M1722B CodeMaster XL+
Defibrillator/Monitor User’s Guide
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Notice
About This Edition
Publication number M1722-94980
Edition 3
Printed in USA
The information in this guide applies to the CodeMaster XL+ defibrillator/monitor. This information is subject to change without notice. Hewlett-Packard shall not be liable for errors contained herein or for incidental or consequential damages in connection with the furnishing, performance, or use of this material.
Edition History
Edition 1, May 1996
Edition 2, May 29, 1998
Edition 3, June 2000
Copyright
Copyright © 1996, 1998, 2000
Hewlett-Packard Company
Andover, MA 01810 USA
This document may not be photocopied, reproduced, or translated to another language without prior written consent of HewlettPackard.
This information is subject to change without notice.
Reproduction, adaptation, or translation without prior written permission is prohibited, except as allowed under the copyright laws.
Medical Device Directive
This product complies with the requirements of the Medical Device Directive 93/42/EEC and carries the 
0123 mark accordingly.
Authorized EU-representative:
Hewlett-Packard Deutschland GmbH
Herrenbergerstrasse 130
D-71034 Boeblingen Germany
Fax: +49-7031-14-2346
Warranty
Hewlett-Packard makes no warranty of any kind with regard to this material, included, but not limited to, the implied warranties or merchantability and fitness for a particular purpose.
WARNING
As with electronic equipment, Radio Frequency (RF) interference between the defibrillator and any existing RF transmitting or receiving equipment at the installation site, including electrosurgical equipment, should evaluated carefully and any limitations noted before the equipment is placed in service
Monitoring during quiescent periods of electrosurgery is possible but electromagnetic interference generated by electrosurgical tools during operation is sufficient to mask cardiac signals. A momentary recovery period is required for the monitor to return to normal operation and will be longer if the diagnostic monitoring mode is used. Pads or electrodes should be placed as far from the surgical area as reasonable while still performing normal function to minimize the possibility of burns. Radio frequency generation from electrosurgical equipment and close proximity transmitters may seriously degrade performance of the CodeMaster XL+ defibrillator/monitor.
Hewlett-Packard assumes no liability for failures resulting from RF interference between HP medical electronics and any radio frequency generating equipment at levels exceeding those established by applicable standards.
CAUTION
The manufacturer, importer and seller are responsible for the effects on safety, reliability and performance only if: assembly operations, extensions, re-adjustments, modifications or repair are carried out by persons authorized by them, and the electrical installation of the relevant room complies with all local regulations and the equipment is used in accordance with the instructions for use. Use of accessories other than those recommended by Hewlett-Packard may compromise product performance.
THIS PRODUCT IS NOT INTENDED FOR HOME USE.
Responsibility of Manufacturer
Hewlett-Packard only considers itself responsible for any effects on safety, reliability and performance of the CodeMaster XL+ defibrillator/monitor if:
assembly operations, extensions, readjustments, modifications or repairs are done by persons authorized by Hewlett-Packard, and
the electrical installation of the relevant room or vehicle complies with the IEC or national requirements, and
the instrument is used according to the instructions for use presented in this manual.
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Conventions Used in This Manual
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Caution statements describe conditions or actions that can result in damage to the equipment or loss of data.
Notes contain additional information on usage.
TEXT represents the messages that appear on the display.
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represents keys on the front panel. |
/,*+7 represents lighted indicators on the key panel.
v
Preface
This manual provides operational, basic maintenance, and troubleshooting instructions for use and proper care of the Hewlett-Packard M1722B CodeMaster XL+ defibrillator.
This manual is organized as follows:
Chapter 1—Getting Acquainted. Provides basic maintenance instructions for safe use and proper care.
Chapter 2—Defibrillating. Contains information about defibrillating a patient and using different paddle sets for defibrillating.
Chapter 3—Monitoring. Contains information about preparing and monitoring a patient that apply to the synchronized cardioversion and pacing procedures.
Chapter 4—Performing Synchronized Cardioversion. Contains information about performing synchronized cardioversion on a patient.
Chapter 5—Pacing (Optional). Contains information about pacing.
