select Cases then press the Select button The highlight moves to the list of av...

Page 268: ...r modems An Ethernet connection 12 lead report settings and set up distribution lists for 12 lead and full disclosure reports Disclosure Log transfer settings Clock Synchronization settings Note Commu...

Page 269: ...capability See Setting up an Ethernet Connection on page 22 27 below for configuring your Ethernet connection 12 Lead Reports Storage and management of 12 lead reports and full disclosure case files...

Page 270: ...Selecting a profile in this list allows you to edit or delete the profile It does not make a profile the active Wi Fi profile selection See Selecting a Pre Configured Access Point Profile on page 22 5...

Page 271: ...save changes and return to the WiFi configuration menu press Cancel to return to the WiFi configuration menu without saving changes Network Setting Use the navigation keys to select either DHCP or St...

Page 272: ...anges and return to the WiFi configuration menu press Cancel to return to the WiFi configuration menu without saving changes Non broadcast SSID Use the navigation keys to enable or disable non broadca...

Page 273: ...i authentication WPA PSK Wi Fi Protected Access Pre shared key WPA2 PSK Wi Fi Protected Access II Pre shared key Enterprise For WPA PSK or WPA2 PSK you are required to enter a security key 8 64 charac...

Page 274: ...the Password corresponding to the Identity entered If the network requires it you may enter an Anonymous Identity The CA certificate is also optional Other options on the screen will be greyed out No...

Page 275: ...select Refresh List Note No message will appear to indicate that the file has loaded After pressing Load Selected press the back arrow to view the list of all currently loaded certificates and keys P...

Page 276: ...s You can configure your USB cellular modem or Bluetooth device to work with the X Series unit Under the Communications menu select Cellular Configure The Cellular menu appears You can use the arrow k...

Page 277: ...e arrow keys to enter information about your cell phone provider Provider Name Provider name is an identifier you choose to refer to this cell phone provider Call Number Call number is an access numbe...

Page 278: ...r Bluetooth devices select Bluetooth Cell Device Configure in the Cellular menu To pair a new device use the navigation keys and select New The unit will then scan for nearby Bluetooth devices that ar...

Page 279: ...give the device an optional nickname or set the provider A provider is not required for Bluetooth devices using the PAN NAP profile Press the back arrow to return to the list of paired devices Note Us...

Page 280: ...50 001355 01 Rev M Changing the PIN It may be necessary to change the PIN on the X Series unit check your device s documentation To change the PIN select Change Pin in the Pair New Device menu then us...

Page 281: ...Ethernet adapter to transfer data to a PC via an Ethernet cable In the Communications menu select Ethernet Configure Use the navigation keys to select either DHCP or Static IP If you select Static IP...

Page 282: ...complete configuration of the X Series device In the Communications menu select Reports Configure Enter your RescueNet Customer ID and Password in the fields provided Before you can transmit 12 lead...

Page 283: ...closure case logs and audio for up to 15 cases to a remote server for subsequent retrieval Use the Supervisor Communications Disclosure Log menu to configure the remote server to which to send the dis...

Page 284: ...may subsequently toggle Daylight Saving Time on or off as necessary on the Set Date and Time screen see Setting the Date and Time on page 2 20 When Clock Sync is enabled and a network connection is av...

Page 285: ...tely and must be manually adjusted at every transition between Standard Time and Daylight Saving Time The Daylight Saving Time offset is zero if Daylight Saving Time is set to Off and 60 minutes if Da...

Page 286: ...ONNECT TO NETWORK The unit is connecting to the network TRANSMITTING The data transfer is in progress TRANSMISSION COMPLETE The data transfer is complete TRANSMISSION FAILED The data transfer has fail...

Page 287: ...e printing option allows you to print the following patient information Waveforms Reports Trends Note A date that contains question marks indicates that the X Series was not able to determine the date...

Page 288: ...ssing The X Series unit will print the displayed waveforms as configured in the Number of Traces option The Print Number of Traces option can be set to 1 2 or 3 Patient vital sign numerics are printed...

Page 289: ...Patient Alarm Report The Print on Patient Alarm setting must be turned on in the Setup Print window Print on NIBP You can print the results of an NIBP measurement each time one occurs This report is c...

Page 290: ...the report highlight Cancel Report and press Select Printing Individual Trend Snapshots Follow the steps below 1 Press the Display Home button to display the Trends window 2 Highlight the Navigate her...

Page 291: ...lete performance and calibration testing at regularly scheduled intervals which should not exceed one year A maintenance log is an important part of a successful maintenance program in which you recor...

