Home

Zoll 1400 Operators Manual

1. ooooooroccoooncconanncnnonononos 33 E ANS eene a a a a a acted dilhnteeate 33 B Explanatio isores a A E E A td 33 m ardiGVerSion PROCE ute ro tras 33 Noninvasive Temporary Pacing cccooncccnnnnnnoconnononnennannnancnnnnnnnnnnnnronornnnananonanenana 39 A ARA E E E dee E NEAT oo ooo E 39 E Special Paeng Applications since 43 SL sie IC INO E aes en Genser EES 43 ASV ACMTOMOUS Pacs a pci 44 A A A e ios 44 ECG MONITO MO ida 45 O 45 E Electrode Placenta ai 46 MN ABYAKe aiid al al Wl eel co code ns rio Parry 46 General Malntenence iia ea 49 o e O 49 E Power Up Sequence Sheek mari eds a aN 49 E Pacer Operation ida E tee 50 M Delivered Energy and Discharge Buttons Check sssisscsssessrerrrrirerrrerrn 50 E Recordar Chak aii 51 E Recorder Panar Undead aa listan oy E Seting VMS sand Dates cian aldo 51 e A ee er er errr rere 52 a Table of Contents CHAPTER 9 Troubleshooting Guides ooooccconocccconocnccononnnococcconnnnnccnannrononanoconanarconanaricananinnos 55 Oracle eect eso pend iia 00 m 5101810 seniii See tts Se te me end Bee era SS Tar rE ONE ae ete ore 57 Mir A E T EES E E E 58 MD lo aaa 59 WARNING The ZOLL PD 1400 Defibrillator Pacemaker and cables and electrodes used for pacing and defibrillation are designed and tested as a unit to ensure safe and effective delivery of therapies Effectiveness is dependent on the combination of the defibrillation or pacing wave form pa
2. A TO HA HH RA AH sng Giscedaeeesece couse as si E THETA EHH sai i La H OTRA TI biia Sct bl HE Cott a i ESS EE A o SRR TH FEEF A Apr ep o n i dE Secs ieEHSSH ESE HIE HETE HEE z AAA A A Er A die EEE PUDO S88 EN 1 aot E Aaa tn Hi ei cee Es A RRA An i rios E ecifiat gt oe EHHH CORA RA cannu casy SIDA REAGE AA itl op sn ett en HETER cree cocessces ARE HA soseesses HERTE HAE EHT EET i EHTE ARA RA AAA HEERE HHHH SSos Sasss anns Sepsa SSS SS FHA HEEE EER HER A Aa Suesabesseuecaues seesi ac us cocsacaauen noppa anoa tt Sly SCAG HHH tee eHe HHRHH HH ttt 4 4 4 EPEE E E eras AA EEEREN EEEH ea ueuactacouse s cuccntens wees cussetecstrces sect sant z assonar Hia ATT ARTUR NOS sap pas MUA ANARE sacs UA AIDA AAA A t pena aneo tere ET HH OEA gest CHRIS HEHE HREH Gite VENDA esger sua BGs D2 RSA HH Ht T 2111 AA HE EEEE BS 50800 NONG RRA A HAT e T HEE H ete t tte TTR ETT SURADA SUADA T AAA p 4 SUSUSETIONS ARANA A AAA 1258 Sees CE et ott ty MEDID TEES atts AA COR tuners oo ATA PUDO PEDIA IDO O oi tiert BASJEDER NBA 9444444 HH ee Seeeeese SUSADA O GEEESEEG ROSS musscevenss ses neces suse Ht tt tite NHT SSSSG0 EUA CUBOS ADAE O Sane SAOR EHH AUD E waanpecsassea 22059299193 sanauenaeaue it iti 4 HHE HEH HHHH 5908008 NUDOS 28 j Onr POFOODORORAN PAGAS snaps adta can It is important to recognize when stimulation has produced a ventricular response Ventricular response
3. Operator s Guide PREFACE CHAPTER 1 CHAPTER 2 CHAPTER 3 About TMS Malasia v E C naper Desconocida e V E O II niatdeGpeiaieiae vi M Parts UiStia indi it VI General Information cuina aa adaa 1 Salely CONSI St A E eee 1 RA AEA A EEE O AEE AEAEE E A E i MU Products CUINA id 2 E Pacemaker r nNCUOD id 2 E SG TOMIALOM FUNGUO oia E cite lane decsaa a teas doadeanaaen eed eead 4 E Monitor and Recorder FUNCHON arica 5 E Radde Electrode OO UGS ersan EA 5 B Baene usna O a headed A E aT 6 E Baten A a A Aa N TA 6 E istrument DIBGNOSUICS ised xcs meemen hohe A E TA 6 M a E E a Se On ae TER Ren ee ee 6 A E E 7 Operating Controls and Indicatorss oocconcoccconconconcnancoronccanonarononanonarononanosa 13 E Switchand Control Locations india 12 E Switch and Control FUMCUONS ao 13 _ Heel aaig dye A A EEE EEE E 16 Multi Function Electrodes ooccooocccnoccconccrononoconnnccnnnnconancnonnnnnnaronannnnanaronannnnnnanons 21 Minis A A IN 21 AN 21 M Multi Function Electrode Cable Installation Operation Testing 21 E Placement of Electrodes viii ati 22 CHAPTER 4 CHAPTER 5 CHAPTER 6 CHAPTER 7 CHAPTER 8 Table of Contents Defibrillationiarniaiaiaa e A 25 MENS MINOS ari acacia 25 E Defibrillation with Paddles aorta di 25 Defibrillation with Multi Function Electrodes ooooooccccccccccccccccccnnncconanicinanan 29 Synchronized Cardioversion With Paddles
4. delivered Energy Selection Charge Time Delivered Energy Display Synchronized Mode Charge Controls Paddles Defibrillation Electrodes Integral Defibrillator Tester Defib On Chapter 1 PACEMAKER VVI demand asynchronous fixed rate when used without ECG leads Rectilinear constant current 40 milliseconds Variable to 140 mA Variable from 30 to 180 ppm Fully defibrillator protected and isolated Message display on monitor Specifically designed adult anterior posterior pre gelled ZOLL NTP 2000 or ZOLL PD 2200 multi function pacing defibrillation electrodes packaged in pairs ZOLL NTP 2100 pediatric electrodes are also available DEFIBRILLATOR Damped sinusoid Selectable at 2 3 5 7 10 20 30 50 100 150 200 300 360 joules Control on sternum paddle and unit front panel Less than 10 seconds Depleted batteries will result in a longer defibrillator charge time CRT monitor displays delivered energy Synchronizes defibrillator pulse to patient s R wave SYNC message displayed on monitor Marker on monitor and on recorder paper identifies R wave Control on apex paddle and on front panel Standard paddles are anterior anterior adult and pediatric Adult paddles slide off to expose pediatric paddles Specifically designed pre gelled ZOLL PD 2200 Multi Function electrodes packaged in pairs can be used in the anterior posterior or anterior anterior position Integral circuitry
5. If your instrument needs calibration adjustment refer to the PD 1400 Service Manual or contact ZOLL Service at 1 800 348 9011 in Mass 1 617 933 9150 International customers If your instrument needs calibration adjustment refer to the PD 1400 Service Manual or contact your nearest authorized ZOLL service center Chapter 9 Troubleshooting guides The troubleshooting guides provided on the following pages are intended for use by non technical medical personnel during PD 1400 operations This section answers many of the common problems or questions that arise during operation If trouble persists after consulting this guide contact the appropriate technical personnel or ZOLL Service Operations A more detailed troubleshooting guide Is found in the PD 1400 Service Manual MONITOR Unit does not turn on No 4 audible beeps NW Check that battery is properly installed NW Replace battery with a fully charged battery Unit turns on with 4 beeps but no display on monitor E Replace battery with a fully charged battery If an STATUS XX message appears on monitor display M Call for service SET CLOCK message appears on the monitor display E Reset time and date information See Chapter 8 ECG LEAD OFF message appears on the monitor display NW Check that the ECG cable is connected to patient and instrument M Check that ECG electrodes are not dry M Replace ECG cable Chapter 9 Noisy ECG displ
6. selected energy level is displayed digitally as DEFIB XXX J SEL on the monitor APPLY PADDLES TO CHEST Apply the paddles firmly to the anterior wall of the chest The sternum paddle should be placed to the right patient s right of the sternum just below the clavicle The apex paddle should be placed on the chest wall just below and to the left of the patient s left nipple along the anterior axillary line If external pacing electrodes are applied it is not necessary to remove them Simply ensure that the paddles contact skin and are not covering any part of any other electrodes There should be ample room for the apex paddle Rub the paddles against the skin to maximize the paddle to patient contact Do not permit gel to accumulate between the paddle electrodes on the chest wall This could cause burns and reduce the amount of energy delivered to the heart The paddles may be used for ECG monitoring Use of paddles for ECG monitoring is intended for emergency situations when time does not allow connection of Emergency Defibrillation Procedure standard monitoring electrodes The unit automatically pre selects PADDLES when It is Initially turned on Pressing the lead button ECG cable and electrodes must already be attached to the patient will allow selection of the desired ECG source lead Il HI or PADDLES Paddles monitoring ts NOT available in PACER ON mode CHARGE DEFIBRILLATOR Press t
7. J SEL message will appear on ECG SIZE LEAD ALARM HEART RATE the monitor If DEFIB XXX J SEL appears Ix I A 9 O press the SYNC button HH AL SYNC XXX J SEL DELIVERED ENERGY JOULES e A USE LEADS message will briefly appear ECG SIZE LEAD ALARM HEART RATE if PADDLES has been selected as the ECG 1x A QO source USE LEADS Synchronized discharge with PADDLES as LAdA ECG source is discouraged since artifacts induced by moving the paddles may resemble SYNC XXX J SEL an R wave and trigger defibrillator discharge at the wrong time DELIVERED ENERGY JOULES An ECG LEAD OFF condition if standard leads are selected as ECG source will prevent synchronized discharge This does not prevent the use of the defibrillator It simply prevents use in a synchronized manner The unit automatically goes out of sync mode after e each discharge e the selector switch has been moved to PACER ON After each discharge the unit reverts to DEFIB where standard non synchronized defibrillation is available To reactivate sync mode press the SYNC button again PREPARE PADDLES Remove the paddles from their holders by grasping the handles and pulling the paddles straight out of the PD 1400 Apply a liberal amount of electrolyte gel to the electrode surface on each paddle To avoid risk of electrical shock to the operator do not allow electrolyte to accumulate on hands or paddle handles Rub the
8. allows complete test of defibrillator charge and discharge without removing paddles from storage wells Identical circuitry allows complete test of unit configured with multi function electrode cable Message display on monitor g Patient Connection Input Protection Electrical Isolation and Shielding Bandwidth Display Format Monitor On Screen Type Screen Size Sweep Speed Viewing Time Heart Rate Pacer Output Current Lead Selection ECG Size Alarm On Off Status ECG Lead Fault Pacer Electrode Fault Defibrillator Paddle Fault Defibrillator Electrode Fault Recorder Paper Out Low Battery Voltage General Information MONITOR AND DISPLAY Via 3 lead ECG cable paddles and electrodes Selectable by front panel switch Fully defibrillator protected Special circuit prevents distortion of ECG by pacer pulse Input protected against high voltage defibrillator pulses and radio frequency interference 0 5 35 HZ 3dB standard 05 35 Hz Diagnostic optional Non fade moving trace Message display on monitor High resolution CRT display 4 5 inches diagonally 56 mm x 86 mm viewing area 25 mm sec 3 4 seconds Digital display on monitor 0 400 bom Digital display on monitor 0 140 mA Display on monitor 5 1 0 1 5 2 0 3 0 cm mV display on monitor Display on monitor User selectable High 60 280 bpm Low 20 100 bpm Message display on monitor Message display on monitor Message displa
