Philips Heartstart XL User manual

HEARTSTART XL

INSTRUCTIONS FOR USE

M4 735A

M4735A HeartStart XL Defibrillator/Monitor

Notice

About This Edition

Edition 7 Printed in the USA Publication number M4735-91900

The information in this guide applies to the M4735A HeartStart XL, release Main 20 and earlier. This information is subject to change without notice.

Philips 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, September, 2000 Edition 2, May, 2001 Edition 3, June, 2002 Edition 4, September, 2002 Edition 4.1, February, 2003 Edition 5, August, 2004 Edition 6, May, 2005 Edition 7, April, 2006

THIS PRODUCT IS NOT INTENDED FOR HOME USE.

IN THE U.S., FEDERAL LAW RESTRICTS THIS DEVICE TO SALE ON OR BY THE ORDER OF A PHYSICIAN.

Medical Device Directive

The M4735A HeartStart XL Defibrillator/Monitor complies with the requirements of the Medical Device Directive

93/42/EEC and carries the

mark accordingly.

For the Declaration of Conformity Statement, please see the Philips Medi cal web site at http://incenter.medical.philips.com/PMSPublic. Scroll over the Quality and Regulatory Tab located in the upper left corner of the window. Click to select Regulatory by Modality. Then click to select Defibrillators and select the entry for Declaration of Con

formity (DoC).

0123

China: After sales service: Beijing MEHECOPHILIPS Medical Equipment Service Center After sales service address: No. 208, 2nd District, Wang Jing Li Ze Zhong Yuan, Chao Yang District, Beijing Postal Code: 100102 Telephone: 010-64392415 Registration Number: SFDA(I)20043212740 Product standard number: YZB/USA 2764-21

Warning

Radio frequency (RF) interference from nearby transmitting devices may

degrade the performance of the M4735A HeartStart XL Defibrillator/ Monitor. Electromagnetic compatibil ity with surrounding devices should be assessed prior to using the defibrillator/ monitor.

All rights are reserved. Reproduction in whole or in part is prohibited without the prior written consent of the copy right holder.

SMART Biphasic is a registered trademark of Philips.

Use of supplies or accessories other than those recommended by Philips may compromise product performance.

Manufacturer

Philips Medical Systems 3000 Minuteman Road Andover, MA USA 01810-1099

Authorized EU-representative

Philips Medizin Systeme Böblingen GmbH Hewlett Packard Str. 2 71034 Böblingen Germany

Canada EMC:ICES-001

This guide uses the following conventions:

WAR NIN G Warning statements describe conditions or actions that can result

in personal injury or loss of life.

CAUTION Caution statements describe conditions or actions that can result in

damage to the equipment or loss of data.

NOTE Notes contain additional information on usage.

TEXT represents messages that appear on the display

Softkey

represents softkey labels that appear on the display above or below the button to which they correspond

iii

Introduction

Overview ............................................................................................................................... 1-2

Intended Use ......................................................................................................................... 1-4

Defibrillation Therapy .......................................................................................................... 1-4

Indications for AED Therapy ......................................................................................... 1-5

Contraindications for AED Therapy ............................................................................... 1-5

Precautions for AED Therapy ......................................................................................... 1-5

Indications for Manual Defibrillation Therapy ............................................................... 1-6

Contraindications for Manual Defibrillation Therapy .................................................... 1-6

Precautions for Manual Defibrillation Therapy .............................................................. 1-6

Noninvasive Pacing Therapy (Optional) .............................................................................. 1-7

Indications ....................................................................................................................... 1-7

Contraindications ............................................................................................................ 1-7

SpO2 Monitoring (Optional) ................................................................................................ 1-7

Indications ....................................................................................................................... 1-8

Contraindications ............................................................................................................ 1-8

Safety Considerations ........................................................................................................... 1-8

Documentation and Training ................................................................................................ 1-9

Contents

Getting Started

Getting Acquainted ............................................................................................................... 2-2

Basic Orientation ............................................................................................................ 2-2

Manual Mode Controls .................................................................................................. 2-5

Display Buttons ............................................................................................................... 2-6

Display Layout ................................................................................................................ 2-7

Connecting to Power ............................................................................................................. 2-9

Inserting the Battery ...................................................................................................... 2-10

Removing the Battery ................................................................................................... 2-11

Low Battery Warning ................................................................................................... 2-12

