GE Cardioserv User manual

CardioServ

Version 4.2

Operator’s Manual

227 446 32 Revision I

The product CardioServ bears the marking

-0459

(notified body GMED)

The authorized representative for GE Medical Systems Infor-

mation Technologies Inc. in Europe is:

indicating its conformity with the provisions of the Council

Directive 93/42/EEC concerning medical devices and fulfills

the essential requirements of Annex I of this directive.

The product complies with the electromagnetic immunity

requirements of standard IEC 60601-1-2/EN 60601-1-2

“Electromagnetic Compatibility – Medical Electrical Equip-

ment”.

The device is in radio-interference protection class B in

accordance with CISPR11/EN 55011.

The CE marking covers only the accessories listed in section

“Order Information and Accessories”.

This manual describes CardioServ with all options included

and reflects software version 4.13.

Revision History

This document is subject to the GE Medical Systems Information Technologies GmbH change order system.

The revision code, a letter that follows the document part number, changes with every update of the manual.

GE Medical Systems

Information Technologies GmbH

Munzinger Str. 3

D-79111 Freiburg, Germany

Tel. +49 (0) 7 61 45 43-0

Fax: +49 (0) 7 61 45 43-233

The country of manufacture appears on the device label.

Part No./Revision Code Date Comment

227 446 32 29 April 1997 Initial Release

227 446 32-A 14 May 1997 SW version 4.1

227 446 32-B 1 July 1997 ECO 202998

227 446 32-C 9 July 1998 ECO 060477

227 446 32-D 6 August 1999 ECO 062982

227 446 32-E 11 June 2001 ECO 066990

227 446 32-F 15 October 2003 ECO 074738

227 446 32-G 13 January 2004 ECO 075566

227 446 32-H 20 December 2004 ECO 079412

227 446 32-I 28 July 2005 ECO 080432

2 CardioServ V 4.2 227 446 32-I

Contents

1. Introduction to CardioServ

2. Controls and Indicators

3. Setup and Performance Test

4. Non-Synchronized Defibrillation

5 Cardioversion (Synchronized Defibrillation)

6. Displaying and Monitoring the ECG

7. The Memories of CardioServ

8. Recording

9. Oxygen Saturation SpO

10. Pacing

11. Configuring the Defibrillator Settings

12. Error Indications and Messages

13. Cleaning, Maintenance and Disposal

14. Technical Specifications

15. Order Information and Accessories

Appendix

Index

227 446 32-I CardioServ V 4.2 3

General Information

* This manual is an integral part of the instrument and

describes its normal use. It should always be kept close to

the equipment. Observance of the manual is a prerequi-

site for proper instrument performance and correct

operation and ensures patient and operator safety.

* The symbol

It serves as an indicator for important facts to be noted

when operating the instrument.

* Information which refers only to certain versions of the

instrument is accompanied by the part number(s) of the

instrument(s) concerned. The part number is given on

the instrument nameplate.

* Patient safety, specified measuring accuracy, and interfer-

ence-free operation can be guaranteed only if original

GEMS IT devices are interconnected (e.g. basic units

and plug-in modules).

* Only use accessories which are listed in this manual or

which have been tested in combination with the device

(e.g. patient cables, electrodes, transducers, sensors,

consumables, etc.). If you use accessories or consumables

from other manufacturers, GEMS IT does not guarantee

safe operation or functioning of the device.

denotes: Refer to Operator’s Manual!



* GEMS IT considers itself responsible for the effects on

safety, reliability, and performance of the equipment,

only if

– assembly operations, extensions, readjustments,

modifications, or repairs are carried out by

GEMS IT or by persons authorized by GEMS IT

– the instrument is used in accordance with the

instructions for use.

* All publications are in conformity with the instrument

specifications and IEC publications on safety of electro-

medical equipment valid at the time of printing. All

rights are reserved for instruments, circuits, techniques,

software programs and names appearing in the manual.

* On request GEMS IT will provide a service manual.

* The GEMS IT quality management system complies

with the standards DIN EN ISO 9001 and EN 46001.

* The warranty does not cover damage resulting from the

use of accessories and consumables from other manufac-

turers.

4 CardioServ V 4.2 227 446 32-I

Introduction to CardioServ

1. Introduction to CardioServ

This section describes

– The capabilities and applications of the CardioServ

defibrillator

– points to note when operating CardioServ

– general points to note when handling a defibrillator

227 446 32-I CardioServ V 4.2 5

Introduction to CardioServ

1.1 General Information

CardioServ is a high-voltage electrotherapy unit

which should be handled only by specially trained

Danger

personnel. Even though the defibrillator is

equipped with various safety features, such as

internal safety discharging, its operation by

unqualified staff could be hazardous to the

patient, the operator, and any assisting personnel.

