LIFEPAK 15 MONITOR / DEFIBRILLATOR ® OPERATING INSTRUCTIONS
LIFEPAK 15 MONITOR/DEFIBRILLATOR ® OPERATING INSTRUCTIONS
Important Information !USA !USA Rx Only Device Tracking The U.S. Food and Drug Administration requires defibrillator manufacturers and distributors to track the location of their defibrillators. If the device is located somewhere other than the shipping address or the device has been sold, donated, lost, stolen, exported, destroyed, permanently retired from use, or if the device was not obtained directly from Physio-Control, please do one of the following: register the device at http://www.
CONTENTS 1 Preface Introduction ...................................................................................................................1-3 Intended Use..................................................................................................................1-4 Modes of Operation .........................................................................................................1-5 2 Safety Information Terms ...........................................................................
7 Data Management Patient Records and Reports ............................................................................................7-3 Memory Capacity ............................................................................................................7-9 Managing Current Patient Records ..................................................................................7-10 Managing Archived Patient Records ................................................................................
1 PREFACE This chapter provides a brief introduction to the LIFEPAK® 15 monitor/defibrillator and describes the product’s intended use. Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . page 1-3 Intended Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-4 Modes of Operation . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-5 ©2007-2013 Physio-Control, Inc.
PREFACE 1 Introduction The LIFEPAK 15 monitor/defibrillator is a complete acute cardiac care response system designed for basic life support (BLS) and advanced life support (ALS) patient management protocols. These operating instructions include information and procedures related to all features of the LIFEPAK 15 monitor/defibrillator. Your LIFEPAK 15 monitor/defibrillator may not have all of these features.
Intended Use Intended Use The LIFEPAK 15 monitor/defibrillator is intended for use by trained medical personnel in out-ofdoors and indoor emergency care settings within the environmental conditions specified on page A-12. The LIFEPAK 15 monitor/defibrillator is designed to be used during ground transportation except when specified otherwise. Monitoring and therapy functions may only be used on one patient at a time.
PREFACE 1 Modes of Operation The LIFEPAK 15 monitor/defibrillator has the following modes of operation: • AED mode—for automated ECG analysis and a prompted treatment protocol for patients in cardiac arrest. • Manual mode—for performing manual defibrillation, synchronized cardioversion, noninvasive pacing, and ECG and vital sign monitoring. • Archive mode—for accessing stored patient information. • Setup mode—for changing default settings of the operating functions.
2 SAFETY INFORMATION This chapter provides important information to help you operate the LIFEPAK 15 monitor/ defibrillator. Familiarize yourself with all of these terms and warnings. Terms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . page 2-3 General Dangers and Warnings . . . . . . . . . . . . . . . . . . . 2-3 ©2007-2013 Physio-Control, Inc.
SAFETY INFORMATION 2 Terms The following terms are used either in these operating instructions or on the LIFEPAK 15 monitor/ defibrillator: Danger: Immediate hazards that will result in serious personal injury or death. Warning: Hazards or unsafe practices that may result in serious personal injury or death. Caution: Hazards or unsafe practices that may result in minor personal injury, product damage, or property damage.
General Dangers and Warnings WARNINGS (CONTINUED) SHOCK OR FIRE HAZARD Do not immerse any portion of this defibrillator in water or other fluids. Avoid spilling any fluids on defibrillator or accessories. Spilled liquids may cause the defibrillator and accessories to perform inaccurately or fail. Do not clean with ketones or other flammable agents. Do not autoclave or sterilize this defibrillator or accessories unless otherwise specified.
SAFETY INFORMATION 2 WARNINGS (CONTINUED) POSSIBLE IMPROPER DEVICE PERFORMANCE Changing factory default settings will change the behavior of the device. Changes to the default settings must only be made by authorized personnel. POSSIBLE DEVICE SHUTDOWN Always have immediate access to a spare, fully charged, properly maintained battery. Replace the battery when the device displays a low battery warning.
3 BASIC ORIENTATION This chapter provides a basic orientation to the LIFEPAK 15 monitor/defibrillator device and its controls, indicators, and connectors. Front View . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . page 3-3 Back View . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-13 Home Screen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-17 Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-21 Options . . . . . . . . . . . . .
BASIC ORIENTATION 3 Front View Figure 3-1 shows the front of the LIFEPAK 15 monitor/defibrillator. The front of the device is described in the following sections. Recommended Adult VF Dose: 200-300-360J LIFEPAK 15 MONITOR/DEFIBRILLATOR CO2 SpO2 MONITOR/DEFBRILLATOR NIBP ECG Self Test in progress... ©Physio-Control, Inc. 2008 All Rights Reserved 3207410-001 P1 P2 DANGER Explosion hazard. Do not use in the presence of flammable gases. WARNING Hazardous electrical output.
Front View Area 1 Recommended Adult VF Dose: 200-300-360J ON ENERGY SELECT CPR ANALYZE LEAD CHARGE SIZE SYNC Figure 3-2 Area 1 Controls 3-4 LIFEPAK 15 Monitor/Defibrillator Operating Instructions
BASIC ORIENTATION 3 Table 3-1 Area 1 Controls CONTROL DESCRIPTION FOR MORE INFORMATION VF dose label Physio-Control recommended energy dose for adult Ventricular Fibrillation (VF). See Biphasic Clinical Summaries at www.physio-control.com 1 ON Turns device ON or OFF. LED illuminated when ON. Press and hold to turn device off. 2 ENERGY SELECT Increases or decreases energy level in Manual mode. See page 5-22 3 CHARGE Charges the defibrillator in Manual mode. See page 5-22 Shock button.
Front View Area 2 PACER RATE CURRENT PAUSE Figure 3-3 Area 2 Controls Table 3-2 Area 2 Controls 3-6 CONTROL DESCRIPTION FOR MORE INFORMATION PACER Activates pacer function. LED illuminated when function is activated and flashes with each current pulse. See page 5-32 RATE Increases or decreases pacing rate. See page 5-32 CURRENT Increases or decreases pacing current. See page 5-32 PAUSE Temporarily slows pacing rate.
BASIC ORIENTATION 3 Area 3 NIBP ALARMS OPTIONS EVENT HOME SCREEN Speed dial Figure 3-4 Area 3 Controls Table 3-3 Area 3 Controls CONTROL DESCRIPTION FOR MORE INFORMATION NIBP Initiates blood pressure measurement. LED illuminated when BP measurement is being obtained. See page 4-37 ALARMS Activates and silences alarms. LED illuminated when alarms are enabled and flashes when an alarm condition occurs. See page 3-21 OPTIONS Accesses optional functions.
Front View Area 4 12-LEAD TRANSMIT CODE SUMMARY PRINT Figure 3-5 Area 4 Controls Table 3-4 Area 4 Controls 3-8 CONTROL DESCRIPTION FOR MORE INFORMATION 12-LEAD Initiates acquisition of 12-lead ECG. See page 4-15 TRANSMIT Initiates transmission of patient data. See page 8-12 CODE SUMMARY Prints CODE SUMMARY™ critical event record. See page 7-4 PRINT Starts and stops printer.
BASIC ORIENTATION 3 Area 5 CO2 See warnings page 2-4 CO2 SpO2/ SpCO/ SpMet SpO2 NIBP NIBP ECG ECG P1 P2 P1 P2 Printer Speaker Therapy cable receptacle Figure 3-6 Area 5 Connectors, Speaker, and Printer Table 3-5 Area 5 Connectors, Speaker, and Printer LABEL DESCRIPTION FOR MORE INFORMATION ® CO2 FilterLine set port See page 4-45 SpO2/SpCO/SpMet Sensor cable port See page 4-25 NIBP Pneumatic tubing port See page 4-37 ECG Green electrically isolated ECG cable port See page 4-3
Front View Connectors CO2 CONNECTOR CO2 SpO2 SpO2/ SpCO/ SpMet ACTION Connect: Open CO2 port door, insert FilterLine connector, and turn clockwise until connector is firmly seated. Disconnect: Rotate FilterLine connector counterclockwise and pull connector out. Connect: Align cable connector with SpO2 port and push in until connector clicks into place. Disconnect: Press the gray buttons on each side of the cable connector simultaneously and pull connector out.
BASIC ORIENTATION CONNECTOR CO2 CO2 SpO2 SpO2/ SpCO/ SpMet 3 ACTION Connect: Open CO2 port door, insert FilterLine connector, and turn clockwise until connector is firmly seated. Disconnect: Rotate FilterLine connector counterclockwise and pull connector out. Connect: Align cable connector with SpO2 port and push in until connector clicks into place. Disconnect: Press the gray buttons on each side of the cable connector simultaneously and pull connector out.
Front View Connecting and Disconnecting the Therapy Cable WARNING POSSIBLE EQUIPMENT DAMAGE AND INABILITY TO DELIVER THERAPY To help protect the therapy cable connector from damage or contamination, keep therapy cable connected to the defibrillator at all times. Inspect and test the therapy cable daily according to the Operator’s Checklist in the back of this manual. PhysioControl recommends replacement of therapy cables every three years to reduce the possibility of failure during patient use.
BASIC ORIENTATION 3 Back View Paddle retainers Paddle test contacts See warnings page 4-45 Standard paddle wells CO2 exhaust port USB port cover 1 2 See warning page 3-14 See warnings page 10-12 and page 10-13 System connector Auxiliary power connector Battery well 2 Battery contacts Battery well 1 Battery pins See warning page 9-4 and page 10-12 Figure 3-11 Back View ©2007-2013 Physio-Control, Inc.
Back View Table 3-6 Back View LABEL DESCRIPTION FOR MORE INFORMATION Battery wells, pins, and contacts Each well holds one Lithium-ion battery. Two pins in each well transfer the battery power. Battery contacts transfer battery status information. See page 10-12 CO2 exhaust port Connects to a scavenger system when monitoring EtCO2 during use of anesthetics. See page 4-45 Standard paddle wells, retainers, and test contacts Paddle wells stow standard (hard) paddles.
BASIC ORIENTATION 3 Batteries The LIFEPAK 15 monitor/defibrillator operates either on battery power using two Lithium-ion batteries, or with auxiliary power using the AC Power Adapter or DC Power Adapter. Batteries may be charged in the Station or Mobile Li-ion Battery Charger, the REDI-CHARGE™ Battery Charger, or in the monitor/defibrillator if it is connected to auxiliary power.
Batteries To install a battery: 1. Confirm that the battery is fully charged, unless the battery will be charged in the monitor/ defibrillator using the power adapter. 2. Inspect battery pins and contacts in the battery wells for signs of damage. 3. Align battery so battery clip is over the pins in the battery well. 4. Insert the end of the battery that is opposite the battery clip into the battery well. 5. Firmly press the clip end of the battery into the battery well until it clicks into place. 6.
BASIC ORIENTATION 3 Home Screen Time Alarm limits Bluetooth icon Battery indicator Heart symbol Alarm indicator HR 150 50 Heart rate SpO2/SpCO/ SpMet SPO2 J Selected energy ECG Lead/Size % Channel 1 CO2 EtCO2 mmHg RR ART mmHg Channel 2 IP1 CVP mmHg IP2 Channel 3 NIBP mmHg NIBP Message area Figure 3-14 Home Screen The Home Screen is the main screen that displays ECG and other information.
Home Screen Table 3-7 Home Screen AREA DESCRIPTION FOR MORE INFORMATION Alarm limits Limits display along the right side of the parameter. See page 3-21 Heart symbol Flashes with detected QRS signals. Alarm indicator Indicates whether alarms are on or silenced. Absence of indicator means alarms are off. Heart rate Device accurately detects and displays heart rates between 20 and 300 beats per minute (bpm).
BASIC ORIENTATION 3 Table 3-7 Home Screen (Continued) AREA DESCRIPTION FOR MORE INFORMATION Bluetooth icon Indicates Bluetooth capability. The LED is illuminated when a Bluetooth connection is established. Select this icon to access the Bluetooth setup menu. See page 8-3 Battery indicator Indicates presence of battery in battery well 1 and 2, relative level of charge, and battery in use. See page 3-20 Selected energy Selected defibrillation energy. ECG Lead/Size Lead and size for ECG.
Home Screen Battery Status Indicators The Home Screen displays battery indicators that show the following information about the batteries installed in the defibrillator: • Presence or absence of battery in battery well • Battery in use • Battery charge state IMPORTANT! Always check the battery charge level and ensure batteries are adequately charged before use. When two batteries are installed, the defibrillator uses the battery with the lowest level of charge first.
BASIC ORIENTATION 3 Note: Older or heavily used batteries lose charge capacity. If a fully charged battery is installed in the defibrillator and the battery status indicator shows less than four bars, the battery has reduced capacity. If a battery status indicator shows only one or two bars after a fully charged battery is installed, the battery has less than half the normal use time and should be recycled.
Alarms Note: The heart rate display and corresponding heart rate alarm should not be relied upon to provide an indication of ventricular fibrillation. Turn on the VF/VT alarm. Alarms Quick Set Limits Silence VF/VT Alarm Wide 2 Min Off Select VF/VT ALARM to turn on continuous monitoring for ventricular fibrillation and ventricular tachycardia in Manual mode. The VF/VT alarm indicator appears above the primary ECG when the alarm is ON.
BASIC ORIENTATION 3 When alarms are ON, you can silence them preemptively for up to 15 minutes. To silence alarms preemptively: 1. Press ALARMS. 2. Select SILENCE. 3. Select SILENCE duration of 2, 5, 10, or 15 minutes. The message ALARMS SILENCED appears in the message area at the bottom of the Home Screen. Note: When you select SILENCE, the VF/VT alarm is not silenced. Options Press OPTIONS to display the Options menu. Rotate the SPEED DIAL to scroll through the choices.
Options Table 3-9 Options Menu Selections (Continued) SELECTION DESCRIPTION FOR MORE INFORMATION Print Select report, format, mode, and speed for printing a current patient report. See page 7-10 User Test Initiate device self-test. See page 10-5 Entering Patient Data To enter patient data: 1. Press OPTIONS. Options Patient... Pacing... Date/Time... Alarm Volume... 2. Use the SPEED DIAL to select PATIENT. Archives... Print... User Test Options / Patient 3.