Continued Use ..................................................................................................................... 2-13

Using a Data Card (Optional) ............................................................................................. 2-14

Inserting a Data Card .................................................................................................... 2-15

Removing a Data Card .................................................................................................. 2-16

Contents

Defibrillating in AED Mode

Overview ............................................................................................................................... 3-3

Defibrillation (using the default configuration) .............................................................. 3-4

Defibrillation (with a modified configuration) ............................................................... 3-5

Preparation ............................................................................................................................ 3-6

Defibrillating ......................................................................................................................... 3-8

Automatic Re-analysis On ............................................................................................ 3-14

Automatic Re-analysis Off ........................................................................................... 3-14

Pausing for CPR .................................................................................................................. 3-15

Monitoring Rhythm ............................................................................................................ 3-17

ERC Protocol ...................................................................................................................... 3-19

Troubleshooting .................................................................................................................. 3-21

Monitoring the ECG

Overview ............................................................................................................................... 4-2

Connecting the ECG Patient Cable ....................................................................................... 4-3

Applying Monitoring Electrodes .......................................................................................... 4-4

Electrode Placement ....................................................................................................... 4-5

Using External ECG Monitors ........................................................................................ 4-7

Selecting the Lead ................................................................................................................. 4-8

Setting the Heart Rate Alarm .............................................................................................. 4-10

Disabling the HR Alarm ..................................................................................................... 4-11

Adjusting the ECG Size ...................................................................................................... 4-11

Adjusting QRS Beeper and Voice Prompt Volume ............................................................ 4-11

Troubleshooting .................................................................................................................. 4-12

Monitoring SpO2

Introduction ........................................................................................................................... 5-2

Understanding Pulse Oximetry ............................................................................................. 5-3

Selecting a Sensor ................................................................................................................. 5-4

Reusable Sensors ............................................................................................................ 5-5

Disposable Sensors ......................................................................................................... 5-5

Applying the Sensor .............................................................................................................. 5-6

Connecting the Sensor Cable ................................................................................................ 5-7

Monitoring ............................................................................................................................ 5-8

Setting Alarms ...................................................................................................................... 5-9

Responding to an Alarm ....................................................................................................... 5-9

Discontinuing SpO2 Monitoring ........................................................................................ 5-10

Caring for Sensors .............................................................................................................. 5-10

Troubleshooting .................................................................................................................. 5-11

Defibrillating in Manual Mode

Manual Mode Display .......................................................................................................... 6-2

Enabling Manual Mode ........................................................................................................ 6-2

Defibrillating in Manual Mode ............................................................................................. 6-3

Using External Paddles ................................................................................................... 6-3

Using Pediatric Paddles .................................................................................................. 6-4

Using Multifunction Defib Electrode Pads ..................................................................... 6-5

Using Switched Internal Paddles .................................................................................... 6-6

Using Switchless Internal Paddles .................................................................................. 6-8

Defibrillation Procedure ................................................................................................. 6-9

1. Select Energy ........................................................................................................ 6-9

2. Charge ................................................................................................................. 6-10

3. Shock .................................................................................................................. 6-11

Entering AED Mode .......................................................................................................... 6-12

Contents

Performing Synchronized Cardioversion

Monitoring the ECG .............................................................................................................7-2

Using Multifunction Defib Electrode Pads ..................................................................... 7-2

Using 3 or 5-wire ECG Leads ......................................................................................... 7-3

Using External Paddles ................................................................................................... 7-4

Using External ECG Monitors ........................................................................................ 7-5

Delivering a Synchronized Shock ......................................................................................... 7-6

Delivering Additional Synchronized Shocks ........................................................................ 7-8

Disabling Sync Mode ............................................................................................................7-8

Pacing (Optional)

vii

Contents

Pacing Operational Controls ................................................................................................. 8-2

Demand Mode Versus Fixed Mode ...................................................................................... 8-2

Monitoring During Pacing .................................................................................................... 8-3

Preparing for Pacing ............................................................................................................. 8-3

Performing Pacing ................................................................................................................ 8-5

Changing Pacing Modes ....................................................................................................... 8-8

Defibrillating During Pacing ................................................................................................ 8-8

Troubleshooting .................................................................................................................... 8-9

Storing, Retrieving & Printing

Overview ............................................................................................................................... 9-2

Marking Events ..................................................................................................................... 9-3