Page 292: ...lies hands free therapy electrodes ECG monitoring electrodes defibrillator gel recorder paper alcohol swabs razors scissors etc Verify that two sets of hands free therapy pads are available Ensure tha...

Page 293: ...and green Visual Alarm indicators illuminate for 2 to 3 seconds Note The yellow LED may remain lit after the unit powers on The X Series unit performs a number of power on self tests Verify that the u...

Page 294: ...s with the pacer status bar behind it 13 Perform the following steps Set the Pacer mode to Fixed Set the Pacer Rate to 60 ppm Set the Output to 100 mA Select the Start Pacer button Verify that the gre...

Page 295: ...OFF button on the Sternum paddle Verify that the recorder begins printing 5 Press the RECORDER ON OFF button again Verify that the recorder stops printing 6 Press the Apex and Sternum paddle electrod...

Page 296: ...s in a battery after it is removed from the charger even if it is not used Regular battery rotation helps to avoid incidents where a low battery condition is encountered because the battery has not be...

Page 297: ...utyl alcohol Denatured ethanol Freon Mild chlorine bleach solution Isopropyl alcohol Trichloroethane trichloroethylene Acetone Vesphene II Enviroquat Staphene Misty Glutaraldehyde Cleaning the NIBP Bl...

Page 298: ...the printer 1 Insert your fingers into the indentations on the sides of the printer door pull the door open then remove any paper from the spool Figure 24 1 Opening the Printer Door and Removing Paper...

Page 299: ...printer door open see Fig 24 1 then remove any paper 2 Locate the print head along the front floor of the printer compartment 3 Gently wipe the print head with a cotton swab moistened with isopropyl a...

Page 300: ...rapy pads in sealed pouches 2 sets not expired b Defib gel or gel pads c ECG monitoring electrodes d Alcohol wipes e Razors scissors f Recorder paper 6 Batteries a Fully charged battery installed in u...

Page 301: ...nitor Display on page A 14 Impedance Pneumography on page A 15 Alarms on page A 16 Recorder on page A 17 Battery on page A 17 General on page A 18 Pacer on page A 19 CO2 on page A 19 Pulse Oximeter on...

Page 302: ...n with a new fully charged battery pack depleted by up to fifteen 200 joule discharges or when operating without a battery using AC power alone at 90 of the rated mains voltage Patient Impedance Range...

Page 303: ...y Defibrillator Setting into a Range of Loads Selected Energy Load 25 50 75 100 125 150 175 Accuracy 1 J 1 J 1 J 1 J 1 J 1 J 1 J 1 J 15 2 J 1 J 2 J 2 J 2 J 2 J 2 J 2 J 15 3 J 2 J 3 J 3 J 3 J 3 J 3 J 3...

Page 304: ...time in milliseconds ms Figure A 1 Rectilinear Biphasic Waveform at 200 Joules Figure A 2 Rectilinear Biphasic Waveform at 150 Joules 40 30 20 10 0 10 20 30 40 0 2 4 6 8 10 12 ms A 25 Ohm 50 Ohm 75 Oh...

Page 305: ...ic Waveform at 120 Joules Figure A 4 Rectilinear Biphasic Waveform at 100 Joules 30 20 10 0 10 20 30 0 2 4 6 8 10 12 ms A 25 Ohm 50 Ohm 75 Ohm 100 Ohm 125 Ohm 150 Ohm 175 Ohm 200 Ohm 25 20 15 10 5 0 5...

Page 306: ...rm at 85 Joules Figure A 6 Rectilinear Biphasic Waveform at 70 Joules 25 20 15 10 5 0 5 10 15 20 25 0 2 4 6 8 10 12 ms A 25 Ohm 50 Ohm 75 Ohm 100 Ohm 125 Ohm 150 Ohm 175 Ohm 200 Ohm 20 15 10 5 0 5 10...

Page 307: ...iphasic Waveform at 50 Joules Figure A 8 Rectilinear Biphasic Waveform at 30 Joules 20 15 10 5 0 5 10 15 20 0 2 4 6 8 10 12 ms A 25 Ohm 50 Ohm 75 Ohm 100 Ohm 125 Ohm 150 Ohm 175 Ohm 200 Ohm 15 10 5 0...

Page 308: ...Waveform at 20 Joules Figure A 10 Rectilinear Biphasic Waveform at 15 Joules 15 10 5 0 5 10 15 0 2 4 6 8 10 12 ms A 25 Ohm 50 Ohm 75 Ohm 100 Ohm 125 Ohm 150 Ohm 175 Ohm 200 Ohm 10 8 6 4 2 0 2 4 6 8 1...