Chapter 6—SpO 2 Monitoring (Optional). Contains information on both cardiac and respiratory systems, and provides details of oxygen transportation in the body.
Chapter 7—Using Advisory Mode (Optional). Contains information on how the CodeMaster XL+ can act as a semi-automatic external defibrillator.
vi
Chapter 8—Troubleshooting. Contains information about troubleshooting and performing diagnostics on the CodeMaster XL+ defibrillator.
Chapter 9—Maintaining the Defibrillator. Contains information about maintaining and cleaning the CodeMaster XL+ defibrillator.
Appendix A—Installation and Setup. Contains information about battery installation and charge, paper installation, and configuration
settings.
Index.
vii
Contents
1Getting Acquainted
Operating Controls and Indications 1-1 Safety Considerations 1-10
AC / Battery Operation 1-12
Battery Life 1-13
2Defibrillating
Defibrillating a Patient 2-1
1.Select Energy 2-2
2.Charge 2-3
3.Shock 2-4
After Using the Defibrillator 2-5
Defibrillating with Alternate Paddle Sets 2-5
3 Monitoring
Using Leads to Monitor 3-1
Preparing the Leads for Monitoring 3-2
Preparing the Patient 3-4
Monitoring Electrodes 3-5
Monitoring 3-6
Heart Rate Alarms 3-7
Printing the Event Summary Record (Optional) 3-8
Recording 3-9
Automatic Recordings 3-9
Post Shock Data (Optional) 3-10
Recorder Errors 3-11
External Monitoring 3-11
4 Performing Synchronized Cardioversion
Performing Cardioversion 4-1
Monitoring During Cardioversion 4-1
Using Paddles for Performing Synchronized Cardioversion 4-3
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Using External Multi-function Defib Electrodes for Performing Synchronized Cardioversion 4-5
After Using the Defibrillator 4-8
5 |
Pacing (Optional) |
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Using the Pacer 5-2 |
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Defibrillation During Pacing 5-5 |
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6 |
SpO2 Monitoring (Optional) |
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SaO2 and SpO2 6-1 |
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Application Notes 6-1 |
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Using SpO2 to Monitor a Patient |
6-3 |
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Apply the Sensor to the Patient 6-4 |
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Troubleshooting Sensor Application |
6-5 |
Connect the Sensor to the CodeMaster XL+ 6-6
Start Monitoring 6-7
SpO2 Readings 6-7
SpO2 Alarms 6-8
Activating SpO2 Alarms 6-8
Deactivating SpO2 Alarms 6-8
Recorder Output 6-9
7 Using Advisory Mode (Optional)
Using Advisory Mode 7-1
Verify Patient Condition 7-2
A.Select Advisory On 7-2
B.Apply External Adhesive Electrodes 7-6
C.Press the Analyze Button 7-8
D.Follow Prompts 7-10
After Using the Defibrillator 7-12
Printing the Advisory Event Summary Record 7-13
Advisory Mode Default Settings 7-18
8 Troubleshooting
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Troubleshooting 8-1
Troubleshooting the Defibrillator 8-1
Troubleshooting the Pacer 8-4
Troubleshooting SpO2 8-6
Troubleshooting the Advisory Mode 8-7
Performing Diagnostics 8-7
Operational Checks 8-9
Every Shift 8-9
Every Day 8-10
Every Week 8-14
Every Three Months 8-14
Every Six Months 8-14
9Maintaining the Defibrillator
Changing the Recorder Paper 9-1 Cleaning the Recorder Printhead 9-2
Maintaining the Battery 9-3
Battery Capacity Check 9-4
Replacing the Battery 9-5
Cleaning Exterior Surfaces 9-6
Cleaning and Sterilizing the Internal Paddles 9-6
Steam Sterilizing the Internal Paddles 9-7 Ethylene Oxide Sterilization 9-8
Supplies 9-9
A Installation and Setup
Installation A-1
Line Voltage Settings A-1
Installing and Charging the Battery A-1
Loading the Recorder Paper A-3
Connecting Paddles and Patient Cables A-4
Setup A-9
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Specifications A-14
Defibrillator A-14
Monitor A-15
Thermal Array Recorder A-16
Size and Weight A-16
Battery A-17
External Pacemaker (Optional) A-17
SpO2 (Optional) A-18
Advisory Mode (Optional) A-18
Calling for Service A-19
Index
xi
Getting Acquainted
This User’s Guide provides operational and basic maintenance instructions for use and proper care of the Hewlett-Packard M1722B CodeMaster XL+ defibrillator/monitor.