9. are built into the paddle assembly They lie directly under the adult electrode surface and are accessed by pushing the PEDI button on the side of each paddle and sliding the adult surface forward When replacing the adult paddle shoe it is important that the shoe is locked correctly in position on the paddle handle Paddle Plate PEDI Button Summary Report allows the operator to store and later retrieve critical ECG event information PD 1400 internal memory automatically records defibrillation and cardioversion segments PACER ON mode heart rate alarm and recorder activated ECG events Summary Report records all associated event information including PD 1400 control settings patient ECG time and date Four events will trigger Summary Report to automatically record information a Defibrillator Discharge mw Selecting PACER ON mode u Heart Rate Alarm triggered m Turning Recorder on or on and then off in rapid sequence Summary Report records each event in chronological order and will store up to 33 defibrillation or 70 non defibrillation events All event data will remain in memory and be accessible until the 1400 has been off for 5 minutes or if data is manually erased If the memory is full a REPORT FULL message will appear on the monitor and no further events will be recorded until the current memory Is erased g SUMMARY REPORT FORMATS Controls and Indicators Summary Report first prints an overview of all t
10. cal shock hazard exists Multi function electrodes should be used no longer than eight 8 hours for continuous pacing The ZOLL PD1400 and NTP 2000 electrodes or PD 2200 muiti function elec trodes are intended for use as a system Do not connect any other device to the output connector SELECT MONITOR ON SET OUTPUT TO OmA ALARM 80 Chapter 6 APPLY ELECTRODES Apply ECG electrodes see Chapter 7 Connect to ECG cable Adjust ECG size and lead for a convenient waveform display Verify proper R wave detection The heart shaped R wave detector flashes on the monitor when proper detection of R wave is taking place Apply back pacer electrodes between scapula and spine at level of heart Apply front pacer electrode to precordium beneath breast on females Anatomical position is identical for either multi function electrodes or NTP 2000 electrodes Connect pacer electrodes to output cable SELECT PACER ON Set pacer rate to a value 10 20 ppm higher than patient s intrinsic rate If no intrinsic rate exists use 60 ppm BEEPER ALARM vrs Observe the pacing artifact stimulus markers LI and verify that it is well positioned in diastole PACING BELOW THRESHOLD o eE E E A RE Pacing Stimull ao Noninvasive Temporary Pacing NTP ERETTE HERE HE et zer El DOS SRPGBOUSES Suan a O HEEE EEP HH ERHET Hethi gt E HEHE EA EHE PHHH THREE EE a PRA EEEE EH w HEHEHE HHH F RRE
11. cap NTP 2000 only Remove the center cap from the front electrode to expose the gelled area while keeping the adhesive covered Once the best location has been determined the electrode should be removed and the area cleansed of salt or other conductive materials such as defibrillator gel The electrode may then be secured after removing tne adhesive backing 4 1 TEST MODE The 4 1 test mode can be used optionally to test for threshold In this mode a stimulus Is delivered to the patient approximately every fourth pace beat The stimulus is demand synchronized to the patient s intrinsic beat Releasing the control causes the instrument to resume normal PACER OUTPUT mA PACER RATE ppm operation ALARM 80 Noninvasive Temporary Pacing NTP PACER LEAD FAULT The message PACER LEAD OFF appears on the monitor in PACER ON mode whenever M the pacer cable is not connected E there is a defect in the cable E the pacer electrodes do not make good skin contact STANDBY PACING For certain patients at risk of developing symptomatic bradycardia it may be advisable to use the ZOLL PD 1400 in standby When used in standby mode the ZOLL PD 1400 automatically provides a pacing stimulus whenever the patient s heart rate drops below a predetermined level To use the ZOLL PD 1400 in standby mode 1 Establish effective pacing see instructions on previous pages Note the mA output at capture and run an ECG strip to document ECG
12. change to DEFIB XXXJ SEL PADDLE CLEANING Paddle plates and handles must be thoroughly cleaned after each use See chapter 8 for correct cleaning procedure Emergency Defibrillation Procedure Emergency Defibrillation Procedure with Multi Function Electrodes WARNING Before proceeding CAREFULLY read the following Emergency defibrillation should be attempted by appropriately trained skilled personnel that are familiar with equipment operation Training appropriateness such as ACLS Advanced Cardiac Life Support certification should be the determination of the prescribing physician Do not touch the bed patient or any equipment connected to the patient during defibrillation All persons in attendance of the patient must be warned to STAND CLEAR prior to defibrillator discharge SELECT DEFIB ON Turn the selector switch to DEFIB ON This turns the power on and automatically sets the defibrillator energy level to 200 joules NOTE Defibrillator ELECTRODES ts selected as the ECG SIZE LEAD ALARM HEART RATE ECG source when the instrument is turned to 1 x A 96 MONITOR ON or DEFIB ON You may then ELECTRODES select any of the ECG leads Il Ill or ELECTRODES ECG cable and electrodes must already be attached to the patient to use lead WW or IIl DEFIB 200 J SEL DELIVERED ENERGY JOULES CHANGE DEFIB ENERGY LEVEL To change the defib energy level from the pre selected level 200J use the
13. e g acute myocar dial infarction drug toxicity anesthesia or surgery especially when distur bances of rhythmicity or conduction are present Prophylactic placement of endocardial electrode which carries risks of displacement infection hemor rhage embolization perforation phlebitis and mechanical or electrical stimula tion of ventricular tachycardia and fibrillation can be avoided 3 Suppression of tachycardia An increase in heart rate from external pacing often suppresses ventricular ectopic activity and may prevent tachycardia Pacemaker Complications Ventricular fibrillation will not respond to pacing and requires immediate defibrilla tion See Chapter 4 for Emergency Defibrillation Procedure The patient s dysryhthmia must therefore be determined immediately so that appropriate therapy can be employed If the patient is in ventricular fibrillation and defibrillation is successful but cardiac standstill ensues asystole the pacemaker should be used Ventricular or supraventricular tachycardias may be interrupted with pacing but in emergency or circulatory collapse synchronized cardioversion is faster and more certain See Chapter 5 for Synchronized Cardioversion Procedure Electromechanical dissociation may occur following prolonged cardiac arrest or in other disease states with myocardial depression Pacing may then produce ECG responses without effective mechanical contractions and other treatment is requir
14. is normally characterized by suppression of the intrinsic QRS Increase pacer output mA until stimulation is effective capture Output mA value is displayed digitally on the lower right of the monitor complex The following tracings are typical EFFECTIVE PACING Pacing above threshold DETERMINING CAPTURE EFFECTIVE PACING Note negative R wave and large T waves EFFECTIVE PACING Note the widened positive QRS which looks like an ectopic beat A paced beat is by definition an ectopic beat NOTE Chapter 6 EFFECTIVE PACING Note the inverted T waves and the absence of P waves Changing ECG leads and size can sometimes be helpful in determining capture Shape and size of the stimulated waveforms can vary depending on lead chosen variation from patient to patient can be expected DETERMINING OPTIMUM THRESHOLD The ideal output current is the lowest value that will maintain capture This is usually about 10 above threshold Typical threshold currents are usually be tween 40 and 80 mA The electrode placement that offers the most direct current pathway to the heart while avoiding large chest muscles will usually produce the lowest threshold Low stimulation currents produce less skeletal muscle contrac tion and are better tolerated Placement of the electrodes will affect the current required to obtain ventricular capture Testing for optimum electrode location may be done with electrodes with a two part protective
15. left 1 x monitor If the ECG LEAD OFF message appears on the monitor inspect the electrodes patient cable VONIOS lead wires and associated connections DELIVERED ENERGY JOULES ECG Monitoring Press the ECG SIZE up down arrows until the desired waveform size is displayed Adjust systole beeper tone volume to suitable level Set the Heart Rate Alarm by pressing the ALARM SET button Refer to the next page for instructions on changing preset settings When the alarm is activated the line crossing out the bell shaped character will disappear Press ALARM ON OFF switch This will activate heart rate alarms When an alarm occurs the recorder will auto a Lene ARON Haan matically run for 15 seconds the bell shaped tx IO 9 F A symbol will flash the heart symbol freezes for Eco easier identification and the audible alarm tone y will sound Deactivating the alarms turns off the ae MONTOS tone and the flashing bell and reactivates the heart symbol to flash with a detected R wave ALARM ON OFF DELIVERED ENERGY JOULES SETTING ALARMS Heart rate alarms have been preset at 30 low and 150 high To change the lower or upper alarm set points 1 Push ALARM SET button Low alarm limit value flashes To change value push A to raise 50 push Y to lower 2 Push ALARM SET button again High alarm limit value flashes To change value push A to raise push Y to lower 3 Push ALARM SET button again to re
16. line is displayed on ECG signal on monitor M Change ECG size E Change ECG lead selection E Change electrode placement E Paper too narrow It should be 50mm wide Light or poor quality tracings annotations on paper NW Ensure correct paper is in use E Ensure paper is installed grid side against recorder printer M Recorder print head requires cleaning trained personnel only WARNING Chapter 9 e PP PPP ff PP ff PPP Pf PPP PPP PPP qm NONINVASIVE PACING Be sure that pacer output current mA is set to OmA when connecting and disconnecting a patient from the PD 1400 PACER LEADS OFF message appears on monitor display Ensure pacing electrodes or multi function electrodes are connected to appropriate cables m Ensure electrodes are not dry Do not use ECG or defibrillator gel Replace electrode if necessary m Ensure good electrode to patient contact no buckling or falling off E Check integrity of pacing cables For multi function cable plug into test connector attached to the multi function cable PACER LEAD OFF should disappear For standard pacing cable connect to ZOLL NTP 4450 Pace Check PACER LEAD OFF should disappear NW Replace pacing cables No stimulus marker 7 present on ECG trace displayed on monitor NW Ensure PD 1400 is in PACER ON mode E Ensure pacing rate ppm dial is set greater than patient rate No ventricular capture beat after stimulus ma