Page 309: ...r Biphasic Waveform at 10 Joules Figure A 12 Rectilinear Biphasic Waveform at 9 Joules 8 6 4 2 0 2 4 6 8 0 2 4 6 8 10 12 ms A 25 Ohm 50 Ohm 75 Ohm 100 Ohm 125 Ohm 150 Ohm 175 Ohm 200 Ohm 8 6 4 2 0 2 4...

Page 310: ...phasic Waveform at 8 Joules Figure A 14 Rectilinear Biphasic Waveform at 7 Joules 8 6 4 2 0 2 4 6 8 0 2 4 6 8 10 12 ms A 25 Ohm 50 Ohm 75 Ohm 100 Ohm 125 Ohm 150 Ohm 175 Ohm 200 Ohm 6 4 2 0 2 4 6 8 0...

Page 311: ...linear Biphasic Waveform at 6 Joules Figure A 16 Rectilinear Biphasic Waveform at 5 Joules 6 4 2 0 2 4 6 0 2 4 6 8 10 12 ms A 25 Ohm 50 Ohm 75 Ohm 100 Ohm 125 Ohm 150 Ohm 175 Ohm 200 Ohm 6 4 2 0 2 4 6...

Page 312: ...ic Waveform at 4 Joules Figure A 18 Rectilinear Biphasic Waveform at 3 Joules 5 4 3 2 1 0 1 2 3 4 5 0 2 4 6 8 10 12 ms A 25 Ohm 50 Ohm 75 Ohm 100 Ohm 125 Ohm 150 Ohm 175 Ohm 200 Ohm 4 3 2 1 0 1 2 3 4...

Page 313: ...asic Waveform at 2 Joules Figure A 20 Rectilinear Biphasic Waveform at 1 Joule 4 3 2 1 0 1 2 3 4 0 2 4 6 8 10 12 ms A 25 Ohm 50 Ohm 75 Ohm 100 Ohm 125 Ohm 150 Ohm 175 Ohm 200 Ohm 2 5 2 1 5 1 0 5 0 0 5...

Page 314: ...with AAMI EC13 2002 section 4 2 9 10 Tall T Wave Rejection Meets AAMI EC13 2002 section 4 1 2 1c for 0 9 mV T wave 0 8 mV with diagnostic response and 1mV QRS Diagnostic Signals Applied to Patient Co...

Page 315: ...n of 0 1 ms to 2 ms with no tail Pulses with overshoot Rejects all pulses with amplitude of 2 mV to 700 mV and duration of 0 1 ms to 2 ms with overshoot up to 100 ms A V sequential pulses A V sequenti...

Page 316: ...Physiological Alarms NIBP SpO2 Resp CO2 IP Temp Audible Same as Heart Rate Alarm Visual Physiological alarms cause the alarming parameter to be displayed in Red with a white background The red device...

Page 317: ...ord Modes Manual and automatic User configurable Battery Type Rechargeable Lithium Ion 11 1Vdc 6 6 Ah 73Wh Capacity With a new fully charged battery operating at room temperature At least 6 hours of c...

Page 318: ...Tested at 2 meters Altitude 170 M to 4572 M 557 feet to 15 000 feet Transport and Storage Temperature 30 to 70 C Humidity 15 to 95 RH non condensing Atmospheric pressure 572 mbar to 1034 mbar Shock v...

Page 319: ...ter for EtCO2 values exceeding 18 mmHg This is tested according to and is compliant with ISO 21647 To achieve the specified accuracies for breath rates above 60 breaths minute the Microstream FilterLi...

Page 320: ...rics Infants 70 100 2 Adults Pediatrics Infants 3 Neonates Oxygen Saturation SpO2 During Motion Conditions 70 100 3 Adults Pediatrics Infants Neonates Oxygen Saturation SpO2 During Low Perfusion Condi...

Page 321: ...p clip LNOP TC I and LNCS M LNCS tip clip LNCS M LNCS TC I sensors use different light emitting diodes The wavelength information is as follows The LNOP transflectance LNCS M LNCS TF I forehead sensor...

Page 322: ...n which encompasses 68 of the population The Masimo SET Technology has been validated for low perfusion accuracy in bench top testing against a Biotek Index 2 simulator and Masimo s simulator with sig...

Page 323: ...mHg Pulse Rate Range Adult 30 to 200 5 BPM Pediatric 30 to 200 5 BPM Neonatal 35 to 220 5 BPM Default Cuff Inflation Pressure Adult 160 mmHg Pediatric 120 mmHg Neonatal 90 mmHg Maximum Cuff Inflation...

Page 324: ...al Service Department NIBPAccuracy NIBP accuracy has been verified utilizing clinical test methods which have been determined to meet the requirements of EN ISO 81060 2 2012 Invasive Pressures Number...