BASIC ORIENTATION 3 Events Use the Events menu to annotate patient events. A selected event appears in the Event log of the CODE SUMMARY critical event record. Events can be customized in Setup mode. For more information, see the LIFEPAK 15 Monitor/Defibrillator Setup Options provided with your device. To select an event: 1. Press EVENT to display the Events menu. Events Generic Oxygen IV Access Nitroglycerin Morphine Cancel Last Generic Intubation CPR Epinephrine Atropine Lidocaine More... 12:20:30 2.
4 MONITORING This chapter describes the monitoring features of the LIFEPAK 15 monitor/defibrillator. Monitoring the ECG . . . . . . . . . . . . . . . . . . . . . . . page 4-3 Acquiring a 12-Lead ECG . . . . . . . . . . . . . . . . . . . . . . 4-15 Monitoring SpO2, SpCO, and SpMet . . . . . . . . . . . . . . 4-25 Monitoring Noninvasive Blood Pressure . . . . . . . . . . . . 4-37 Monitoring ETCO2 . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-45 Monitoring Invasive Pressure . . . . . . . . . . . .
MONITORING 4 Monitoring the ECG Intended Use The electrocardiogram (ECG) is a recording of the electrical activity of the heart. ECG monitoring allows for identification and interpretation of cardiac rhythms or dysrhythmias and calculation of heart rate. The ECG is obtained by placing either electrodes or paddles on the patient and allows the heart’s electrical activity to be monitored and recorded. ECG monitoring is a tool to be used in addition to patient assessment.
Monitoring the ECG Selecting ECG Lead The LIFEPAK 15 monitor/defibrillator includes two methods for selecting or changing the ECG lead. To select or change the displayed ECG lead using the LEAD button: : 1. Press LEAD. If any ECG lead currently appears on the Home Screen, the lead changes to PADDLES. If PADDLES lead is currently displayed, the lead changes to Lead II. Lead Paddles I II III AVR AVL AVF II, CO2 I, II, III AVR, AVL, AVF 2.
MONITORING 4 Changing ECG Size The LIFEPAK 15 monitor/defibrillator includes two methods for selecting or changing ECG size. To select or change the displayed ECG size using the SIZE button: 1. Press SIZE. 2. While the SIZE menu is displayed, press SIZE again or rotate the SPEED DIAL to the desired size. Size To select or change the displayed ECG size using the SPEED DIAL: Channel 1 Lead Size II 1.0 1. For the primary ECG, outline and select CHANNEL 1 and then select SIZE. 2.
Monitoring the ECG Adjusting the Systole Volume To adjust the systole beep volume, use the SPEED DIAL to outline and select the HR area on the Home Screen. The following menu appears: 1. Press the SPEED DIAL to select QRS VOLUME. HR 2. Rotate the SPEED DIAL to the desired volume. QRS Volume 3. Press the SPEED DIAL to set the volume. Note: The volume is reset to OFF each time the device is turned off.
MONITORING 4 2. Place the other therapy electrode or STERNUM paddle on the patient’s upper right torso, lateral to the sternum and below the clavicle as shown in Figure 4-1. Special Situations for Electrode or Paddle Placement When placing therapy electrodes or standard paddles, be aware of the special requirements in the following possible situations: Obese Patients or Patients with Large Breasts Apply therapy electrodes or standard paddles to a flat area on the chest, if possible.
Monitoring the ECG Monitoring Using ECG Cable Accessories The following ECG cables, shown in Figure 4-2, are available for ECG monitoring with the LIFEPAK 15 monitor/defibrillator: • 12-lead (either of 2 types) • 3-lead • 4-wire • 5-wire 12-Lead Cable 12-Lead Cable Main cable Limb lead attachment Main cable (4-wire) Precordial lead attachment Precordial lead attachment 3-Lead Cable 5-Wire Cable Figure 4-2 12-Lead, 3-Lead, 4-Wire, and 5-Wire ECG Cables ECG Monitoring Procedure To perform ECG monitori
MONITORING RA/R LA/L RL/N LL/F AHA Labels RA Right Arm LA Left Arm *RL Right Leg LL Left Leg 4 IEC Labels R Right L Left N Negative F Foot *Note: Not used for 3-lead cable. Figure 4-3 Limb Lead Electrode Placement 4. Prepare the patient’s skin for electrode application: • Shave excessive hair at electrode site. • For oily skin, clean skin with alcohol pad. • Gently scrape skin to remove surface layer of dead cells and improve conduction of electrical signals.
Monitoring the ECG Precordial Lead ECG Monitoring The precordial (chest) leads (see Table 4-1, "ECG Leads Color Codes") can be used for monitoring when using the 12-lead cable or 5-wire cable. To perform precordial lead ECG monitoring: 1. Insert the precordial lead attachment into the main cable as shown in Figure 4-2 on page 4-8. 2. Place the precordial lead electrodes on the chest as described in the 12-lead ECG procedure and shown in Figure 4-5 on page 4-16.
MONITORING 4 Monitoring Patients Who Have Internal Pacemakers The LIFEPAK 15 monitor/defibrillator internal pacemaker detection feature can be used to help identify internal pacemaker pulses on the printed ECG. When enabled, this feature uses lead V4 to detect internal pacemaker pulses. If V4 is not available because it is not attached or is too noisy, Lead II or Paddles Lead is used.
Monitoring the ECG Troubleshooting Tips If problems occur while monitoring the ECG, check Table 4-2 for aid in troubleshooting. For basic troubleshooting problems, such as no power, see "General Troubleshooting Tips" on page 10-18. Table 4-2 Troubleshooting Tips for ECG Monitoring OBSERVATION POSSIBLE CAUSE CORRECTIVE ACTION Any of these messages displayed: Therapy electrodes not connected • Connect therapy electrode. One or more ECG electrodes disconnected • Connect ECG electrode.
MONITORING 4 Table 4-2 Troubleshooting Tips for ECG Monitoring (Continued) OBSERVATION POSSIBLE CAUSE CORRECTIVE ACTION Monitor displays dashes (---) instead of heart rate Heart rate is < 20 bpm • Use ECG printout to calculate heart rate. Heart rate is > 300 bpm • Use ECG printout to calculate heart rate. Pacing function is active • No corrective action needed. Poor electrode-skin contact • Reposition cable or lead wires to prevent electrodes from pulling away from patient.
Monitoring the ECG Table 4-2 Troubleshooting Tips for ECG Monitoring (Continued) OBSERVATION POSSIBLE CAUSE CORRECTIVE ACTION ECG amplitude too small Poor electrode-skin contact • Prepare skin and apply new electrodes. ECG lead selected • Increase ECG gain or change ECG lead. Patient condition (for example, significant myocardial muscle loss or tamponade) • Increase ECG gain or change ECG lead.
MONITORING 4 Acquiring a 12-Lead ECG Intended Use The 12-lead ECG offers paramedics and emergency physicians significant advantages over the single lead ECG trace typically available in EMS. The 12-lead ECG not only provides a diagnostic quality ECG for use in the detection of ST elevation myocardial infarction (STEMI), but also allows the knowledgeable paramedic to determine the area of myocardial injury, anticipate associated potential complications, and implement treatment strategies accordingly.
Acquiring a 12-Lead ECG Limb Lead Electrode Sites When acquiring a 12-lead ECG, limb lead electrodes are typically placed on the wrists and ankles as shown in Figure 4-4. The limb lead electrodes can be placed anywhere along the limbs. Do not place the limb lead electrodes on the torso when acquiring a 12-lead ECG.
MONITORING 4 To locate the V1/C1 position: 1. Place your finger at the notch in the top of the sternum. 2. Move your finger slowly downward about 3.8 centimeters (1.5 inches) until you feel a slight horizontal ridge or elevation. This is the Angle of Louis where the manubrium joins the body 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.
Acquiring a 12-Lead ECG 6. Encourage the patient to remain as still as possible. WARNING POSSIBLE INACCURATE DIAGNOSIS If age and sex are not entered when a 12-lead ECG is obtained, the interpretive statements are based on a default of a 50-year-old male and may provide incorrect analysis for that patient. 7. Press 12-LEAD. The 12-LEAD / AGE menu appears, prompting you to enter the patient’s age. Use the SPEED DIAL to select the age.
4 MONITORING general, it is best to wait at least 30 seconds after applying the last electrode before pressing the 12-LEAD button, to allow for electrode/skin stabilization. Also, good skin preparation shortens the stabilization time. Computerized ECG Analysis Computerized ECG analysis statements are automatically printed on 12-lead ECG reports. Printing of the interpretive statements is a setup option and may be turned off in Setup mode.
Acquiring a 12-Lead ECG 12-lead ECG reports, see the LIFEPAK 15 Monitor/Defibrillator Setup Options provided with your device. Alternatively, press OPTIONS, select PRINT, select REPORT: 12-LEAD, and then select FORMAT. 1 mV reference ECG size Patient ID Report type and number Name: Lee, William 12-Lead 1 Record ID: Patient ID: Incident: Age: 50 041495091422 528760224 BF382 Sex: M 24 Apr 08 PR 0.170s QT/QTc P-QRS-T Axes aVR Standard measurement HR 78 bpm QRS 0.
MONITORING 4 Note: The fiducial marks displayed in the 4-channel format identify the measurement intervals used for the interpretive statements of the analysis program. These marks are part of the analysis program and cannot be turned off. aVR V4 V1 Lee, William 12-Lead 1 Name: V2 aVL aVF V5 V3 STJ Level 0.00 mm I 0.00 mm II III -1.10 mm aVR 0.00 mm aVL 0.00 mm aVF 0.00 mm V6 HR 78 bpm 24 Apr 08 PR .
Acquiring a 12-Lead ECG Note: The LIFEPAK 15 monitor/defibrillator acquires ECG data and performs the interpretive analysis based on the full frequency of 0.05–150 Hz. The 0.05–40 Hz bandwidth affects only the printed appearance of the ECG data. The 12-lead ECG printed in the 0.05–40 Hz setting can be used to diagnose acute myocardial ischemia and ST-segment elevation myocardial infarction (STEMI). This is because the low frequency limit of 0.05 Hz is not changed from the standard diagnostic setting of 0.
MONITORING 4 Troubleshooting Tips Table 4-3 Troubleshooting Tips for the 12-Lead ECG OBSERVATION POSSIBLE CAUSE CORRECTIVE ACTION Any of these messages displayed: One or more ECG electrodes disconnected • Confirm ECG electrode connections. CONNECT ECG LEADS ECG LEADS OFF XX LEADS OFF ECG cable is not connected to monitor • Confirm ECG cable connections. Poor electrode-skin contact • Reposition cable and/or lead wires to prevent electrodes from pulling away from patient.
Acquiring a 12-Lead ECG Table 4-3 Troubleshooting Tips for the 12-Lead ECG (Continued) OBSERVATION POSSIBLE CAUSE CORRECTIVE ACTION Monitor does not complete 12-lead ECG operation sequence Operator pressed another function button (such as PRINT) before 12-lead ECG sequence completed • Press 12-LEAD to acquire another 12-lead ECG. Allow enough time for sequence to complete. Noisy signal and message displayed: Signal noise for more than 30 seconds • Press 12-LEAD to acquire another 12-lead ECG.
MONITORING 4 Monitoring SpO2, SpCO, and SpMet SpO2, SpCO™, and SpMet™ are optional features for the LIFEPAK 15 monitor/defibrillator. When all three options (SpO2, SpCO, and SpMet) are installed, the pulse oximeter measures functional oxygen saturation (SpO2), carboxyhemoglobin concentration (SpCO), and methemoglobin concentration (SpMet) in the blood. IMPORTANT! SpO2-only sensors and combination SpO2, SpCO, and SpMet sensors are available for use.
Monitoring SpO2, SpCO, and SpMet Indications Pulse oximetry is indicated for use in any patient who is at risk of developing hypoxemia, carboxyhemoglobinemia, or methemoglobinemia. SpO2 monitoring may be used during no motion and motion conditions, and in patients who are well or poorly perfused. SpCO and SpMet accuracies have not been validated under motion or low perfusion conditions. Contraindications None known.
MONITORING 4 WARNINGS (CONTINUED) INACCURATE PULSE OXIMETER READINGS The pulsations from intra-aortic balloon support can be additive to the pulse rate on the oximeter pulse rate display. Verify patient’s pulse rate against the ECG heart rate. POSSIBLE SKIN INJURY Prolonged, continuous use of a sensor may cause irritation, blistering, or pressure necrosis of the skin. Check the sensor site regularly based on patient condition and type of sensor. Change the sensor site if skin changes occur.
Monitoring SpO2, SpCO, and SpMet How a Pulse Oximeter Works A pulse oximeter sensor directs light through a patient’s fleshy body site (usually a finger or toe). The sensor sends wavelengths of light from the emitter to the receiving detector as shown in Figure 4-11.
MONITORING 4 To help ensure optimal performance: • Use a dry and appropriately sized sensor. • Choose a site that is well perfused. The ring finger is preferred. • Choose a site that least restricts patient movement, such as finger of the non-dominant hand. • Be sure the fleshy part of the digit completely covers the detector. • Keep the sensor site at the same level as the patient’s heart. • Apply the sensor according to the Directions for Use provided with the sensor.
Monitoring SpO2, SpCO, and SpMet Oximeter Monitoring Procedure Power to the pulse oximeter is controlled by the LIFEPAK 15 monitor/defibrillator. When the defibrillator is turned on, the oximeter turns on and performs a calibration and self-test that requires approximately 20 seconds. During the calibration and self-test, the screen does not display SpO2, SpCO, or SpMet information. To conserve battery power, the pulse oximeter goes into “sleep mode” when not in use.
MONITORING 4 SpCO/SpMet Advisory If the SpCO or SpMet reading is above normal limits, indicating a dangerous amount of carboxyhemoglobin or methemoglobin, an Advisory occurs. During an Advisory: • The elevated SpCO or SpMet value is displayed instead of SpO2. • The elevated value flashes and the alarm tone sounds. • One of the following Advisory messages appears in the message area: Advisory: SpCO > 10% Advisory: SpMet > 3% To cancel the Advisory, press ALARMS. The SpO2 area reverts to the SpO2 reading.
Monitoring SpO2, SpCO, and SpMet Volume To adjust the pulse tone volume: SpO2_SpCo_SpMet Parameter SpO2 Volume Sensitivity Averaging Time SpO2 1. Rotate the SPEED DIAL to outline the SpO2 area on the Home Screen. 2. Press the SPEED DIAL. 3. Highlight and select SPO2 VOLUME. Normal 8 Seconds 4. Rotate the SPEED DIAL to the desired volume. 5. Press the SPEED DIAL to set the volume.