17. morphology at capture 2 Set the mA output 10 higher than the minimum mA output necessary to effect consistent ventricular capture 3 Turn the pacing rate below the patient s heart rate This suppresses pacing unless the patient s own rate drops below the set pacing rate The pacing rate should be set at a level needed for adequate cardiac output 4 Check the threshold periodically SPECIAL PACING APPLICATIONS Noninvasive Temporary Pacing may be performed in the Cardiac Cath Lab either for emergency pacing or in standby mode The pacing electrodes are essentially radiotransparent except for steep imaging angulations where slight shadows may be observed T Chapter 6 AAA Noninvasive Temporary Pacing may also be performed in the Operating Room provided the electrodes do not interfere with the surgical field While the ZOLL PD 1400 exceeds industry standards for resistance to interference from electrosurgical apparatus under certain conditions it may not be possible to properly monitor or pace while electrosurgical apparatus is operating ASYNCHRONOUS PACING The ZOLL PD 1400 is a VVI demand pacemaker the safest and most effective design for Noninvasive Temporary Pacemakers Proper demand pacing requires a reliable high quality surface ECG If ECG electrodes are not available or there is some circumstance which prevents or interferes with the surface ECG it may be necessary to operate the pacemaker asynchronously To p
18. won t charge energy level does not increment on display E Check that discharge switches in paddles or in multi function cable are not stuck on E Have battery checked Charge time to 360J exceeds 10 seconds E Normal if operating in low battery condition up to 20 seconds W Charge battery E Have device serviced Energy will not discharge when both discharge buttons are pressed E Sixty 60 seconds had elapsed after initial charge Energy was internally discharged E Device is in SYNC mode and no ORS complex is detected E Energy internally discharged because energy selector arrows were moved to another energy selection E Unit not completely charged when defib buttons pressed Wait for ready message and ready tone Unable to SYNC cardioversion discharge M Ensure SYNC ts displayed on monitor E Check for SYNC marker high intensity dot or line on R wave If not present change ECG size and or lead selection NW Alter ECG lead wire placement Troubleshooting Guides No apparent energy delivery to patient M Check for ELECTRODE OFF or PADDLE OFF message on monitor NW Perform defibrillator self test as described in Chapter 8 W If test fails have the unit serviced promptly mM if Defib Pace electrodes are used ensure proper placement and contact al Under certain circumstances some patients will not twitch when energy is delivered
19. Defibrillation Electrodes This manual should be kept with the PD 1400 at all times Chapter 1 General Information Provides cautions and warnings and a general product overview Describes basic pacemaker defibrillator monitor and recorder functions as well as batteries battery charger diagnostics and Multi Function electrode paddle options Includes detailed product specifications important ZOLL service information and ZOLL s warranty statement Chapter 2 Operating Controls and Indicators Locates and describes the function of all switches controls and indicator lights Describes Summary Report operation and recorder configuration Chapter 3 Multi Function Electrodes Introduces the ZOLL Multi function electrodes Describes general application and use of the multi function cable and ZOLL PD 2200 Multi function electrodes Chapter 4 Defibrillation Divided into two sections Chapter 4 describes the defibrillation procedure when using paddles or multi function electrodes Chapter 5 Synchronized Cardioversion Chapter 5 explains and describes the procedure for synchronized cardioversion when using paddles or multi function electrodes es MA INITIAL INSPECTION PARTS LIST Preface Chapter 6 Noninvasive Temporary Pacing Describes the pacing procedure with NTP 2000 electrodes and multi function electrodes Also describes special pacing applications Chapter 7 ECG Monitoring Describes ECG electrode placement
20. F button and check that the strip chart is correctly annotated with the current time and date selected ECG size source and heart rate Verify that the real time clock is operating correctly by waiting for several minutes before running the recorder again 2 NOTE BATTERY CARE CHANGING THE BATTERY Checks and Procedures Time and date may require resetting if the PD 1400 has been without batteries for more than 12 hours or if the installed battery has been without a charge for more than 12 hours A medical grade sealed lead acid battery is used which unlike nickel cadmium Nicad batteries requires little periodic maintenance and no deep discharge cycling Depleted batteries will result in slower defibrillator charging times When the indicates a low battery message the operator should immediately replace the battery with a fully recharged battery The ZOLL PD 1400 has been designed for quick removal and replacement of the battery pack To remove the battery insert a finger into the recess at the left end of the battery Press against the battery to disengage the battery locking clip and lift the battery out To install a battery align the D shaped recess molded into the battery case with the battery removal finger recess in the PD 1400 Set the battery into the battery well The shape of the battery will allow the battery to seat itself This concludes the basic PD 1400 functional checkout U S A customers
21. NTP PACING ELECTRODES PD 1400 WITH MULTI FUNCTION ELECTRODES pe as LED Operating Controls and Indicators SELECTOR SWITCH The selector switch allows selection of any of the three operating modes MONITOR ON DEFIB ON PACER ON It also turns the power off The monitor is always on except in the OFF position DEFIB ENERGY SELECTOR BUTTONS Two sets of up down arrow buttons one set located on the front panel and the other located on the sternum paddle control the defibrillator energy level Press and hold the appropriate up A or down Y arrow button until the desired energy level is displayed on the monitor CHARGE Press the charge button on the front panel or if using paddles on the apex paddle handle to charge the defibrillator to the energy level selected with the defib energy selector buttons When the charge button is pressed the defibrillator charges to the selected energy level in 10 seconds or less when using fully charged batteries To change the selected energy level after the charge button has been pressed simply select a different energy level using the appropriate defib energy selector button and press charge again If both discharge buttons are pressed during the charge cycle the PD 1400 will not charge and a CANNOT CHARGE message will appear on the monitor DISCHARGE The multi function electrode cable has two red discharge buttons mounted in the instrument connector Both must be presse
22. RODUCT DESCRIPTION PACEMAKER FUNCTION Chapter 1 o O a a The ZOLL PD 1400 Pacemaker Defibrillator combines a patented noninvasive temporary pacemaker a DC defibrillator a non fade monitor and an annotating strip chart recorder in an integral self contained instrument The PD 1400 is lightweight compact and can be transported with a patient Power is provided by an easily replaceable battery pack The battery pack can be quickly recharged and tested using the ZOLL Battery Support System Noninvasive Temporary Pacing NTP is an established and proven technique This therapy is safe and is easily and rapidly applied in both emergency and non emergency situations when temporary cardiac stimulation is indicated The ZOLL PD 1400 Pacemaker Defibrillator contains a demand pacemaker consisting of a pulse generator and ECG sensing circuitry The output current of the pacemaker is continuously variable up to 140 mA and the rate is continuously variable from 30 to 180 pulses per minute ppm The pacing output pulse is delivered to the heart by specially designed ZOLL NTP pacing electrodes or ZOLL multi function electrodes placed on the back and the precordium Only ZOLL NTP or ZOLL multi function electrodes should be con nected to this instrument The characteristics of the output pulse together with the design and placement of the electrodes minimize cutaneous nerve stimulation lower cardiac stimulation thresholds and reduce discomf
23. Synchronized Cardioversion After 6 10 seconds of charging to the selected energy level the charge indicator light will illuminate on the apex paddle A distinctive audible tone will sound and the energy ready SYNC XXXJ RDY will be displayed on the monitor The defibril lator Is now ready All persons attending the patient should be warned to STAND CLEAR DISCHARGE DEFIBRILLATOR Verify again that the ECG waveform is stable and that a marker pulse appears ONLY with each R wave of the cardiac cycle Verify that no one is in contact with the patient monitoring cable or leads bed rails or any other potential current pathway Press and hold both discharge buttons one on each paddle or if using multi function electrodes the two buttons on the cable simultaneously The defibrillator will discharge with the next detected R wave If additional countershocks are necessary readjust the energy level as necessary and repeat Note that SYNC XXX J SEL must be selected after each discharge Should you need to disarm the charged defibrillator if countershock is not needed turn the selector switch to MONITOR ON or change the selected energy level Any stored energy will be dumped internally If the selected energy is changed in the DEFIB ON mode the monitor will display SYNG IO SEL if the defibrillator is not discharged within 60 seconds of reaching the selected energy level it will automatically dump the stored ene
24. ace asynchronously simply detach the surface ECG electrodes or remove the ECG cable and set the rate and mA at the known capture level or high enough 100mA to presume capture You should be aware that there will be no ECG activity on the ZOLL PD 1400 monitor and other means of determining capture such as the patient s pulse will be necessary Asynchronous pacing should only be performed in emergency situations where there are no other alternatives PEDIATRIC PACING Noninvasive pacing on pediatric patients is done in an identical manner to adult pacing Smaller size pediatric pacing electrodes Part No NTP 2100 are available for patients less than 15 kg Continuous pacing of neonates can cause burns If it is necessary to pace for more than 30 minutes caution and periodic inspection of the underlying skin is strongly advised PREPARATIONS ELECTRODE PLACEMENT LEAD CONFIGURATIONS ECG Monitoring The ZOLL PD1400 Pacemaker Defibrillator can be used for either short term or long term cardiac monitoring A fully charged battery provides 3 5 typical hours of continuous monitoring The ZOLL PD1400 has built in protection circuitry to allow patient monitoring to continue during a defibrillation attempt Monitoring electrodes may become polarized during defibrillation discharge causing the ECG waveform to briefly go off scale High quality silver silver chloride Ag AgCl electrodes minimize this effect and circuitry in the instrume
