LIFEPAK, LIFENET, and QUIK-COMBO are registered trademarks of Physi o-Control, Inc. ADAPTIV, CODE-STAT, cprMAX, REDI-PAK, and Shock
Advisory System are trademarks of Physio-Control, Inc. Microsoft and Windows are registered trademarks of Microsoft Corporation. Ambu is a
registered trademark of the Ambu Corporation. Specifications are subject to change without notice.
This instrument is to be used by authorized personnel only.
Rx Only
Device Tracking
The U.S. Food and Drug Administration requires defibrillator manufacturers and distribut ors to track the location of
their defibrillators. If the device is located somewhere other than the shipping address or the device has been sold,
donated, lost, stolen, exported, destroyed, permanently retired from use, or if the device was not obtained directly
from Physio-Control, please do one of the following: register the device at http://www.physio-control.com, call the
device tracking coordinator at 1.800.426.4448, or use one of the postage-paid address change cards located in the
back of this manual to update this vital tracking information
Responsibility for Information
It is the responsibility of our customers to ensure that the appropriate person(s) within their organization have
access t o this information, including cautions and warnings provided throughout this manual.
TABLE OF CONTENTS1
Preface
About Defibrillation ................................................................................................................................................. vi
Indications for Use ................................................................................................................................................... vi
Defibrillation..................................................................................................................................... .................. vi
ECG Monitoring................................................................................................................................................. vi
Operator Considerations ......................................................................................................... ............................ vii
About the LIFEPAK 1000 Defibrillator ............................................................................................................. vii
Defibrillator Features.................................................................................................................................... vii
Text Conventions ................................................................................................................................................... viii
General Warnings and Cautions ........................................................................................................................1-2
Controls and Indicators ........................................................... ........................................................................... 2-2
3 How to Use the LIFEPAK 1000 Defibrillator
Modes of Operation ........................................ .....................................................................................................3-2
Defibrillation Warnings and Cautions.....................................................................................................3-2
Defibrillation in AED Mode ..................................................................................................................................3-3
Basic Steps for Using the LIFEPAK 1000 Defibrillator......................................................................3-3
Special Situations for Electrode Placement........................................................................................3-4
Defibrillation in Manual Mode ............................................................................................................................3-5
Auto Tests..................................................................................... ...................................................................5-2
Service ......................................................................................................................................................................5-6
Product Recycling Information ................................................................. ........................................................5-6
Supplies, Accessories, and Training Tools ....................................................................................................5-7
Warranty Information .......................................... ..................................... ...........................................................5-7
A Specifications
B Shock Advisory System
C cprMAX™ Technology
D Changing Setup Options
E User’s Checklist
Defibrillation is a recognized means of terminating certain potentially fatal arrhythmia s. A d irect current
defibrillator applies a brief, high-energy pulse o f electricity to the heart muscle. The Physio-Control
LIFEPAK
disposable defibrillation electrod es applied to the patient's chest.
Defibrillation is only one a s pect of the medical care required to resuscitate a p atient with a shockable ECG
rhythm. Depending on the situation, other measures may include:
• Cardiopulmonary r esuscitation (CPR)
• Supplemental oxygen
•Drug therapy
It is recognized that successful resuscitation is relat ed to the length of time be tween the onset of a heart
rhythm tha t does not circulate blood (ventricula r fibrillation, pulseless ventricular tachycardia) and
defibrillation. The American Heart Association has identified the following as critical links in the chain of
survival from sudden cardiac arre st (SCA).
•Early access
• Early CPR by first responders or bystanders
®
1000 defibrillator is an automated external defibrillator (AED) that delivers this energy through
• Early defibrillation
• Early advanced life support
The physiological s tate of the patient may affect the likelihood o f successful defibrillation. Thus, failure to
resuscitate a patient is not a reliable indicator of defibrillator performance. Often, patients will exhibit a
muscular re sp ons e (such as jumpin g or tw itchin g) durin g en ergy transfer. The absence of such a response
is not a reliable indicator of actual energy delivered or defibrillator performance.
INDICATIONS FOR USE
Defibrillation
Defibrillation is a recognize d means of terminating certain potentially fat al a rrhythmias, such as
ventricular fibrillation and symptomatic ventricular tachycardia.
The defibrillator is to be used in AED mode only on patients who are in cardiopulmonary arrest. The patient
must be unresponsive, not breathing normally, and showing no signs of circulation.
The defibrillator may be used with standard defibrillation pads only on adults and children who are 8 years
old or more or who weigh more than 25 kg (55 lbs). The defibrillator may be used on children who are less
than 8 years old or weigh less than 25 kg (55 lbs) with Infant/Child Reduced Energy Defibrillation
Electrodes.
ECG Monitoring
ECG monitoring is for use on conscious and unconsci ous patients of all ages for the purpose of ECG
rhythm recognition and heart rate monitoring.
The LIFEPAK 1000 defibrillator requires operator interaction to defibrillate the patient.
The defibrillator is intended for use by personnel who are authorized by a physician or medical director
and have, at a minimum, the following skills and training.
•CPR training
• Defibrillator training equivalent to that recommended by the American Heart Association
• Training in the use of the LIFEPAK 1000 defibrillator
The LIFEPAK 1000 defibrillator is intended for use in hospital and out-of-h ospital environments.
Manual mode is intende d f or us e by personnel trained in ECG recognition who w ant t o us e the d efibrilla t or
to deliver a shock independent of AED mode. The operator has control over the charging and delivery of
shocks.
ECG mode provides a nondiagnostic ECG display and is intended for use by personnel trained in ECG
recognition to allow for rhythm and heart rate monitoring using standard ECG electrodes. When in ECG
mode, the defibrillator’s shock capability is disabled; however, the LIFEPAK 1000 defibrillator continues
to analyze the patient’s ECG for a potentially shockable rhythm.
ABOUT THE LIFEPAK 1000 DEFIBRILLATOR
The LIFEPAK 1000 defibrillator is a se miautomatic model that can be operated in either of three mod es:
AED mode, Manual mode , and ECG mode. The defibrillator uses the patented Physio-Control Shock
Advisory System™ (SAS) to analyze the patient's electrocardiographic (ECG) rhythm and prompts you
when it detects a shocka bl e rhythm and when it does not detect a shockable rhythm. Responder
interaction is required to provide therapy (defibrillation) to the patient.
Defibrillator Features
The following paragraphs introduce the LIFEPAK 1000 defibrillator features.
Heart Rhythm Analysis
The patented Physio-Control Shock Advisory System evaluates the patient’s heart rhythm.
ECG Display (optional)
This feature allows display of the ECG us ing the 3-wire (Lead II) cable and when using the defibrillator in
AED mode. This feature is also n ecessary to use the defibrillator in Manual mode.
Defibrillation Waveform
The defibrillation shock, using ADAPTIV™ Biphasic technology, is delivered in the form of a biphasic
truncated exponential (BTE) defibrillation waveform. LIFEPAK bip hasic d efibrillators me asure the patient’s
transthoracic impedance and automatically adjust the defibrillation waveform current, duration, and
voltage to meet the needs of the individual patient. Patient impedance is measured whenever
defibrillation electrodes are in contact with the patient.
The cprMAX technology is designed to allow resuscitation protocols to maximize the amount of CPR
administered during treatment using the LIFEPAK 1000 defibrillator.
When used with the factory default settings enabled, the defibrillator allows AED protocols to be
consistent w i th the 2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and
Emergency Cardiovascular Care and European Resuscitation Council Guidelines for Resuscitation.
Data Management
The LIFEPAK 1000 defibrillator digitally records patient data, including ECG rhythm and d e livered shocks.
Recorded data may be transferred from the defibrillator to a PC using an infrared connection. The PC
®
must have one of our LIFENET
Battery Options
products installed to collect and review the r e corded p atient data.