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Operating Controls and Indications
The following figures and tables detail the controls and indications on the
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Safety Considerations
The CodeMaster XL+ stores high voltage energy and is capable of delivering up to 360 joules of DC energy to a 50 ohm impedance.
•To remove power from the instrument, you must turn the Energy Select control to Off (Standby). Disconnecting the CodeMaster XL+ from an AC outlet will not remove power because the instrument is battery powered.
•To disarm a charged instrument, use one of three methods:
-Turn the Energy Select control from an energy level setting to the Monitor On or Off (Standby) position.
or
-Place the paddles in their holders and depress both Shock buttons. or
-Leave the unit charged for 60 seconds and it will automatically disarm.
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• Do not leave the instrument turned on when it is not in use and it is not plugged |
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• Do not discharge the defibrillator with the paddles shorted together. To do so can |
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• Disconnect any other medical electronic equipment from the patient during |
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defibrillation discharge unless labelled as defibrillator protected. |
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AC / Battery Operation
The CodeMaster XL+ defibrillator can be operated on AC line power. The following is a list of AC and battery operating instructions.
•The battery will charge when the instrument is connected to AC power even if the Energy Select switch is in the Off (Standby) position.
• Battery charging is indicated by the %$77 &+5* light being on.
•A fully depleted battery will recharge to 90% of full capacity in two hours and 100% capacity in 18 hours. To preserve battery integrity, the battery must be fully recharged each time the battery is depleted.
•A new battery or one that has been stored for an extended period requires 24 hours of charging before use.
•When the unit is not in use, connect it to AC power with the Energy Select switch position off. This is to maintain a full battery charge and to prolong battery life.
•To operate on internal battery power only, disconnect the power cord from the AC outlet.
•A fully charged battery will nominally provide fifty 360 joule charge-shock cycles or 2.5 hours of continuous monitoring (15° C-40° C).
Continuous recording will reduce monitoring time available when you are using the unit on battery power.
When the LOW BATTERY message is displayed on the monitor, plug the unit into AC power.
From the time the LOW BATTERY message is first displayed to when the battery capacity is fully depleted (instrument shutdown), there is typically enough reserve battery capacity to provide either 30 minutes of monitoring, or five 360 joule charge-shock cycles.
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If a battery is defective, there is significantly less monitoring or charge capacity available after the LOW BATTERY message appears than if the battery is merely depleted.
A unique audible alarm will sound continuously when there are 60 seconds of battery capacity remaining. The instrument will automatically shut off after 60 seconds.
If the battery has been fully depleted, plugging the instrument into AC will immediately restore full operation.
Frequent battery discharges to the low battery level will degrade battery life.
Battery Life
The sealed lead-acid battery used in the CodeMaster XL+ will provide optimum life when the unit is continually connected to AC power when not in use. The battery operates best when it is fully charged after each use. To fully charge a depleted battery requires 18 hours of continuous charge time. Because it is not always practical to allow a full charge cycle between uses, the CodeMaster XL+ can charge a depleted battery to 90% of its capacity in approximately two hours. However, battery capacity and battery life will be reduced if the battery is not allowed to fully charge after each use. For improved battery life, consider ways to reduce the number of instrument uses between full charge cycles.
When the instrument is not plugged into AC power, some current is drawn from the battery to maintain memory and startup logic. Remove the battery if the instrument is to be stored for extended periods (more than one month) without AC power. Note on the instrument that the battery has been removed. After an extended storage period, test the battery according to the battery capacity check as described in “Maintaining the Battery” on page 9-3.