25. activates The recorder may also be config ured not to print during these events See Recorder Configuration Chapter 2 for more information PADDLE ELECTRODE OPTIONS BATTERIES BATTERY CHARGER INSTRUMENT DIAGNOSTICS SERVICE Chapter 1 The ZOLL PD 1400 will pace defibrillate cardiovert and monitor using either defibrillation paddles and NTP 2000 electrodes or using ZOLL Multi function electrodes PD 2200 Operation of the ZOLL PD 1400 is identical for both methods except that defibrilla tion Energy Select Charge Discharge and recorder on off controls located on the paddles are not available when using multi function electrodes The operator must use the controls located on the PD 1400 front panel To switch between paddles and multi function electrodes the operator simply unplugs one cable and plugs in another The ZOLL PD 1400 uses special medical grade sealed lead acid batteries PD 4410 that when fully charged will provide 2 5 hours minimum 3 5 hours typical of monitoring Use of the defibrillator pacemaker and recorder will reduce this time A LOW BATTERY message appears on the monitor and the unit will beep twice in a row once a minute when the battery must be replaced See battery specifications on page 10 for more information Battery charging and charge capacity evaluation is easily performed with the ZOLL PD 4420 Battery Support System Up to four batteries can be charged simultane
26. and ECG monitoring procedures Chapter 8 General Maintenence Describes several routine checks and procedures to assure proper unit operation Includes instructions for battery care and for setting operator defined values such as time and date Chapter 9 Troubleshooting guides Includes troubleshooting guides intended for use by non technical medical personnel during PD 1400 operation Carefully inspect each container for damage If the shipping container or cushion material is damaged it should be kept until the contents have been checked for completeness and the instrument has been checked for mechanical and electrical integrity The contents of the shipment should be as shown below Procedures for installation and initial checks are presented in Chapter 1 If the contents are incomplete if there is mechanical damage or if the instrument does not pass its electrical self test U S A customers should call ZOLL Medical Corporation 1 800 348 9011 International customers should contact their nearest ZOLL authorized representative If the shipping container is damaged also notify the carrier ZOLL PD 1400 Pacemaker Defibrillator E 1 rechargeable battery pack Ml Standard Apex Sternum defibrillator paddles with built in pediatric paddles 1 ECG cable NW 1 pacer cable E 1 set adult pacing electrodes M 1 set pediatric pacing electrodes E 2 rolls recorder paper M 2 Operator s Manuals M Service Manual not included in shipme
27. ange DISCHARGE buttons located on the multi function cable to deliver energy to the patient if the defibrillator is not discharged within 60 seconds of reaching the selected energy level it will automatically dump the stored energy internally During the ten seconds prior to this internal dump the charge ready tone will beep intermittently The charge ready tone will then stop the charge indicator light will go off and the monitor message will change to DEFIB XXXJ SEL It the electrodes are not properly attached to the patient and the defibrillator discharge buttons are pressed after charging the defibrillator an ELECTRODES OFF message will appear on the monitor and the defibrillator will not discharge The defibrillator will maintain its charge for the full 60 seconds If the electrode problem is corrected within this 60 seconds It is not necessary to charge the defibrillator again Simply press the discharge buttons to discharge the unit WARNINGS GENERAL INFORMATION PROCEDURE Synchronized Cardioversion Before proceeding CAREFULLY read the following Synchronized cardioversion should only be attempted by skilled personnel trained in advanced cardiac life support ACLS and familiar with equipment operation The precise cardiac arrhythmia must be determined before attempting defibrillation Do not touch the bed patient or any equipment connected to the patient during defibrillation Ail persons in attendanc
28. ay when using paddles as ECG source WM Ensure PADDLES is selected E Press and firmly hold paddles against patient Use gel on paddles NW Clean paddle surface M Check cable for damage Poor ECG signal level calibration pulse normal 10mm 1mV M Change ECG size E Change to another lead Il Ill ELECTRODES or PADDLES NW Ensure ECG electrodes are not dried out and are making good contact E Install new electrodes using different placement No systole sound beat detection or heart rate and flashing heart are not being displayed on monitor E Increase beeper volume on top of unit NW Change ECG size NW Change ECG lead selection Alter ECG electrode placement E Patient heart rate less than 20 BPM No sync marker displayed on ECG monitor signal or recorder printout or intermittently displayed on R wave M Ensure SYNC ts displayed on the monitor E Change ECG size NW Change ECG lead selection NW Alter ECG electrode placement 56 Troubleshooting Guides RECORDER NO PAPER message appears on monitor M Recorder out of paper NW Remove paper check paper type check recorder for paper jam reload paper NW Recorder needs adjustment Recorder makes a stuttering sound when activated NW Check paper path of recorder for paper jam SYNC marker y not annotating at top of paper E Ensure SYNC is displayed on the monitor E Ensure high intensity dot or
29. d and held simultaneously to dis charge the defibrillator Each paddle has a red discharge button located near the forward end of the handle Press and briefly hold both buttons simultaneously to discharge the defibrillator CHARGE INDICATOR LIGHT Located on the apex paddle this light turns on when the defibrillator is charged and ready Chapter 2 SYNC In sync mode the unit synchronizes defibrillator discharge with the first detected R wave after both discharge buttons are pressed and held down This mode is typically used for cardioversion procedures The sync button can be used in the defibrillation or the monitor mode For synchronized operation press the sync button once The SYNC XXX J or SYNC MONITOR message appears on the display A distinctive marker appears on the monitor with each detected R wave To return to standard defibrillation mode for instant discharge press the sync button again The ZOLL PD 1400 is designed to leave sync mode and revert to standard defibrillation mode after discharge PACER OUTPUT mA This switch is used to control the amount of current to the pacemaker electrodes For conscious patients it should be gradually increased until capture is recognized The output is displayed digitally on the monitor PACER RATE ppm When pacing is selected this control sets the rate at which the pacemaker will operate It must be set above the patient s intrinsic rate in order for the pac
30. e maker to provide stimulation 4 1 BUTTON This control is used optionally to test for threshold or to determine the underlying rhythm When depressed approximately every 4th beat Is a paced beat Releasing the control causes the instrument to resume normal operation LEAD Selection of the ECG source is accomplished through the lead button Pressing the button sequentially selects and displays each option on the monitor Il WE PADDLES defibrillator paddles or ELECTRODES multi function elec trodes Electrodes or paddles is automatically selected when the instrument powers up in defib on or monitor on Lead Il is automatically selected when the instrument powers up in pacer on ECG monitoring through multi function electrodes is accomplished by selecting ELECTRODES ECG monitoring through the paddles is accomplished by selecting PADDLES Paddles monitor Ing Is not available in pacer on mode E d Controls and Indicators ALARM ON OFF The ALARM ON OFF button is used to activate and deactivate the heart rate alarm The bell symbol is located in the top center of the monitor When the alarms are activated only a bell appears When the alarm on is deactivated a line crosses through the bell symbol When the alarm on is active and an alarm condition is detected an audible alarm sounds and the bell symbol flashes To avoid possible confusion with the defibrillator charged tone the hea
31. e of the patient must be warned to STAND CLEAR prior to defibrillator discharge Certain arrhythmias such as Ventricular Tachycardia VT atrial fibrillation and atrial flutter require synchronizing the defibrillator discharge with the ECG R wave to prevent the induction of ventricular fibrillation In this case a synchronizing SYNC circuit within the instrument detects the patient s R waves When the discharge buttons are pressed and held the unit will discharge with the next detected R wave thus avoiding the vulnerable T wave segment of the cardiac cycle During SYNC the ZOLL PD places a marker pulse on the ECG as it appears on the monitor to indicate the point in the cardiac cycle where discharge will occur This marker pulse appears as an intensified dot or line on the ECG waveform For documentation a marker also designates this discharge point above the wavetorm on the ECG recorder strip The cardioversion procedure is identical for either paddles or multi function electrodes The ECG lead selected message will change from PADDLES to ELECTRODES when using multi function electrodes and the paddle charge and discharge buttons are not available SELECT MONITOR ON Connect ECG leads Chapter 5 Select desired ECG lead by pressing LEAD button e LEAD E E X USE LEADS NOTE The warning USE LEADS will briefly appear whenever PADDLES is selected as the ECG source during cardioversion S
32. e performed on pediatric patients 15kg or less using special pediatric electrodes ZOLL NTP 2100 Prolonged pacing in excess of 30 minutes particu larly in neonates could cause burns Caution and periodic inspection of the underlying skin are recommended The ZOLL Pacemaker Defibrillator contains a standard DC defibrillator capable of delivering up to 360 joules of energy It may be used In synchronized mode for performance of synchronized cardioversion by using the R wave of the patient s ECG as a timing reference The ZOLL PD 1400 uses conventional paddles or disposable pre gelled multi function electrodes for defibrillation Intended Use Defibrillator This product is to be used only by qualified medical personnel for the purposes of converting ventricular fibrillation VF a cardiac rhythm incompatible with life to sinus rhythm or other cardiac rhythms capable of producing hemodynamically significant heart beats In addition this product may be used in the synchronized mode to terminate certain atrial and ventricular tachycardias and other arrhythmias resistant to drug therapy A qualified physician must decide when synchronized cardioversion Is appropriate MONITOR FUNCTION RECORDER FUNCTION General Information Defibrillator Complications Inappropriate defibrillation or cardioversion on a patient e g with no malignant arrhythmia may precipitate ventricular fibrillation asystole or other dangerous arr