A nonrechargeable lithium manganese dioxide (Li/MnO2) battery provides power to the defibrillator. The
battery has indicators that a pproximate the remaining state of charge. To save battery life if the
defibrillator is accidentally turned on or left on, the defibrillator automatically turns off if it is not
connected to a patient and no buttons are pressed for 5 minutes.
Daily Self-Test
The defibrillator performs a daily self-test e v er y 24 hours an d every time you turn on the defibrillat or. This
feature tests the most important circuitry in the defibrillator to give the responder a high degree of
confidence that it is ready for use.
Readiness Display
The LIFEPAK 1000 defibrillator includes a readiness display. The OK symbol appears in the display if the
daily self-test is completed successfully. A battery symbol that approximates the remaining state of
charge is also visible. If the self-test detects that service is required, the
OK symbol disappears and the
service symbol appears.
TEXT CONVENTIONS
Throughout this manual, special text characters are used to indicat e labels, screen messages, and voice
prompts.
Operating contr ol labels:
Screen messages, and voice
prompts:
CAPITAL LETTERS such as ON/OFF and SHOCK.
CAPITAL ITALICIZED LETTERS such as PUSH ANALYZE and
CONNECT ELECTRODES
This section provides important information to help you operate the LIFEPAK 1000 defibrillator.
Familiarize yourself with all of these terms, warnings, and symbols.
Termspage 1-2
General Warnings and Cautions1-2
Symbols1-3
The following terms are used either in this manual or on the LIFEPAK 1000 defibrillator.
Danger: Immediate hazards that will result in serious personal injury or dea th.
Warning: Hazards or unsafe practices that could result in serious personal injury or de ath.
Caution: Hazards or unsafe practices that could result in minor personal injury, product damage, or
property damage.
GENERAL WARNINGS AND CAUTIONS
The following section provides g eneral warning and caution statements. Other specific w arnings and
cautions are provided as needed in other sections of this m anual.
WARNINGS!
Shock hazard.
The defibrillator delivers up to 360 joules of electrical energy. Unless properly used as describ ed in these
operating instructions, this electrical energy may cause serious injury or death. Do not attempt to
operate this device unless thoroughly familiar with these operating instructions, and the function of all
controls, indicators, connections, and accessories.
Shock hazard.
Do not disassemble the defibrillator. It contains no responder-serviceable components and dangerous
high voltages may be present. Contact authorized service personnel.
Shock or fire hazard.
Do not immerse any portion of this device in water or other fluids. Avoid spilling any fluids on device or
accessories. Do not clean with ketones or other flammable agents. Do not autoclave or sterilize this
device or accessories unless otherwise specified.
Possible fire or explosion.
Do not use this device in the presence of flammable gases or anesthetics. Use care when operating this
device close to oxygen sources (such as bag-valve-mask devices or ventilator tubing). Turn off gas
source or move source away from patient during defibrillation.
Possible electrical interference with device performance.
Equipment operating in close proximity may emit strong electromagnetic or radio frequency
interference (RFI) which could affect the performance of this device. RFI may result in improper device
operation, distorted ECG, or failure to detect a shockable rhythm. Avoid operating the device nea r
cauterizers, diathermy equipment, cellular phones, or other portable and mobile RF communications
equipment. Do not rapidly key EMS radios on and off. Refer to “LIFEPAK 1000 De fibrillat or Electr omagne tic Compliance Guidance” for recommended distances of equipment. Contact authorized service personnel
if assistance is required.
Possible electrical interference.
Using cables, electrodes, or accessories not specified for use with this device may result in increased
emissions or decreased resistance to electromagnetic interference which could affect the performance
of this device or of equipment in close proximity. Use only parts and accessories specified in these
operating instructions.
Possible electrical interference.
This defibrilla tor may cause electromagnetic interference (EMI) especially during charge and energy
transfers. EMI may affect the perf orm anc e of equipment operatin g in clos e proximity. Verify the effects
of defibrillator discharge on other equipment prior to using defibrillator in an emergency situation, if
possible.
Always have access to a spare, fully-charged, properly maintained battery. Replace the batt er y when the
device display s a low battery warning.
Possible improper device performance.
Using other manufacturers’ cables, electrodes, or batteries may cause the device to perform improperly
and invalidates the safe ty agency certification and may invalidate the warranty. Use only the acc essories
specified in these operating instructions.
Safety risk and possible equipment damage.
Monitors, defibrillators, and their accessories (including ele ctrodes and cables) contain ferromagnetic
materials. As with all ferromagnetic equipment, these products must no t be used in the presence of the
high magnetic field created by a Magnetic Resonance Imaging (MRI) device. The high magnetic field
created by an MRI device will attract the equipment with a force sufficient to cause death or serious
personal injury to persons be tw een the equipment an d the MRI de vice. This ma gnetic a ttr a ction may als o
damage the equipment. Skin burns will also occur due to heating of electrically conductive materials,
such as patient leads and pulse oximeter sensors. Consult the MRI manufacturer for more information.
CAUTION!
Possible equipment damage.
This device may be damaged by mechanical or physical abuse such as immersion in wat er or dropping the
device. If the device has been abused, remove it from use and contact authorized service personnel.
SYMBOLS
The following symbols may be found in this manual or on various configurations of the LIFEPAK 1000
defibrillator and its accessories.
Defibrillation-protected. Type BF patient connection
Symbol indicating self-test completed successfully
Use By date shown: yyyy-mm-dd or yyyy-mm
This end up
Fragile/breakable.
Handle with care.
Protect from water
Single use only
Mark of conformity to applicable European Directives
Canadian Standards Association certification for Canada and the United States
Cable Connector
For USA audiences only
Date of manufacture
Power On/Off
Shock button
Shock symbol
Symbol indicating location of battery compartment
Recommended storage temperature: 15° to 35°C (59° to 95°F). Storage at
extreme temperatures of -30° and 60°C (-22° and 140°F) is limited to seven
days. If storage at these temperatures exceeds one week, the electrode
shelf-life will be reduced.
Recommended shipping temperature: -20° to 50°C (-4° to 122°F).
Relative humidity range 5% to 95%
Do not place near an open flame
Do not crush, puncture, or disassemble battery
Nonrechargeable battery
Refer to instructions for disposal procedure
Rx Only or Rx Only
IP55
Do not dispose of this product in the unsorted municipal waste stream. Dispose
of this product according to local regulations. See
http://recycling.medtronic.com for instructions on disposing of this product.
Infant Child Reduced Energy Elec trodes are not compatibl e with QUIK-C OMBO
defibrillation and therapy cables. To use Infant/Child Electrodes, connect
Infant/Child electrodes directly to the AED.
Lot number (batch code). YY (year) and WW (week) of manufacture.
This section introduces you to the controls and indicators on the LIFEPAK 1000 defibrillator.
Figure2-1 Controls and Indicator
Table 2-1 Controls and Indicators
FeatureDescription
1 Readiness displa yThe re adiness display alerts you to the defibrillat or’s readiness status.
Three symbols ( , , ) allow you to determine whether the
defibrillator is ready for use or needs attention.
The following defines what each symbol represents and when/where
each appears.
The wrench indicator appears on the readiness display when a
condition exists that prevents or could prevent normal defibrillator
operation.
The OK symbol indicates that the defibrillator is ready for use.
This symbol is visible only when the defibrillator is off.
The battery symbol appears on the readiness display when the
defibrilla t or is o ff. When on e bar i s visible in the symbol, the b a tt er y is
low. If the symbol is blank, the battery is extremely low and the OK
symbol will not appear when the defibrillat or is off.
2SpeakerProvides audio voice prompts and tones.