The user instructions given in this manual refer to a

☞

CardioServ unit equipped with pacemaker and

SpO2 measuring system.

CardioServ is a light-weight, portable defibrillator with ECG

monitor and built-in recorder.

The device is designed for external and internal defibrillation.

It can be used both for semi-automatic and for manual defi-

brillation. Furthermore CardioServ is capable of monitoring

the heart rate with adjustable alarm limits.

CardioServ can be expanded with a transcutaneous pacemaker

and/or SpO2 measuring system which also monitors the

measured SpO2 values.

The device is easy and convenient to operate. Three operating

steps are sufficient to deliver the defibrillation shock. The

display can be turned 180° to allow the user to view the

information when the device is standing upright.

Defibrillation can be performed with standard defibrillation

paddles, defibrillation pads and internal electrodes.

In addition to line power operation, the defibrillator operates

on battery power from a slot-in rechargeable battery, and on

12-Volt power supplied from an emergency vehicle.

6 CardioServ V 4.2 227 446 32-I

Introduction to CardioServ

I/A

120

100

-20 0 2 4 6 8 10 12

Ra = 50 Ohm Ra = 100 Ohm Ra = 25 Ohm

L = 26 mH

C = 32 μF

R = 6,5 Ω

Figure 1-1. CardioServ current-discharge curve (360 J)

t/ms

CardioServ comes with three memories whose contents can

be documented individually:

– text memory (code summary documentation)

– event memory (16-s ECG)

– trend memory (trend plots of HR, SpO2, 45 min,

9 hours)

The built-in recorder is initiated automatically or manually.

Extensive safety precautions have been taken to protect the

patient and the user from inadvertent delivery of defibrillation

shocks.

The current-discharge curve corresponds to an approximate

sinusoidal halfwave with aperiodic decay. Figure 1-1 shows

the discharge curve for various external resistances.

227 446 32-I CardioServ V 4.2 7

1.2 For your Safety

Introduction to CardioServ

The safety information given below is divided into the catego-

ries “Danger”, “Warning” and “Caution”.

indicates an imminently hazardous situation

which, if not avoided, will result in death or

Danger

serious injury.

indicates a potentially hazardous situation which,

Warnin

if not avoided, could result in death or serious

injury.

indicates a potentially hazardous situation which,

if not avoided, may result in minor or moderate

Caution

injury and/or damage to the equipment.

provides application tips or other useful information

☞

to assure that you get the most from your equipment.

CardioServ is designed to comply with IEC 60601/

☞

EN60601 requirements. It is Class I equipment and

has an internal power source.

CardioServ operates on line voltages between 95

Warnin

and 240 Volts, 49 to 65 Hz. The mains plug

must be connected to an appropriate power supply

with a non-fused earthed wire. The use of exten-

sion cords is not permitted.

Before putting the device into operation, visually

Warnin

check all connecting cables and electrodes for signs

of damage. Damaged cables and electrodes must

be replaced immediately, before use.

When disconnecting the device from the power

Warnin

line, first remove the plug from the wall outlet.

Disconnect the device from the power line and

Warnin

operate it on battery power, if the integrity of the

protective earth conductor is in doubt.

Set up the device in a location which affords

sufficient ventilation. The ventilation openings of

Caution

the device must not be obstructed. The ambient

conditions specified in the “Technical Specifica-

tions” section must be ensured at all times.

8 CardioServ V 4.2 227 446 32-I

Introduction to CardioServ

Warnin

Danger

Warnin

Danger

Warnin

Caution

Devices intended for emergency application must

not be exposed to low temperatures during storage

and transport to avoid moisture condensation at

the application site. Wait until all moisture has

vaporized before using the device. Avoid using the

defibrillator under conditions where prolonged

exposure to or excessive contact with moisture can

occur.

Before putting the defibrillator into operation,

make sure that the paddles and all connection

cables are dry.

CardioServ is an emergency device and must be

ready for operation at any time. For this reason,

the defibrillator battery must always be charged.

This can be achieved by leaving the defibrillator

connected to the power line when it is not needed

in an environment where only battery operation

is possible.

Possible explosion hazard if used in the presence

of concentrated oxygen.

CardioServ is suitable for application in a humid

environment provided the regulations concerning

drip-proof equipment of IEC 60601 are strictly

observed. However, avoid defibrillation in a very

moist or wet environment, unless absolutely

necessary.

Use only the original GEMS IT batteries, as

these are designed for an extended temperature

range.

Magnetic and electrical fields are capable of

Warnin

interfering with the proper performance of the

device. For this reason make sure that all external

devices operated in the vicinity of the defibrillator

comply with the relevant EMC requirements. X-

ray equipment, MRI devices and radio systems

are a possible source of interference as they may

emit higher levels of electromagnetic radiation.