33. ed Pacing may evoke repetitive responses tachycardia or fibrillation in the presence of generalized hypoxia myocardial ischemia cardiac drug toxicity electrolyte imbalance and other cardiac diseases Pacing by any method tends to inhibit intrinsic rhythmicity Abrupt cessation of pacing particularly at rapid rates can cause ventricular standstill and should be avoided DEFIBRILLATOR FUNCTION Chapter 1 Pacemaker Complications The Noninvasive Temporary Pacemaker may cause discomfort of varying intensity which may occasionally be severe and preclude its continued use in conscious patients Similarly unavoidable skeletal muscle contraction may be troublesome in very sick patients and may limit continuous use to a few hours Erythema of the skin under the electrodes often occurs but is inconsequential There are reports of transient inhibition of spontaneous respiration in unconscious patients with previously available units when the anterior electrode was placed too low on the abdomen This device may not be connected to internal pacemaker electrodes in contact with the myocardium Only electrodes supplied by ZOLL Medical Corporation should be used There have been rare reports of burns under the anterior electrode when pacing adult patients with severely restricted blood flow to the skin Prolonged pacing should be avoided in these cases and periodic inspection of the skin is advised Pediatric Pacing Pacing can b
34. electrode surfaces together to evenly distribute the applied gel 2 WARNING Chapter 5 APPLY PADDLES TO CHEST Apply the paddles firmly to the anterior wall of the chest The sternum paddle should be placed to the right patient s right of the sternum just below the clavicle The apex paddle should be placed on the chest wall just below and to the patient s left of the left nipple along the anterior axillary line if external pacing electrodes are in place it is not necessary to remove them Simply ensure that the paddles contact skin and are not covering any part of any other electrodes Rub the paddles against the skin to maximize the paddle to patient contact Do not permit gel to accumulate between the paddles gel bridge on the chest wall this could cause burns and reduce the amount of energy delivered to the heart If using multi function electrodes apply to the patient as shown on the package and connect to the multi function cable CHARGE DEFIBRILLATOR Press the charge button on the front panel or if using paddles on the apex paddle handle To increase or decrease the selected energy after the charge button has been pressed press the up down arrows until the desired energy level is displayed Changing the joules selected value while the unit is charging or charged will cause the unit to discharge the defibrillator inter nally Press the CHARGE button again to charge the unit NOTES
35. es are depleted 35 defibrillator chargings to maximum energy 360J or 2 5 hours minimum 3 5 hours typical of continuous monitoring or 2 5 hours of continuous monitoring pacing at 60 mA 80 beats min Use ZOLL PD 4420 Battery Support System only for proper operation See Battery Support System Operator s Guide for detailed information about battery charging and capacity evaluation General Information ACCESSORIES STANDARD M Standard Apex Sternum defibrillator paddies with built in pediatric paddles NW 1 ECG cable NW 1 pacer output cable M 1 set adult pacer electrodes W set pediatric pacer electrodes E 1 roll recorder paper E 1 Battery Pack E 2 Operator s manuals M 1 Service manual not included in shipment supplied on request M inservice video tape OTHER ACCESSORIES NW NTP 2000 Adult pacing electrodes 12 pair box M NTP 2100 Pediatric pacing electrodes 6 pair box M PD 2200 Adult Multi function pacing defibrillation electrodes 12 pair box E PD 2900 Standard Apex Sternum paddles MW NTP 3002 Pacer output cable NW NTP 4450 Output verification unit for noninvasive pacer M PD 4400 Multi function cable assembly for Multi function pacing defibrillation electrodes E PD 4410 Replacement battery mM PD 4420 Battery Support Charger System M PD 4450 Carrying Case M PD 3001 AHA Standard 3 wire ECG cable M 9500 0003 IEC Standard 3 wire ECG cable MM Chapter 1 PD 1400 WITH STANDARD PADDLES AND
36. he charge button on the front panel or on the apex paddle handle To increase or decrease the selected energy after the CHARGE button has been pressed use either the sternum paddle or front panel defib energy select buttons to select the new energy level Changing the joules selected value while the unit is charging or charged will cause the unit to discharge the defibrillator internally Press the CHARGE button again to charge the unit After 6 10 seconds of charging to the selected level the charge indicator light will light on the apex paddle A distinctive charge ready continuous tone sounds and the energy ready DEFIB XXX J RDY message displays on the monitor The defibrillator is now ready All persons attending patient should be warned to STAND CLEAR DISCHARGE DEFIBRILLATOR Verify that no one is in contact with the patient monitoring cable or leads bed rails or any other potential current pathway Simultaneously press and briefly hold both DISCHARGE buttons one on each paddle to deliver energy to the patient NOTES Chapter 4 if the defibrillator is not discharged within 60 seconds of reaching the selected energy level the PD 1400 automatically dumps the stored energy internally During the ten seconds prior to this internal dump the charge ready tone will beep intermittently The charge ready tone will then stop the charge indicator light will go off and the monitor message will
37. he events currently stored in memory including total number of defibrillation shocks delivered total pacing time cumulative time the PD 1400 is turned on or if you have just manually erased a report the time of the start of the next report time of last event as well as the date and space for patient name and comments All segments have vertical dashed cut lines every 8 5 inches to facilitate easy mounting on 8 5 x 11 paper On the last event recorded SUMMARY COMPLETE will be printed at the bottom left of the recorder strip ETE EEE EAEE ee eee neers ae aia ete seal apt SE age HET IGH WHEE GER aia ote mat oe a iat at PMB THT eS te y uns bad dedo Hace eau Ricos el ea oe FH A AUNIA E 7 aad Rec ng ERAT HE aranais HHEH EHIH EEH E aug Et m e e a a re ee e a a a iii Ii TI Defibrillation Format Summary Report records 6 seconds of pre shock and 8 seconds of post shock patient ECG data Also recorded is joules selected sync if on includes sync indicator arrows ECG lead ECG size time and date Chapter 2 PACER ON Format Summary Report records 6 seconds of pre PACER ON patient ECG data Also recorded is the ECG lead ECG size patient s heart rate time and date 15 19 50 10 MAY 32 ARTO ert FH ane pias HE After establishing a paced rhythm turn the recorder on briefly to record in Summary Report the paced rhythm SE il ET a i La dl el H dura rusts ci El oa Heart Rate Alarm Ac
38. hythmias Defibrillation without proper application of paddle electrolyte gel may be ineffective and cause burns particularly when repeated shocks are necessary Defibrillator Output Energy The ZOLL PD 1400 delivers up to 360 joules into a 50 ohm impedance The energy delivered through the chest wall however is controlled by skin imped ances An adequate amount of electrolyte gel must be applied to the paddles and a torce of 10 12 kilograms must be applied to each paddle in order to minimize skin impedance If multi function electrodes are used make sure that they are properly applied See Chapter 3 This product contains a non fade monitor for observation of the patient s cardiac rhythm The monitor displays the ECG in moving trace mode at 25 mm sec for a period of 3 4 seconds Also displayed on the monitor are E heart rate derived from measuring R to R intervals E lead selections Il III PADDLES or ELECTRODES M ECG size 5 1 0 1 5 2 0 3 0 cm mV E pacemaker output in milliamps E defibrillator output in joules M other operational prompts messages and diagnostic codes The hard copy recorder is used to document events The recorder normally operates in the delay mode 6 seconds to insure capture of critical ECG informa tion It may be activated manually by pressing the RECORDER ON OFF button It will be activated automatically whenever the defibrillator discharge buttons have been pressed or a Heart Rate Alarm
39. l either cable simply plug it into the connector When using the multi function cable the operator must check the electrode packaging labels Only Pacing Defibrillation Electrodes will operate with the multi function cable The labels on the electrodes must have the words PACE printed in green and DEFIB printed in red Chapter 3 Located on the multi function cable connector are two orange discharge buttons When pressed and firmly held the defibrillator will discharge when the defibrillator charge is ready Discharge Buttons PLACEMENT Anatomical placement of the multi function electrodes is identical to placement of OF ELECTRODES ZOLL NTP 2000 pacing electrodes Remove the electrodes from the storage pouch Remove the protective cover exposing the gel area and adhesive Place the round electrode labelled FRONT directly over the cardiac apex beneath the breast on females See the diagram on the package Place the rectangular electrode labelled BACK on the back between the patient s left scapula and spine at heart level NOTE The back electrode may be placed over the patient s right sternal area if it is not possible to access the patient s posterior Effective defibrillation will result but pacing will usually be less effective When placing the electrodes be sure to press firmly on the adhesive area around the electrode periphery Gently press the gel area after the elec