3
Green
ON/OFF button turns the power on or off. The button is lit
Heart rate indicator. The heart rate indicator displays hear t rates between 20 – 300 bpm. Indicator is
present in Manual mode or when the 3-wire ECG cable is used.
Battery status symbol. When the defibrillator is turned on, this symbol appears on the screen indicating
the relative level of charge . On e b ar indicates the batt ery is low. When the b attery is very low, the symbol
is blank and a
REPLACE BATTERY message appears on the screen.
ECG. The ECG appearing on the screen is a nondiagnostic ECG, obtained by means of the therapy
electrode s or the Lead II ECG ca ble. The presence of an ECG does not ensure that the patient has a pulse.
Softkey labels. These labels define the function that can be activated by pressing the softkey.
and
This section provides an overview of information and instructions for using the LIFEPAK 1000 defibrillator.
Modes of Operationpage 3-2
Defibrillation in AED Mode3-3
Defibrillation in Manual Mode3-5
Troubleshooting Tips for Defibrillation3-6
ECG Monitoring (ECG Mode)3-8
The defibrillator delivers up to 360 J of electrical energy. When discharging the de fibrillator, do not touch
the disposable therapy electrodes.
Shock hazard.
If a person is touching the patient, bed, or any conductive material in contact with the patient during
defibrillation, the delivered energy may b e partially discharge d through that person. Clear everyone away
from contact with the patient, bed, and other conductive material before discharging the defibrillator.
Possible skin burns.
During defibrillation, air pockets between the skin and therapy electrodes may cause patient skin burns.
Apply therapy electrodes so that entire electrode adheres to skin. Do no t reposition the electrodes once
applied. If the position must be changed, remove and replace with new electrodes.
Possible skin burns and ineffective energy delivery.
Therapy electrodes that are dried out or damaged may cause electrical arcing and patient skin burns
during defibrillation. Do not use therapy electrodes that have been removed from foil package for more
than 24 hours. Do not use electrodes beyond expiration date. Check that elec trode adhesive is intact and
undamaged. Replace ther apy electrodes after 50 shocks.
Possible interference with implanted electrical device.
De fibrillation m ay cause implanted de vic es t o m alfunction. Pla ce therapy electrode s away from implante d
devices if possible. Check implanted device function after defibrillation, if possible.
Possible misinterpretation of data.
Do no t analyze in a mo vin g v ehicle. Mo tion ar tifac t ma y a ff ect the ECG signal resulting in an inappropria t e
shock or no shock advised m e ssa ge. Motion detect ion m ay delay analysis. Stop vehicle and stand clear of
patient during analysis.
Possible misinterpretation of data.
Do not move the AED during analysis. Moving the AED during analysis may aff ec t the ECG signal resultin g
in an inappropriate shock or no shock advised decision. Do not touch the patient or the AED during
analysis.
CAUTION!
Possible equipment damage.
Before using this defibrillator, disconnect all equipment that is not defibrillator-protected from the
patient.
For children less than 8 years of age or 55 lbs (25 kg), use Infant/Child
Reduced Energy Defibrillation electrodes. Do not use Pediatric
QUIK-COMBO electrodes; these electrodes do not attenuate the energy
delivery by this defibrillator.
DEFIBRILLATION IN AED MODE
The LIFEPAK 1000 defibrillator uses the patented Physio-Control Shock Advisory System to evaluate the
patient’s heart rhythm. The LIFEPAK 1000 defibrillator has an optional feature that displays the ECG
wa veform and Heart Rate Indicator in AED mode. The operation in AED mode remains the same whether
or not the defibrillator displays the ECG waveform. When
with all of the AED messages and prompts. When
ECG DISPLAY is set to OFF, the messages and prompts
ECG DISPLAY is set to ON, the ECG appears
fill the screen.
Basic Steps for Using the LIFEPAK 1000 Defibrillator
1 Establish that the patient is in cardiopulmonary arrest (the patient
must be unre sponsive, not breathing normally and sho w ing no signs of
circulation).
2 Press
ON/OFF to turn on the defibrillator (the green LED illuminates).
Voice prompts will sound, guiding you through the rescue process.
3 Prepare the patient for therapy electrode placement.
• If possible, place the patient on a hard surface away from standing
water.
• Remove clothing from the patient's upper torso.
• Remove excessive hair from the electrode sites. If shaving is
necessary, avoid cutting the skin.
• Clean the skin an d dry it briskly with a towel or gauze.
• Do not apply alcohol, tincture of benzoin, or antiperspirant to the
skin.
4 Apply the ther ap y electr ode s t o the pa tient's che st. St artin g fr om one
end, pre ss the electrodes firmly onto the patient's skin, as shown.
5 Connect the electrodes to the defibrillator (if they are not already
connected).
6 Follow the screen messages and voice prompts provided by the
The following descriptions of voice prompts and messages are based on the default settings for AED
mode. Changing the setup options may result in different AED behavior.
CONNECT ELECTRODES
STAND CLEAR, ANALYZING
NOW, STAND CLEAR
PREPARING TO SHOCK
STAND CLEAR, PUSH SH OCK
BUTTON
Voice prompt and message when a patient has not been connected to
the defibrillator.
Voice prompt and message when a patient is connected to the
defibrillator.
Do not touch or move the patient, or therapy cables, during analysis.
ECG analysis requires 6–9 seconds.
Message displayed if the defibrillator detects a shockable rhythm.
The defibrillator charges to the joule setting for that shock number.
A rising tone and a chargin g bar on the screen indicate that the
defibrillator is charging.
Voice prompt and message when charging is complete.
The (shock) button flashes.
Clear everyone away from the patient, bed, or any equipment
connected to the patient.
Press the (shock) button to discharge the defibrillator.
The energy le v el f o r shocks depends on the energy protocol setup o pti on
and the analysis decisi on after shocks.
If the (shock) button is not pressed within 15 seconds, the defibrillator
disarms the shock button, and the
DISARMING... message appears on the
screen.
ENERGY DELIVERED
START CPR
Message displayed after each shock.
A message and countdown timer (min:sec format) appears for the CPR
time.
NO SHOCK ADVISED
V oic e pr ompt an d m essa g e whe n the de fibrilla t or d e t ects a nonsh ock able
rhythm. The defibrillator will not charge, and a shock cannot be delivered.
When a
NO SH OCK ADVISED pr ompt f ollows a shock and CPR, the energy
level will not increase for the next shock.
Special Situations for Electrode Placement
When placing electrodes on the patient, be aware of special situations:
Obese Patients or Patients with Large Breasts
Apply the electrodes to a flat area on the chest, if possible. If skin folds or breast tissue prevent good
adhesion, spread skin folds apart to create a flat surface.
Thin Patients
Follow the contour of the ribs and spaces when pressing the electrodes onto the torso. This limits air
space or gaps under the electrodes and promotes good skin c ontact.
Patients with Implanted Pacemakers
If possible, place defibrillation electrodes away from the internal pacemaker generator. Treat this patient
like any other patient requiring emerg e ncy care.
Apply the electrodes in the anter ior-lateral position. Treat this patient like any other patient requiring
emergency care.
Alternate Anterior-Posterior Electrode Position
The electrodes may be placed in an anterior-poste rior position as follows:
1 Place either the ♥ or + therapy electrode over the left precordium as shown in Figure 3-1. The upper
edg e of the electrode should be below the nipple. Avoid placement over the nipple, the diaphragm, or
the bony prominence of the sternum if possible.
2 Place the other electrode behind the heart in the infrascapular a rea as shown in Figure3-1. F or patient
comfort, place the cable connection away from the spine. Do not place the electrode over the bony
prominences of the spine or scapula.
Figure3-1 Anterior-Posterior Placement
DEFIBRILLATION IN MANUAL MODE
The LIFEPAK 1000 defibrillator provides a Manual mode to override th e AED features of the defibrillator.