The defibrillator is designed for intracardiac appli-

☞

cation.

Devices may be connected to other devices or to

Warnin

parts of systems only when it has been made

certain that there is no danger to the patient, the

operators, or the environment as a result. In those

instances where there is any element of doubt

concerning the safety of connected devices, the

user must contact the manufacturers concerned or

other informed experts as to whether there is any

possible danger to the patient, the operator, or the

environment as a result of the proposed combina-

tion of devices. Standards IEC 60601-1-1/

EN 60601-1-1 must be complied with in all

cases.

Set up the device so that the operator has a clear,

☞

unobstructed view of the front panel.

Liquids must not be allowed to enter the device.

Warnin

Devices into which liquids have penetrated must

be immediately cleaned and checked by a service

technician.

227 446 32-I CardioServ V 4.2 9

Introduction to CardioServ

Danger

Caution

Warnin

Caution

Use only the original GEMS IT patient cables.

Do not connect other signal sources to the cables.

Patient signal inputs labelled with the

symbol are protected against damage resulting

from defibrillation and electrocautery voltages.

Nevertheless extreme care must be taken when

devices which are directly connected to the patient

remain applied during electrocautery or defibril-

lation. The distance between ECG electrodes

should be at least 15 cm. If in doubt, disconnect

the patient cable from the device while applying

the defibrillation pulse or performing

electrocautery.

For defibrillation of children use only the special

clip-on electrodes for children listed in section 15

“Order Information and Accessories”.

The full responsibility for the use of accessories

from other manufacturers lies with the user.

Check the device performance at regular intervals

(once a month), strictly following the instructions

given in section 3.2. Do not select high energy

levels for test discharges with defibrillation elec-

trodes shorted together.

At the end of its service life, CardioServ and its

accessories must be disposed of in compliance with

Caution

the special waste control regulations for electronic

parts. If you have any questions in this matter,

please contact GEMS IT GmbH.

Dispose of the packaging material, observing the

Warnin

applicable waste-control regulations and keeping

it out of children’s reach.

Literature

Medical Device Directive

EN 60601-1/1990 + A 1: 1993 + A2: 1995: Medical electrical

equipment. General requirements for safety

EN 60601-1-1/9.1994 + A1 12/1995: General requirements

for safety. Requirements for the safety of medical electrical

systems.

IEC Publication 513/1994: Fundamental aspects of safety

standards for medical equipment.

ROY, O.Z.: Summary of cardiac fibrillation thresholds for

60-Hz currents and voltages applied directly to the heart.

Med. & Biol. Engn. & Computing 18: 657...659 (1980).

For each defibrillation, verify that the selected

and the displayed/charged energy are identical.

Caution

CardioServ also operates on line power when the

☞

battery is depleted or missing.

10 CardioServ V 4.2 227 446 32-I

Introduction to CardioServ

General points to note when handling a defibrillator

Electromedical equipment such as the CardioServ

Warnin

defibrillator must only be handled by persons who

are trained in the use of such equipment and are

capable of applying it properly.

Before using the equipment, the operator must

Warnin

ascertain that it is in correct working order and

operating condition.

The defibrillator paddles must be clean and dry.

Danger

The person carrying out the defibrillation should

☞

have at least one assistant.

The operator must be trained in the use of the

Warnin

defibrillator.

All assistants must be briefed regarding the

Warnin

preparations for and execution of defibrillation.

All tasks must be assigned clearly.

Warnin

Defibrillating a patient with normal heart

rhythm may induce ventricular fibrillation.

Danger

Position the patient flat on a hard, dry surface

where the patient is electrically insulated. The

Caution

patient must not be allowed to come into contact

with metal parts, e.g., bed or litter, in order to

prevent unwanted pathways for the defibrillation

current which endanger the assistants. For the

same reason, do not place the patient on wet

ground (rain, accident in swimming pool).

Have a pacemaker at hand, if possible.

☞

Should cardiac arrest occur or be imminent during

☞

preparations for defibrillation, administer heart

massage and artificial respiration (CPR).

Do not allow the defibrillator paddles to come

into contact with other electrodes or metal parts

Danger

which are in contact with the patient.

Transducers and instruments that are not defi-

brillation-proof must be disconnected from the

Caution

patient.

Interrupt heart massage and artificial respiration

immediately before triggering the shock.

Danger

Immediately before triggering the shock discon-

nect tubes and have assistants step back.

Caution

227 446 32-I CardioServ V 4.2 11

Introduction to CardioServ

Caution

Danger

Warnin

Caution

The patient’s chest must be dry, as moisture causes

unwanted pathways for the defibrillation current.