40. nt supplied on request SAFETY CONSIDERATIONS WARNING General Information The ZOLL PD 1400 is a high energy device capable of delivering up to 360 joules To completely deactivate the PD 1400 you must turn the selector switch to the OFF position In order to disarm a charged defibrillator E Turn the selector switch to MONITOR ON or PACER ON or E Change the defibrillator energy selected value or E if using paddles place them in their holders and depress both discharge buttons As a safety feature the ZOLL PD 1400 will automatically discharge internally if it has been left charged for more than 60 seconds Federal U S A law restricts this device to use by or on the order of a physician Do not use the ZOLL PD 1400 in the presence of flammable agents such as gasoline or anesthetics Using the instrument near the site of a gasoline spill may cause an explosion Do not discharge with paddles shorted together or in open air Stand clear of patient when defibrillating Do not discharge into multi function electrodes that are not properly placed on a patient Using the device near or within puddles of water is a shock hazard to the operator patient and nearby personnel Internal pacemakers may cause the heart rate meter to count the pacemaker rate during incidences of cardiac arrest or other arrhyth mias Pacemaker patients should be carefully observed Do not rely solely on heart rate meters nn MA P
41. nt or any equipment connected to the patient during defibrillation All persons in attendance of the patient must be warned to STAND CLEAR prior to defibrillator discharge SELECT DEFIB ON Turn the selector switch to DEFIB ON This turns the power on andautomatically selects the energy level of 200 joules Defibrillator PADDLES is selected as the ECG ECGSIZE LEAD ALARM HEART RATE source when the instrument is turned to 1 x MONITOR ON or DEFIB ON You may then PADDLES select any of the other ECG lead sources lead Il Illor PADDLES ECG cable and electrodes must already be attached to the DEFIB 200 J SEL patient to use lead I Il or IIl DELIVERED ENERGY JOULES PREPARE PADDLES Remove the paddles from their holders by grasping the handles and pulling the paddles straight out of the PD 1400 Apply a liberal amount of electrolyte gel to the electrode surface of each paddle Use of electrode gel patches can be substituted for gel applied to paddle surfaces WARNING WARNING Chapter 4 To avoid risk of electrical shock to the operator do not allow electrolyte gel to accumulate on hands or paddle handles Rub the electrode surfaces together to evenly distribute the applied gel CHANGE DEFIB ENERGY LEVEL To change the pre selected defib energy level 200J use either pair of up down arrow buttons One pair is located on the front panel the other pair is located on the sternum paddle The
42. nt will return the trace to the monitor display within a few seconds ECG monitoring may be accomplished through multi function electrodes or through standard defibrillation paddles However this is typically done only for emergency evaluation of patient condition when ECG leads are not attached to the patient Proper application and placement of electrodes is essential for quality ECG monitoring Good contact between the electrode and skin minimizes the negative effects of motion artifacts and signal interference RA White Electrode Place near right mid clavicular line directly below clavicle LA Black Electrode Place near left mid clavicular line directly below clavicle LL Red Electrode Place between 6th and 7th intercostal space on left mid clavicular line Chapter 7 ATTACH MONITORING ELECTRODES Peel the protective backing from the electrode Be careful to keep adhesive surface free of electrolyte gel Apply the electrodes firmly to the patient s skin pressing around the entire perimeter of the electrodes Attach snap on leads and check for good contact between the electrode and the lead termination Plug the patient cable connector into the ECG ECG Input Connector input connector located at the front right of the instrument SET THE CONTROLS Set selector switch to the MONITOR ON position Press the LEAD button until the desired lead Is ECG SIZE LEAD ALARM HEART RATE selected selected lead is indicated at upper
43. ontact ZOLL Medical at 1 800 348 9011 in Massachu setts 1 617 933 9150 Please try to have the following information available to expedite service E A description of the problem E Department where equipment is in use M Sample ECG strips documenting problem if available E A hospital Purchase Order to allow tracking of loan equipment International customers Should the ZOLL PD 1400 require service it should be returned in Its original container to the nearest authorized ZOLL Medical Corporation service center GENERAL 10 7 cm high x 33 5 cm wide x 31 cm long 4 2 in x 13 2 in x 12 2 in 5 9 kg 13 lbs with PD 4400 multi function cable 6 8 kg 15 Ibs with paddles Sealed lead acid battery 2 5V cell 5 cells wired in series In North America 1 year including use of a loaner Outside North America consult ZOLL authorized representative Meets or exceeds all AAMI specifications for defibrillators Meets or exceeds UL 544 IEC 601 and CSA standards for medical equipment and MIL STD 810D Method 514 3 Figure 514 3 35 Cat 6 Swept Sine Random Vibration Universal Helicopter MIL STD 810D Method 514 3 Cat 3 All patient connections are Isolated Temperature O C to 55 C operating 40 C to 75 C storage and shipping Humidity 5 to 95 relative humidity So Type Pulse Type Pulse Duration Pulse Amplitude Pacing Rate Output Protection Pacer On Pacer Electrodes Waveform Output Energy
44. ort due to skeletal muscle contraction The unique design of the ZOLL PD 1400 allows clear viewing and interpretation of the electrocardiogram ECG on the monitor during external pacing without offset or distortion Proper operation of the PD 1400 together with correct electrode placement s critical to obtaining the optimum results The operator must be thoroughly familiar with these operating instructions Intended Use Pacemaker This product may be used for cardiac pacing for any purpose in Conscious or unconscious patients for up to a few hours duration as an alternative to endocardial stimulation The purposes of pacing include 1 Resuscitation from standstill or bradycardia of any etiology Noninvasive pacing has been used for resuscitation from standstill or temporary acceleration of bradycardia in Stokes Adams disease sick sinus syndrome reflex vagal standstill and drug induced standstill due to procainamide quini General Information dine digitalis b blockers verapamil etc and unexpected circulatory arrest due to anesthesia surgery angiography and other therapeutic or diagnostic procedures It is safer more reliable and more rapidly applied in an emer gency than endocardial or other temporary electrodes 2 As a standby when standstill or bradycardia might be expected As a stand by when arrest or symptomatic bradycardia might be expected the external pacer is used especially in pacemaker procedures
45. ould be no PACE LEAD OFF message Remove the pacer cable from the unit Slowly turn the knob up to 15 mA The PACER LEAD OFF message should appear The above tests quickly verify basic pacer functions f you have ZOLL s PACECHECK Part No NTP 4450 you can further test the pacer output cable and verify pacer calibration Perform this check once a week Turn the selector switch to DEFIB ON Set the defib energy level to 100 joules Verify that the adult paddle or multi function electrode cable is installed If using paddles be sure the paddles are pushed all the way into their holders Leaving the paddles in their holders or as appropriate plugging the multi function electrode cable into its test connector press either charge button Wait for the charge ready tone to sound and verify that the energy ready value displayed on the monitor registers 100 joules When performing this check using paddles use your thumbs to operate the discharge buttons No portion of the hand should be near the paddle plates Press and firmly hold both discharge buttons simultaneously The message TEST OK or TEST FAILED should appear on the display A brief automatic recorder run also indicates TEST OK if the unit is providing delivered energy within specifications g RECORDER CHECK CHANGING PAPER SETTING TIME AND DATE Checks and Procedures If TEST FAILED appears contact appropriate technical per
46. ously and testing is a simple one step operation See the ZOLL Battery Support Operator s Guide for more detailed information on the specifications use and management of ZOLL PD 1400 batteries The computer contained within the ZOLL PD 1400 performs self diagnostic tests on critical circuits when the instrument is initially turned on and periodically during operation The READY message that appears briefly on the monitor during initial power up verifies proper operation of these circuits During operation an STATUS XX message will indicate if a problem has been detected If this occurs contact authorized service personnel In the U S A contact ZOLL Medical service telephone 1 800 348 9011 The ZOLL PD 1400 Pacemaker Defibrillator will provide trouble free operation without periodic recalibration or adjustment However it is suggested that appropriately trained and qualified personnel perform periodic routine tests of the device to verify proper operation See Chapter 8 a SPECIFICATIONS Size Weight Power Warranty Design Standards Patient Safety Environmental General Information U S A customers Should the ZOLL PD 1400 require service it should be returned in its original container to ZOLL Medical Corporation 500 West Cummings Park Woburn Massachusetts 01801 6516 Attn Service Manager Loaner instruments are available for use while repairs are being completed To request loan equipment c
47. rgency situations when time does not allow connection of standard monitoring electrodes The unit automatically pre selects ELECTRODES when it is initially turned on If the ECG electrodes and cable are already attached to the patient pressing the lead button will allow selection of the desired ECG source lead II HI or ELECTRODES If the multi function cable is not properly attached a PADDLE FAULT message will appear on the monitor and the defibrillator will disarm Itself o ne NOTES Emergency Defibrillation Procedure CHARGE DEFIBRILLATOR Press the CHARGE button on the front panel To increase or decrease the selected energy after the CHARGE button has been pressed use the defib energy select arrow buttons to select the new energy level Changing the joules selected value while the unit is charging or charged will cause the unit to discharge the defibrillator internally Press the CHARGE button again to charge the unit After 6 10 seconds of charging to the selected level a distinctive charge ready continuous tone will go on and the energy ready message DEFIB XXX J RDY displays on the monitor The defibrillator is now ready All persons attending patient should be warned to STAND CLEAR DISCHARGE DEFIBRILLATOR Verify that no one is in contact with the patient monitoring cable or leads bed rails or any other potential current pathway Simultaneously press and firmly hold both or