Manual mode provides operator-initiated analysis, charge, shock, and disarm functions. This mode is
useful in a tier e d response system when a provider trained in manual defibrilla tion and auth orize d t o pla ce
the defibrillator in Manual mode takes over the scene from a BLS-AED trained provider.
To use Manual mode:
1 Press the Menu button.
2Select
3 If the displayed ECG rhythm appears shockable, press
4 Clear everyone away from the patient, bed, or any equipment connec ted to the patient.
5 When the charge is complete, press the flashing (shock) button to deliver energy to the patient.
6 After delivering a shock, the energy for each subsequent shock is automatically selected b as e d on the
Note: To remove an unwanted charge at any time, press
YES to enter Manual mode. The ECG trace and Heart Rate Indicator appear on the screen.
CHARGE to initiat e chargin g of the defibrillator.
The screen w ill indicate that the defibrillator is charging and a charge tone will sound.
The LIFEPAK 1000 defibrillator can be set up to display an ANALYZE softkey when in Manual mode.
To initiate an analysis:
1 Confirm that the patient is unresponsive, not breathing, and without a pulse.
2 Press
ANALYZE.
3 If the rhythm analysis r e sul ts in a No Shock Advise d decision, the defibrillator remains in Manual mode
without further prompts.
4 If the rhythm analysis results in a Shock Advised decision, the defibrillator automatically begins
charging accompanied by a charge tone. If you determine tha t a sh ock is not warranted, press
DISARM.
5 When the charge is complete, clear everyone away from the patient, bed, or any equipment
connect ed to the patient.
6 Press the flashing (sho ck) button to deliver energy to the patient.
7 After delivering a shock, the defibrillator remains in Manual mode.
TROUBLESHOOTING TIPS FOR DEFIBRILLATION
This section ex pla ins problem conditions that you may encounter while using the defibrillator.
Table 3-1 Troubleshooting Tips for Defibrillation
ObservationPossible CauseWhat To Do
Screen blank and ON
LED lit.
CONNECT ELECTRODES
voice prompt is heard.
CHECK CONNECTOR
AND ELECTRODES
prompt is heard.
Screen not functioning properly.• AED and therapy functions may still
operate. If needed for therapy, follow
voice prompts and continue to use
device to tr eat patient. If unable to use
voice prompts for any reason,
administer CPR if the patient is not
resp on din g, not breathing n orm ally, an d
showing no signs of circulation.
• Contact authorized service personnel.
Poor electrode-to-skin contact.
• Firmly press electrodes on patient’s
skin.
• Clean, shave, and dry the patient’s skin
prior to placing pads on skin.
Electrode pads are dry, damaged,
• Replace the electrode pads.
or have passed the expiration
date.
Electrode pads are not removed
from the liner.
• Remove the electrode pads from the
liner and apply them to the patient’s
chest
Connection to the defibrillator is
voice
inadequate.
• Check to be sure that the electrode
connector is completely inserted.
Table 3-1 Troubleshooting Tips for Defibrillation (Continued)
ObservationPossible CauseWhat To Do
Defibrillator cannot
deliver the requi red
shock.
Defibrillator battery power is low.
• Administer CPR if the patient is not
resp on din g, not brea thin g normally, an d
showing no signs of circulation.
• Check battery indicator. Replace
battery if needed.
Voic e prompts sound
faint or distorted.
Defibrillator battery power is low.
• Administer CPR if the patient is not
resp on din g, not brea thin g normally, an d
showing no signs of circulation.
• Check battery indicator. Replace
battery if needed.
MOTION DETECTED and
STOP MOTION voice
Patient movement because of
location.
• Move patient to stable location, if
possible.
prompts are heard.
Patient movement because of
• Check patient for normal breathing.
breathing.
CPR being performed during
• Stop CPR during analysis.
analysis.
Vehicle mot ion.
Electrical/radio frequency
interference.
• Stop vehicle during analysis, if possible.
• Move communication or other
suspected devices away from the
defibrillator when possible.
De fibrillator does not
deliver voice prompts or
beeping tone s after you
turn it on.
Speaker not functioning.• AED and therapy functions may still
operate. If needed for therapy, follo w
screen prompts and continue to use
device to treat patient. If unable to use
screen prompts for any reaso n,
administer CPR if the patient is not
resp on din g, not brea thin g normally, an d
showing no signs of circulation.
• Contact authorized service personnel.
Depleted battery.
• Administer CPR if the patient is not
resp on din g, not brea thin g normally, an d
showing no signs of circulation.
• Check battery indicator. Replace
battery if needed.
• Contact authorized service personnel.
The readiness display
is blank.
The defibrillator has been turned
on.
Operating temperature is too
low.
LCD not operating properly.
• Normal condition when the defibrillat or
is in use.
• Operate the defibrillator within the
specified temperature range.
AHA Labels IEC Labels
RA Right ArmR Right
LALeft ArmLLeft
LLLeft LegFFoot
LA/LRA/R
LL/F
ECG MONITORING (ECG MODE)
WARNING!
Possible misinterpretation of ECG data.
The frequency response of the screen is intended only for basic ECG rhythm identification; it does not
provide the resolution required for pacemaker pulse visibility, accurate measurements, such as QRS
duration, and ST segment interpretation. For such purposes, use ECG monitors with an appropriate
frequency response.
Possible delay in therapy.
Do not attempt to connect a 3-wire ECG cable to a QUIK-COMBO therapy cable or any other AED. The
ECG cable is functional only with the LIFEPAK 1000 defibrillator.
The LIFEPAK 1000 defibrillator pr ovides nondiagnostic ECG display of the patient’s heart rhythm when the
ECG cable is connected and the electrodes are appl ied.
Note: You do not have to turn the defibrillator off befo re changing from therapy electrodes to the
ECG cable or vice versa.
To monitor a patient’s ECG:
1 Connect the ECG cable.
Note: The ECG cable uses the same receptacle used by the therapy electrodes.
2 Apply ECG electrodes to the patient’s chest as shown in Figure 3-2
Figure 3-2 Connecting the ECG Electrodes for ECG monitoring
After the ECG electrodes are connected, the defibrillator displays the patient’s heart rhythm and heart
rate in a lead II configuration. Lead II is the only lead available with this cable.
While in ECG mode, the defibrillator’s sh ock capability is disabled; however, the defibrillator continues to
evaluate the patient’s ECG for a potentially shockable rhythm. Remember that the presence of an ECG
rhythm does not ensure that the patient has a pulse.
If a shockable rhythm is detected, the defibrillator prompts
CONNECT THERAPY ELECTRODES.
1 Confirm the patient’s condition: Not responsive? Not breathing? No signs of circulation?
2 Remove the ECG cable and connect the therapy electrodes to the defibrillator.
3 Apply the therapy electrodes to the patient’s chest, keeping them at least 2.5 cm (one inch) away
from the ECG electrodes. If necessary, remove the ECG electrodes.
4 Follow the defibrillator’s voice and screen prompts.
The LIFEPAK 1000 defibrillator provides an infrared method to transfer defibrillator data.
Overview of Data Storage
Every time you use the defibrillator, it digitally saves patient data that can be transferred to a PC. You can
provide patient data to aid in case review for quality control, traini ng, and research purposes. You should
become familiar with local requirements for reporting a use of the LIFEPAK 1000 defibrillator and for
providing use data. For assistance in retrieving data from the defibrillator, contact your local
Physio-Control sales representative or authorized service personnel.
Data Stored by the LIFEPAK 1000 Defibrillator
Whenever you turn on the defibrillator and connect it to a patient, it automatically stores data about the
patient. When this data is transferred to a data management system for review (for example,
CODE-STAT™ software), three patient reports are available: Event Log, Cont inuous ECG, and CODE
SUMMARY. Table 4-1 describes these reports.
