User Manual

Monitoring
3-6 LIFEPAK 20e Defibrillator/Monitor Operating Instructions
5 Apply ECG electrodes:
• Confirm package is sealed and Use By date has not passed.
• Attach an electrode to each of the lead wires.
• Grasp electrode tab and peel electrode from carrier.
• Inspect electrode gel and ensure the gel is intact (discard electrode if gel is not intact).
• Hold electrode taut with both hands. Apply the electrode flat to the skin. Smooth tape
outwardly. Avoid pressing the center of the electrode.
• Secure the trunk cable clasp to the patient’s clothing.
6 Select the lead on the monitor screen.
7 If necessary, adjust ECG size.
8 Press
PRINT to obtain an ECG printout.
ECG Electrode Requirements
Electrode quality is critical for obtaining an undistorted ECG signal. Always check the date code
on electrode packages for the Use By date before applying the electrodes to a patient. Do not use
electrodes with expired Use By date codes. Disposable electrodes are intended for a single use.
For best ECG monitoring results, use silver/silver chloride (Ag/AgCl) electrodes. These
electrodes provide a rapid display of post-defibrillation ECG.
Leads Off Messages
If an electrode or lead wire disconnects during ECG monitoring, the monitor emits an audible
alarm and displays a leads off message. The ECG trace becomes a dashed line
. The alarm and
messages continue until the electrode or lead wire is replaced.
Color Coding for ECG Leads
The lead wires and the electrode snaps for the patient ECG cable are color coded according to
AHA or IEC standards as listed in Table 3-1.
Monitoring Patients with Internal Pacemakers
The LIFEPAK 20e defibrillator/monitor typically does not use internal pacemaker pulses to
calculate the heart rate. However, the monitor may detect internal pacemaker pulses as QRS
complexes. This may result in an inaccurate heart rate display.
Smaller amplitude internal pacemaker pulses may not be distinguished clearly. For improved
detection and display of internal pacemaker pulses, turn on the internal pacemaker detector, and/
or connect the ECG cable, select an ECG lead, and print the ECG in diagnostic frequency
response.
Large amplitude pacemaker pulses may overload the QRS complex detector circuitry so that no
paced QRS complexes are counted. To help minimize ECG pickup of large unipolar pacemaker
pulses when monitoring patients with internal pacemakers, place ECG electrodes so the line
Table 3-1 ECG Leads Color Codes
Leads AHA Label AHA Color IEC Label IEC Color
Limb Leads RA White R Red
LA Black L Yellow
RL Green N Black
LL Red F Green
CBrownCBrown