48. rgy internally During the ten seconds just prior to this internal disarm the charge ready tone will beep intermittently The charge ready tone will then stop and the monitor mes sage will be SYNC XXXJ SEL A PADDLE FAULT message will appear on the monitor whenever the paddles or multi function electrodes are not connected or are improperly seated in the unit The unit will disarm itself if such a fault occurs A Chapter 5 PADDLE CLEANING Paddle plates and handles must be thoroughly cleaned after each use See chapter 8 for the correct cleaning procedure WARNINGS PACING PROCEDURE Chapter 6 Noninvasive Temporary Pacing Before proceeding CAREFULLY read the following Noninvasive pacing can be accomplished using either standard NTP 2000 pacing electrodes or PD 2200 Multi function electrodes Anatomical place ment and operation is identical To pace with NTP 2000 pacing electrodes the paddles must be pluged into the unit The pacing connector is part of the paddles cable assembly PD 2200 Multi function electrodes will not operate with the paddles installed To pace with PD 2200 Multi function electrodes the multi function cable must be pluged into the unit NTP 2000 electrodes will not operate with the multi function cable installed Both pacing electrodes should be attached to the patient before connecting the output cable Avoid touching the gelled area of the electrode while pacing A minor electri
49. rker on ECG monitor display MN Increase output current level E Change ECG Lead select NW Review pacing electrode placement Verify that pacemaker is delivering the proper current using the ZOLL NTP 4450 Pace Check or have appropiate technical staff check output W Check for pulse of patient Y Troubleshooting Guides Patient on Standby pacing gets paced intermittently If ECG lead wire comes off pacer will automatically pace asynchronously E Ensure ECG electrode connection and placement M Check ECG cable for damage E Patient R wave to R wave interval varying Pace rate close to patient rate Heart rate is 0 with proper pacing capture displayed on ECG trace M Change ECG size M Change ECG Lead Selection E Check patient s pulse Bedside Central Station monitor display becomes erratic when pacing E Patients cannot be double patch ECG monitored while pacing Use ZOLL adapter cable NTP 3007 DEFIBRILLATOR PADDLE FAULT message appears on monitor display E Remove and reinstall paddle cable plug into receptacle on front of PD 1400 Noisy ECG signal when using paddles as ECG source M Ensure PADDLES is selected E Press and firmly hold paddles against patient Use gel on paddles WM Clean paddle surface E Check cable for damage Chapter 9 An STATUS XX message appears on monitor display NW Have instrument serviced promptly by trained personnel Defibrillator
50. rt rate alarm tone sounds different different frequency when the defibrillator is on ECG SIZE This control allows the operator to change the size of the ECG signal Size options are 5 1 0 1 5 2 0 3 0 cm mV and are indicated on the monitor in the upper left center of the display RECORDER ON OFF Two buttons one located on the front panel and the other located on the sternum paddle start and stop the hard copy recorder BEEPER VOLUME ECG The volume control allows manual adjustment of the systole beeper tone from maximum volume to inaudible The heart rate alarm and charge ready volumes are not adjustable PAPER COMPARTMENT Opens recorder paper storage ALARM SET This control allows the user to change the high heart rate alarm setting pre set at 150 and low heart rate alarm setting pre set at 30 The A button increments the displayed value The W button decrements the displayed value SUMMARY Summary Report automatically records in the PD 1400 s internal memory critical patient ECG data control settings date time and therapies administered during certain events This information can be retrieved printed on the recorder any time by pressing the SUMMARY button DEFIBRILLATOR TEST LOAD CONNECTOR The test connector is used to test the defibrillator output when using the multi function electrode cable Not Shown in photos See Chapter 8 SUMMARY REPORT Chapter 2 PEDIATRIC PADDLES Pediatric size paddles
51. single pair of electrodes The PD 1400 has been designed to operate with standard paddles and ZOLL NTP 2000 pacing standard electrodes or PD 2200 multi function electrodes without standard paddles To switch between standard paddle electrode multi function electrode options the operator must remove either the standard paddles pacing cable or the multi function cable and install the other See photos on page 12 ZOLL PD 2200 Multi Function Pacing Defibrillation Electrodes are anterior posterior pre gelled disposable electrodes They are applied to the patient in the same manner and location as standard pacing electrodes The multi function electrodes can only be used with a multi function cable ZOLL NTP 2000 pacing electrodes can only be used with a standard pacing cable The ZOLL PD 1400 cables and electrodes are designed and tested as a unit to provide maximum patient safety and comfort Use of electrodes and or cables other than those supplied by ZOLL could compromise patient safety and voids ZOLL s warranty If continuous pacing with multi function electrodes exceeds 8 hours you must replace the electrodes The ZOLL PD 4410 Multi Function Cable connects to the standard paddles receptacle on the right front of the unit in the same manner as the paddles cable To remove either cable press the two locking buttons one on top of the connector and one on the bottom together and pull the connector out from the PD 1400 To instal
52. sonnel or ZOLL immediately Press the RECORDER ON OFF button The recorder will run until you press the button again While the recorder is running press and hold the up and down arrows located next to the alarm set button This will generate calibration pulses Inspect the recorder waveform for uniformity and darkness Inspect for uniformity of annotation characters and completeness of words Check recorder speed by verifying that a new calibration pulse appears approximately every 13 small divisions 1 3 cm and is 10 1mm high NEAR A MESA En ae ES ia LE ES E e Tat 7 Me mr e rE EEEE IE Check for adequate supply of paper Press the recorder release button The door and paper carriage will tilt up Remove the empty or low paper roll Place a new roll of thermal paper between the two side knobs with the paper coming off the top of the roll and the grid facing down Pull enough paper off the roll so that the paper extends out of the recorder when the recorder Grid on door is closed Bottom Close recorder door Check the time and date on the recorder annotation If it is not correct set as follows Turn the selector switch to OFF SO MA Chapter 8 Press and hold the ALARM SET button on the ECG SIZE LEAD ALARM HEART RATE top of the PD 1400 With the ALARM SET button Ix I QO O pushed turn the selector switch to the MONITOR ON position When the date display appears on the monitor release the ALARM SET bu
53. t the beginning of each shift and the end of each use to ensure adequate recording capability A red stripe on the paper means that the paper supply is low and should be replaced A NO PAPER message appears on the monitor when the recorder is activated without paper The recorder automatically shuts off when there is no paper Press the RECORDER ON OFF button to start the recorder again after loading new paper INSPECTION CLEANING POWER UP SEQUENCE CHECK Chapter 8 General Maintenence Resuscitation equipment must be maintained at peak performance The following operational checks should be performed periodically once a day to once a week to ensure proper equipment operation Assure that the unit is clean with no fluid spills and nothing is stored on the unit Check that paddle surfaces are clean Inspect all cables cords and connectors for good condition Verity presence and proper condition of all disposable supplies electrode gel monitor electrodes recorder paper alcohol swabs razors antiperspirant Assure that two sets of pacing or multi function electrodes are available in sealed packages Check expiration dates on all electrode packages Clean the PD 1400 paddles and cables with a soft cloth mild soap and water The recorder parts should be cleaned with a damp soft cloth only Do not immerse any part of the PD 1400 including paddles in water Do not use alchol or ketones MEK acetone etc Avoid
54. tandard ECG leads DEFIB 200 J SEL are recommended during cardioversion since they provide signal quality that is typically superior to that of paddles Multifunction electrodes may be used as an ECG source and signal quality will be equal to that of standard leads except immediately following a discharge when there may be more noise due to muscle tremors especially if an electrode is not in complete contact with the skin The use of standard ECG leads also provides the choice of three leads for ECG source multi function electrodes provide only one DELIVERED ENERGY JOULES PRESS SYNC BUTTON An intensified dot or line will appear on the monitor at each detected R wave to indicate where discharge will occur Verify that the intensified dot or line ECGSIZE LEAD ALARM HEART RATE marker is clearly visible on the monitor and Ix I A 96 is consistent from beat to beat If neces sary use the LEAD BUTTON or ECG SIZE AA button to select the lead which yields the eee SANO ONO ER SELECT DEFIB ON 7 Turn the selector switch to DEFIB ON The PD 1400 automatically sets the energy level to 200 joules If necessary change the defib energy level using the up down arrow buttons One pair is located on the front panel the other pair if using paddles is located on the sternum paddle The selected energy level is displayed digitally on the monitor SYNC XXXJ SEL NOTE WARNING Synchronized Cardioversion e A SYNC XXX
55. tented electrode designs and proprietary gel formulas Use of pacing or defibrillation cables and electrodes not provided by ZOLL Medical Corporation is a safety hazard and pacing and defibrillation functions will be severely compromised Use of equipment not recommended by ZOLL Medica Corporation is con trary to the manufacturer s recommendations and intended use for the product and voids the warranty for this device CHAPTER DESCRIPTIONS Preface This manual provides information necessary for the safe and effective use and care of the ZOLL PD 1400 Pacemaker Defibrillator Persons using the ZOLL PD 1400 should be appropriately trained skilled personnel familiar with the use of this device Training appropriateness such as Advanced Cardiac Life Support ACLS should be the determination of the prescribing physician ZOLL Medical Corporation manufactures a comprehensive and compatible line of cardiac resuscitation equipment The ZOLL D 900 Defibrillator PD 1200 Pace maker Detfibrillator and PD 1400 Pacemaker Defibrillator have been designed so use of each model is complimentary The operator will find that each model is similar in look and operation Controls and switches have been designed to operate in a similar manner and therapies are applied in the same sequence The PD 1200 and PD 1400 use the same Noninvasive Temporary Pacing NTP 2000 electrodes and all ZOLL models can be configured to use PD 2200 Multi Function Pacing