Table 4-1 Patient Reports
Report TypeDescription
Event LogA chronological log of all events. An event is a condition noted by the defibrillator.
Event s are listed on page 4-3.
Continuous ECGForty minutes of the patient’s ECG rhythm beginning when the patient is
connected to the defibrillator and ending when the defibrillator is turned off.
CODE SUMMARYCombine s the Event Log and a sampling of continuous ECG rhythms associated
with certain events, such as defibrillation.
The LIFEPAK 1000 defibrilla t or c an s t or e up t o two patient r ec or ds: one f or the cur r ent p a tient an d one for
the previous patient. When y ou us e the defibrillat or
, it is important t o transfer the pa tient data as soon as
possible af ter use. The Comple te Record for the current patient includes the Continuous ECG and Event
Log. If you treat a second patient, the first patient’s Continuous ECG is reformatted into a CODE
SUMMARY report. If you treat a third patient, all of the first patient’s data is deleted and the second
patient’s Continuous ECG is reform atted into a CODE SU MMARY Repo rt.
Table 4-2 Patient Records
Complete RecordSummaryContinuous ECG
Current PatientXXX
Previous Patient
X
If you turn the d efibrillator on and off without attaching electrodes to a patient, the defibrillator does not
create a new patient record and the patient records in the defibrillator are not altered.
The LIFEPAK 1000 defibrillator does not delete patient data afte r you transfer the data to a PC. The
defibrillator deletes previous patient data only when it is connected to a new patient or a simulator.
Test and Service Data
The LIFEPAK 1000 defibrillator stores a test log consisting of the most recent auto-tests, power cycles,
and battery re placements. The test log lists the test results and any errors detected. The test log data is
available only to authorized service personnel or to responders who are using the appropriate LIFENET
system product.
Check Patient
Charge RemovedOut of Waveform Memory
*
Out of Event Memory
Shock AdvisedManual ModePower Off
Charge CompleteReplace Bat tery
SHOCK X-XXXJ
*
These events include ECG samples in the Summary Report.
Table 4-4 Test Log Report
Test Log
*
Charg e Button Pressed
Reco very Time
*
Self Test Po wer On
Self Test Pass/Fa il
User Power On/Off
Battery Changed
Overview of Connections for Transmitting Reports
Patient, test, and service data can be transmitted from the LIFEPAK 1000 defibrillat or to a PC-compatible
computer equipped with CODE-STAT software, version 6.0 or later, a Physio-Control LIFENET system
product. LIFENET system products are compatible with Microsoft
Windows XP.
The LIFEPAK 1000 defibrillator (see Figure2-1) supports wireless, infrared communications for
transmitting data from the defibrillator to your computer. To receive the transmission, your computer
must have an operational IrDA port.
If your computer does not have an IrDA port, you can install an IrDA adapter to provide the needed
interface. Physio-Control recommends installing an IrDA adapter on all computers to ensure successful
communication connections and data transmissions.
IrDA adapters are available f or serial or USB computer por ts. Follow the inst allation and usag e ins truc tions
provided with the adapter, ensuring that the adapter mount (receiving end) is pos itioned on a stable
surface. Figure 4-1 provides guidelines to follow for positioning the defibrillator and the IrDA adapter
before initiating a transmission.
Note: The shaded cone in Figure4-1 represents the approximate parameters for positioning the
defibrillator’s IrDA port opposite the IrDA adapter. As the distance between the two increases, so
does the possible range for aligning them.
You initiate and control transmission of device data at your computer using a LIFENET system product.
This includes initiating data download, selecting reports to be transmitted, and monitoring transmission
progress. More information about configuring your LIFENET system product and instructions for
transmi tting d e vic e da t a are provid ed i n the user s guide an d r eference c a r ds tha t a cc omp an y the LIFENE T
system product.
This section expla ins how to help keep your LIFEPAK 1000 defibrillator in good working condition. Cared
for prop erly, the defibrillator is built to give you many years of service.
Maintenance and Testing Schedulepage 5-2
Self-Test Performance5-2
Inspection5-3
Cleaning5-4
Battery Maintenance5-4
Electrode Storage5-5
Service5-6
Product Recycling Information5-6
Supplies, Accessories, and Training Tools5-7
Warranty Information5-7
Use the f ollowing schedule in conjunction with the internal quality assurance program of the hospital,
clinic, or emergency medical service where the defibrillator is used.
On a regular basis, you should do the following:
• Check the readiness display to determine the level of battery charge and that the OK symbol is visible.
• Check the Use By date on the therapy electrode packet.
• Check other emergency supplies that may be stored with the defibrillator.
If the OK symbol is not visible, the level of battery charge is low, or the electrode Use By date has passed,
the defibrillator needs attention. Replace the battery and the electrode packet, or call your authorized
service per sonnel.
When establishing your local inspection schedule, consider how often the defibrillator will be used and
how familiar the operators are with using a defibrilla tor. For example, if the defibrillator is used rarely,
weekly inspections are app ropriate. An inspection checklist is provided in Appendix E.
Table 5-1 Recommended Maintenance Schedule
OperationAfter UseAs RequiredWeekly
Complete Operator’s Checklist (see Appendix E).X
Inspect defibrillator.XX
Clean defibrillator.XX
Check that all necessary supplies and accessories,
such as electrodes, are present.
XX
SELF-TEST PERFORMANCE
Whenever the LIFEPAK 1000 defibrillator is turn ed on after it has been off for at least 60 seconds, it takes
approximately 5seconds to complete a self-test and to indicate a low or replace battery condition.
Self-Tests
Each time you turn it on, the defibrillator performs internal self-tests to check that internal electrical
components and circuits work properly. The defibrillator stores the results of all user power on self-tests
in a test log. When the defibrillator is on and a problem requires immediate service, such as a
malfunctioning charging circuit, the defibrillator prompts
if needed for an emergency; otherwise, remove the defibrillator from active use and contact authorized
service personnel to correct the problem as soon as possible. The service symbol will remain visible until
the problem is corrected.
CALL SERVICE. Atte mpt to use the defibrillator
Auto Tests
The defibrillator performs automatic self-tests daily and monthly at 0300 (3:00 a.m.) if not in us e. During
the automatic self-test, the defibrillator turns itself on (ON/OFF LED illuminates) briefly and completes
the following tasks:
If the defibrillator detects a problem during an auto test that requires service, it displays the service
symbol. If the service symbol is visible, you should attempt to use the defibrillator, if needed, for a cardiac
emergency. However, you should contact authorize d s ervice pers onnel t o correct the problem as soon as
possible. The se rvice symbol will remain visible until the problem is corrected.
The automatic self-test is not performed if the defibrillator is already turned on at 0300 or if the battery
is not installed. If the defibrillator is turned on while a self-test is in progress, the test is halted; the
defibrillator will turn on normally.
INSPECTION
Routinely inspect all devices, accessories, and cables by following the ins tructions in Table 5-2.
Clean the LIFEPAK 1000 defibrillator accessories as described in Table 5-3. Use only the cleaning agents
liste d in the table.
CAUTION!
Possible equipment damage.
Do not clean any part of the defibrillator or accessories with bleach, bleach dilution, or phenolic
compounds. Do not use abrasive or flammable cleaning agents. Do not steam, autoclave, or gas-sterilize
the defibrillator or accessories.
Table 5-3 Recommended Cleaning Methods
Items
Cleaning PracticeRecommended Cleaning Agent
Defibrillator case, display,
crevices, and accessories
Clean with damp sponge or
cloth.
• Quaternary ammonium compounds
• Rubbing (isopropyl) alcohol
• Peroxide (peracetic acid) solutions
BATTERY MAINTENANCE
The LIFEPAK 1000 defibrillator is powered by the LIFEPAK 1000 nonrechargeable lithium manganese
dioxide batte ry pak.