Events Recorded ................................................................................................................... 9-4

Creating a Patient Record ..................................................................................................... 9-6

Printing the Internal Event Summary ................................................................................... 9-7

Printing Events ...................................................................................................................... 9-9

Setting Up and Configuring the HeartStart XL

Connecting/Disconnecting Patient Cables .......................................................................... 10-2

Connecting Cables to the Patient Cable Connector ...................................................... 10-3

Connecting the SpO2 Patient Cable .............................................................................. 10-5

Connecting the ECG Patient Cable ............................................................................... 10-6

Configuring the HeartStart XL ........................................................................................... 10-7

Accessing the Configuration Menu .............................................................................. 10-7

Configurable Parameters ............................................................................................... 10-8

Modifying the Configuration ...................................................................................... 10-15

Returning to the Default Configuration ...................................................................... 10-15

Saving Settings to a Data Card ................................................................................... 10-16

Loading Settings from a Data Card ............................................................................ 10-16

Printing Settings .......................................................................................................... 10-16

Maintaining the HeartStart XL

Operational Checks ............................................................................................................. 11-2

Before You Begin ......................................................................................................... 11-2

viii

Contents

Every Shift .................................................................................................................... 11-3

Every Month ................................................................................................................. 11-3

Using External Paddles ................................................................................................. 11-4

Using Pads .................................................................................................................... 11-5

Using Internal Paddles .................................................................................................. 11-7

Battery Maintenance ........................................................................................................... 11-8

Recharging Batteries ..................................................................................................... 11-9

Battery Capacity Test .................................................................................................... 11-9

Battery Capacity ......................................................................................................... 11-12

Battery Life Expectancy ............................................................................................. 11-12

Storing Batteries ......................................................................................................... 11-12

Discarding Batteries .................................................................................................... 11-12

Loading Printer Paper ....................................................................................................... 11-13

Cleaning Instructions ........................................................................................................ 11-15

Cleaning the HeartStart XL ........................................................................................ 11-15

Cleaning the Printer Printhead .................................................................................... 11-15

Cleaning Defib Pads & Monitoring Electrodes .......................................................... 11-16

Cleaning the External and Internal Paddles ................................................................ 11-16

Cleaning the Pads Cable ............................................................................................. 11-17

Cleaning the ECG Cable ............................................................................................. 11-17

Cleaning the SpO2 sensor and cable ........................................................................... 11-17

Supplies & Accessories .................................................................................................... 11-18

Disposing of the HeartStart XL ........................................................................................ 11-23

Troubleshooting

System Messages ................................................................................................................ 12-2

Momentary Messages ......................................................................................................... 12-5

Troubleshooting Tips .......................................................................................................... 12-7

Calling for Service ............................................................................................................ 12-10

Asia/Asia Pacific ......................................................................................................... 12-11

Specifications & Safety

Specifications ...................................................................................................................... 13-2

Defibrillator .................................................................................................................. 13-2

Contents

ECG Monitoring ........................................................................................................... 13-6

Display .......................................................................................................................... 13-9

Battery ......................................................................................................................... 13-10

Noninvasive Pacing .................................................................................................... 13-12

SpO2 Pulse Oximetry ................................................................................................. 13-13

Event Storage .............................................................................................................. 13-14

General ........................................................................................................................ 13-14

Environmental ............................................................................................................. 13-14

Symbol Definitions ........................................................................................................... 13-16

Clinical Performance Summary - Defibrillation ............................................................... 13-21

Methods ...................................................................................................................... 13-21

Results ......................................................................................................................... 13-21

Conclusion .................................................................................................................. 13-22

Clinical Performance Summary - Cardioversion .............................................................. 13-23

Methods ...................................................................................................................... 13-23

Results ......................................................................................................................... 13-23

Conclusion .................................................................................................................. 13-25

Clinical Performance Summary - Internal Defibrillation ................................................. 13-26

Overview ..................................................................................................................... 13-26

Methods ...................................................................................................................... 13-26

Results ......................................................................................................................... 13-27

Conclusion .................................................................................................................. 13-27

Safety Considerations ....................................................................................................... 13-28

Electromagnetic Compatibility ......................................................................................... 13-32

(Devices with Serial Numbers US001XXXXX) ........................................................ 13-32

Reducing Electromagnetic Interference ...................................................................... 13-33