4 MONITORING Pulse Rate Monitoring If ECG monitoring is not active, the SpO2 sensor can be used to monitor the patient’s pulse rate. The pulse rate value is indicated by PR (SPO2). Pulse rate monitoring is a tool to be used in addition to patient assessment. Care should be taken to assess the patient at all times. Check pulse manually if patient shows signs of abnormal pulse rate. Cleaning Pulse oximetry sensors may be adhesive (single-patient use) or reusable.
Monitoring SpO2, SpCO, and SpMet Table 4-4 Troubleshooting Tips for SpO2, SpCO, and SpMet (Continued) OBSERVATION POSSIBLE CAUSE CORRECTIVE ACTION SPO2: NO SENSOR DETECTED Sensor not connected to patient or cable disconnected from monitor/defibrillator • Check that sensor and cable are connected properly. • Check that appropriate sensor is in use. Damaged cable or sensor • Replace damaged cable or sensor. Sensor may be too tight • Reposition sensor. • Relocate sensor.
MONITORING 4 Table 4-4 Troubleshooting Tips for SpO2, SpCO, and SpMet (Continued) OBSERVATION POSSIBLE CAUSE CORRECTIVE ACTION SPO2: CHECK SENSOR message Sensor is disconnected from patient or cable • Attach the sensor. • Check that sensor is secure. Excessive ambient light • Remove or block light source, if possible. • Cover sensor with opaque material, if necessary. Faulty or defective sensor • Replace sensor.
Monitoring SpO2, SpCO, and SpMet Table 4-4 Troubleshooting Tips for SpO2, SpCO, and SpMet (Continued) OBSERVATION POSSIBLE CAUSE CORRECTIVE ACTION SPCO/SPMET: POOR QUALITY SIGNAL message appears When the signal quality is low, the accuracy of the measurement may be compromised • Check that sensor and cable are connected properly. • Move sensor to a better perfused site.
MONITORING 4 Monitoring Noninvasive Blood Pressure Intended Use The LIFEPAK 15 noninvasive blood pressure (NIBP) monitor measures blood pressure (BP) using the oscillometric measurement technique to determine systolic, diastolic, and mean arterial pressures, and pulse rate. The measurement can be initiated manually or set to recur automatically at predetermined intervals.
Monitoring Noninvasive Blood Pressure NIBP Monitoring Warnings and Caution WARNINGS POSSIBLE LOSS OF INTRAVENOUS ACCESS AND INACCURATE INFUSION RATE Do not apply the blood pressure cuff on an extremity that is used for an intravenous infusion. Patency of the intravenous infusion may be affected by blood pressure measurement due to the occlusion of blood flow. POSSIBLE CIRCULATION IMPAIRMENT Prolonged, continuous use of a blood pressure cuff may impair blood flow to the extremity.
MONITORING 4 reach a peak amplitude and then start to decrease. The rising and falling amplitude values form a curve that is analyzed to yield systolic pressure, diastolic pressure, and mean arterial pressure (MAP). The NIBP monitor measures the pulse rate by tracking the number of pulses over time. The NIBP monitor uses artifact rejection techniques to provide accurate results under most operating conditions.
Monitoring Noninvasive Blood Pressure Cuff Selection The use of properly designed and sized cuffs is essential for the accurate measurement of blood pressure. The cuff must fit snugly around the extremity to occlude the artery. For a list of BP cuffs that are intended for use with the LIFEPAK 15 monitor/defibrillator, see the LIFEPAK 15 Monitor/ Defibrillator Accessories Catalog at store.physio-control.com.
MONITORING 4 Note: Measurement data is recorded in the LIFEPAK 15 monitor/defibrillator Vital Sign Log. For more information about the Vital Sign Log and its use, see Chapter 7, "Data Management." Manual Single-Measurement Procedure The NIBP measurement typically takes 40 seconds to complete. If the measurement is not completed within 120 seconds, the cuff automatically deflates. To obtain a manual single measurement: 1. Press ON. 2. Select the appropriately-sized cuff. 3.
Monitoring Noninvasive Blood Pressure To set timer-controlled measurements: 1. Press ON. 2. Select the appropriately-sized cuff. 3. Properly align the cuff artery markings, if present, and apply snugly to the extremity. 4. Connect the tubing to the cuff and to the NIBP port on the monitor. 5. Rotate the SPEED DIAL to outline the NIBP area. 6. Press the SPEED DIAL. The NIBP menu appears. 7. Select INTERVAL and then select the desired time interval. 8.
MONITORING 4 Troubleshooting Tips Table 4-5 Troubleshooting Tips for NIBP Monitoring OBSERVATION POSSIBLE CAUSE CORRECTIVE ACTION NIBP AIR LEAK message appears Cuff applied too loosely • Check cuff for snug fit on patient. • Check that the cuff/monitor connection is secure. • Check cuff for leaks. Do not use a cuff that exhibits a leak. Leak in cuff/monitor pneumatic system NIBP FLOW ERROR message The pneumatic system is not maintaining stable cuff pressure • Deflate or remove cuff.
Monitoring Noninvasive Blood Pressure Table 4-5 Troubleshooting Tips for NIBP Monitoring (Continued) OBSERVATION POSSIBLE CAUSE CORRECTIVE ACTION NIBP TIME OUT message appears The monitor did not complete a measurement in 120 seconds • Check cuff for snug fit on patient. • Check that cuff artery markings are aligned with the artery. • Repeat measurement. • Try a higher initial pressure. • If this message persists, use another method to measure the patient’s blood pressure.
MONITORING 4 Monitoring ETCO2 Intended Use The end-tidal CO2 (EtCO2) monitor is a capnometric device that uses non-dispersive infrared spectroscopy to continuously measure the amount of CO2 during each breath and report the amount present at the end of exhalation (EtCO2). The sample is obtained by the side stream method and can be used with intubated or nonintubated patients. Respiration rate is also measured and displayed in breaths per minute.
Monitoring ETCO2 WARNINGS (CONTINUED) INACCURATE READINGS HAZARDS POSSIBLE INACCURATE PATIENT ASSESSMENT The EtCO2 monitor is intended only as an adjunct in patient assessment and is not to be used as a diagnostic apnea monitor. An apnea message appears if a valid breath has not been detected for 30 seconds and indicates the time elapsed since the last valid breath. It must be used in conjunction with clinical signs and symptoms.
MONITORING 4 You can set up the LIFEPAK 15 monitor/defibrillator to use the capnography Body Temperature Pressure Saturated (BTPS) conversion method. This option corrects for the difference in temperature and moisture between the sampling site and alveoli. The correction formula is 0.97 × the measured EtCO2 value. See the LIFEPAK 15 Monitor/Defibrillator Setup Options provided with your device.
Monitoring ETCO2 Similar to the diminished slope of the Expiratory Upstroke, this pattern can occur in asthma, chronic obstructive pulmonary disease (COPD), partial upper-airway obstruction, or partial mechanical obstruction such as a partially kinked ETT. Inspiratory Downstroke The fall to baseline (IV-V segment) is a nearly vertical drop. This slope can be prolonged and can blend with the expiratory plateau in cases of leakage in the exhale portion of the breathing circuit.
MONITORING 4 Note: The capnography module performs self-maintenance within the first hour of monitoring and once an hour during continuous monitoring. The self-maintenance includes “auto-zeroing.” Selfmaintenance is also initiated when the surrounding temperature changes 8°C (14.4°F) or more, or the surrounding pressure changes greater than 20 mmHg. The CO2 module detects this change and attempts to purge the tubing.
Monitoring ETCO2 CO2 Detection A CO2 waveform appears when any CO2 is detected, but CO2 must be greater than 3.5 mmHg for a numerical value to be displayed. However, the CO2 module will not recognize a breath until the CO2 is at least 8 mmHg (1.0% or kPa). Valid breaths must be detected in order for the apnea alarm to function and to count the respiratory rate (RR). The RR represents an average over the last eight breaths.
MONITORING 4 Troubleshooting Tips Table 4-6 Troubleshooting Tips for EtCO2 Monitoring OBSERVATION POSSIBLE CAUSE CORRECTIVE ACTION ALARM APNEA message appears and waveform is solid line at or near zero No breath has been detected for 30 seconds since last valid breath • Check the patient. FilterLine connection to device is loose • Twist FilterLine connector clockwise until tight and firmly seated.
Monitoring ETCO2 Table 4-6 Troubleshooting Tips for EtCO2 Monitoring (Continued) OBSERVATION POSSIBLE CAUSE CORRECTIVE ACTION EtCO2 values are erratic FilterLine connection to device is loose • Twist FilterLine connector clockwise until tight and firmly seated. A leak in the FilterLine set • Check for connection leaks and line leaks to patient, and correct, if necessary. A mechanically ventilated patient breathes spontaneously or patient is talking • No action required.
MONITORING 4 Note: To decrease the likelihood of the FilterLine connection coming loose during use, handstraighten the tubing after removal from the package before connecting to patient or device. For general troubleshooting tips, see Table 10-2 on page 10-18. ©2007-2013 Physio-Control, Inc.
Monitoring Invasive Pressure Monitoring Invasive Pressure Intended Use The LIFEPAK 15 invasive pressure (IP) monitor is intended for measuring arterial, venous, intracranial, and other physiological pressures using an invasive catheter system with a compatible transducer. The IP monitor is a tool to be used in addition to patient assessment. Care should be taken to assess the patient at all times; do not rely solely on the IP monitor.
MONITORING 4 WARNINGS (CONTINUED) HEALTH HAZARDS POSSIBLE LETHAL ARRHYTHMIA Ventricular fibrillation may be induced if the isoelectric barrier of the transducer is disrupted. The isoelectric barrier within the transducer may be disrupted if the transducer body is damaged. Do not use a transducer that is visibly damaged or leaking fluid. INCREASED INTRACRANIAL PRESSURE Do not use a continuous flush device with transducers used for intracranial monitoring.
Monitoring Invasive Pressure How IP Monitoring Works IP monitoring involves the conversion of fluid pressure into an electrical signal. The conversion is accomplished with a pressure transducer. The transducer is connected to a patient’s indwelling pressure catheter using a special assembly of tubing, stopcocks, adapters, flush valves, and fluids, commonly known as a flush system. The transducer translates the pressure wave into an electrical signal.
MONITORING 4 6. Open the transducer’s stopcock to air to zero the transducer and remove stopcock cap. Select the P1 area. Select ZERO from the menu. The message P1 ZEROED appears when zeroing is complete and the pressure values are displayed as zeros. 7. Close the stopcock to air. The patient’s pressure waveform should be displayed. A scale is automatically selected to display the pressure. Confirm that pressure amplitude correlates with the digital readout.
Monitoring Invasive Pressure Cleaning IP transducers are disposable and are intended for single-patient use. Do not clean and reuse transducers. Dispose of the contaminated waste according to local protocols. IP cables are reusable and may be cleaned. To clean the reusable IP cable: 1. Disconnect the cable from the monitor. 2. Use a clean, soft cloth dampened with a germicidal solution to wipe clean. 3. Allow to dry before reconnecting the cable to the monitor.
MONITORING 4 Table 4-8 Troubleshooting Tips for IP Monitoring (Continued) OBSERVATION POSSIBLE CAUSE CORRECTIVE ACTION No waveform. No pressure reading. Transducer closed to patient • Check patient. Check stopcock positions and monitor setup. Defibrillator shock just delivered • None. Transducer level higher than the heart • Reposition transducer to correct height. Loose connection • Tighten all connections.
Monitoring Invasive Pressure Table 4-8 Troubleshooting Tips for IP Monitoring (Continued) OBSERVATION POSSIBLE CAUSE CORRECTIVE ACTION Catheter whip (fling) artifact Pulmonary Artery Excessive catheter movement. Motion of the catheter tip within the vessel accelerates fluid movement in the catheter, causing artifact to be superimposed on the pressure wave, increasing readings by 10–20 mmHg. • Change catheter tip position.
MONITORING 4 Monitoring Continuous Temperature Intended Use The LIFEPAK 15 temperature monitor is intended for continuous monitoring of body temperature. Indications Temperature monitoring is indicated for use in patients who require continuous monitoring of body temperature. Contraindications None known.
Monitoring Continuous Temperature How Temperature Monitoring Works The temperature probe contains a thermistor which converts temperature to electrical resistance. The LIFEPAK 15 monitor/defibrillator measures the resistance and converts it into degrees Celsius or Fahrenheit. The probe accuracy is ±0.1°C. Note: Celsius or Fahrenheit reporting may be selected in Setup mode. For more information, see the LIFEPAK 15 Monitor/Defibrillator Setup Options provided with your device.
4 MONITORING – Skin (Note: Measurement Specialties skin temperature probe 4499HD is approved for use with the LIFEPAK 15 monitor/defibrillator. Do not use Measurement Specialties part number 4499.) For a list of the accessories that are intended for use with the LIFEPAK 15 monitor/defibrillator, contact your Physio-Control representative or see the LIFEPAK 15 Monitor/Defibrillator Accessory Catalog at www.physio-control.com.
Monitoring Continuous Temperature Cleaning and Disposal Temperature probes are disposable and intended for single-patient use. Do not clean and reuse temperature probes. Dispose of the contaminated waste according to local protocols. Temperature adapter cables are reusable and may be cleaned. To clean the reusable temperature cable: 1. Disconnect the cable from the monitor. 2. Use a clean, soft cloth dampened with a germicidal solution to wipe clean.
MONITORING 4 Table 4-11 Troubleshooting Tips for Temperature Monitoring (Continued) OBSERVATION POSSIBLE CAUSE CORRECTIVE ACTION Temperature area of home screen is blank Initial temperature not automatically displayed until device detects temperature between 24.8° and 45.2°C (76.6° and 113.4°F) • Allow up to 3 minutes for probe to equilibrate. • Check that probe is positioned properly. Temperature probe not detected by device • Check connections between probe, adapter cable, and device.
Vital Sign and ST Segment Trends Vital Sign and ST Segment Trends Intended Use The trends feature of the LIFEPAK 15 monitor/defibrillator provides the ability to graphically display and document the patient’s vital signs (VS) and ST segment measurements for up to eight hours. VS trending is intended for use with any patient who requires continuous monitoring of vital signs over an extended period of time to identify changes in patient condition and to document patient response to therapy.