Therefore, when using flammable skin cleansing

agents, wait until they have completely dried.

Possible explosion hazard if used in the presence

of concentrated oxygen, flammable substances

(gasoline) or anesthetic agents. Oxygenation in

the vicinity of the defibrillation paddles must be

strictly avoided; if necessary, interrupt oxygen

supply while defibrillating the patient.

To prevent sparking

– the electrodes should make full contact with

the body

– the electrodes should be pressed firmly onto

the thorax.

Do not deliver shocks into open air. High voltage

may briefly be present at the unprotected paddle

surfaces as a result and endanger the persons

present.

Warnin

Defibrillating a patient who has an implanted

pacemaker is likely to impair the pacemaker

function or cause damage to the pacemaker.

Therefore, the following should be observed:

– Select the smallest energy level possible for the

application.

– Do not apply the defibrillation paddles in the

vicinity of the pacemaker electrodes.

– The availability of an external pacemaker is

of utmost importance in this case.

– After the defibrillation the working order of

the implanted pacemaker should be checked

immediately.

Also be aware that children require less energy for

a successful defibrillation than adults. For the

first defibrillation pulse delivered to babies and

toddlers, select an energy level of 2 joules/kg body

weight. For subsequent shocks, increase the energy

up to 4 joules/kg.

When defibrillating children it is especially

important to verify that the paddles make full

Caution

contact with the body surface. This is to be ob-

served also when using the clip-on electrodes for

children (Part No. 303 439 95).

12 CardioServ V 4.2 227 446 32-I

Controls and Indicators

2. Controls and Indicators

This section describes the CardioServ operating controls and

indicators and explains their function.

When operating elements in this manual are identified with

a reference number in parentheses, this number refers to

Figure 2-1 in this section.

You will also find an explanation of all signs and symbols

used on the CardioServ defibrillator.

227 446 32-I CardioServ V 4.2 13

Controls and Indicators

Shock

STERNUM

J (50 )

102030

Autosequence

P/min

–

Dem

Fix

100

300

360

150

200

Shock

Charge

Shock

Sync

13 8 975

1 Select energy

Apply electrode cream to both paddles

Charge defibrillator

Press charge button on apex paddle (on the device, when using adhesive or internal electrodes)

Deliver shock3

Press buttons on both paddles simultaneously (on the device, when using adhesive or internal electrodes)

APEX

Charge

Shock

APEX

1418 17 16 15

Option

Figure 2-1. Controls and indicators of CardioServ

14 CardioServ V 4.2 227 446 32-I

SpO

EKG





Controls and Indicators

1 Defibrillator paddles

Shock

button to trigger the defibrillation shock – together

with button (8)

3 keys to adjust the LCD contrast. Press both

keys simultaneously to obtain a screen copy.

4 Energy selector, on/off switch

Charge

key to charge the unit (manual mode) and to

Shock

trigger the defibrillation shock – together with key (6). This key assumes the function of button (8) when internal paddles or adhesive electrodes are used.

Shock

key to trigger the defibrillation shock – together

with key (5). This key assumes the function of button (2) when internal paddles or adhesive electrodes are used.

7 Five selection keys F1 to F5 whose functions change

with the menu displayed. The respective key functions are indicated by symbols or labels in the bottom line on the LCD. From the main menu, that appears on power up, you can access submenus which, in turn, allow the selection of further options. The back function returns you to the next higher menu level. The main menu reappears automatically if you do not depress any of the keys for about 30 seconds.

button to charge the unit (manual mode) and

Charge

Shock

trigger the defibrillation shock – together with button (2)

11 key to start and stop the recorder. This key assumes

the function of button (9) when internal paddles or adhesive electrodes are used.

12 Green indicator is lit when the defibrillator operates

on line power.

13 Yellow indicator

is lit when the defibrillator battery

is being charged.

14 Connection for defibrillator paddles

(controls 15 to 18 only on models with pacemaker)

15 Keys

16 Keys

17 Pacing mode selection key

P/min

to adjust the pacer output

P/min

to adjust pacer rate

Dem

Fix

(demand/fixed rate)

18 Key to enable and disable the pacemaker

19 Aperture to open the paper compartment

20 Connector for power cord

21 Unassigned

22 1-Volt ECG output

23 Connector for SpO2 sensor

9 button to start and stop the recorder.

Sync

key to switch to the synchronized operating mode

24 Connector for patient cable (ECG signal input)

(section 5 “Cardioversion”)

227 446 32-I CardioServ V 4.2 15

Controls and Indicators

Explanation of the signs and symbols used on the defibrillator

Type CF equipment with highly insulated patient

connections, suitable for intracardiac application,

connections defibrillation-proof.