Restrictions for Use .................................................................................................... 13-34

Immunity Level ........................................................................................................... 13-34

Electromagnetic Compatibility ......................................................................................... 13-35

(Devices with Serial Numbers US002XXXXX) ........................................................ 13-35

Reducing Electromagnetic Interference ...................................................................... 13-36

Restrictions for Use .................................................................................................... 13-36

Emissions and Immunity .................................................................................................. 13-37

Guidance and Manufacturer’s Declaration ................................................................. 13-38

Recommended Separation Distances .......................................................................... 13-45

1Introduction

The M4735A HeartStart XL Defibrillator/Monitor is designed to meet your resuscitation and monitoring needs. This guide provides instructions for safe and proper operation, set-up, configuration, and care of your M4735A HeartStart XL Defibrillator/Monitor.

In this chapter, you’ll find general information that you should become familiar with before using the defibrillator/monitor.

M4735A HeartStart XL Defibrillator/Monitor 1-1

Overview

The M4735A HeartStart XL Defibrillator/Monitor is a lightweight, portable, semi-automatic external defibrillator. It offers two modes of operation for defibrillation:

z Automated External Defibrillation (AED) Mode z Manual Mode

Both modes incorporate a low energy SMART Biphasic waveform for defibrillation.

In AED Mode, the M4735A HeartStart XL Defibrillator/Monitor analyzes the patient’s ECG and advises you whether or not to deliver a shock. Voice prompts guide you through the defibrillation process by providing instruc tions and patient information. Voice prompts are reinforced by messages that appear on the display.

In Manual Mode, the M4735A HeartStart XL Defibrillator/Monitor turns control of the defibrillation process over to you. You assess the patient’s ECG, and select the energy setting for defibrillation if necessary. Manual Mode also allows you to perform synchronized cardioversion and offers noninvasive pacing (optional).

Defibrillation is performed through external or internal paddles (both optional), or through multifunction defib electrode pads. Monitoring is avail able in AED and Manual Mode through pads, 3-lead ECG monitoring electrodes, or optional 5-lead ECG monitoring electrodes. Optional pulse oximetry (SpO

While monitoring ECG or SpO

) monitoring is also available in AED and Manual Modes.

, you may set heart rate and/or SpO2 alarms to

alert you when these parameters are outside the defined limits.

1-2 Introduction

Overview

The M4735A HeartStart XL Defibrillator/Monitor automatically stores critical events in its internal memory, such as shocks and alarm violations. Additional events of interest may also be marked for storage. These events can be printed as they occur or as part of an Event Summary. The M4735A Heart Start XL Defibrillator/Monitor also allows you to store data and events on an optional HeartStart XL-compatible data card (see Chapter 11 for a listing) for downloading to HeartStart Event Review Data Management Systems.

The versatile M4735A HeartStart XL Defibrillator/Monitor is highly configurable to better meet the needs of diverse users. The messages and softkeys vary, depending on how the M4735A HeartStart XL Defibrillator/Monitor is configured. Be sure to familiarize yourself with your configuration before using the M4735A HeartStart XL Defibrillator/Monitor (see HeartStart XL” on page 10-7).

The M4735A HeartStart XL Defibrillator/Monitor is powered by AC power and a rechargeable sealed lead acid (SLA) battery which allows the defibrilla tor to charge to 200 joules in less than three seconds. Proper care of your batteries will ensure that they have the energy required to operate the M4735A HeartStart XL Defibrillator/Monitor and to deliver the appropriate therapy. (See

“Battery Maintenance” on page 11-8.) Similarly, performing the specified operational checks will ensure that the M4735A HeartStart XL Defibrillator/Monitor is functioning properly and ready for use. (See “Operational Checks” on page 11-2.)

“Configuring the

M4735A HeartStart XL Defibrillator/Monitor 1-3

Intended Use

The M4735A HeartStart XL Defibrillator/Monitor is for use in the hospital by qualified medical personnel trained in the operation of the device and quali fied by training in basic life support, advanced cardiac life support, or defibrillation. It must be used by or on the order of a physician.

When operating as a semi-automatic external defibrillator in AED Mode, the M4735A HeartStart XL Defibrillator/Monitor is suitable for use by medical personnel trained in basic life support that includes the use of an AED.

When operating as a defibrillator/monitor in Manual Mode, the M4735A HeartStart XL Defibrillator/Monitor is suitable for use by healthcare profes sionals trained in advanced cardiac life support.

