GE ApexPro, Руководство оператора

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Viewing real-time patient data
2001989-200E ApexPro™ 7-15
The Detect Pace option enables/disables the pacemaker detection program. It must be
used whenever the monitored patient has a pacemaker.
There are two pacemaker processing modes, Pace 1 and Pace 2 . The 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 select a
mode. For more information, refer to ECG control settings on page 7-11 .
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.
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.
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.
For successful monitoring of pacemaker patients follow these suggestions:
„
Use recommended electrode placement.
„ Brady , Pause , and Low Heart Rate are additional alarms available for use when
monitoring pacemaker patients.
„
Problems you may experience are:
‹ heart rate double counting;
‹
inaccurate alarms for low heart rate or asystole;
‹ pacemaker spikes not recognized by the software.
„
Possible solutions to above problems are:
‹ relearn arrhythmia;
‹
try an alternate electrode placement;
‹ try Single-Lead analysis;
‹
try switching to the other pace detection mode.
Multi-vector pace detection
The ApexPro CH transmitter uses multi-vector pace detection. Here are some
additional guidelines for successful monitoring pacemaker patients when using the
ApexPro CH transmitter.
„ When using the 5- or 6-leadwire set with all the electrodes attached, pace
detection occurs on two ECG leads simultaneously.
„
The default leads used for detection are II and V. If these leads are not available,
multi-vector pace detection switches to available leads.