GE Marquette Responder 3000, Руководство оператора

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Displaying and Monitoring the ECG
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Monitoring Arrhythmia
The device allows you to continuously monitor the
ECG for arrhythmias (see Appendix "The
Arrhythmia Detection Program").
The program is enabled and disabled from the
setup menu (see chapter 13, section "Device –
Analysis").
When the program is active, you will see the
message "VF/VT" in the ECG parameter window
(Figure 7-6).
When the analysis algorithm detects a shockable
arrhythmia, the message "Check Patient" (manual
defibrillator) or "Press Analyse" (semiautomatic
defibrillator) is displayed, and the device will also
give VF alarm. When the audible alarm is active
you will also hear an alarm tone.
Enabling the pacemaker will automatically
interrupt the arrhythmia monitoring program.
Due to motion artifact the device may not be able
to detect these arrhythmias during patient
transport.
Note
Do not rely on this alarm alone because it will
only be activated in the event of shockable ar-
rhythmias; also monitor the patient by means of
the HR alarm limits.
ECG
I
II
III
15.07.1999 09:05:00
semiautom.
62
ECG
SpO2
etCO2
QRSPulse
Tone
OFF
Next
Menu
VF / VT 160 40
bpm
Figure 7-6. Arrhythmia monitoring enabled
Monitoring Pacemaker Patients
When monitoring the heart rate of pacemaker
patients, only the patient's QRS complexes must be
counted and pacer pulses must be rejected. For this
purpose, the Marquette Responder® 3000 has an
electronic pacer pulse suppression algorithm
which rejects the pacer pulses so they are not
counted as QRS complexes. Depending on the
pacemaker model used and on the position of the
electrodes, the compensation pulse following
every pacer pulse may be considered as a QRS
complex. Every pacemaker must provide an
oppositely charged current (reverse current) after
delivering a pacing pulse. In this situation and
when the pacer pulse is ineffective, the displayed
heart rate may be misinterpreted, and the device
will not give alarm in the presence of bradycardia
or asystole.
Always monitor pacemaker patients by means of
separate ECG electrodes and not via the defibrilla-
tion electrodes.
As an additional precaution, monitor pacemaker
patients by means of pulse oximetry.
It depends on the pacer pulse parameters, whether
or not the compensation pulse is counted as a QRS
complex (see chapter 19 "Technical Specifica-
tions").
For pacemaker patients, the ECG signal size
should be greater than 1 mV.
Warning
No HR Alarm — If several adverse conditions
exist at once during monitoring of pacemaker
patients, the possibility that pacer pulses are inter-
preted (and counted) as QRS complexes should be
considered. Therefore, pacemaker patients should
always be watched closely.