Defibrillation Therapy

Defibrillation therapy is the definitive method for termination of a variety of potentially fatal arrhythmias. The M4735A HeartStart XL Defibrillator/Moni tor provides this therapy through the application of a brief biphasic pulse of electricity to the cardiac muscle. This electrical energy is transferred through attached internal paddles applied directly to the patient’s heart, or through attached paddles or disposable multifunction defib electrode pads applied to the patient’s bare chest.

NOTE Successful resuscitation is dependent on many variables specific to the

patient’s physiological state and the circumstances surrounding the patient event. Failure to have a successful patient outcome is not a reliable indicator of defibrillator/monitor performance. The presence or absence of a muscular response to the transfer of energy during electrical therapy is not a reliable indicator of energy delivery or device performance.

1-4 Introduction

Defibrillation Therapy

Indications for AED Therapy

An AED is to be used in the presence of a suspected cardiac arrest on patients of at least 8 years of age that are:

z Unresponsive z Not breathing z Pulseless

Contraindications for AED Therapy

An AED is not to be used on patients that exhibit one or any combination of the following:

z Responsiveness z Spontaneous breathing z Palpable pulse

Precautions for AED Therapy

The AED algorithm is not designed to handle erratic spiking problems caused by a properly or improperly functioning pacemaker. In patients with cardiac pacemakers, the M4735A HeartStart XL Defibrillator/Monitor may have reduced sensitivity and not detect all shockable rhythms.

NOTE The Philips HeartStart XL AED algorithm is not intended for children under 8

years of age. For children older than 8 years, the American Heart Association recommends that standard operating procedures for AEDs be followed. American Heart Association Guidelines 2005 for Cardiopulmonary Resusci

tation and Emergency Cardiovascular Care. Dallas, Texas; AHA; 2005.

M4735A HeartStart XL Defibrillator/Monitor 1-5

Defibrillation Therapy

Indications for Manual Defibrillation Therapy

Asynchronous defibrillation is the initial treatment for ventricular fibrillation and ventricular tachycardia, in patients who are pulseless and unresponsive.

Synchronous defibrillation is indicated for termination of atrial fibrillation. The SMART Biphasic waveform utilized in the HeartStart XL Defibrillator/ Monitor has undergone clinical testing demonstrating its effectiveness for cardioversion of atrial fibrillation.

The SMART Biphasic waveform utilized in the M4735A HeartStart XL Defibrillator/Monitor has undergone clinical testing in adults. These trials support the waveform’s effectiveness for defibrillation of ventricular tachyarrhythmias at the 150J setting.

In Manual mode operation, the M4735A HeartStart XL Defibrillator/Monitor incorporates some user selectable lower energy levels that were not used in the clinical trials.

There are currently no clinical studies related to the use of the SMART Biphasic waveform in pediatric applications.

Contraindications for Manual Defibrillation Therapy

Asynchronous defibrillation therapy is contraindicated in patients that exhibit one or any combination of the following:

z Responsiveness z Spontaneous breathing z Palpable pulse

Precautions for Manual Defibrillation Therapy

Defibrillating asystole can inhibit the recovery of natural pacemakers in the heart and completely eliminate any chance of recovery. Asystole should not be routinely shocked.

1-6 Introduction

Noninvasive Pacing Therapy (Optional)

The M4735A HeartStart XL Defibrillator/Monitor provides noninvasive transcutaneous pacing by delivering a monophasic, electrical stimulus to the heart. This stimulus is intended to cause cardiac depolarization and myocar dial contraction. The medical care provider selects the stimulus current and rate settings. The energy is delivered through multifunction defib electrode pads applied to the patient’s bare chest.

Indications

Noninvasive pacing is one method of treating patients with symptomatic bradycardia. It can also be helpful in patients with asystole, if performed early.

Contraindications

Noninvasive pacing is contraindicated in the treatment of ventricular fibrillation. Noninvasive pacing in the presence of severe hypothermia may be contraindicated.

SpO2 Monitoring (Optional)

A pulse oximeter is a noninvasive device that indicates the oxygen saturation (SpO

) of arterial blood. This measurement is obtained through a probe that

directs red and near infrared light through arterial beds. Hemoglobin absorbs these lights differently when it is bound with oxygen. Pulse oximetry mea sures this difference and translates the measurement into a saturation percentage that is displayed as an SpO2 reading.