MONITORING 4 How VS Trends Work Each active vital sign can be displayed graphically for time ranges of 30 minutes, and 1, 2, 4, and 8 hours. The vital signs are HR, SpO2, SpCO, SpMet, CO2, Temp, and RR; and systolic, diastolic, and mean pressures. Data is sampled every 30 seconds. If valid data is not available, a blank space is substituted on the graph. NIBP values are plotted only when an NIBP measurement is obtained. VS measurements are not averaged or filtered.
Vital Sign and ST Segment Trends How ST Trends Work ST measurements can be displayed graphically for time ranges of 30 minutes, and 1, 2, 4, and 8 hours. ST trending is initiated by obtaining the patient’s first 12-lead ECG. The ST J-point (STJ) is the part of the ST segment that is measured (see Figure 4-17). The STJ measurement is plotted on the ST trend graph (see Figure 4-18).
MONITORING 4 Increase and then decrease in STJ Lead Current STJ Change in STJ Figure 4-18 ST Trend Graph This ST trend graph depicts the changes in STJ from a patient’s first 12-lead ECG over 10 minutes of monitoring time. The patient’s initial ECG showed no ST elevation in any lead. Then the patient developed 3 mm elevation in Lead II. This change in ST elevation is represented by the vertical bars and lasted approximately 5 minutes. (Each vertical bar represents a 30-second interval).
Vital Sign and ST Segment Trends Displaying and Printing Trend Graphs The trend graph for any active vital sign or ST measurement can be displayed in Channel 2 or 3. The example in Figure 4-18 shows the trend graph in Channel 3. Only two trend graphs can be displayed at a time, but the device collects trend data on all active vital sign values. To display trend graphs: 1. Rotate the SPEED DIAL to outline Channel 2 or 3, and then press the SPEED DIAL to select the channel. The Channel menu appears. 2.
5 THERAPY This chapter describes patient therapy. General Therapy Warnings and Cautions . . . . . . . . . page 5-3 Therapy Electrode and Standard Paddle Placement . . . . . 5-4 Automated External Defibrillation (AED) . . . . . . . . . . . . . 5-7 Manual Defibrillation . . . . . . . . . . . . . . . . . . . . . . . . . 5-22 Synchronized Cardioversion Procedure . . . . . . . . . . . . . 5-27 Noninvasive Pacing . . . . . . . . . . . . . . . . . . . . . . . . . .
THERAPY 5 General Therapy Warnings and Cautions WARNINGS SHOCK HAZARDS SHOCK HAZARD The defibrillator delivers up to 360 joules of electrical energy. When discharging the defibrillator, do not touch the paddle electrode surfaces or disposable therapy electrodes. SHOCK HAZARD If a person is touching the patient, bed, or any conductive material in contact with the patient during defibrillation, the delivered energy may be partially discharged through that person.
Therapy Electrode and Standard Paddle Placement WARNINGS (CONTINUED) POSSIBLE SKIN BURNS Electrodes and cables that are not specified for use with the LIFEPAK 15 defibrillator may malfunction and cause skin burns. Use only the electrodes and cables that are specified for use with the LIFEPAK 15 defibrillator.
THERAPY 5 • Briskly wipe the skin dry with a towel or gauze. This mildly abrades the skin and removes oils, dirt, and other debris for better electrode adhesion to the skin. • Do not use alcohol, tincture of benzoin, or antiperspirant to prep the skin. Anterior-Lateral Placement Anterior-lateral placement is used for ECG monitoring, defibrillation, synchronized cardioversion, and noninvasive pacing. To perform anterior-lateral placement: 1.
Therapy Electrode and Standard Paddle Placement Anterior Posterior QUIK-COMBO Therapy Electrodes Figure 5-2 Anterior-Posterior Placement Special Situations for Electrode or Paddle Placement When placing therapy electrodes or standard paddles, be aware of the special requirements in the following possible situations.
THERAPY 5 Automated External Defibrillation (AED) Intended Use When used in AED mode, the LIFEPAK 15 monitor/defibrillator is a semiautomatic defibrillator that provides a prompted treatment protocol and ECG analysis using a patented Shock Advisory System™ (SAS). This software algorithm analyzes the patient’s electrocardiographic (ECG) rhythm and indicates whether or not a shockable rhythm is detected. AED mode requires operator interaction in order to defibrillate the patient.
Automated External Defibrillation (AED) AED Warnings WARNINGS MISINTERPRETATION OF DATA HAZARDS POSSIBLE MISINTERPRETATION OF DATA Do not analyze in a moving vehicle. Motion artifact may affect the ECG signal resulting in an inappropriate SHOCK or NO SHOCK ADVISED message. Motion detection may delay analysis. Stop vehicle and stand clear of patient during analysis.
5 THERAPY AED Procedure The following descriptions of AED prompts (voice and text) are based on the factory default settings for AED mode. The settings are consistent with the 2005 American Heart Association (AHA) and European Resuscitation Council (ERC) guidelines. Changing the setup options may result in different AED behavior. The CPR metronome automatically sounds during CPR times and can only be silenced and unsilenced. To perform automated external defibrillation: 1.
Automated External Defibrillation (AED) 6. Press ANALYZE to initiate the analysis. Stop CPR. WARNING POSSIBLE MISINTERPRETATION OF DATA Do not move the AED during analysis. Moving the AED during analysis may affect the ECG signal resulting in an inappropriate SHOCK or NO SHOCK ADVISED decision. Do not touch the patient or the AED during analysis. The ANALYZING NOW—STAND CLEAR prompts occur.
5 THERAPY AED Mode 200J available Push SHOCK button! When charging is complete, the available energy is displayed. The STAND CLEAR, PUSH SHOCK BUTTON! ( ) message occurs, followed by a “Shock ready” tone. Clear everyone away from touching the patient, bed, or any equipment that is connected to the patient. To cancel, push Speed Dial AED Mode Press (shock) to deliver energy to the patient.
Automated External Defibrillation (AED) When the CPR countdown time ends, the PUSH ANALYZE prompts occur. These prompts repeat every 20 seconds until you press ANALYZE. AED Mode Push ANALYZE No Shock Advised The following prompts occur if no shock is advised: AED Mode If the AED detects a nonshockable rhythm, the NO SHOCK ADVISED prompts occur. The defibrillator does not charge, and no shock can be delivered.
THERAPY 5 Subsequent analysis for SHOCK ADVISED and NO SHOCK ADVISED sequences are the same as described above. The energy level for Shock 2, 3, and greater depends on the ENERGY PROTOCOL setup and the analysis decision. When a NO SHOCK ADVISED decision follows a shock, the energy level does not increase for the next shock. When a SHOCK ADVISED decision follows a shock, the energy level increases for the next shock.
Automated External Defibrillation (AED) Shock Counter The shock counter (x) indicates how many shocks have been delivered to the patient. The shock counter resets to zero whenever the defibrillator is turned off for longer than 30 seconds. AED Mode CPR Time and Metronome During use, CPR time shown on the countdown timer will vary slightly due to the metronome. When the CPR metronome is active during use, CPR times are adjusted to end CPR compression “tocks” on a compression cycle.
THERAPY 5 Select YES to enter Manual mode. Manual Mode Enter Manual Mode? Yes No Push Speed Dial to confirm • AED/Passcode—A passcode screen appears: Manual Mode Rotate and press the SPEED DIAL to enter the passcode. Enter Manual Mode passcode The code changes to dots to protect the passcode, and the defibrillator enters Manual mode. You have three opportunities to enter the correct password. After an incorrect attempt, the message INCORRECT--TRY AGAIN appears.
Automated External Defibrillation (AED) The START CPR prompts occur. AED Mode Start CPR 1:46 After 3 seconds, a countdown timer appears and the IF YOU WITNESSED THE ARREST, PUSH ANALYZE prompts occur. These prompts provide an opportunity to end the initial CPR early and proceed directly to analysis. AED Mode Start CPR 1:46 Note: The decision to end CPR early is based on your protocol and if you witnessed the arrest.
THERAPY 5 When initial CPR time ends, the NO SHOCK ADVISED prompts occur, followed by PUSH ANALYZE. Shock Advised If the AED detects a shockable rhythm, the START CPR prompts occur, followed by IF YOU WITNESSED THE ARREST, PUSH ANALYZE. AED Mode These prompts provide an opportunity to end the initial CPR early and proceed directly to delivering a shock. Start CPR Note: The decision to end CPR early is based on your protocol and if you witnessed the arrest.
Automated External Defibrillation (AED) Advisory Monitoring Advisory Monitoring is a special way to set up AED mode that allows the use of all the monitoring functions without initiating the AED prompted protocol when the device is turned on. When needed, the AED mode prompted protocol can be initiated by pressing ANALYZE. In addition, access to Manual mode therapies—that is, manual defibrillation, synchronized cardioversion, or pacing—by unauthorized users can be restricted, if necessary.
THERAPY 5 Troubleshooting Tips Table 5-1 Troubleshooting Tips for AED Mode OBSERVATION POSSIBLE CAUSE CORRECTIVE ACTION CONNECT ELECTRODES message Therapy electrodes are not connected to the therapy cable • Check for electrode connection. Electrodes do not adhere properly to the patient • Press electrodes firmly on patient’s skin. • Clean, shave, and dry the patient’s skin as recommended. • Replace the electrodes. Electrodes are dry, damaged, or out of date • Apply new electrodes.
Automated External Defibrillation (AED) Table 5-1 Troubleshooting Tips for AED Mode (Continued) OBSERVATION POSSIBLE CAUSE CORRECTIVE ACTION DISARMING message appears (shock) button not pressed within 60 seconds after charge complete • Recharge the defibrillator, if desired. SPEED DIAL pressed • Recharge the defibrillator. Therapy electrodes or cable disconnected • Reconnect electrode or cable. Energy did not escalate After a shock, the next analysis was NO SHOCK ADVISED • No action needed.
THERAPY 5 Table 5-1 Troubleshooting Tips for AED Mode (Continued) OBSERVATION POSSIBLE CAUSE CORRECTIVE ACTION Home Screen is blank but ON LED is illuminated Screen not functioning properly • Press ANALYZE and follow voice prompts to treat patient. Analysis result is NO SHOCK ADVISED and ECG shows a perfectly flat, isoelectric line. The Test Load is connected to therapy cable • Remove the Test Load and connect therapy electrodes to the cable.
Manual Defibrillation Manual Defibrillation The LIFEPAK 15 monitor/defibrillator provides manual defibrillation using adult and pediatric QUIK-COMBO pacing/defibrillation/ECG electrodes, adult standard paddles, or pediatric paddles. For more information, see "Paddle Accessory Options" on page 6-1. The LIFEPAK 15 monitor/defibrillator is capable of providing intra-operative direct defibrillation and synchronized cardioversion with the internal paddles accessory designed for the LIFEPAK 15 defibrillator.
THERAPY 5 Manual Defibrillation Warnings WARNINGS SHOCK HAZARD Conductive gel (wet or dry) on the paddle handles can allow the electrical energy to discharge through the operator during defibrillation. Completely clean the paddle electrode surfaces, handles, and storage area after defibrillation.
Manual Defibrillation Manual Defibrillation Procedure To perform manual defibrillation: 1. Verify that the patient is in cardiopulmonary arrest (unconscious, pulseless, not breathing normally). 2. Press ON. 3. Identify the electrode or paddle sites on the patient and prepare the patient’s skin. (See "Patient Skin Preparation" on page 5-4.) Use either the anterior-lateral or anterior-posterior position. 4. Connect the therapy electrodes to the therapy cable and confirm cable connection to the defibrillator.
THERAPY 5 performance. Patients often exhibit a muscular response (such as jumping or twitching) during an energy transfer. The absence of such a response is not a reliable indicator of actual energy delivery or device performance. Using the CPR Metronome When CPR is required during cardiac arrest, the CPR metronome provides audible prompts that guide the user to deliver CPR with proper timing in accordance with the 2005 American Heart Association and European Resuscitation Council CPR guidelines.
Manual Defibrillation Table 5-2 Default Age-Airway C:V Ratios in Manual Mode AGE-AIRWAY C:V RATIO Adult - No Airway* 30:2 Adult - Airway** 10:1 Youth - No Airway*** 15:2 Youth - Airway 10:1 * No Airway = No artificial airway in place ** Airway = Advanced artificial airway in place *** Youth = Pre-pubescent child Note: The compression-to-ventilation ratio selections can be set up according to local medical protocols.
THERAPY 5 always provides “tocks” and ventilation prompts at the set ratio for both AED mode and Manual mode. In this situation, the CPR Metronome menu does not appear when CPR is pressed during use—pressing the CPR button only activates and deactivates the metronome at the fixed C:V ratio. Synchronized Cardioversion Procedure The LIFEPAK 15 monitor/defibrillator can be set up to remain in Sync mode or to return to Asynchronous mode after a shock is delivered.
Synchronized Cardioversion Procedure 7. Prepare the patient’s skin and apply therapy electrodes to the patient in the anterior-lateral position. (See "Therapy Electrode and Standard Paddle Placement" on page 5-4.) If using standard paddles, apply conductive gel to the paddles and place paddles on the patient’s chest. 8. Press ENERGY SELECT or rotate the SPEED DIAL to select the desired energy. On the standard (hard) paddles, rotate the ENERGY SELECT dial. 9. Press CHARGE.
THERAPY 5 Troubleshooting Tips Table 5-3 Troubleshooting Tips for Defibrillation and Synchronized Cardioversion OBSERVATION POSSIBLE CAUSE CORRECTIVE ACTION Charge time to 360 joules exceeds 10 seconds Battery low • Replace battery with fully charged battery. Operating temperature is too low • Move patient and device to warmer environment, if necessary. Device is in Sync mode and QRS complexes are not detected • Adjust ECG size for optimum sensing QRS or deactivate SYNC if rhythm VF/VT.
Synchronized Cardioversion Procedure Table 5-3 Troubleshooting Tips for Defibrillation and Synchronized Cardioversion (Continued) OBSERVATION POSSIBLE CAUSE CORRECTIVE ACTION DISARMING message appears (shock) button not pressed within 60 seconds after charge complete • Recharge the defibrillator, if desired. Energy selected after charge complete • Recharge the defibrillator. SPEED DIAL pressed • Recharge the defibrillator. PACER pressed • Recharge, if necessary, or no action, if pacing desired.