Follow the guidel ines described in this section to help maximize battery life and performance. Use only
Physio-Control battery paks designed for use with the LIFEPAK 1000 defibrillator. Do not use any other
batteries.
WARNINGS!
Safety risk and possible equipment damage.
• Damaged batt eries may leak and cause personal injury or equipment damage. Handle damaged or
leaking batteries with extreme care.
• Do not c ar r y a b a tt er y pak where metal objects (such as ca r keys or paper clips) could short-circuit the
battery terminals. The resulting excessive current flow can cause extremely high temperatures and
may result in damage to the battery pak or cause fire or burns.
• Keep batteries away from children.
Possible defibrillator shutdown.
When the LIFEPAK 1000 defibrillator displays the REPLACE BATTERY message, replace the battery
immediately.
Possible loss of power during patient care.
Using an improperly maintained battery to power the defibrillator may cause power failure without
warning. Maintain batteries as described in these operating instructions.
Note: When a battery pak is removed from the defibrillator, battery and service symbols appear on
the readiness display. After replacing the battery pak, the device resets the readiness display.
The nonrechargeable battery pak never requires recharging. The approximate level of charge in the
battery appears on the readiness display when the defibrillator is off or on the screen when the
defibrillator is in use.
When optimally maintained, a new nonrechargeable battery pak can provide approximately 17 hours of
“on time” or 440 discharges at 200 joules. Just turning the defibrillator on (“on time”) uses up battery
capacity. Each year, battery capacity decreases while the battery is in the defibrillator because of the
battery’s normal self-discharge rate and the energy used by the defibrillator auto tests. If installed in the
defibrilla tor and the defibrillator is not used, the battery pak has a standby life of five years.
A new nonrechargeable battery pak has a shelf life of five years if stored at the proper temperature. The
battery pak (s tored outside the defibrillator) self-discharges over time; therefore, when the battery is
eventually placed in the defibrillator, its useful life will be reduced depending on how long it “sat on the
shelf.”
To properly maintain nonrechargeable battery paks:
• Do not attempt to recharge.
• Do not expose to temperatures greater than those specified in Appendix A.
• Do not allow electrical connection between the battery contacts.
WARNING!
Possible explosion, fire, or noxious gas.
Attempting to recharge a nonrechargeable battery pak can cause an explosion or fire or release noxious
gas. Dispose of expired or depleted nonrechargeable battery paks as described in these operating
instructions.
CAUTION!
Possible battery damage.
Electrical connection between battery c ontacts can blow an internal fuse and permanently disable the
battery.
ELECTRODE STORAGE
For information about defibrillation electrode storage, refer to the electrode operat ing instructions.
Do not disassemble the defibrillator. It contains no responder-serviceable components and dangerous
high voltages may be present. Contact authorized service personnel.
If the LIFEPAK 1000 defibrillator requires service as indicated by testing, troubleshooting, or the servi ce
symbol, contact authorized service personnel. In the USA, call
your local Physio-Control representative. When you call Physio-Control to request service, provide the
following information:
• Model number and part number
• Serial number
• Observation of the problem that led to the call
If the defibrillator must be shipped to a service center or to the factory, pack it in the original shipping
container. If this is no t possible, ship the defibrillator in protective packing to prevent shipping damage.
1.800.442.1142. Outside the USA, contact
PRODUCT RE CYCLING INFORMATION
All materials should be recycled according to national and local regulations. Contact your local
Physio-Control representative for assistance or refer to http://recycling.medtronic.com for instructions
on disposing of this product.
Preparing for Disposal of Nonrechargeable Batteries
Nonrechargeable batterie s should be fully discharged before disposal.
Before disposing of nonr echa rgeable batter y paks, cov er the b attery terminals with the plastic discha rger
cap provided with the new battery. Refer to the battery discharge instructions included with your new
battery.
Disposing of Nonrechargeable Batteries
Follow your national, regional, and local regulations for disposal. Contact a local Physio-Control
represent ative for more informat io n.
In the USA, Environmental Protection Agency and Department of Transportation re gulations allow
disposal of nonrechargeable batter ies with ordinary household waste provided that they are fully discharged. Be sure to comply with any other loc al or regional regulations before disposal. For more
information or assistance, conta ct your local Physio-Control representative or call 1.800.442.1142.
Recycling the Defibrillator
Recycle the defibrillator at the end of its useful life. It should be clean and contaminant-free prior to
being recycled.
Recycling Disposable Electrodes
After disposable electrodes are used, follow your local clinical procedures for recycling.
Recycling Packaging
Pa ckaging should be recycled according to national and local regulations.
Table 5-4 lists supplies, accessories, and training tools for the LIFEPAK 1000 defibrillator.
To order in the USA, call 1.800.442.1142. Outside the USA, contact your loc al Physio-Control
representative.
Table 5-4 Supplies, Accessories, and Training Tools
Item DescriptionCatalog Number
QUIK-COMBO™ Electrodes with REDI-PAK™ preconnect systemCAT. 11996-000017
Infant/Child Reduced Energy D efibrillation Electr od e s (not compatible w ith
QUIK-COMBO defibrillation cable)
Infant/Child Electrodes Star ter Kit (English, Dutch, French, German,
CODE-STAT Data Review SoftwareCAT. 94404-000003
LIFENET DT Express Information Management SystemCAT. 21340-000095
CAT. 11101-000016
CAT. 11101-000017
CAT. 11101-000018
CAT. 21300-005027
WARRANTY INFORMATION
Refer to the product warranty statement included with your LIFEPAK 1000 defibrillator. For duplicate
copies, contact your local Physio-Control representative.
All specificat ions a re at 20° C (68°F) unless otherwise stated.
Defibrillator
WaveformBiphasic Truncated Exponential with v o ltage and duration compensation for
patient impedance.
With Adult Pads:
Patient Impedance Range: 10 – 300 ohms
The following specifications apply from 25 t o 175 ohms.
Energy Accuracy:
10% of the energy setting into 50 ohms
15% of the rated energy output into 25 – 175 ohms
Rated energy outpu t is the nominal delivered energy based on the energy
setting and patient impedance, as defined in the following chart.
The following specifications apply from 25 to 175 ohms.
Energy Accuracy (into 50 ohms):
Selected energy ÷ 4 +/- 15%; 86 joules +/- 15% maximum
Rated energy output is the nominal delivered energy based on the energy se ttin g
and patient impedance, as defined in the following chart.
ECG Analysis system tha t a dvis e s whe ther a shock is appr opria t e, mee ts
rhythm recognition criteria specified in DF80 and IEC 60601-2-4. In AED
mode, the device allows a shock only if SAS advises defibrillation.
Shock Ready TimeTime to first shock (electrodes connected to a patient at power on and
initial rhythm finding is Shock Advised):
• Less than 25 sec to 200 joules
• Less than 30 sec to 360 joules
Energy Sequence:Multiple lev els, configurable from 150 to 360 joules
Shock-to-Shock cycle
Less than 25 seconds
time (200J to 300J):
Time for a 3-shock
Less t han 70 seconds
sequence
(200J/300J/360J):
Manual Mode
Energy SequenceDelivers energy at levels selected in Setup mode.
Charge TimeCharge time:
• 200 joules in less than 7 sec (typical)
• 360 joules in less than 12 sec (typical)
ECG Mode
ECG DisplayPro vides nondiagnostic ECG display of the patient’s heart rhythm.
Display
Size (Active viewing
area)
Display Type320 dot x 240 dot LCD with backlight
Frequency Response0.55 Hz to 21 Hz (-3 dB), nominal
Waveform Sweep
Display Range Differential: ±1.4 mV full scale, nominal
Specifications
Heart Rate20 to 300 BPM digital display.
Display "---" if heart rate is less than 20 BPM.
