GE Medical Systems marquette Dash 2000, Руководство оператора, Страница: 160 / 272

8-20 Dash 2000 Patient Monitor Revision C
2005873-001
Monitoring Internal
Pacemaker Patients
NOTE: ECG monitoring with patients on non-invasive transcutaneous
pacemakers may not be possible due to large amounts of energy
produced by these devices. Monitoring ECG with an external
device may be needed.
The DETECT PACE option enables/disables the pacemaker detection
program. It must be used whenever the monitored patient has a pacemaker.
Pace detection choices are
Pace 1 , Pace 2 , and Off .
NOTE: Moderate and maximum ECG filtering is not recommended with
pacemaker patients. (Refer to this chapter, ECG Filter.)
There are two pacemaker processing modes, Pace 1 and Pace 2. The Pace 1
and Pace 2 modes use different algorithms for pacemaker artifact rejection.
The clinician must be the judge as to which mode is better for each patient. The
pacemaker detection program defaults off so if you have a patient with a
pacemaker, you will have to turn the program on.
Follow this procedure:
1. Select DETECT PACE option from the Analysis Settings menu. A
popup menu opens.
MAIN
MENU
PREV.
MENU
DETECT
PACE:
OFF
ECG
FILTER:
MONITORG
OFF
PACE 2
PACE 1
HELP >
QRS
WIDTH:
NORMAL
088
DETECT PACE Popup Menu
2. Rotate the Trim Knob control so the pointer is in front of your choice.
The Pace 2 mode is much more conservative in recognizing paced QRS
morphologies and is recommended for use whenever possible. It is
designed to minimize the possibility of counting pacemaker artifact as
QRS complexes during ASYSTOLE. If the monitor does not adequately
detect paced beats in the Pace 2 mode, then the user may wish to try
the Pace 1 mode.
NOTE: Please observe all cautions as described when choosing the Pace 1
mode of operation.
The Pace 1 mode allows successful detection of the largest variety of
paced QRS morphologies. As a direct consequence, this mode does have
a higher risk of counting pacemaker artifact as QRS complexes during
ASYSTOLE. For this reason, it is imperative that the user keep
patients with pacemakers under close observation. It is also
recommended that the user set the low heart rate limit on the monitor
close to the minimum pacing rate, and that the BRADY arrhythmia
alarm level be elevated to a WARNING or CRISIS level.
3. Press the Trim Knob control to confirm the change and close the popup
menu.
When either pace mode is enabled, the software places an artificial spike on
the waveform, whenever the pacemaker triggers. When pacemaker detection is
on, it is indicated by a “P” in the patient's ECG parameter window
.