THERAPY 5 Table 5-3 Troubleshooting Tips for Defibrillation and Synchronized Cardioversion (Continued) OBSERVATION POSSIBLE CAUSE CORRECTIVE ACTION ABNORMAL ENERGY DELIVERY Open air discharge with standard paddles • Press paddles firmly on patient’s chest when discharging. Standard paddles placed face(shock) button to-face when pressed • Perform test discharges per Operator’s Checklist. • See "Manual Defibrillation Warnings" on page 5-23.
Noninvasive Pacing Table 5-3 Troubleshooting Tips for Defibrillation and Synchronized Cardioversion (Continued) OBSERVATION POSSIBLE CAUSE CORRECTIVE ACTION Home Screen is blank but ON LED is illuminated Screen not functioning properly • Print ECG strip to assess rhythm and other active vital signs. • Press ANALYZE and use AED mode, if necessary. For general troubleshooting tips, see Table 10-2 on page 10-18.
THERAPY 5 Noninvasive Pacing Warnings WARNING POSSIBLE INABILITY TO PACE Using other manufacturers’ combination therapy electrodes with this device could cause a decrease in pacing efficacy or the inability to pace because of unacceptably high impedance levels and invalidate the safety agency certifications. Use only the therapy electrodes that are specified in these operating instructions.
Noninvasive Pacing To perform noninvasive pacing: 1. Press ON. 2. Connect the patient ECG cable, apply ECG electrodes to the ECG cable and patient, and select Lead I, II, or III. To receive the best monitoring signal, make sure there is adequate space between the ECG electrodes and the therapy electrodes. 3. Identify the QUIK-COMBO therapy electrode sites on the patient. Use either the anterior-lateral or anterior-posterior position and prepare the patient’s skin.
THERAPY 5 11.To stop pacing, reduce current to zero or press PACER. Note: To defibrillate and stop noninvasive pacing, press CHARGE. Pacing automatically stops. Proceed with defibrillation. The physiologic state of the patient may affect the likelihood of successful pacing or of skeletal muscle activity. The failure to successfully pace a patient is not a reliable indicator of pacemaker performance. Similarly, the patient’s muscular response to pacing is not a reliable indicator of current delivered.
Noninvasive Pacing Troubleshooting Tips Table 5-4 Troubleshooting Tips for Noninvasive Pacing OBSERVATION POSSIBLE CAUSE CORRECTIVE ACTION Device does not function when PACER is pressed Power off • Check if power is ON. Low battery • Replace battery with fully charged battery. Therapy electrodes off • Check for message displayed. • Inspect therapy cable and electrode connections. Pacing rate set below patient's intrinsic rate • Increase PPM.
THERAPY 5 Table 5-4 Troubleshooting Tips for Noninvasive Pacing (Continued) OBSERVATION POSSIBLE CAUSE CORRECTIVE ACTION No muscle response to pacing Patient’s heart rate may be greater than noninvasive pacer ppm • No action needed. The Test Load is connected to therapy cable • Remove the Test Load and connect therapy electrodes to cable. Patient muscle response is variable and depends on patient condition. Muscular response to pacing is not a reliable indicator of current delivered.
Noninvasive Pacing Table 5-4 Troubleshooting Tips for Noninvasive Pacing (Continued) OBSERVATION POSSIBLE CAUSE CORRECTIVE ACTION Pacing starts spontaneously Patient’s heart rate falls below set pacing rate • Appropriate pacemaker function; assess patient. During standby pacing, ECG lead disconnects and pacing begins asynchronously • Reconnect ECG lead. Set pacing rate (ppm) and ECG paced rate do not appear to match Internal error detected • Print ECG and calculate the pace rate.
THERAPY 5 Pediatric ECG Monitoring and Manual Mode Therapy Procedures WARNINGS BURN HAZARDS POSSIBLE PATIENT SKIN BURNS Do not use pediatric QUIK-COMBO electrodes on adults or larger children. Delivery of defibrillation energies equal to or greater than 100 joules (typically used on adults) through these smaller electrodes increases the possibility of skin burns.
6 PADDLE ACCESSORY OPTIONS This chapter provides information about the paddle accessory options that may be used with the LIFEPAK 15 monitor/defibrillator. QUIK-COMBO Therapy Electrodes . . . . . . . . . . . . . page 6-3 Standard Paddles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-6 Sterilizable Internal Defibrillation Paddles . . . . . . . . . . 6-10 ©2007-2013 Physio-Control, Inc.
PADDLE ACCESSORY OPTIONS 6 QUIK-COMBO Therapy Electrodes Physio-Control QUIK-COMBO therapy electrodes are pre-gelled, self-adhesive therapy electrodes used for defibrillation, synchronized cardioversion, ECG monitoring, and pacing (see Figure 6-1). Figure 6-1 QUIK-COMBO Therapy Electrodes A QUIK-COMBO therapy electrode set: • Is a substitute for standard paddles. • Provides Lead II monitoring signal when placed in the anterior-lateral position.
QUIK-COMBO Therapy Electrodes Table 6-1 QUIK-COMBO Electrodes TYPE DESCRIPTION QUIK-COMBO Electrodes, with 61 cm (2 ft) of lead wire, designed for patients weighing 15 kg (33 lb) or more QUIK-COMBO RTS Electrodes, providing a radio-transparent electrode and lead wire set, designed for patients weighing 15 kg (33 lb) or more QUIK-COMBO with REDI-PAK™ preconnect system Electrodes designed for patients weighing 15 kg (33 lb) or more and that allow preconnection of the electrode set to the device while
PADDLE ACCESSORY OPTIONS 6 To remove QUIK-COMBO therapy electrodes from the patient: 1. Slowly peel back the therapy electrode from the edge, supporting the skin as shown in Figure 6-3. Figure 6-3 Removing Therapy Electrodes from Skin 2. Clean and dry the patient’s skin. 3. When applying new electrodes, adjust the positions slightly to help prevent skin burns. 4. Close the protective cover on the therapy cable connector when the cable is not in use.
Standard Paddles Standard Paddles Adult Standard Paddles Standard paddles are hard, hand-held paddles that are applied to the patient’s chest to briefly monitor the ECG or to deliver defibrillation shocks. Figure 6-4 describes the features of the standard paddles. (SHOCK) BUTTONS Discharge the defibrillator. Both buttons must be pressed simultaneously to deliver energy. ENERGY SELECT PRINT CHARGE PRINT BUTTON Activates printer. Function is identical to PRINT button on front panel.
PADDLE ACCESSORY OPTIONS 6 3. Examine paddle surfaces, handles, cables, and connectors for damage or signs of wear. • Cables that show signs of wear such as loose cable connections, exposed wires, or cable connector corrosion must be removed from use immediately. • Paddles that have rough or pitted electrodes should be removed from use immediately. Note: Standard paddles are not sterile or sterilizable. Do not autoclave, gas sterilize, immerse in fluids, or clean with alcohol or solvents.
Standard Paddles Note: Do not use conductive gel between adult and pediatric paddles. Pediatric paddle Adult paddle Figure 6-6 Attaching a Pediatric Paddle Removing Pediatric Paddles To remove pediatric paddles: 1. Press down on the rear tab. 2. Slide the pediatric paddle off (see Figure 6-7). 1 2 Figure 6-7 Removing a Pediatric Paddle Placing Pediatric Paddles Adult paddles are recommended if the paddles fit completely on the child’s chest. Allow at least 2.5 cm (1 in.) of space between the paddles.
PADDLE ACCESSORY OPTIONS 6 Sternum Apex Figure 6-8 Anterior-Lateral Paddle Position Anterior-Posterior Placement Place the STERNUM paddle anteriorly over the left precordium and the APEX paddle posteriorly behind the heart in the infrascapular area (see Figure 6-9). Apex Sternum Figure 6-9 Anterior-Posterior Paddle Position Cleaning Pediatric Paddles Individually protect paddles before and after cleaning to prevent damage to paddle surfaces. After each use: 1.
Sterilizable Internal Defibrillation Paddles Sterilizable Internal Defibrillation Paddles Physio-Control internal paddles are specifically designed for open chest cardiac defibrillation. Figure 6-10 Sterilizable Internal Defibrillation Paddles Internal paddles are available in several sizes. To order internal paddles, contact your Physio-Control representative or order online at store.physio-control.com (U.S. only).
7 DATA MANAGEMENT This chapter describes how to manage current and archived Patient Records when using the LIFEPAK 15 monitor/defibrillator. Patient Records and Reports . . . . . . . . . . . . . . . . . page 7-3 Memory Capacity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-9 Managing Current Patient Records . . . . . . . . . . . . . . . . 7-10 Managing Archived Patient Records . . . . . . . . . . . . . . . 7-11 ©2007-2013 Physio-Control, Inc.
DATA MANAGEMENT 7 Patient Records and Reports When you turn on the LIFEPAK 15 monitor/defibrillator, a new Patient Record is created and stamped with the current date and time. All events and associated waveforms are digitally stored in the Patient Record as reports, which you can print, transmit, or download to the LIFENET® System, or to post-event review products such as CODE-STAT™ or DT EXPRESS™ software. For information on how to print a report, see "How to Print a Current Report" on page 7-10.
Patient Records and Reports Table 7-1 Report Types (Continued) 1 2 PRINT FROM MONITOR REPORT TYPE DESCRIPTION Continuous Report2 Provides real-time waveform data, acquired when the device is powered on and electrodes are connected or other waveform data is displayed in channels 2 or 3. Only for post-event review with CODE-STAT or DT EXPRESS software. TRANSMIT X Transmission of a 12-lead ECG report automatically includes transmission of the Vital Signs Summary.
DATA MANAGEMENT 7 Note: When CODE SUMMARY reports are transmitted, they are always sent in the long format. Transmitted CODE SUMMARY reports do not include the Trend Summary. The CODE SUMMARY report always contains the Preamble and the Event/Vital Sign Log. See Figure 7-1 for an example.
Patient Records and Reports Figure 7-2 Possible Event Log Entries Monitoring Operator Initiated • • • • • • • • • • • • • • • • • Check patient Initial rhythm Replace battery 12-lead NIBP Alarm events IP label change Vital signs 5-wire on/off SpCO/SpMet Advisory AED • • • • • • Connect electrodes Motion Analysis Analysis stopped Shock advised No shock advised CPR Metronome • On/Off • Age-Airway changed Defibrillation • • • • Event Alarms on/off Print VF/VT alarm on/off Sync on/off Snapshot Interna
DATA MANAGEMENT 7 Table 7-3 Waveform Events (Continued) EVENT NAME WAVEFORM DATA (WHEN CAPTURED) SHOCK X 3 seconds prior to shock and 5 seconds after shock PACING X STARTED 8 seconds prior to increase of current from 0 PACING X SET 8 seconds after ppm and mA are stable for 10 seconds PACING X CHANGED 8 seconds after pacing rate, current, or mode is changed PACING X STOPPED 3 seconds prior to pacing current is zero and 5 seconds after PACING X PAUSED Initial 8 seconds while PAUSE is pressed
Patient Records and Reports Analysis Event Name: Segment 1 Lee, William Record ID: Patient ID: Incident: Age: 50 Shockable Segment 2 Nonshockable Segment 3 Shockable Sex: M 24 Apr 2007 Analysis 1 Shock Advised HR Shock Event Name: Record ID: Patient ID: Incident: Age: 50 Lee, William Preshock Shock Postshock Combo Pads Sync On Sex: M 24 Apr 2007 Shock 1 200J Impedance HR SpO2•PR SpCO SpMet EtCO2 (mmHg)•RR IP1 IP2 Check Patient Event Name: Record ID: Patient ID: Incident: Age: 50 Check P
DATA MANAGEMENT 7 Pacing Event Name: Record ID: Patient ID: Incident: Age: 50 Lee, William Pacing 6 Stopped Sex: M 24 Apr 2007 Pacing 6 Stopped PR SpO2•PR SpCO SpMet EtCO2(mmHg)•RR IP1 IP2 Figure 7-3 Waveform Event Printout Examples Memory Capacity The LIFEPAK 15 monitor/defibrillator retains data for two or more patients when you switch power off or remove the batteries.
Managing Current Patient Records Managing Current Patient Records You can add specific patient information to a current Patient Record. For more information, see "Entering Patient Data" on page 3-24. How to Print a Current Report To print a current report: Options Patient... Pacing... Date / Time... Alarm Volume... Archives... Print... User Test... Options / Print Print Report Format Mode Speed Code Summary 3-Channel Monitor 25mm/sec 1. Press OPTIONS. The Options menu appears. 2. Select PRINT.
DATA MANAGEMENT 7 Managing Archived Patient Records When you turn off the LIFEPAK 15 monitor/defibrillator, the current Patient Record is saved in the archives. You can print, edit, delete, or download archived records. For information about downloading to CODE-STAT software, see Chapter 8, "Data Transmission." You can also transmit individual reports from an archived Patient Record. For information about transmitting an archived report, see Chapter 8, "Data Transmission.
Managing Archived Patient Records Options / Archives Send Data... Edit... Print... Delete... You can send, print, edit, or delete an archived record. For information about sending an archived record, see Chapter 8, "Data Transmission." Turn power off to exit Archives Mode Printing Archived Patient Reports To print archived patient reports: Options / Archives Send Data... Edit... Print... Delete... 1. In Archive mode, select PRINT.
DATA MANAGEMENT Options / Archives / Print Print Patient LEE, WILLIAM Report Code Summary Format 3-Channel Cancel 7 2. If the PATIENT, REPORT, and FORMAT settings are correct, go to Step 6. 3. To select a different patient, select PATIENT and then select the desired patient from the list. 4. To select a different report, select REPORT and then select one of the following: • • • • CODE SUMMARY TREND SUMMARY VITAL SIGNS 12-LEAD 5.
Managing Archived Patient Records Options / Archives / Edit Patient 031006122424 Last Name LEE First Name WILLIAM Patient ID 528760004 Incident BF412 Age 56 Sex Male 2. Select PATIENT. 3. Add the necessary patient information. Only blank fields may be edited. 4. Press HOME SCREEN and then turn off the device. Deleting Archived Patient Records To delete archived patient records: Options / Archives Send Data... Edit... Print... Delete... 1. In Archive mode, select DELETE.