Type CF equipment with highly insulated patient

connections, suitable for intracardiac application,

connections not defibrillation-proof.

Standby mode (for line-power operation)

Power off

Battery charging

Recorder start

ECG signal

Contrast

Standby or preparatory state only for a part of the

equipment

On, only for a part of the equipment



Hardcopy of screen image

This symbol indicates that the waste of electrical

Refer to Operator’s Manual

and electronic equipment must not be disposed as

unsorted municipal waste and must be collected

separately. Please contact an authorized representa-

tive of the manufacturer for information concern-

ing the decommissioning of your equipment.

Direction indicator

Signal output

Audible alarm on/off

High voltage

16 CardioServ V 4.2 227 446 32-I

Setting Up CardioServ and Testing Its Performance

3. Setting Up CardioServ and Testing Its Performance

In this section you will find information about

– putting CardioServ into operation

– connecting CardioServ to the 12-Volt power supply of

an ambulance vehicle

– customizing the CardioServ settings to suit your per-

sonal requirements

– testing the CardioServ performance before using it on a

patient

227 446 32-I CardioServ V 4.2 17

Setting Up CardioServ and Testing Its Performance

3.1 Setting Up CardioServ

The defibrillator is a high-voltage electrotherapy

device and must be handled by qualified person-

Danger

nel only. Improper use of this device can endanger

life. Do not fail to observe the information given

in this manual and only entrust the device to the

hands of trained persons.

Check the electrodes and their leads for signs of

damage every time before you use the defibrilla-

tor. In particular, make a close visual inspection

of the insulation. Replace internal electrodes or

the contact inserts when you detect signs of me-

chanical damage.

CardioServ operates on:

– line power (95 to 240 V, 49 to 65 Hz)

– battery power (rechargeable batteries), i.e., independent

of the power line

– 12-Volt power supplied from the emergency vehicle

(with optional defibrillator mounting system)

* Use the power cord to connect the defibrillator to the

power line (Figure 3-1).

Figure 3-1. Power input

18 CardioServ V 4.2 227 446 32-I

Setting Up CardioServ and Testing Its Performance

360

Shock

Charge

P/min

Shock

Sync

Figure 3-2. Green indicator (indicating that defibrillator is

supplied from the power line)

Figure 3-3. Inserting the battery

* Check that the green indicator is lit (Figure 3-2).

* Check that the battery is in place (Figure 3-3).

Pull back the catch on the underside of the device to remove

the battery. When inserting it, make sure that it clicks prop-

erly into place.

When a battery is inserted, the yellow indicator

starts

flashing as soon as the defibrillator is connected to the power

line (to indicate that the battery is charging). The battery is

fully charged after 16 hours and the indicator is continuously

lit.

* Check that the supply of chart paper is sufficient (Figure

3-4). A stripe marks the last 3 meters of the roll.

Figure 3-4. Recording strip

227 446 32-I CardioServ V 4.2 19

Setting Up CardioServ and Testing Its Performance

Power Supply From Emergency Vehicles

A qualified technician can be called in to connect the

CardioServ to the 12-Volt supply of an emergency vehicle.

The following points must be noted:

– The negative terminal of the ambulance power supply

system must be connected to the ambulance chassis for

grounding.

– The positive lead of the ambulance power supply system

intended to supply the current must be protected with a

10-A fuse.

– Use only the defibrillator mounting system listed in

section 15 “Order Information and Accessories” or the

external charging unit, if your CardioServ has been

modified accordingly.

Check that the contacts for power supply from the



Figure 3-5. Accu Service Unit

defibrillator mounting system on the underside of

CardioServ (next to battery) are clean. Do not damage

We recommend our Accu Service Unit for optimal

☞

them in any way.

care of the batteries. It prolongs the batteries’ service

life and guarantees their operational readiness at all

Important Information on Battery-Power Operation

times.

Rechargeable batteries require special maintenance and con-

A NiCd battery should not be charged while

Warnin

located in direct sunlight, over a radiator, in cold

storage, or in other temperature extremes (not

below 5 °C). When the instrument is charging,

ambient temperatures exceeding 40 °C may

adversely affect battery capacity and life.

20 CardioServ V 4.2 227 446 32-I

tinued checks to assure they function in emergency situations.

It is normal for batteries of this type to selfdischarge when not

in use.

The battery charges automatically when CardioServ is con-

nected to the power line (yellow indicator (13) flashes).

Setting Up CardioServ and Testing Its Performance

In order to ensure its functioning as an emergency device, the

defibrillator should not be disconnected from the power line

for more than 48 hours.