This battery was selected because it provides optimum performance and battery life over a wide range of operating conditions. The life expectancy of this battery is dependent on many variables, including temperature and usage. Periodically check the battery capacity to determine whether to replace it. The battery capacity check is described in “Maintaining the Battery” on page 9-3.
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When plugged into AC power, the CodeMaster XL+ will function normally with no |
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battery installed, however the time required to charge the defibrillator will increase. |
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Defibrillating
This chapter contains information about defibrillating a patient and using different paddle sets for defibrillating.
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Defibrillating a Patient
The following section describes the three steps to defibrillating a patient:
1Select Energy
2Charge
3Shock
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1. Select Energy
1Turn the Energy Select control to the desired energy level. The defibrillator is now on.
2Prepare the paddles by following these steps.
a.Remove the paddles from their holders by grasping the handles and lifting them straight up.
b.Holding both paddles in one hand, apply electrolyte paste to the electrode surface of each paddle.
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Do not rub the electrode surfaces together to distribute the applied paste. Placing the electrode surfaces together increases the risk of an accidental paddle-to-paddle discharge.
3Apply the paddles as described in Figure 2-2.
a.Place the Sternum paddle near the upper sternum in the patient’s right midclavicular line, just below the clavicle.
b.Place the Apex paddle on the chest just below and to the left of the patient's left nipple, in the anterior-axillary line.
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4Rub the paddles lightly against the skin to distribute the electrolyte paste and increase contact between the patient skin and the paddles. Then keep the paddles still to reduce motion artifact on the monitor.
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5 Apply 10 to 12 kg (22-25 lbs) of pressure to the paddles.
2. Charge
1 Press &KDUJH on either the Apex paddle or on the instrument front panel.
2Call out "Clear!" to alert personnel to stand away from the patient.
3Wait for the charge done indicators: &+$5*( '21( light and Charge Done tone. When the unit is armed, the monitor Delivered Energy display shows the available energy in joules.
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If the defibrillator does not charge, refer to Chapter 8, ”Troubleshooting”.
Resetting the Selected Energy Level
To increase or decrease the selected energy level after pressing the Charge button, perform the following steps.
1Move the Energy Select control to the new energy level.
2Wait for the Charge Done indicators.
3. Shock
To shock the patient, perform the following steps.
1Briefly adjust paddle pressure and placement to optimize patient contact, as registered on the paddle contact indicator (if supplied).
2Verify that no one is in contact with the patient, the monitoring cable or leads, the bed rails, or another potential current pathway.
3Call out "Clear!" to alert personnel to stand away from the patient.
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4Press and briefly hold both Shock buttons (one on each paddle) simultaneously, to deliver energy to the patient.
If the defibrillator does not shock, refer to Chapter 8, ”Troubleshooting”.
If you must disarm the charged defibrillator (if countershock is not needed), turn the Energy Select control to Monitor On. Any stored energy will be discharged internally and the available energy on the display will return to 0.
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After Using the Defibrillator
If installed, if you want to print an Event Summary now, press 
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. See “Printing the Event Summary Record (Optional)” on page 3-8. After you use the defibrillator, perform the following steps to prepare the defibrillator for its next use.
1Turn the Energy Select control to Off (Standby).
2Return the instrument to its storage location, and plug the power cord into an
AC power outlet. Verify that the %$77 &+5* and $& 32:(5 lights are on.
3Clean all paddles, controls, and cables. Refer to Chapter 9, ”Maintaining the Defibrillator” for cleaning instructions.
4Check that sufficient recorder paper and electrolyte paste or defibrillator electrodes are available for the next use of the defibrillator.
Defibrillating with Alternate Paddle Sets
The CodeMaster XL+ will defibrillate with several different electrodes/paddles sets.
• Adult/Pediatric Anterior/Anterior External Paddles
• Anterior/Posterior Paddles
• External Multi-Function Defib Electrodes
• Internal Paddles
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Performing Pediatric Defibrillation
The CodeMaster XL+ paddle set comes with pediatric paddles. To use the pediatric paddle set, depress the release latch at the front of the standard external paddle set while pulling forward on the adult paddle surface. This action will remove the adult paddle contact surface and expose the smaller pediatric contact surface. When
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