8 DATA TRANSMISSION This chapter describes how to transmit Patient Records and reports from the LIFEPAK 15 monitor/ defibrillator. About Transmitting Patient Records and Reports. . . page 8-3 Preparing the Monitor for Transmission . . . . . . . . . . . . . 8-4 Using Bluetooth Wireless Communication. . . . . . . . . . . . 8-5 Using a Direct Connection. . . . . . . . . . . . . . . . . . . . . . 8-10 Transmitting Reports . . . . . . . . . . . . . . . . . . . . . . . . .
DATA TRANSMISSION 8 About Transmitting Patient Records and Reports You can transmit current and archived data from the LIFEPAK 15 monitor/defibrillator to the LIFENET® System or to post-event review products such as CODE-STAT™ or DT EXPRESS™ software. The LIFEPAK 15 monitor can transmit patient reports using the following methods: • Bluetooth® wireless connection—If your LIFEPAK 15 monitor has the Bluetooth feature installed and enabled, you can transmit data using a wireless connection.
Preparing the Monitor for Transmission Preparing the Monitor for Transmission Before you can transmit using a wireless or direct connection, you must define transmission sites and output ports in the LIFEPAK 15 monitor Setup mode. For each transmission site, select an output port: • For wireless transmission, set OUTPUT PORT to BLUETOOTH WIRELESS. • For a direct connection, set OUTPUT PORT to DIRECT CONNECT.
DATA TRANSMISSION 8 Using Bluetooth Wireless Communication Bluetooth technology is a short-range wireless communication technology that is available as an option on the LIFEPAK 15 monitor/defibrillator. When Bluetooth technology is installed, the Bluetooth icon appears on the Home Screen. See Figure 8-2. For more information about supported Bluetooth technologies, see www.physio-control.com.
Using Bluetooth Wireless Communication Preparing for a Wireless Transmission Before you can send wireless transmissions from the LIFEPAK 15 monitor, you must prepare the monitor and target devices for communication. The target device must: • Be Bluetooth-enabled, turned on, and discoverable. • Have the LIFENET PC Gateway application or the patient care reporting software CODE-STAT or DT EXPRESS installed and running. • Have a Bluetooth COM port configured for incoming data.
DATA TRANSMISSION 8 The various PSC prefixes correspond to LIFEPAK 15 monitor modes of operation. Table 8-2 lists the LIFEPAK 15 monitor modes and the service class and friendly name prefix that is discoverable in each mode. For example, when the LIFEPAK 15 monitor is in Archive mode and the filter is on, it can discover devices whose friendly names begin with A_ or B_.
Using Bluetooth Wireless Communication Establishing a Bluetooth Connection You must know the friendly name of the target device that you want to connect to. To establish a Bluetooth connection: Bluetooth Setup Connect Search Filter Passcode... Wireless Disconnect (Not Connected) Find Devices... 0000 On LIFEPAK 15 Device ID: LP151234 When device appears, select Stop C_EMS123 C_EMS345 B_HOSPITAL1 B_HOSPITAL2 C_EMS456 C_EMS789 C_HOSPITAL3 Stop Bluetooth Setup Connect Search Filter Passcode...
DATA TRANSMISSION 8 Re-establishing a Bluetooth Connection The LIFEPAK 15 monitor retains in its memory two last-connected devices, limited to one in each mode—one for cardiac care (AED or Manual mode) and one for Archive mode. When the LIFEPAK 15 monitor is powered on and the wireless feature is set to WIRELESS ON, the monitor automatically searches for the last connected device. If the last connected device in that mode is turned on and within range, a connection is established automatically.
Using a Direct Connection Using a Direct Connection A special cable can be used to create a direct connection between the LIFEPAK 15 monitor and a gateway or PC. Figure 8-3 shows the equipment connections to send reports directly to a computer using a direct cable connection.
DATA TRANSMISSION 8 To establish a direct connection: 1. Position the PC or LIFENET Gateway within reach of the LIFEPAK 15 monitor. Note: If you are storing a LIFENET Gateway (modem) in the carrying case, only store the modem in the side pouch. Do not store LIFENET Gateways in the back pouch. 2. Configure a COM port on the PC for incoming data. 3. Connect the cable to the system connector on the monitor and to the PC. 4.
Transmitting Reports Transmitting Reports After you have established a wireless or direct connection, you can transmit Patient Records and reports. All patient reports can be transmitted real time during patient monitoring (Manual or AED mode), or reports can be transmitted post event (Archive mode). How to Transmit a Current Patient Report To transmit a current patient report: 1. Press TRANSMIT. The Transmit menu appears. Transmit Send Report Site Cancel... 2.
DATA TRANSMISSION 8 2. If the PATIENT, REPORT, and SITE are correct, proceed to Step 7. Options / Archives / Send Data Send Patient All Patients Report All Site None Connection... (Not Connected) Cancel... 3. To transmit records for a particular patient, select PATIENT. A list of patients appears.
Considerations When Transmitting Data Transmission Status Report Whenever you attempt to transmit a record, a transmission report is automatically printed at the completion of the transmission attempt. The transmission report indicates the date and time of the transmission attempt and the final status of the transmission. Cancelling a Transmission You can cancel a transmission that is in process.
DATA TRANSMISSION 8 Troubleshooting Tips Table 8-3 Troubleshooting Tips for Data Transmission OBSERVATION POSSIBLE CAUSE CORRECTIVE ACTION Bluetooth icon on LIFEPAK 15 monitor has red X across it WIRELESS is set to OFF in the • Set WIRELESS to ON. • If red X remains, Bluetooth module in LIFEPAK 15 monitor may be faulty. Contact qualified service representative.
Troubleshooting Tips Table 8-3 Troubleshooting Tips for Data Transmission (Continued) OBSERVATION POSSIBLE CAUSE CORRECTIVE ACTION Unable to find a particular Bluetooth device, or BLUETOOTH Search filter may be on and target device does not have a PSC prefix • Confirm that target device is on and discoverable. • Confirm friendly name of target device. • Set SEARCH FILTER to OFF and then select FIND DEVICES again. Target device is not functioning • Confirm that target device is on and discoverable.
DATA TRANSMISSION 8 Table 8-3 Troubleshooting Tips for Data Transmission (Continued) OBSERVATION POSSIBLE CAUSE CORRECTIVE ACTION Unable to transmit using a gateway device that has a functioning direct connection or Bluetooth connection Transmission sites are not set up in LIFEPAK 15 monitor • Define transmission sites. Each site name must exactly match the name of the target device. See LIFEPAK 15 Monitor/Defibrillator Setup Options provided with your device.
Troubleshooting Tips Table 8-3 Troubleshooting Tips for Data Transmission (Continued) OBSERVATION POSSIBLE CAUSE CORRECTIVE ACTION LOST DIRECT CONNECTION Direct connection was interrupted • Verify cable connections between LIFEPAK 15 monitor and gateway or PC. • Attempt to retransmit. Connection with Bluetooth target device was interrupted • Verify target device is ready to receive transmissions. • Attempt to retransmit.
9 POWER ADAPTER This section describes the AC Power Adapter and the DC Power Adapter. Basic Orientation . . . . . . . . . . . . . . . . . . . . . . . . . page 9-3 Using the Power Adapter. . . . . . . . . . . . . . . . . . . . . . . . 9-5 General Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . 9-8 ©2007-2013 Physio-Control, Inc.
POWER ADAPTER 9 Basic Orientation The AC Power Adapter and DC Power Adapter are optional accessories for use only with the LIFEPAK 15 monitor/defibrillator. These power adapters: • Provide operating power to the monitor/defibrillator with or without batteries installed. • Provide power to charge batteries installed in the monitor/defibrillator. The AC Power Adapter operates with either 120 or 240 Vac line power. The DC Power Adapter operates with 12 Vdc power.
Basic Orientation WARNINGS LOSS OF POWER HAZARDS POSSIBLE LOSS OF POWER DURING PATIENT CARE Physio-Control has no information regarding the performance or effectiveness of its LIFEPAK monitor/defibrillators if other manufacturers’ power adapters are used. Using other manufacturers’ power adapters may cause the device to perform improperly and invalidate the safety agency certifications. Use only power adapters that are labeled with the LIFEPAK 15 device symbol shown here.
POWER ADAPTER 9 Using the Power Adapter This section provides information about operating the AC and DC power adapters that can be used with the LIFEPAK 15 monitor/defibrillator. AC Power Adapter Operation To use the AC Power Adapter: 1. Connect the AC power cord to the power adapter and a grounded AC outlet. 2. Verify that the green LED strip illuminates. 3. Connect the power adapter output cable to the power adapter. 4.
Using the Power Adapter DC Power Adapter Operation To use the DC Power Adapter: 1. Connect the DC power cable to the power adapter and a 12 Vdc power source. 2. Verify that the green LED strip illuminates. 3. Connect the power adapter output cable to the power adapter. 4. Connect the green end of the power adapter output cable to the auxiliary power connector on the back of the monitor/defibrillator. 5. Verify that the AUXILIARY POWER LED on the defibrillator is illuminated. 6.
POWER ADAPTER 9 Output Extension Cable with Breakaway Connector One optional output extension cable may be connected between the power adapter and the power adapter output cable, if desired. The output extension cable is equipped with a breakaway connector that can be pulled apart without manually rotating the lock ring. With the breakaway connector, you can quickly separate the monitor/defibrillator from the power adapter without damaging the cables or connectors.
General Maintenance General Maintenance Maintenance and Service The power adapter contains no serviceable parts. If the power adapter does not function correctly, contact your local Physio-Control representative for assistance. Cleaning WARNING POSSIBLE ELECTRICAL SHOCK Unplug the power adapter from the power source before cleaning. CAUTION POSSIBLE EQUIPMENT DAMAGE Do not clean any part of the power adapter or its accessories with phenolic compounds. Do not use abrasive or flammable cleaning agents.
9 POWER ADAPTER Troubleshooting Tips Table 9-3 Troubleshooting Tips for Power Adapter OBSERVATION POSSIBLE CAUSE CORRECTIVE ACTION POWER LED on power adapter does not light Power cord not plugged into power adapter or power source • Connect power cord. Defective power adapter or power cord • Replace with working power adapter and power cord. Blown fuse or tripped circuit breaker in building • Contact qualified service personnel.
Warranty Warranty Refer to the warranty statement shipped with the power adapter. For duplicate copies, contact your local Physio-Control representative.
10 MAINTAINING THE EQUIPMENT This chapter describes how to perform operator-level maintenance, testing, and troubleshooting for the LIFEPAK 15 monitor/defibrillator and selected accessories. For additional information about accessories, refer to specific accessory operating instructions. General Maintenance and Testing . . . . . . . . . . . . page 10-3 Battery Maintenance . . . . . . . . . . . . . . . . . . . . . . . . 10-12 Cleaning the Device . . . . . . . . . . . . . . . . . . . . . . . . .
MAINTAINING THE EQUIPMENT 10 General Maintenance and Testing Periodic maintenance and testing of the LIFEPAK 15 monitor/defibrillator and accessories are important to help prevent and detect possible electrical and mechanical discrepancies. If testing reveals a possible discrepancy with the defibrillator or accessories, see "General Troubleshooting Tips" on page 10-18.
General Maintenance and Testing Table 10-1 Recommended Maintenance Schedule for Clinical Personnel OPERATION DAILY AFTER USE Complete Operator’s Checklist. Includes QUIK-COMBO therapy cable check and Standard Paddles Monitoring and User Test X Inspect defibrillator X X Check that all necessary supplies and accessories are present (for example, fully charged batteries, gel, electrodes, ECG paper, etc.
MAINTAINING THE EQUIPMENT 10 • Transmits the self-test results if the TRANSMIT RESULTS option is enabled. (Transmission may take up to 4 minutes.) • Turns itself off If the defibrillator detects a problem during an auto test, it annotates the fault condition on the printed test report. For more information about enabling the TRANSMIT RESULTS option, see the LIFEPAK 15 Monitor/ Defibrillator Setup Options guide provided with your device.
General Maintenance and Testing Note: It is important to understand defibrillator operation. For suggested procedures to help keep personnel acquainted with normal defibrillator operation, see the function checks that are provided in this chapter. The function checks used may vary according to your local protocols. To test the defibrillator by performing the function checks, you need a simulator. To troubleshoot device performance, see Table 10-2 on page 10-18.
MAINTAINING THE EQUIPMENT 10 Standard Paddles Synchronized Cardioversion Check WARNING SHOCK HAZARD The defibrillator delivers up to 360 joules of electrical energy. Unless discharged properly as described in this test, this electrical energy may cause serious personal injury or death. Do not attempt to perform this test unless you are qualified by training and experience and are thoroughly familiar with these operating instructions.
General Maintenance and Testing 11.Press PRINT. WARNING POSSIBLE PADDLE DAMAGE AND PATIENT BURNS Press paddles firmly onto the defibrillator checker plates when discharging to prevent arcing and formation of pits on paddle surfaces. Pitted or damaged paddles may cause patient skin burns during defibrillation. 12.Apply firm pressure with both paddles on the defibrillator checker paddle plates, and simultaneously press and hold both (shock) buttons while observing the screen. 13.
MAINTAINING THE EQUIPMENT 10 Therapy Cable Monitoring and Synchronized Cardioversion Check CAUTION POSSIBLE SIMULATOR DAMAGE Do not discharge more than 30 shocks within an hour, or 10 shocks within a fiveminute period, or pace continually into Physio-Control patient simulators. Simulators may overheat.
General Maintenance and Testing 11.Press PRINT. WARNING SHOCK HAZARD During defibrillation checks, the discharged energy passes through the cable connectors. Securely attach cable connectors to the simulator. 12.After the tone sounds indicating full charge, press and hold Home Screen. (shock) while observing the 13.Confirm that the defibrillator discharges on the next sensed QRS complex. 14.Press PRINT again to stop the printer. 15.
MAINTAINING THE EQUIPMENT 10 7. Confirm that sense markers appear on each QRS complex. If sense markers do not appear, or appear elsewhere on the ECG, press the SELECTOR on waveform Channel 1 and adjust ECG size from the menu. 8. Confirm that the RATE menu appears. 9. Press CURRENT and increase the current to 80 mA. 10.Observe the screen for captured complexes. Confirm the PACER LED flashes with each delivered pacing pulse. 11.Disconnect the QUIK-COMBO therapy cable from the simulator.
Battery Maintenance Battery Maintenance This section provides information about the Physio-Control Lithium-ion batteries that are specifically designed for use in the LIFEPAK 15 monitor/defibrillator. Lithium-ion batteries are low maintenance and require no scheduled cycling to prolong battery life.