Heart symbol flashes for each QRS detection
Displayed ECGECG information is received from therapy pads in anterior-lateral or
anterior-posterior positions, or from the 3-wire ECG cable in Lead II.
Controls
On/OffControls device power
ShockControls the delivery of defibrillation energy
Soft KeysUsed durin g device setup and during patient use: Analyze, Charge,
Disarm
Menu buttonUsed to access additional device features
Readiness Display
The readiness display shows device status
OK IndicatorIndicates OK when the last self-test was completed successfully.
Battery Capacity
Segmented display showing battery capa city
Indicator
Service IndicatorService required when displayed
Environmental
Note: All performance specifications defined assume that the device has been stored
(two hours minimum) at the operating temperature prior to op eration.
Operating
Temperature
One-Hour Operating
Temperature
Storage TemperatureWith battery and electrodes, maximum exposure time limited to seven
Atmospheric Pressure575 hPa to 1060 hPa, 4572 to -382 meters (15,000 feet to -1250 feet)
Relative Humidity5% to 95% (noncondensing)
Dust/WaterIEC 60529 IP55 with battery and REDI-PAK electrodes installed
ShockMIL-STD-810F, Method 516.5, Procedure 1, (40g peak, 15–23 msec pulse ,
BumpEN 1789 and IEC 60068-2-29, Test Eb: (1000 bumps, 15g, 6 ms, vertical
0° to 50°C (32° to 122°F)
From room temperature to temperature extreme, one-hour duration:
-20° to 60°C (-4° to 140°F)
days: -30° to 60°C (-22° to 140°F)
45 Hz crossover frequency)
direction)
Drop• 18-inch drop onto each surface, repeated 5 times each, 30 drops total
• EN 1789 0.75 meter drop onto each surface, 6 drops total
• MIL-STD-810F, 516.5 Procedure IV, 1 meter drop on each corner, edge,
and surface
VibrationMIL-STD-810F, Method 514.5, Category 20 Ground Vehicle: Random
CapacityTypically will provide 440 200-joule discharges or 1030 minutes of
oper a tin g time w ith a new battery (370 200-joule shocks or 900 minute s
of operating time at 0°C (32°F)
Weight0.45 kg (1.0 lb)
Shelf Life (prior to
installation)
Standby LifeA new battery provid es device power for 5 years.
Low Battery IndicatorAt least 30 200-joule shocks or 75 minutes of operating time remain
After the battery is stored f or 5 years at 20°C to 30°C, the device will
The Shock Advisory System (SAS) is an ECG analysis system built into the LIFEPAK 1000 defibrillat or that
advises the responder if it det ects a sh ockable or nonshockable rhythm. This system makes it possible for
individuals not traine d to interpret ECG rh ythms to prov ide potentially-lifesaving therapy to victims of
ventricular fibrillation or pulseless ventricular tachycardia. The SAS contains the following features:
• Electrode contact determination
• Automated interpretation of the ECG
• Responder control of sh ock therapy
• Motion detection
Electrode Contact Determination
The patient's transthoracic impedance is measured through the defibri llation electrodes. If the baseline
impedance is higher than a maximum limit, it is determined that the electrodes are not in sufficient
contact with the patient or not properly connected to the defibrillator. ECG analysis and shock delivery
are inhibited. The responder is advised to c onnect electrodes any time electrode contact is inadequate.
Automated Interpretation of the ECG
The Shock Advisory System is designed to recommend a shock if it detects the following:
•
Ventricular fibrillation — with a peak-to-peak amplitude of at least 0.08 mV
•
V entricul ar t a ch ycardia — defined as ha vin g a he a rt rate of at least 120 bea ts per minut e, QRS w idth of at
least 0.16 seconds, and no app arent P waves.
The SAS is designed to recommend no shock for ECG rhythms including pulseless electrical activity,
idioventricular rhythms, bradycardia, supraventricular tachycardias, and normal sinus rhythms.
ECG analysis is performed on consecutive 2.7 second segments of ECG. The analysis of two out of three
segments must agree before a decision (
The LIFEPAK 1000 defibrillator SAS performance for adult an d pediatric ECGs is summarized in the
LIFEPAK 1000 Shock Advisory System (SAS) Performance Rep ort on the LIFEPAK 1000 Product CD.
SHOCK ADVISED or NO SHOCK ADVISED) is made.
Control of Shock Therapy
The Shock Advisory System causes the AED to charge automatically when it detects the presence of a
shockable rhythm. When a sh ock able rhy thm is detected, the de fibrilla t or instructs the us er t o d eliver the
shock by pressing the shock button.
Motion Detection
The Shock Advisory System detects patient motion independent of ECG analysis. A motion detector is
designed into the LIFEPAK 1000 defibrillator
. Motion Detection can be configured to be ON or OFF.
A number of activities can create motion, including CPR, rescuer movement, patient movement, vehicle
mov ement, and some internal pacemakers. If variations in the transthora cic impedance signal exceed a
maximum limit, the Shock Advisory System determines that patient motion of some kind is present. If
motion is detected, the ECG analysis is inhibited. The operator is advised by a displayed message, a voice
prompt, and an audible alert. Aft e r 10 seconds, if motion is still present, the motion alert stops and the
analysis always proceeds to completion. This limits the delay in therapy in situations where it may not be
possible to st o p the motion. Howe v er, the rescuer should remove the source of motion whenever possible
to minimize the chance of artifact in the ECG.
There are two reasons why ECG analysis is inhibited when the motion alert occurs, and why the rescuer
should remove the source of the motion whenever possible:
• Such motion may cause artifact in the ECG signal. This artifact may occasionally cause the Shock
Advisory System to reach an incorrect decision.
• The motion may be caused by a responder's interventions. To reduce the risk of inadvertently shocking
a resp on d er, the motion alert prompts the resp on der to move away from the patient. This will stop the
motion and ECG analysis will proceed.
Physio-Control cprMAX t echnology is design e d t o allow resuscitation pr otocols to maximize the quantity
of CPR administered during treatment with an AED, consistent with the 2005 American Heart
Association Guidelines for Cardiopulmonary Resuscitation and Emergency Car diovascular Care
2
Guidelines) and the European Resuscitation Council Guidelines for Resuscitation 2005
(ERC Guidelines).
Setup options should be changed only under the direction of a physician knowledge able in
cardiopulmonary resuscitation who is familiar with the literature in this area.
The cprMAX technology includes the follo wing setup options:
•
INITIAL CPR. Prompts the user to perform an initial period of CPR. Applies only to immediately after
turning on the AED or after the first analysis.
•
PRESHOCK CPR Time . Prompts for CPR after a shockable ECG rhythm is detected, before the shock is
delivered. If
INITIAL CPR is set to OFF, then PRESHOCK CPR applies to all shock advised decisions
(including the first analysis).
•
CPR TIME 1 and 2. CPR time periods after shocks or no shock advised decisions respectively.
•
STACKED SHOCKS. Eliminates the analysis after each shock and inserts prompting for CPR after each
shock; when set to
•
PULSE CHECK. Indicates when, if ever, the device is to prompt for pulse checks.
OFF, eliminates the three-stack shock.
AED protocols are aligned w i th the AHA and ERC Guidelines when the setup options are set as follows:
1
(AHA
•Initial CPR:
OFF
•PreShock CPR Time: OFF
•CPR Times 1 and 2: 120 SECONDS
•Stacked Shocks: OFF
•Pulse Check: NEVER
The above options are the factory default settings for cprMAX technology. Your medical director
protocols should determine whether or not to change the options and should ensure that you receive
training.
AED OPERATION WITH CPRMAX TECHNOLOGY
The following paragraphs describe AED operation with cprMAX technology setup options.
