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9650-001355-01 Rev. M

X Series Operator’s Guide

14-1

Chapter 14

12-Lead ECG Interpretive Analysis

The X Series 12-Lead input is Type CF defibrillator proof.

This chapter describes 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 provides simultaneous acquisition and storage of
12-Lead information for adult and pediatric patients, and, when enabled, post-acquisition
Interpretive Analysis for adult patients.

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Содержание X Series

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

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

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

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

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

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

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

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

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

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

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

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

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

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

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

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

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

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

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

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

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

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

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

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

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

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

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

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

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

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

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

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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...

Страница 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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