M4735A HeartStart XL Defibrillator/Monitor 1-7

Safety Considerations

Indications

SpO2 monitoring is indicated for use when it is beneficial to assess a patient’s oxygen saturation level.

Contraindications

There are no known contraindications for SpO2.

NOTE Readings should be carefully considered in the presence of certain circum-

stances. Inaccuracies may result from the use of pulse oximeters in the presence of certain circumstances, such as hemoglobin saturated with compounds other than oxygen, (such as carbon monoxide), hypothermia, hypovolemia, patient movement, nail polish and excessive ambient light.

Safety Considerations

General warnings and cautions that apply to use of the M4735A HeartStart XL Defibrillator/Monitor are provided in Chapter and cautions specific to a particular feature are provided in the appropriate section of this guide.

13. Additional warnings

1-8 Introduction

Documentation and Training

Documentation for the M4735A HeartStart XL Defibrillator/Monitor includes:

z M4735A HeartStart XL Defibrillator/Monitor Instructions for Use z M4735A HeartStart XL Defibrillator/Monitor Quick Reference Card,

and

z About Sealed Lead Acid Batteries, an application note on battery

maintenance.

Training tools available for use with the M4735A HeartStart XL include:

z Using the M4735A HeartStart XL Defibrillator/Monitor, a workbook z HeartStart XL User Training CD-ROM z HeartStart XL User Training Video

For additional online documentation and training, please visit our website:

www.medical.philips.com/cms.

Available online training materials include:

z AED Application Note z SpO

z Pacing Application Note

M4735A HeartStart XL Defibrillator/Monitor 1-9

Concept Guide

2 Getting Started

Congratulations on purchasing your HeartStart XL!

This chapter will give you a quick tour of your new defibrillator/monitor’s controls and display.

The HeartStart XL ships complete with the cables, battery, and paper necessary for easy operation. This chapter will help you get your HeartStart XL up and running by following a few easy steps, including:

z Connecting to AC Power z Inserting the battery z If desired, inserting the optional HeartStart XL-compatible Data Card

(see Chapter 11 for a listing).

NOTE To connect cables to the HeartStart XL, refer to “Setting Up and Configuring

the HeartStart XL” in Chapter 10.

M4735A HeartStart XL Defibrillator/Monitor 2-1

Getting Acquainted

Energy Select Knob

Getting Acquainted

This section provides an overview of the HeartStart XL controls, connections, and display layout. A review of control functionality is also provided.

Basic Orientation

Review the figure for a general layout of the controls, where the patient cables connect, and where to insert the battery and Data Card.

Figure 2-1 Basic Orientation (Front)

Mark

AC Power

Batt Charge

Print Strip

Event Summary

Vol ume

ECG Size

Pacer

Speaker

Patient Cable Connector

Data Card

Rate

Mode

Start/Stop

Output

Battery

2-2 Getting Started

Figure 2-2 HeartStart XL (Back)

Getting Acquainted

Printer

NOTE If your HeartStart XL does not have the SpO

these controls and the related information described in this section.

ECG Connector

SpO

Connector

ECG Out (Sync) Jack

AC Power

or Pacing option, disregard

M4735A HeartStart XL Defibrillator/Monitor 2-3

Getting Acquainted

Defibrillation Controls

Defibrillation controls consist of an energy select knob and a set of softkeys that perform the function displayed as a label above each button. These controls assist in both AED and Manual Mode defibrillation.

Audiovisual Controls

Adjusts the volume of voice prompts and the QRS beeper. At the lowest setting, the QRS beeper is muted. The voice prompts and other alert tones cannot be muted.

Adjusts the size of the ECG waveform displayed, printed, and stored. Pressing

and simultaneously generates a

1 mV calibration pulse.

NOTE To permanently turn the QRS beeper off, use the General settings in

Configuration mode. See Chapter 10 “Setting Up and Configuring the HeartStart XL”.

Monitoring Controls

Monitoring controls consist of a set of softkeys that perform monitoring functionality. These functions are displayed in the softkey label below each button. Monitoring softkeys also control heart rate and SpO

alarms, and

selection of the ECG source to monitor.

2-4 Getting Started

Getting Acquainted

Print Controls

Print controls perform the function shown on each button. The print controls from are:

Strip

Prints ECG data, defibrillation events, and marked events real-time or with a 6 second delay (as configured). Press to start printing; press again to stop printing.