56. tivated Format Summary Report records 6 seconds of pre alarm patient ECG Also recorded is the ECG lead ECG size patient s heart rate time and date If the pacer is on during this event the pacing rate and pacing current is also recorded 15 21 47 10 i E Beeman Ty ARJEN i peni ATT e o a a it Hala UU He Esas es a ti E aaa ae aS aS g da Spas Ee Controls and Indicators Recorder On Format Summary Report records 6 seconds of pre recorder on patient ECG Also recorded is the ECG lead ECG size patient s heart rate time and date If the pacer is on during this event the pacing rate and pacing current Is also recorded SEDARE IEAI RTS SEETI DATS tye is H epitr 141144 j H RRHH EN Danilo disp ii PRINTING A REPORT ERASING A REPORT To retrieve recorded event reports press the SUMMARY button on the top of the PD 1400 The recorder will print all events in chronological order currently in the 1400 s memory If the recorder is on or the defibrillator is charging the SUMMARY button is inactive To stop printing a ACER A SACER ARTE pa report press the SUMMARY button again or turn the unit off You may print an unlimited number of copies of the report simply by pressing the SUMMARY button again The PD 1400 will interrupt printing a report if the heart rate alarm activates the defibrillator charge button is pressed or the recorder turns on If report printing Is interrupted press the SUMMARY b
57. trode is attached to remove any trapped air This ensures good skin coupling If placing both electrodes on the chest back of patient is not accessible do not allow electrode gel to accumulate on the chest wall This could produce a gel bridge and cause burns or reduce the amount of energy delivered to the heart 22 ELECTRODES OFF MESSAGE Multi Function Electrodes ALARM HEART RATE lf the operator attempts to defibrillate with multi ie function electrodes and the electrodes are not properly connected or applied to the patient an ELECTRODES OFF message will appear on the monitor Check to see that all connections have been correctly made before continuing The PD 1400 will maintain its charge for 60 seconds If the cause of the electrode fault has been fixed within 60 seconds the operator can discharge the defibrillator without recharging it If the charge ready tone stops the operator must recharge the defibrillator IX I A 96 ELECTRODES OFF DEFIB 200J SEL DELIVERED ENERGY JOULES WARNING NOTE Chapter 4 Defibrillation with Paddles Before proceeding CAREFULLY read the following Emergency defibrillation should be attempted by appropriately trained skilled personnel that are familiar with equipment operation Training appropriateness such as ACLS Advanced Cardiac Life Support certification should be the determination of the prescribing physician Do not touch the bed patie
58. tton Observe the DATE message on the lower portion of the screen with the current day flashing DATE XX Use the ALARM SET up A arrow to increase the DELIVERED ENERGY JOULES value and use the down W arrow to decrease the value Observe that holding the A arrow will increment repeatedly while holding the VW arrow will decrement repeatedly The range of acceptable values is 1 through 31 Set the value to the current day Press the ALARM SET button again and observe that the month is now flashing Repeat above steps to set the correct month The range of acceptable values is JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC Press the ALARM SET button again and observe that the current year now flashes Repeat above steps to set the correct year The range of acceptable values is 00 through 99 Press the ALARM SET button again The DATE message is replaced by a TIME message indicating the current hour and minute The displayed hour now flashes Repeat above steps The range of acceptable values is 00 through 23 Set the value to the current hour Press the ALARM SET button again The displayed minute now flashes Repeat above steps The range of acceptable values Is 00 through 59 Press the ALARM SET button again The lower portion of the screen returns to the normal MONITOR display Verify that the time and date are set correctly by generating a strip chart recording Press the RECORDER ON OF
59. turn to alarm monitoring mode RECORDER The Recorder will document the ECG trace with a 6 second delay at all times OPERATION To start the recorder press the RECORDER 1 T A OG ON OFF button beside the monitor The recorder will run continuously until the button is pressed again To stop the recorder press the RECORDER ON OFF button again MONITOR DELIVERED ENERGY JOULES RECORDER CONFIGURATION NOTES Chapter 7 Each time the recorder is started the time date ECG lead size and heart rate are printed on the top part of the paper If the pacer is operating the output current will also be printed Similarly if the defibrillator has been discharged the deliv ered energy will be printed Recording shows annotations during monitoring Ere He IES o T EH j EH BE a e A ce The PD 1400 s recorder is programmed to run automatically for 15 seconds whenever a defibrillator discharge has occurred or a heart rate alarm has been triggered The operator may reconfigure the 1400 not to print during these events by pressing and holding for 4 seconds the RECORDER ON OFF button and simultaneously turning the selector switch from the OFF position to MONITOR ON The 1400 will beep twice to indicate that the configuration is complete To switch back to automatic recorder mode repeat this sequence All event informa tion will be stored by Summary Report regardless of this configuration The paper supply should be checked a
60. up down arrow buttons located on the front panel The selected energy level is displayed digitally as DEFIB XXX J SEL on the monitor y NOTES Chapter 4 APPLY ELECTRODES TO CHEST Remove the electrodes from the storage pouch Remove the protective cover exposing the gel area and adhesive Place the round electrode labelled FRONT directly over the cardiac apex beneath the breast on females See the diagram on the package Place the rectangular electrode labelled BACK on the back between the patient s left scapula and spine at heart level Connect the electrode connector jack to the multi function cable The back electrode may be placed over the patient s right sternal area if it is not possible to access the patient s posterior Effective defibrillation will result but pacing will usually be less effective When placing the electrodes be sure to press firmly on the adhesive area around the electrode periphery Gently press the gel area after attaching the electrodes to the patient to remove any trapped air This ensures good skin coupling If placing both electrodes on the chest back of patient is not accessible do not allow electrode gel to accumulate on the chest wall This could produce a gel bridge and cause burns or reduce the amount of energy delivered to the heart Multi function electrodes may be used for ECG monitoring Use of multi function electrodes for ECG monitoring is for eme
61. using abrasives e g paper towels on the monitor window Do not autoclave the PD 1400 Special care should be taken to clean the defibrillation paddles after each use Build up of gel will interfere with paddle ECG first look and may produce a shock nazard to the operator Keep paddle holding area clean With the selector switch in the OFF position observe the following Turn the selector switch to the MONITOR ON position and observe the following A 4 beep tone indicates the power up sequence ECGSIZE LEAD ALARM HEART RATE 1 X A 96 The word READY will be briefly displayed ELECTRODES followed by MONITOR in the center of the display screen The ECG size should be 1 X PADDLES or ELECTRODES should be MONITOR displayed in the center of the monitor aaa 1 PACER OPERATION DELIVERED ENERGY AND DISCHARGE BUTTONS CHECK WARNING Chapter 8 The message ECG LEAD OFF will be displayed any time leads Il or Ill are selected and no ECG cable is connected or the lead wires are not attached to a patient Turn the selector switch to PACER ON Turn pacer rate control to 150 ppm and press the RECORDER ON OFF button to generate a strip Verify that the pace pulses occur approximately every 10 small divisions 2 large divisions 1 cm Press the 4 1 button and verify that the frequency of pulses decreases 8 large divisions 4 cm per pulse Turn the pacer output control to 0 mA There sh
62. utton again If the recorder is out of paper and the SUMMARY button is pressed a PAPER OUT message appears on the monitor Load paper and press SUMMARY again to print the report To erase all recorded information press and hold for 4 seconds the ALARM SET up arrow button A and SUMMARY button simultaneously An ERASING REPORT message will appear on the monitor Turning the unit off for more than 5 minutes will also erase all reports PACER OUTPUT MA __ PACER RATE ppm BEEPER ALARM RECORDER CONFIGURATION Chapter 2 The PD 1400 s recorder is programmed to run automatically for 15 seconds whenever a defibrillator discharge has occurred or a heart rate alarm has been triggered The operator may reconfigure the 1400 not to print during these events by pressing and holding for 4 seconds the ALARM SET down arrow Y button and simultaneously turning the selector switch from the OFF position to MONITOR ON The 1400 will beep five times 4 beeps for normal start up and 1 beep for recorder configuration to indicate that the configuration is complete To switch back to automatic recorder mode repeat this sequence All event information will be stored by Summary Report regardiess of this configuration INTRODUCTION MULTI FUNCTION ELECTRODES WARNING MULTI FUNCTION CABLE Multi Function Electrodes ZOLL PD 2200 Multi function electrodes allow the operator to hands off defibrillate cardiovert pace and ECG monitor with a
63. y on monitor Message display on monitor Message display on monitor Message display on monitor Paper Speed Delay Annotations Writing Method Print out Modes Control Automatic Function Type Voltage Recharge Time Service Low Battery Indicator Operating Time Charger Chapter 1 RECORDER Standard 40 mm thermal grid width 50 mm paper width 25 mm sec 6 seconds Time date defib energy heart rate pacer output QRS sync marker ECG size lead alarm defib test OK Fall High resolution thermal array print head Manual or automatic user configurable Front panel and paddle 15 second recording initiated by alarm conditions and defibrillator discharge BATTERIES Rechargeable sealed lead acid medical grade 2 5 V cell 5 cells wired in series 2 hours for depleted pack to 90 of battery capacity 16 hours for full recharge Battery pack is easily removed as a unit Message displayed on monitor and 2 beep low battery tone sounds once a minute For 20 seconds before shut off from a low battery the PD 1400 will beep twice every 2 seconds The time from display of the LOW BATTERY message until the instrument shuts down will vary depending on the battery condition For a battery in good condition fully charged prior to initiating battery operation the message display to shut down time will be approximately 40 minutes in monitor mode Defibrillator charge time may be extended when batteri

Zoll 1400 Operators Manual

Contents

Download Pdf Manuals

Related Search

Related Contents