Page 325: ...10 C plus probe error Resolution 0 1 C Scale Fahrenheit or Celsius Temperature Display Signal 20Hz no averaging Probe YSI 400 and 700 series Mode of Operation Direct mode Display T1 T2 T Minimum Measu...

Page 326: ...e consecutive 120 150 and 170 joules efficacy of the rectilinear biphasic waveform with that of a monophasic waveform three consecutive 200 300 and 360 joules A significance level of p 0 05 or less wa...

Page 327: ...er Clinical trial for Cardioversion of Atrial Fibrillation AF Overview The defibrillation efficacy of ZOLL s Rectilinear Biphasic Waveform was compared to a monophasic damped sine waveform in a prospe...

Page 328: ...for monophasic There was a significant difference between the first shock efficacy of biphasic shocks at 70J of 68 and that of monophasic shocks at 100J of 21 p 0 0001 95 confidence interval of the di...

Page 329: ...studies refer to above of the M Series Biphasic Defibrillator Waveform demonstrated that high conversion rates are achieved when defibrillation pads are placed as shown in the following diagram Place...

Page 330: ...onment Emissions test Compliance Electromagnetic environment guidance RF Emissions CISPR 11 Group 1 The X Series unit uses RF energy only for its internal function Therefore its RF emissions are very...

Page 331: ...l commercial or hospital environment Surge IEC 61000 4 5 1 kV line s to line s 2 kV line s to earth 1 kV differential mode 2 kV common mode Mains power quality should be that of a typical commercial o...

Page 332: ...level in each frequency range d Interference may occur in the vicinity of equipment marked with the following symbol NOTE 1 At 80 MHz and 800 MHz the higher frequency range applies NOTE 2 These guidel...

Page 333: ...5 GHz d 0 35 80 MHz to 800 MHz d 0 7 800 MHz to 2 5 GHz where P is the maximum output power rating of the transmitter in watts according to the transmitter manufacturer and d is the recommended separa...

Page 334: ...MHz to 800 MHz 800 MHz to 2 5 GHz 0 01 0 12 0 12 0 12 0 23 0 1 0 38 0 38 0 38 0 73 1 1 2 1 2 1 2 2 3 10 3 8 3 8 3 8 7 3 100 12 12 12 23 For transmitters rated at a maximum output power not listed abo...

Page 335: ...equipment transmitters and the X Series as recommended below according to the maximum output power of the communications equipment Rated maximum output power of equipment in watts Separation distance...

Page 336: ...iability Measures amplitude and temporal regularity auto correlation of peaks and troughs Determines if multiple 3 second segments are shockable then displays SHOCK ADVISED message Clinical Performanc...

Page 337: ...operation See 47 CFR Section 15 19 a 3 The user is cautioned to maintain 20cm 8 inches of space from the product to ensure compliance with FCC requirements This device is limited to indoor use in the...

Page 338: ...Specifications A 38 www zoll com 9650 001355 01 Rev M...

Page 339: ...d Breakaway Patient Cable Complete Trunk Cable 4 lead wire set with detachable 6 V precordial lead wire set AAMI ECG 12 Lead Breakaway Patient Cable Complete Trunk Cable 4 lead wire set with detachabl...

Page 340: ...eonate 2 4 2 7 1 cm single tube w male luer connector box of 10 Neonate 3 5 4 9 1 cm single tube w male luer connector box of 10 Neonate 4 6 9 11 7 cm single tube w male luer connector box of 10 Neona...

Page 341: ...r SpHb SpMet SpO2 3 ft Sensor includes 200 SpHb Tests Rainbow DCI SC 400 Adult Reusable Finger Sensor SpHb SpMet SpO2 3ft Sensor includes 400 SpHb Tests Rainbow DCI SC 400 Pediatric Reusable Finger Se...

Page 342: ...able ZOLL Sterilizable Internal Handle black without Switch 1 0 spoon 10 cable ZOLL Sterilizable Internal Handle black without Switch 1 6 spoon 10 cable ZOLL Sterilizable Internal Handle black without...

Page 343: ...e Abbott Interface cable Edwards s 5 V V mm Hg IEC 60601 2 34 and AAMI BP 22 compliant Compatible IBP Transducers Abbott Transpac IV Edwards Truwave To purchase these transducers contact your local Ab...

Page 344: ...rying Case X Series Backpack ECG 80 mm Chart Recorder Paper Cable adapter USB to Ethernet USB Cable Extension X Series Multi Tech Cell Modem GSM Version X Series Multi Tech Cell Modem CDMA Version X S...

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