A fully charged battery supplies power for 35 defibrillation

shocks of 360 joules or 2 hours of monitoring (or 1.2 hours of

monitoring if the CardioServ unit has pacemaker and SpO

option). It takes 16 hours to charge a depleted battery.

Proceed as follows to test the battery charge level:

☞

– Disconnect CardioServ from the power line.

– Trigger a test discharge of 360 joules (see

section 3.2 “Testing the Defibrillator Perform-

ance”).

– If you are not prompted to charge the battery,

the charge level should be sufficient for at least

5 more 360-joule shocks.

Monthly battery maintenance and checks:

☞

1. Disconnect CardioServ from the power line and

discharge fully charged battery in the monitoring

mode. To do so, set energy selector switch to ,

(SpO2 sensor not connected) and wait until device

switches off.

Inserting CardioServ In Its Softcase

* Open both zips on the CardioServ softcase.

* Undo the two Velcro strips on the front of the softcase.

* Open the Velcro flap located in front of the CardioServ

printer.

* Place the softcase on the small base, so that the softcase is

positioned as though you were carrying it.

* Disconnect the paddles on the CardioServ and remove

them.

* Hold all the opened up parts of the softcase to the side

and put the CardioServ into the softcase.

* Pull the softcase by the two Velcro strips on the black

base into position, ensuring that the feet of the

CardioServ are in the cut-out openings provided.

* Close the two front Velcro strips as well as the flap in

front of the printer at the side.

2. Check how long it takes before battery is depleted.

If the time is less than 1.8 hours, the battery is too

old or improperly maintained and must be

replaced.

3. Recharge the battery. This will take 16 hours.

For easy, convenient care and maintenance of the

batteries, use our “Accu Service Unit”.

227 446 32-I CardioServ V 4.2 21

* Close the zips.

* If the individual cut-out openings for the external con-

nections, paddles or feet are not correctly positioned,

pull the material at this point into the right shape.

* Reconnect the paddles and put them back into the

CardioServ recesses.

Customizing the defibrillator settings

Setting Up CardioServ and Testing Its Performance

Further steps that can be taken while setting up the defibrilla-

tor include customizing the device functions. This allows you

to select defibrillator default settings which suit your personal

preferences. CardioServ saves these configured settings and

reactivates them automatically every time you switch the

Refer to section 11 “The Defaults Menu” for a detailed

explanation of how to customize the CardioServ, including

the language selection (available languages are English,

French, German, Italian, Portuguese, Russian, Spanish and

Swedish).

defibrillator on. The following chart shows the factory settings

of all parameters and the optional adjustments.

retemaraP noitpircseD gnitteSyrotcaF egnartnemtsujdA sgnittesdezimotsuC

stimiLRH stimilmralaRH 061/04 ffo003ot51ffo

ytivitisneS ezislangisGCE 1 Vm/mc2,1,5.

daeL 1 selddap+sdaeldradnatslla

.qesotuA slevelygrenegnicneuqesotua J063,J002,J002 ,J063,J003,J002,J051

OpS

stimiL stimilmrala ffo/09 ffo001ot51ffo

kcoL-C OpSdezinorhcnys-GCE

OpS

resU )sretcarahc04(emanrotxeteerf

emiT.tnI OpS

mralAliaFdaeL ffo s03/ffo

peeBSRQ ffo ffo/no

enoTmralA ffo ffo/no

tuotnirPmralA tratsredrocer.motua ffo ffo/no

tuotnirPkcohS tratsredrocer.motua no ffo/no

tuotnirP.tnoC tratslaunamnopupotsredrocer ffo ffo/no

rekamecaP etareslup MPB06 nim/P051ot51

yalpsiD lamron desrever/lamron

yalpsiD seerged0 seerged081/seerged0

emuloV slangisoiduallafoemulov duol wol/duol

retliFCA zH05 ffo/zH06/zH05

retliFelcsuM tcafitranoitomfonoitanimile no ffo/no

emiT/etaD

tamroFetaD YYYY:MM:DD YYYY:DD:MM/YYYY:MM:DD

egaugnaL namreG ,namreG,hcnerF,hsilgnE

tluafedyrotcaF sgnittesyrotcafhsilbatseer ffo ffo/no

emitnoitargetni s8 )dednemmocerton(s21,s8,s4

tnemerusaem ffo ffo/no

,naissuR,eseugutroP,nailatI

hsidewS,hsinapS

Table 1

22 CardioServ V 4.2 227 446 32-I

Setting Up CardioServ and Testing Its Performance

J (50 Ω)

Autosequence

Figure 3-6. Switching on CardioServ

a b

Paddle

160 BPM

140 ECG

HR Alarm

3.2 Testing the Defibrillator

100

150

200

300

360

Charge

Shock

Sync

Performance

On power up CardioServ runs an automatic selftest. Any

malfunctions identified during this test result in an error

message displayed on the LCD (refer to section 12 “Error

Indications and Messages”). As a further performance test a

trial defibrillation can be triggered.