Summary

Mark

Prints the Event Summary. (See “Storing, Retrieving & Printing”for more information.) Printing may be stopped by pressing

Summary

the or button.

Strip

Inserts a time-stamped annotation in the Event Summary. May be configured to print an annotated ECG strip when pressed.

Manual Mode Controls

Manual Mode controls provide access to manual defibrillation, and synchronized cardioversion and optional pacing functionality.

Figure 2-3 Manual Mode Controls: Energy Select Knob and Pacing Controls

M4735A HeartStart XL Defibrillator/Monitor 2-5

Getting Acquainted

Display Buttons

Can enable both Manual Mode and AED Mode. The AED On position activates AED Mode. Manual On enables Manual Mode, synchronized cardioversion and pacing (optional).

Button below the display (far left) that enables synchronized cardioversion when first pressed in Manual Mode; disables synchronized cardioversion when pressed again.

Pacer

green LED), allowing you to use the buttons below to define pacing rate, mode, and current output. Also turns off the Pacer function when pressed a second time.

Activates the pacing function buttons (as indicated by the

Rate

Start

Stop

Adjusts the pacing rate.

Starts pacing. Delivers pacer pulses when first pressed; stops pacing when pressed again.

Mode

Output

NOTE Synchronized cardioversion and pacing controls only function when Manual

Selects Demand or Fixed Mode for pacing.

Adjusts the current output for pacing.

Mode is enabled.

2-6 Getting Started

Display Layout

The following figures show the layout of the display in:

Getting Acquainted

z AED Mode, with ECG and SpO

z Manual Mode

NOTE ECG and SpO

disabled independently in the configuration.

Figure 2-4 AED Mode Display Layout (ECG and SpO2 Enabled)

Heart Rate HR Alarm

ECG

Defibrillation Soft Keys

monitoring capabilities enabled

monitoring capabilities disabled

monitoring capabilities for AED Mode may be enabled and

Lead

HR ALARM

132

System Message

Momentary Message

LEAD

SELECT

Lead II

User Message

PAUSE

Displayed

ON/OFF

ANALYZE SHOCK

SpO2

SpO

value

SpO2

ALARM

Pulse 130

114J

Shocks: 0

00:15:02

SpO

alarm

Pleth Bar Pulse Rate

ECG Gain

Current Charge

Shocks Delivered Incident Timer

The Incident Timer shows the elapsed time since the HeartStart XL was turned on, provided patient contact was established. If the HeartStart XL is powered on after being off for less than two minutes, the Incident Timer resumes where it left off. If power is off for more than two minutes, the Inci

dent Timer resets to zero (00:00:00). If an Event Summary is printed, the incident timer will be set to zero the next time the unit is turned on.

M4735A HeartStart XL Defibrillator/Monitor 2-7

Getting Acquainted

Figure 2-5 AED Mode Display Layout (ECG and SpO2 disabled)

System Message

Momentary Message

ECG

Defibrillation Soft Keys

PAU SE

User Message

ANALYZE

150J

Shocks: 0

00:15:02

SHOCK

ECG Gain

Current Charge

Shocks Delivered Incident Timer

User messages accompany voice prompts to guide you through the defibrillation process.

System and Momentary Messages:

z alert you to conditions that require your attention, z provide status information, or z offer recommendations.

A System Message remains on the display until the condition that generated the message no longer exists. A Momentary Message is temporary and appears on the display for a minimum of 3 seconds. For a list of system and momentary messages, see Chapter

12.

2-8 Getting Started

+ 204 hidden pages

Philips Heartstart XL User manual

Specifications and Main Features

Frequently Asked Questions

User Manual

1Introduction

Overview

Intended Use

Defibrillation Therapy

Indications for AED Therapy

Contraindications for AED Therapy

Precautions for AED Therapy

Indications for Manual Defibrillation Therapy

Contraindications for Manual Defibrillation Therapy

Precautions for Manual Defibrillation Therapy

Noninvasive Pacing Therapy (Optional)

Indications

Contraindications

SpO2 Monitoring (Optional)

Safety Considerations

Indications

Contraindications

Documentation and Training

2 Getting Started

Getting Acquainted

Basic Orientation

Manual Mode Controls

Display Buttons

Display Layout