MAINTAINING THE EQUIPMENT 10 CAUTION POSSIBLE EQUIPMENT DAMAGE When storing the LIFEPAK 15 monitor/defibrillator for an extended period of time, the battery should be removed from the device. Receiving New Batteries New batteries do not arrive fully charged. Charge each new battery before use.
Battery Maintenance • Inspect batteries for damage or leakage. If battery is damaged or leaking, recycle the battery and obtain a new battery. • Remove the Charge Before Use label from new batteries before placing batteries in the charger or in the LIFEPAK 15 monitor/defibrillator. • The battery fuel gauge does not function until the battery is charged. For more information about the fuel gauge, see "Batteries" on page 3-15.
MAINTAINING THE EQUIPMENT 10 Cleaning the Device CAUTION POSSIBLE EQUIPMENT DAMAGE Do not clean any part of this device or its accessories with bleach, bleach dilution, or phenolic compounds. Do not use abrasive or flammable cleaning agents. Do not attempt to sterilize this device or any accessories unless otherwise specified in accessory operating instructions. Clean the LIFEPAK 15 monitor/defibrillator, therapy and ECG cables, and batteries with a damp sponge or cloth.
Storing the Device Storing the Device To take the LIFEPAK 15 monitor/defibrillator out of service and store it for an extended period of time, follow these guidelines: • Remove the batteries. • Store the defibrillator and batteries at room temperature. For more information about storage and operating specifications, see the Environmental section in Table A-1.
MAINTAINING THE EQUIPMENT 10 Loading Paper Check the amount of paper in the printer as part of the daily check according to the Operator’s Checklist provided in the back of this manual. CAUTION POSSIBLE PRINTER MALFUNCTION Using other manufacturers’ printer paper may cause the printer to function improperly or damage the print head. Use only Physio-Control printer paper. The printer is equipped with an out-of-paper sensor to protect the printer printhead.
General Troubleshooting Tips General Troubleshooting Tips If a problem is detected with the LIFEPAK 15 monitor/defibrillator during operation or testing, refer to the troubleshooting tips in Table 10-2. If the problem cannot be corrected, remove the LIFEPAK 15 monitor/defibrillator from active use and contact a qualified service technician for service and repair.
MAINTAINING THE EQUIPMENT 10 Table 10-2 General Troubleshooting Tips (Continued) OBSERVATION POSSIBLE CAUSE CORRECTIVE ACTION AUXILIARY POWER LED not Power adapter not properly connected to auxiliary power source • Check that power adapter is properly connected to auxiliary power. Power adapter not properly connected to monitor/ defibrillator • Check that power adapter is properly connected to monitor/defibrillator.
General Troubleshooting Tips Table 10-2 General Troubleshooting Tips (Continued) OBSERVATION POSSIBLE CAUSE CORRECTIVE ACTION Fuel gauge on battery does not illuminate Extremely depleted battery • Charge battery in Station-Mobile or REDI-CHARGE battery charger. Faulty battery • Replace battery. High power draw • Press ON immediately to turn device back on. Low battery power • Replace battery immediately. • Press ON to turn device back on.
MAINTAINING THE EQUIPMENT 10 Table 10-2 General Troubleshooting Tips (Continued) OBSERVATION POSSIBLE CAUSE CORRECTIVE ACTION CHECK PRINTER message Printer paper jams, slips, or misfeeds • Reinstall paper. • If problem persists, contact qualified service technician. Printer is out of paper • Add new paper. Device self-test circuitry detects service condition • Continue to use defibrillator or pacemaker, if needed. • Turn device off and then on again. Note that this creates a new “patient.
Service and Repair Service and Repair WARNINGS SHOCK HAZARD Do not disassemble the defibrillator. It contains no operator serviceable components and dangerous high voltages may be present. Contact a qualified service technician for repair. INEFFECTIVE ENERGY DELIVERY HAZARD Service mode is for authorized personnel only. Improper use of Service mode may inappropriately alter the device’s configuration and may change energy output levels.
MAINTAINING THE EQUIPMENT 10 Product Recycling Information Recycle the device at the end of its useful life. Recycling Assistance The device should be recycled according to national and local regulations. Contact your local Physio-Control representative for assistance. Preparation The device should be clean and contaminant-free prior to being recycled. Recycling of Disposable Electrodes After using disposable electrodes, follow your local clinical procedures for recycling.
Accessories Accessories Table 10-3 lists accessories that are available for the LIFEPAK 15 monitor/defibrillator. To order, contact your Physio-Control representative or order online at store.physio-control.com. Note: The LIFEPAK 15 monitor/defibrillator and its accessories that are intended for direct or casual contact with the patient are latex-free.
MAINTAINING THE EQUIPMENT 10 Table 10-3 Accessories for the LIFEPAK 15 Monitor/Defibrillator (Continued) CATEGORY SpO2 – Nellcor RELATED ACCESSORY Masimo Red™ MNC patient cable (for use with Nellcor sensors) Disposable Nellcor D-20, D-25, I-20, and N-25 sensors Disposable Oximax™ Max-A, Max-I, Max-N, Max-P, and Max-R sensors Reusable Oximax DS-100A sensor SpCO and SpMet Rainbow patient extension cables Rainbow reusable sensors Rainbow disposable sensors Rainbow light shields NIBP NIBP blood pressure
A APPENDIX A SPECIFICATIONS AND PERFORMANCE CHARACTERISTICS This appendix contains the specifications and performance characteristics for the LIFEPAK 15 monitor/defibrillator and the LIFEPAK 15 monitor/defibrillator batteries. It also lists high and low alarm limits, alarm performance characteristics, and factory default settings. ©2007-2013 Physio-Control, Inc.
APPENDIX A Specifications and Performance Characteristics Table A-1 lists the LIFEPAK 15 monitor/defibrillator specifications for the device. Table A-2 lists the specifications for the LIFEPAK 15 monitor/defibrillator batteries. Table A-3 lists the high and low limits for alarms when either the wide or narrow alarm setting is selected on the LIFEPAK 15 monitor/defibrillator. Table A-4 lists the alarm performance characteristics.
Specifications and Performance Characteristics Table A-1 LIFEPAK 15 Monitor/Defibrillator Specifications (Continued) CHARACTERISTIC DESCRIPTION Analog ECG Output Output: 1 volt/mV Frequency Response: 0.67 to 32 Hz (except 2.5 to 25 Hz for Paddles ECG and 1.
APPENDIX A Table A-1 LIFEPAK 15 Monitor/Defibrillator Specifications (Continued) CHARACTERISTIC DESCRIPTION PHYSICAL Weight Basic monitor/defibrillator with new roll paper and two batteries installed: 8.6 kg (18.9 lb) Fully featured monitor/defibrillator with new roll paper and two batteries installed: 9.1 kg (20.1 lb) Lithium-ion battery: < 0.60 kg (1.3 lb) Accessory bags and shoulder strap: 1.77 kg (3.9 lb) Standard (hard) paddles: 0.95 kg (2.1 lb) Height 31.7 cm (12.5 in) Width 40.1 cm (15.
Specifications and Performance Characteristics Table A-1 LIFEPAK 15 Monitor/Defibrillator Specifications (Continued) CHARACTERISTIC DESCRIPTION COMMUNICATIONS The device is capable of transferring data records by wired or wireless connection.
APPENDIX A Table A-1 LIFEPAK 15 Monitor/Defibrillator Specifications (Continued) CHARACTERISTIC Adults/Pediatrics DESCRIPTION ±2 digits (during no motion conditions) ±3 digits (during motion conditions) Dynamic signal strength bar graph Pulse tone as SpO2 pulsations are detected SpO2 Update Averaging Rate User selectable: 4, 8, 12 or 16 seconds SpO2 Sensitivity User selectable: Normal, High SpO2 Measurement Functional SpO2 values are displayed and stored Pulse Rate Range 25 to 240 bpm Pulse Rat
Specifications and Performance Characteristics Table A-1 LIFEPAK 15 Monitor/Defibrillator Specifications (Continued) CHARACTERISTIC CO2 Accuracy DESCRIPTION CO2 partial pressure at Accuracy: sea level: (0–80 bpm)* 0 to 38 mmHg (0 to 5.1 kPa) (>80 bpm)* ±2 mmHg (0.27 kPa) 39 to 99 mmHg (5.2 to 13.2 kPa) ±5% of reading + 0.08% for every 1 mmHg (0.13 kPa) above 38 mmHg (5.1 kPa) 0 to 18 mmHg (0 to 2.4 kPa) ±2 mmHg (0.27 kPa) 19 to 99 mmHg (2.55 to 13.3 kPa) ±4 mmHg (0.
APPENDIX A Table A-1 LIFEPAK 15 Monitor/Defibrillator Specifications (Continued) CHARACTERISTIC DESCRIPTION TEMPERATURE Sensors Measurement Specialties 4400 series esophageal/rectal and Foley catheter temperature probes, and 4499HD skin temperature probe Displayed Range 24.8° to 45.2°C (76.6° to 113.4°F) Resolution 0.1°C Accuracy ±0.
Specifications and Performance Characteristics Table A-1 LIFEPAK 15 Monitor/Defibrillator Specifications (Continued) CHARACTERISTIC DESCRIPTION DEFIBRILLATOR Charge Time (per EN 60601-2-4) AC Operation Only: Maximum Time from Charge to Shock Ready (Manual Mode): Voltage Charge Time 90-240 Vac (Nominal): 360 J within 10 seconds Maximum Time from Initiation of Analysis to Shock Ready (AED Mode): Voltage Charge Time 90-240 Vac (Nominal) 360 J within 30 seconds Maximum Time from Power-on to Shock Re
APPENDIX A Table A-1 LIFEPAK 15 Monitor/Defibrillator Specifications (Continued) CHARACTERISTIC DESCRIPTION Maximum Time from Initiation of Analysis to Shock Ready (AED Mode): Battery Status Charge Time Fully charged 200 J within 15 seconds, nominal Fully charged, followed by 15 full-energy shocks 360 J within 30 seconds Fully charged 360 J within 30 seconds Maximum Time from Power-on to Shock Ready (Manual Mode): Battery Status Charge Time Fully charged, followed by 15 full-energy shocks 36
Specifications and Performance Characteristics Table A-1 LIFEPAK 15 Monitor/Defibrillator Specifications (Continued) CHARACTERISTIC DESCRIPTION Waveform Shape and Measured Parameters I1 I2 T1 I3 T2 I4 Biphasic Waveform Patient Impedance () 25 50 75 100 125 150 175 A-10 Phase 1 Duration (ms) Min Max 5.1 6.0 6.8 7.9 7.6 9.4 8.7 10.6 9.5 11.2 10.1 11.9 10.6 12.5 Phase 2 Duration (ms) Min Max 3.2 4.2 4.4 5.5 4.9 6.5 5.6 7.3 6.2 7.7 6.6 8.2 6.9 8.6 Tilt (%) Max 85.2 74.7 67.6 62.2 56.6 52.6 49.
APPENDIX A Table A-1 LIFEPAK 15 Monitor/Defibrillator Specifications (Continued) CHARACTERISTIC DESCRIPTION Rated energy output is the nominal delivered energy based on the energy setting and patient impedance as defined in the following chart.
Specifications and Performance Characteristics Table A-1 LIFEPAK 15 Monitor/Defibrillator Specifications (Continued) CHARACTERISTIC Pre-Shock CPR Pulse Check DESCRIPTION Allows the user to be prompted for CPR while the device is charging. Options are OFF, 15, 30 seconds Allows the user to be prompted for a pulse check at various times. Options are ALWAYS, AFTER SECOND NSA, AFTER EVERY NSA, NEVER Stacked Shocks Allows for CPR after 3 consecutive shocks or after a single shock.
APPENDIX A Table A-1 LIFEPAK 15 Monitor/Defibrillator Specifications (Continued) CHARACTERISTIC DESCRIPTION Bump 1000 bumps at 15 g with pulse duration of 6 msec Impact, Non-operating EN 60601-1 0.5 + 0.05 joule impact UL 60601-1 6.
Specifications and Performance Characteristics Table A-3 Alarm Limits VITAL SIGN (VS) PATIENT WIDE LIMITS* VS VALUE LOW HIGH NARROW LIMITS* LIMITS RANGE DEFAULT LIMITS** LOW HIGH LOW LOW Heart Rate <60 -20 +35 -10 +25 30–150 100–250 50 150 (HR) 60–79 -25 +40 -20 +30 Pulse Rate (PR) 80–104 -30 +40 -30 +30 (bpm) >105 -35 +45 -25 +25 SpO2 >90 -5 +3 -5 +3 50 90–100 85 100 (%) <90 -5 +3 -5 +3 <90 -20 +35 -10 +25 30 245 50 200 90–114 -20 +35 -10 +2
A APPENDIX Table A-4 Alarm Performance Characteristics CHARACTERISTIC DESCRIPTION Heart Rate Alarm For a 1 mV, 206 bpm tachycardia, the average detection time was 4.6 seconds. Time For a test signal half as large, the average was 4.1 seconds. In this case the device sensitivity was increased to 5mV/cm. For a test signal twice as large, the average was 3.1 seconds. For a 2 mV, 195 bpm tachycardia, the average detection time was 2.5 seconds. For a test signal half as large, the average was 2.2 seconds.
Specifications and Performance Characteristics Table A-4 Alarm Performance Characteristics (Continued) CHARACTERISTIC DESCRIPTION Visual Alarms Alarms are indicated visually by: • The violated parameter flashes in inverse video with a message in the message area of the display. • These visual indications remain on the display until the alarm is corrected. Visual indication of alarms continue even when the tones have been silenced.
APPENDIX A Table A-5 Setup Options Factory Default Settings (Continued) MENU Pacing Monitoring MENU/ITEM Rate Current Mode Internal Pacer Channels Set 1 Continuous Data SpO2 Tone CO2 NIBP Temperature Trends 12-Lead Auto Transmit Auto Print Print Speed Interpretation Format Events Events Page 1 Events Page 2 ©2007-2013 Physio-Control, Inc.