The energy selector is used to switch CardioServ on and off.

Once you have become familiar with CardioServ you can thus

switch on the defibrillator and select the required energy in

one single operation.

* Set the energy selector to the position. No energy

will be stored in this position of the switch.

The defibrillator beeps and displays a checkered pattern

(LCD performance test). Next the main display appears

(Figure 3-7).

The “Paddle” message (b, Figure 3-7) indicates that no pa-

tient cable is connected and that the ECG signal is acquired

via the defib paddles. Upon connection of the patient cable

FreezeSpO2ECG

the selected ECG lead is displayed here. CardioServ is now

ready for operation.

Figure 3-7. CardioServ main display

a heart/pulse-rate reading with alarm limits b ECG signal source c 1-mV calibration pulse d alarm message, QRS blip e signal trace, channel 1 f signal trace, channel 2 g menu

227 446 32-I CardioServ V 4.2 23

Setting Up CardioServ and Testing Its Performance

Do not trigger more than 5 consecutive test

discharges (or internal safety discharges) within

Caution

15 minutes at max. energy setting.

Paddle

160 BPM

140 ECG

HR Alarm

Figure 3-8. Display of selected energy

360 J

MenuFreezeSpO2ECG

Test Discharge

A test discharge can be triggered to check the defibrillator

discharge circuit. For this test the stored energy is discharged

into the device via two contacts in the paddle compartments.

* Set the energy selector to 360 joules (50 joules, if inter-

nal electrodes are connected). The display first shows the

selected energy (Figure 3-8).

Charge

* Press the

(Press the

Shock

button on the paddle to charge the unit.

Charge

key on the defibrillator, when using

Shock

internal electrodes.)

You may now watch the defibrillator charging.

* When the selected energy level has been reached,

CardioServ beeps and the stored energy is displayed

(Figure 3-9).

Do not deliver shocks into open air. High voltage

may briefly be present at the unprotected paddle

Caution

surfaces as a result and endanger the persons

onds. To do so, simultaneously press the buttons on

Charge

both paddles (or press the two

Shock

keys on the

defibrillator, when using internal electrodes).

present.

If more than 5% of the available energy are lost before the

defibrillation pulse is triggered, CardioServ recharges until the

required energy level is reached.

24 CardioServ V 4.2 227 446 32-I

* Trigger the defibrillation pulse within the next 30 sec-

Setting Up CardioServ and Testing Its Performance

Paddle

160 BPM

140 ECG

HR Alarm

Energy available

Figure 3-9. Display of available energy

If you do not trigger the defibrillation pulse within

☞

30 seconds, an internal safety discharge is initiated

automatically.

360 J

MenuFreezeSpO2ECG

After defibrillation, the beeping sound stops, and the energy

actually delivered into a 50-ohm resistance is displayed for

10 seconds in place of the stored energy (Figure 3-9). The

delivered energy must not deviate more than ±15% or

±4 joules (whichever is greater) from the selected value. A

recording is initiated at the same time (16-second strip).

Should the discharge circuit be interrupted (paddles not

properly placed on contacts in the compartments, defective

lead), an internal safety discharge is initiated 200 ms after the

defibrillation shock has been triggered. In this case the “deliv-

ered energy” is “0”.

If the defibrillator cannot store the selected energy so that

selected and stored energy values differ, the LCD shows the

message “Energy high” or “Energy low”. The defibrillation

pulse can be triggeed all the same.

* Switch off CardioServ (set energy selector to ).

The message “Energy high” or “Energy low”

indicates that CardioServ needs to be repaired.

Caution

If, in spite of this energy storage problem, the

device has to be employed, it will display the

message “Self-test failed. Charge Energy Error”

Testing the Pacemaker Performance

The performance of the pacemaker can be tested with a

commercially available pacemaker tester (e.g. CS300 Simula-

tor from GEMS IT, part no. 417 983-001).

upon power up. In this situation press one of the

function keys and proceed as usual.

Performance Test

Caution

Test the defibrillator performance once a week:

test 1 – defibrillator connected to mains, battery

removed,

test 2 – defibrillator disconnected from mains,

battery inserted

227 446 32-I CardioServ V 4.2 25

For your notes

Setting Up CardioServ and Testing Its Performance

26 CardioServ V 4.2 227 446 32-I

Non-Synchronized Defibrillation

4. Non-Synchronized Defibrillation

This section describes first how to perform a non-synchro-

nized defibrillation, using the standard defibrillation

paddles. The subsequent explanations refer to the use of

internal and disposable adhesive electrodes.