Initial CPR
The INITIAL CPR option prompts the user to perform an initial period of CPR. The choices are: OFF,
ANALYZE FIRST and CPR FIRST. The factory d efault is OFF.
•The
OFF setting has no prompting for an initial CPR period.
•The
ANALYZE FIRST setting pr ompts f or analysis an d then CP R. If the analysis determines that a shock
is needed, the AED will prompt,
opportunity to end CPR early and proceed dire ctly to delivering a shock.
IF YOU WITNESSED THE ARREST, PUSH CANCEL, which provides the
1
2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.
Circulation 2005;112 (Supplement IV).
2
European Resuscitation Council Guidelines for Resuscitation 2005. J. Resuscitation 2005; 67 (Supplement 1).
•The CPR FIRST setting prompts the user to perform CPR immedia tely after the defibrilla tor is powered
on. The AED will also prompt,
IF YOU WITNESSED THE ARREST, PUSH CANCEL, which provides the
opportunity to end CPR early and proceed directly to analysis.
Organizations that choose to implement this option should develop a protocol and provide training to
resp onders instructing them when to end the initial CPR interval early. Potential situations for instructing
responders to end CPR early include:
• The patient's collapse was witnessed by the responder.
• The responder a scerta ins that fewer than four or five minutes have elapsed since the patient's
collapse.
• The patient exhibits agonal breathing, an indicator of a short downtime.
• The responder ascertains that CPR of adequate quality and duration has already been provided before
att aching the AED electrodes.
Initial CPR Time
The INITIAL CPR TIME option applies when INITIAL CPR is set to ANALYZE FIRST or CPR FIRST. It sets the
CPR time for that CPR period. The tim e choices for
SECONDS. The default setting is 120 SECONDS.
INITIAL CPR TIME are: 15, 30, 45, 60, 90, 120, and 180
PreShock CPR Time
The PRE SHOCK CPR time option inserts prompting for CPR when a shockable ECG rhy thm is de tected and
during the time the AED is charging. It applies only when analysis results in
When
INITIAL CPR is set to OFF or CPR FIRST, PRESHOCK CPR time applies to the first and all subsequent
shocks. When
subsequent shocks. The choices for
INITIAL CPR is set to ANALYZE FIRST, PRESHOCK CPR time applies to the second and all
PRESHOCK CPR time are: OFF, 15, and 30 SECONDS. To prompt for
CPR only fo r the time the capacitor is charging, select the 15-seconds CPR interval. The
not enabled until charging and CPR time are completed. The default setting for
OFF.
Note: Although the SHOCK button is disabled during the PRESHOCK CP R interval, it becomes active
as soon as the
PRESHOCK CPR interval ends. To minimize the interval between the final chest
SHOCK ADVISED decisions.
SHOCK button is
PRESHOCK CPR time is
compression and shock delivery (while maintaining responder safety), protocols that select this
option should provide specific training and protocols to address the rapid transition from
CPR
to shock delivery.
PRESHOCK
Stacked Shocks
When set t o OFF, the STACKED SHOCKS option inserts pr omptin g f or CP R a ft er e ach (a sin gle) shock. This
eliminates the three-shock stack. CPR is prompted after the shock regardless of the ECG rhythm. The
CPR time following the shock is determined by the
SHOCKS
When this option is set to
optio n are ON or OFF. The default setting is OFF.
ON, the defibrillator follows the previously traditional stacked shock protocol
and delivers up to three consecutive shocks, as necessary, without interposed CPR.
CPR TIME 1 setting selected. Choices for the STACKED
Pulse Check
The PULSE CHECK option inserts prompting to check for a pulse or check the patient, depending on the
PULSE PROMPT setting. The choices for PULSE CHECK are: ALWAYS, AFTER EVERY NSA, AFTER SECOND
NSA
, and NEVER. The default setting is NEVER.
•The
ALWAYS option prompts for a pulse check after CPR TIME 1 and 2, after a NO SHOCK ADVISED
Setup options allow you to define operating features for your defibrillator, such as CPR intervals. Setup
options are listed in tables beginning with Table D-1.
To enter Setup mode:
1 Ensure that no electrodes or cables are connected to the defibrillator.
2 Press and hold both softkeys and press the
Enter Setup Mode passcode
ON/OFF button. The Enter Setup Mode screen appears.
Press button to set
FigureD-1 En ter Setup Mode
3 Enter the Setup mode passcode. The factory default passcode is 0000—press the MENU button four
times to accept the default passcode. For info rmation on how to change the passcode, see page D-6.
Note : To exit Se tup mode, turn the d e fibrilla t or o ff. If you changed the s e tup o ptions, the chan g e s are
saved and will appear the next time you turn the defibrillator on. (Refer to Setup menu options that
follow.)
Access the General Setup menu from Setup to view general purpose settings. The underlined bold
options in Table D-2 are the factory default settings.
Table D-2 General Setup Menu
Menu ItemHelp MessageOptions
DEVICE ID
DATE/TIME
AUDIO
DEVICE DATA
DELETE AFTER
SEND
PREVIOUS PAGE
Set the device ID.User selectable, 0-9, A-Z, up to 20 characters.
Default is
SERIAL NUMBER.
Set current date and time.Default is PACIF IC TIME.
Set audio parameters.See Table D-3.
Display device data.
Delete patient data after sending. ON, OFF.
Go back to previous page.
Access the audio options from Audio on the General Setup menu. The underlined bold options in
Table D-3 are the factory default settings.
Table D-3 General Setup Menu—Audio Setup Submenu
Menu ItemHelp MessageOptions
PROMPT VOLUME
Set volume for alarms, tones, and
MEDIUM, HIGH.
voice prompts.
SHOCK TONE
SERVICE ALERT
PREVIOUS PAGE
Enable shock tone.ON, OFF.
Enable the service alert tone.ON, OFF.
Go back to previous page.
Access the AED menu from the AED Mode option in Setup. The underlined bold options in
Table D-4 are the factory default settings.
Table D-4 AED Setup Menu
Menu ItemHelp MessageOptions
ENERGY
PROTOCOL
CPR
PULSE
Set the defibrillation energy
See Table D-5.
sequence.
Set CPR options for AED mode.See Table D-6.
Set pulse pr ompt o ptions for AED
Access the Set Passcode screen, shown in Figure D-3, from the top-level Setup menu.
FigureD-3Set Passcode Screen
Use the INCREASE and DECREASE softkeys and the MENU button to set the passcode. Be sure to record
the new passcode—the passcode is required each time yo u enter Setup mode.
Access Service mode, shown in Table D-9, from the top-level Setup menu.
Table D-9 Service Setup Menu
Menu ItemHelp MessageOptions
DEFIB CAL
PIXEL TEST
SERVICE LOG
SERVICE DATA
DEVICE LOG
SET P ASSCODE
Start defibrillator calibr ation.
Test display pixels.
Show service log.
Show d evice data.
Display device log.
Set Service mode access
Electrodes storage 5-5
Energy Protocols submenu D-4
Entering
Device informationD-7
Setup modeD-1
Event and Test Log 4-3
F
Features
Battery viii
cprMAX Technology viii
Daily self-test viii
Data management viii
ECG display (optional)vii
Heart rhythm analysis vii
LIFEPAK 1000 defibrillator vii
Readiness display viii
Manual mode therapy 3-5
Manual setup menu D-5
Modes of operation 3-2
Monitoring in ECG mode 3-8
Motion Detected 3-7
Motion detection B-1
, B-2
N
No shock advised operating
scenarioC-1
O
Obese patients 3-4
Supplies 5-7
Symbols 1-3
T
Terms
Caution 1-2
Danger 1-2
Warning 1-2
Test and service data 4-2
Text conventions viii
Therapy in AED mode 3-3
Thin patients 3-4
Training tools 5-7
Transmitting reports 4-3
Troubleshooting