Specifications and Performance Characteristics Table A-5 Setup Options Factory Default Settings (Continued) MENU MENU/ITEM Alarms Volume Alarms VF/VT Alarm Printer Auto Print ECG Mode Monitor Mode Diagnostic Mode Alarm Waveforms Event Waveforms Vitals Waveforms Transmission Sites Default Site Default Report Wireless Search Filter Clock Date/Time Clock Mode DST Time Zone A-18 FACTORY DEFAULT SETTINGS Event 20 Amiodarone Event 21 Dopamine Event 22 Bicarb 5 Off Off Defibrillation On Pacing Off Che
B APPENDIX B SCREEN MESSAGES This appendix describes the screen messages that the LIFEPAK 15 monitor/defibrillator may display during normal operation. ©2007-2013 Physio-Control, Inc.
APPENDIX B Table B-1 Summary of Screen Messages MESSAGE DESCRIPTION 12-LEAD ECG UNAVAILABLE A 12-lead was requested but the necessary ECG data is not available. ABNORMAL ENERGY DELIVERY A discharge occurred when the paddles were shorted together, when hard paddles did not have adequate contact with the patient or were discharged in the air, or patient impedance was out of range. Message may also appear in certain types of internal faults.
Screen Messages Table B-1 Summary of Screen Messages (Continued) MESSAGE DESCRIPTION CHARGING TO XXX J Appears when CHARGE is pressed on the front panel or standard paddles. CHECK FOR PULSE AED prompt after each standard 3-shock sequence or NO SHOCK ADVISED message. B-2 CHECK PATIENT! A potentially shockable rhythm has been detected when the VF/ VT alarm is on. CHECK PATIENT. IF NO PULSE, PUSH ANALYZE A potentially shockable rhythm has been detected when using Advisory Monitoring.
APPENDIX B Table B-1 Summary of Screen Messages (Continued) MESSAGE DESCRIPTION CPR: YOUTH-AIRWAY X:Y An option for CPR metronome. The patient is a youth (younger than the age of puberty) for whom an advanced airway has been established. The specified C:V ratio will be used. CPR: YOUTH-NO AIRWAY X:Y An option for CPR metronome. The patient is a youth (younger than the age of puberty) for whom an advanced airway has not been established. The specified C:V ratio will be used.
Screen Messages Table B-1 Summary of Screen Messages (Continued) B-4 MESSAGE DESCRIPTION MAINTENANCE DUE Reminder message that appears at the interval that is set in Service mode. Message continues to appear until reset or turned off. MANUAL MODE DISABLED Access to Manual mode from AED mode has been restricted. MOTION DETECTED!/STOP MOTION! Motion was detected during ECG analysis. NIBP AIR LEAK NIBP cuff applied too loosely or there is a leak in cuff/monitor pneumatic system.
APPENDIX B Table B-1 Summary of Screen Messages (Continued) MESSAGE DESCRIPTION PUSH ANALYZE Press ANALYZE to begin ECG analysis. PUSH AND HOLD SHOCK BUTTON! The defibrillator is in Sync mode, fully charged, and ready to provide therapy. PUSH AND HOLD PADDLE BUTTONS TO SHOCK! The defibrillator is in Sync mode, fully charged, and ready to provide therapy with hard paddles connected. PUSH SHOCK BUTTON! The defibrillator is fully charged and ready to provide therapy.
Screen Messages Table B-1 Summary of Screen Messages (Continued) B-6 MESSAGE DESCRIPTION SPO2: SEARCHING FOR PULSE A sensor is connected to the patient and is searching for a pulse. SPO2: SENSOR DOES NOT SUPPORT SPCO OR SPMET The sensor in use only measures SpO2. SPO2: UNKNOWN SENSOR A sensor that is not Physio-Control approved is connected to the device. STAND CLEAR/PUSH SHOCK BUTTON Prompts you to stand clear and push START CPR Prompts you to begin providing CPR to the patient.
APPENDIX B Table B-1 Summary of Screen Messages (Continued) MESSAGE DESCRIPTION XX LEADS OFF ECG electrode such as “RA” is disconnected. XX% TRANSMITTED Specified percent of the transmission is completed. ©2007-2013 Physio-Control, Inc.
C APPENDIX C SHOCK ADVISORY SYSTEM This appendix describes the basic function of the Shock Advisory System™ (SAS) algorithm. ©2007-2013 Physio-Control, Inc.
APPENDIX C Overview of the Shock Advisory System The Shock Advisory System (SAS) is an ECG analysis system built into the biphasic LIFEPAK 15 monitor/defibrillator that advises the operator as to whether it detects a shockable or nonshockable rhythm. This system makes it possible for individuals who are not trained to interpret ECG rhythms to provide potentially lifesaving therapy to victims of ventricular fibrillation or pulseless ventricular tachycardia.
Shock Advisory System complexes, and normal sinus rhythms. These rhythms are specifically mentioned in the AHA recommendations. The SAS does not continue analyzing the ECG after a SHOCK ADVISED decision is reached. Shock Advisory System Performance ECG analysis by the Shock Advisory System (SAS) in the LIFEPAK 15 monitor/defibrillator was tested by playing ECG waveforms from the Physio-Control database through the electrode connector.
APPENDIX C Table C-2 LIFEPAK 15 Monitor/Defibrillator SAS Performance by Rhythm Category RHYTHM CLASS Shockable: Coarse VF ECG TEST1 SAMPLE SIZE PERFORMANCE GOAL OBSERVED PERFORMANCE 168 >90% sensitivity LIFEPAK 15 monitor/defibrillator meets the AAMI2 DF80 requirements and AHA3 recommendations. 65 >75% sensitivity LIFEPAK 15 monitor/defibrillator meets the AAMI DF80 requirements and AHA recommendations.
Shock Advisory System Motion Detection The Shock Advisory System detects patient motion independent of ECG analysis. A motion detector is designed into the LIFEPAK 15 monitor/defibrillator. MOTION DETECTION can be set up to be ON or OFF. For more information, see the LIFEPAK 15 Monitor/Defibrillator Setup Options provided with your device. A number of activities can create motion, including CPR, rescuer movement, patient movement, and some internal pacemakers.
D APPENDIX D ELECTROMAGNETIC COMPATIBILITY GUIDANCE This appendix provides guidance and manufacturer’s declaration of electromagnetic compatibility. ©2007-2013 Physio-Control, Inc.
APPENDIX D Electromagnetic Compatibility Guidance Electromagnetic Emissions Table D-1 Guidance and Manufacturer’s Declaration - Electromagnetic Emissions The LIFEPAK 15 monitor/defibrillator is intended for use in the electromagnetic environment specified below. The customer or the user of the LIFEPAK 15 monitor/defibrillator should assure that it is used in such an environment.
Electromagnetic Compatibility Guidance Electromagnetic Immunity Table D-2 Guidance and Manufacturer’s Declaration - Electromagnetic Immunity The LIFEPAK 15 monitor/defibrillator is intended for use in the electromagnetic environment specified below. The customer or the user of the LIFEPAK 15 monitor/defibrillator should assure that it is used in such an environment.
APPENDIX D Table D-3 Guidance and Manufacturer’s Declaration - Electromagnetic Immunity The LIFEPAK 15 monitor/defibrillator is intended for use in the electromagnetic environment specified below. The customer or the user of the LIFEPAK 15 monitor/defibrillator should assure that it is used in such an environment.
Electromagnetic Compatibility Guidance c d Field strengths from fixed transmitters, such as base stations for radio (cellular/cordless) telephones and land mobile radios, amateur radio, AM and FM radio broadcast and TV broadcast cannot be predicted theoretically with accuracy. To assess the electromagnetic environment due to fixed RF transmitters, an electromagnetic site survey should be considered.
E SYMBOLS This appendix provides information about the symbols that are used in these operating instructions, or on the LIFEPAK 15 monitor/defibrillator, its accessories, packaging, or training tools. ©2007-2013 Physio-Control, Inc.
APPENDIX E Symbols The symbols in Table E-1 may be found in these operating instructions or on the LIFEPAK 15 monitor/defibrillator, its accessories, packaging, or training tools. Table E-1 Symbols SYMBOL DESCRIPTION Device or User Interface Attention, consult accompanying documents Alarm on Alarm off VF/VT alarm on VF/VT alarm is on, but is silenced or suspended Battery in well, fully charged. For a description of all battery indicators, see "Battery Status Indicators" on page 3-20.
Symbols Table E-1 Symbols (Continued) SYMBOL DESCRIPTION Display mode button Home Screen button CO2 exhaust CO2 Input/output Defibrillation-proof type CF patient connection Defibrillation protected, type BF patient connection Do not dispose of this product in the unsorted municipal waste stream. Dispose of this product according to local regulations. See www.physio-control.com/recycling for instructions on disposing of this product.
APPENDIX E Table E-1 Symbols (Continued) SYMBOL N13571 DESCRIPTION Indicates that a product complies with applicable ACA standards Positive terminal Negative terminal Fuse Battery Static-sensitive device. Static discharge may cause damage.
Symbols Table E-1 Symbols (Continued) SYMBOL DESCRIPTION Warning, high voltage or CAUTION - FIRE HAZARD Do not disassemble, heat above 100°C (212°F), or incinerate battery CAUTION - FIRE HAZARD Do not crush, puncture, or disassemble battery Use By date shown: yyyy-mm-dd or yyyy-mm Indoor use only Item is latex free Lead free Dispose of properly 35°C 50°C 95°F 122°F 15°C 0°C 59°F 32°F Store in a cool, dry location (0° to 50°C, 32° to 122°F) Single use only 2 electrodes in 1 package 10 packag
APPENDIX E Table E-1 Symbols (Continued) SYMBOL DESCRIPTION Treatment Tear here Press electrode firmly onto patient Connect QUIK-COMBO cable Slowly peel back protective liner on electrode Do not use this pediatric QUIK-COMBO electrode on LIFEPAK 500, LIFEPAK 1000, LIFEPAK CR® Plus, or LIFEPAK EXPRESS® defibrillators For use on adults Not for use on adults For use on children up to 15 kg (33 lb) Not for use on children under 15 kg (33 lb) Remove label from battery Charge battery Insert batter
Symbols Table E-1 Symbols (Continued) SYMBOL DESCRIPTION Rechargeable battery AC-DC power adapter DC-DC power adapter For use with the LIFEPAK 15 monitor/defibrillator Power input Power output DC voltage AC voltage Shipping carton This end up Fragile/breakable Handle with care Protect from water Recommended storage temperature -20° to 60°C (-4° to 140°F) Relative humidity range 10 to 95% or E-6 Recycle this item LIFEPAK 15 Monitor/Defibrillator Operating Instructions
INDEX Numerics 12-lead ECG 4-8 Acquiring 4-15 Cable 4-8 Diagnosing acute myocardial ischemia using 4-22 Diagnosing STEMI using 4-22 Fiducial marks 4-21 Frequency response 4-21 Intended use 4-15 Limb lead electrode placement 4-16 Overriding signal noise in 4-18 Precordial lead electrode sites 4-16 Report formats 4-20 Troubleshooting tips 4-23 3-lead cable 4-8 4-wire cable 4-8 5-wire cable 4-8 A AC Power Adapter operation 9-5 Accessories 10-24 Acute Coronary Syndrome (ACS) 4-15 Adult paddles (see Paddles) Ad
INDEX Troubleshooting tips 5-29 Deleting archived records 7-14 E ECG 12-lead (see Numerics) Adjusting systole volume 4-6 Applying electrodes 4-9 Cable check 10-4 Cables 4-8 Changing size 4-5 Intended use 4-3 Monitoring procedure 4-7 Monitoring using precordial leads 4-10 Report formats 4-20 Selecting lead 4-4 Troubleshooting tips 4-12 Editing archived records 7-13 Electrodes Applying 4-9 Limb lead placement of 4-9 Placement, special situations 5-6 Precordial lead sites 4-16 QUIK-COMBO 6-3 Removing 6-4 Rep
INDEX Temperature 4-61 Vital sign trends 4-66 N NIBP Artifact rejection techniques 4-39 Cleaning accessories 4-42 Cuff selection 4-40 Intended use 4-37 Oscillometric measurement technique 4-39 Procedure 4-40 Troubleshooting tips 4-43 Noninvasive pacing 5-32 Intended use 5-32 Procedure 5-33 Troubleshooting tips 5-36 O Options menu 3-23 Oscillometric measurement technique 4-39 Output ports, configuring 8-4 Overriding ECG signal noise 4-18 P Pace arrow Internal pacing E-3 Noninvasive pacing E-3 Pacemakers,
INDEX SpMet 4-28 Advisory 4-31 Intended use 4-25 Procedure 4-30 Troubleshooting tips 4-33 SpO2 4-28 Adjusting pulse tone volume 4-32 Adjusting sensitivity 4-32 Averaging time 4-32 Intended use 4-25 Procedure 4-30 Troubleshooting tips 4-33 Waveform 4-31 ST J-point (STJ) 4-68 ST segment trends 4-66 Standard paddles (see Paddles) STEMI (ST-segment elevation myocardial infarction) 4-22 Sterilizable internal defibrillation paddles 6-10 Sternum paddle placement 4-7, 5-5 Storing batteries 10-13 Synchronized cardi
LIFEPAK®15 Monitor/Defibrillator Operator’s Checklist This is a recommended checklist to use to inspect and test this monitor/defibrillator. Daily inspection and test is recommended. This form may be reproduced. Unit Serial No:______________________________ Instruction Location:_____________________________________ Recommended Corrective Action Date Initials ✔ each box after completing 1. Inspect physical condition for: Foreign substances Clean the device.
Recommended Corrective Action Instruction Date Initials 8. Perform standard (hard) paddles check in Manual mode.* (If hard paddles are not used with the defibrillator, go to Step 9.) a.Disconnect and examine cable for cracking, damage, broken, or bent parts or pins. Replace paddles. b.Connect paddles to defibrillator. c.Examine for paddle surface pitting and presence of dried or wet gel. Replace paddles, or clean paddles. d.Press LEAD. Select PADDLES. e.
LIFEPAK 15 MONITOR/DEFIBRILLATOR OPERATING INSTRUCTIONS For further information, please call Physio-Control at 1.800.442.1142 or visit www.physio-control.com Physio-Control, Inc. 11811 Willows Road NE P. O. Box 97006 Redmond, WA 98073-9706 USA Tel 425.867.4000 Fax 425.867.4121 www.physio-control.com Physio-Control, Inc., 11811 Willows Road NE, Redmond, WA 98052 USA Physio-Control Operations Netherlands B.V., Keizersgracht 125-127, 1015 CJ Amsterdam ©2007-2013 Physio-Control, Inc. All rights reserved.