At the end of this section you will find a summary of all

necessary operating steps (brief operating instructions).

227 446 32-I CardioServ V 4.2 27

Non-Synchronized Defibrillation

4.1 Defibrillation with Standard

Electrodes

The information given in section 1.2 must be

Warnin

observed without fail to ensure safe and reliable

application of the device.

Always switch off CardioServ before exchanging

the defibrillation paddles.

Danger

Paddle

160 BPM

140 ECG

HR Alarm

200 J

SpO2ECG

Figure 4-1. Main display, indication of ECG lead, manual

operation and selected energy

MenuFreeze

The energy selector can be set to the autosequence position,

where the defibrillator automatically sequences the preset

energy levels. The preset factory default setting is the sequence

recommended by AHA/ERC (200 J, 200 J, 360 J). The

factory default values can be changed from the defaults menu.

You can choose among 150 J, 200 J, 300 J and 360 J.

* Set the energy selector (4) to “Autosequence” or to the

required energy value (this turns on CardioServ).

The defibrillator beeps and displays a checkered pattern (LCD

performance test). Next the main display appears (Figure

4-1). When a patient cable is connected the selected ECG

lead is displayed (selectable).

* Check that the energy selector locks in on the correct

position and that the display shows the selected energy

(Figure 4-1).

The energy depends on the defibrillation mode, on the

patient’s age and constitution. In external application the

thickness of the tissue is also a factor which influences the

amount of energy required.

The energy necessary for successful ventricular defibrillation

without damaging the myocardium has for many years been a

matter of scientific controversy. The manufacturer is therefore

not able to give any recommendations.

28 CardioServ V 4.2 227 446 32-I

Figure 4-2. Removing the paddles

Do not apply the paddles over

Warnin

– sternum or clavicle

– nipples

– implanted pacemaker or defibrillator.

Non-Synchronized Defibrillation

In emergency situations AHA recommends for adult patients

1. defibrillation with 200 joules; if unsuccessful, repeat

2. defibrillation with 200 joules; if unsuccessful, repeat

3. defibrillation with max. energy setting (360 joules).

Please note that children require less energy for successful

ventricular defibrillation than adults. For the first defibrilla-

tion pulse delivered to babies and small children, select an

energy level of 2 joules/kg body weight. For subsequent

shocks, the energy may be increased to 4 joules/kg.

In compliance with IEC requirements the energy adjusted on

this defibrillator is not the stored energy, but the energy

released into an external resistance of 50 ohms (patient resist-

ance + electrode-to-skin contact resistance). The energy

selector is labelled accordingly.

* Remove the paddles from their compartments (as shown

in Figure 4-2). Carefully dry the electrodes, if they are

wet. The handles, in particular, must be completely dry.

Apply an ample amount of electrode cream to each

paddle.

STERNUM

* Apply the electrodes to the patient’s thorax so that the

greatest possible amount of energy flows through the

myocardium (the imaginary connecting line between the

Charge

APEX

two electrode centers should be identical with the cardiac

median line; Figure 4-3).

* Press paddles firmly down onto the patient’s thorax..

Figure 4-3. Paddle application points

227 446 32-I CardioServ V 4.2 29

Non-Synchronized Defibrillation

Charge

Shock

STERNUM

Charge

Shock

APEX

Figure 4-4. Buttons to initiate energy storage and to trigger the

defibrillation shock

Paddle

160 BPM

140 ECG

HR Alarm

The ECG signal trace appears on the monitor.

* Do not touch the patient any more and warn all those

present.

Charge

* Press the

Shock

button (8) on the apex paddle to initiate

charging (Figure 4-4). When using internal electrodes or

defibrillation pads, press

Charge

on the device.

Shock

When the selected energy level has been reached (message

“Energy available”), CardioServ beeps and the stored energy is

displayed (Figure 4-5).

* Trigger the defibrillation shock within the next 30 sec-

onds by simultaneously pressing the buttons on both

paddles (Figure 4-4). When using internal electrodes or

defibrillation pads, press

Charge

Shock

and

Shock

on the device.

If more than 5% of the available energy are lost before the

defibrillation shock is triggered, CardioServ recharges until

the required energy level is reached.

Energy available

FreezeSpO2ECG

200 J

Figure 4-5. Display of available energy

☞

When the defibrillator is already charged you can

increase the energy level simply by turning the energy

selector to the new setting. To decrease the energy

level, set the selector to the lower value and initiate

charging again.

30 CardioServ V 4.2 227 446 32-I

+ 96 hidden pages

GE Cardioserv User manual

Specifications and Main Features

Frequently Asked Questions

User Manual