Primedic DefiMonitor XD Operating Instructions Manual

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Operating instructions
MGA21324 / GB / K05
DefiMonitor XD
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Publisher
METRAX GmbH
Phone: 0741/257-0
Email: info@primedic.com
Web: www.primedic.com
Address: Rheinwaldstr. 22
D-78628 Rottweil
Germany
Release date: 11.04.2012
Proprietary note
METRAX GmbH reserves all rights to these operating instructions. Without approval from METRAX GmbH, these operating instructions may not be duplicated or made accessible to third parties. The same applies to individual parts or excerpts of these operating instructions.
Non-compliance with this gives rise to a right to claim damages and can have consequences under criminal law (refer to DIN 34).
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Table of contents
Table of contents
1 Introduction 6
1.1 Foreword 6
1.2 Validity 6
1.3 Warranty 6
1.4 Disclaimers 7
1.5 Symbols used in these operating instructions 8
1.6 Pictograms on the device 9
1.7 Pictograms on SavePads 10
1.8 Image mark on the encompassing packaging 10
2 Intended use 11
2.1 Indication/Contraindication for Defibrillation 13
2.2 Possible complications 13
2.3 Users 14
3 Safety information 15
3.1 General information 15
3.2 General safety instructions 16
3.3 Safety notes for you, the user 17
3.4 Safety notes for protection of the patient 17
3.5 Safety notes for the protection of third parties 19
3.6 Safety notes for protection of the device 19
4 Description of device 20
4.1 General description 20
4.2 Description of device details 22
4.3 Capacity display 33
4.4 Data management 34
4.5 Description of the accessories 35
4.5.1 Paddles 35
4.5.2 PRIMEDICTM SavePads Connect cable 36
4.5.3 PRIMEDICTM SavePads 36
4.5.4 ECG patient cable, 3-pin 37
4.5.5 SpO2-Sensor (only for PRIMEDIC™ DefiMonitor XD3/XD30/XD300/XD330) 38
5 Preparatory measures before (initial) start-up 39
5.1 Unpacking 39
5.2 Inserting / Changing the SaveCard 39
5.3 Power supply 40
5.3.1 Inserting PRIMEDIC™ AkuPak 41
5.3.2 Removing PRIMEDIC™ AkuPak 42
5.4 Loading the PRIMEDIC™ AkuPak 43
5.4.1 Charging the AkuPak in the optional PRIMEDIC™ Charger Basis / Charger Comfort 44
5.5 Connecting the mains cable 44
5.6 Inserting paper in the printer 45
6 Device self-test 46
6.1 Self-test when the PRIMEDIC™ DefiMonitor XD is switched on 46
6.2 Automatic, periodic self-tests 46
7 Operating the PRIMEDIC™ DefiMonitor XD 47
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Table of contents
7.1 Switching on / off 47
7.1.1 Switching the PRIMEDIC™ DefiMonitor XD on 47
7.1.2 Switching the PRIMEDIC™ DefiMonitor XD off 47
7.2 Selecting the operating mode 47
7.2.1 Operating modes 47
7.2.2 Auto mode (AED mode) 47
7.2.3 Manual mode (MAN Mode) 48
7.3 Changing the configuration/setup 48
7.4 Parameter list menu 49
7.4.1 Changing the configuration – Example: time 51
7.4.2 MMI Test (Man-Machine Interaction) 51
7.5 Alarms 51
7.5.1 ECG Alarm 52
7.5.2 VF Alarm 52
7.5.3 SPO2 Alarm 53
7.6 Event button 53
7.7 Operating the printer 54
7.7.1 Log of the ECG signal 54
7.8 Automatic printout after each shock (Autoprint) 55
7.9 Printing out the Event Memory 56
8 Applying the electrodes 57
8.1 Undressing the patient 57
8.2 Positioning 57
8.2.1 Positioning self-adhesive electrodes and paddles 57
8.2.2 Positioning the ECG self-adhesive electrodes 58
8.2.3 Positioning the PRIMEDIC™SavePads Connect for pacing 58
8.3 Removing hair growth from chest 60
8.4 Drying the skin 60
8.5 Placing the electrodes 60
8.6 Checking the electrodes 61
8.7 Changeover of ECG source 62
9 Auto mode (AED mode) 63
9.1 Voice output by the device / Preliminary examination of the patient 63
9.2 Carrying out ECG analysis in Auto mode 64
9.3 Defibrillation required 64
9.4 Defibrillation not required 66
9.5 Keeping the defibrillator ready for use 66
10 Manual mode (MAN Mode) 67
10.1 Carrying out defibrillation 67
10.1.1 Power selection 67
10.1.2 Charging 68
10.1.3 Triggering defibrillation 68
10.2 SYNC and ASYNC mode 69
10.3 Keeping the defibrillator ready for use 71
11 Attaching the SpO2 sensor 72
12 Operating the pacer 73
12.1 General information on operating the Pacer XD 73
12.2 Setting the Pacer operating modes 74
12.3 Setting the stimulation rate 75
12.4 Setting the stimulation intensity 76
12.5 Starting and stopping pacing 76
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Table of contents
12.6 Defibrillation during pacing / Defibrillation via self-adhesive electrodes 78
13 Cleaning, maintenance and dispatch 79
13.1 Cleaning 79
13.2 Servicing 79
13.2.1 Servicing check list 79
13.3 Dispatching the PRIMEDIC™ DefiMonitor XD 80
14 List of error codes 81
15 Disposal 87
16 Technical Data 88
17 Accessories 92
18 Warranty conditions 93
19 Depiction of the current time function 94
20 Rhythm detection system in AED mode 101
21 General information on the use of pulse oximeters 104
22 Guidelines and manufacturer's declaration – Electromagnetic emissions 106
23 General instructions and rules for using PRIMEDIC™ AkuPaks 111
24 Safety checks 113
25 Index of diagrams 114
Contact details 115
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Introduction 6 / 116
DefiMonitor XD 21324 / GB / K05
METRAX GmbH
1 Introduction
1.1 Foreword
Dear User,
You are faced with the task of using the PRIMEDIC™ DefiMonitor XD in a medical emergency on human beings.
To ensure that you can react quickly and correctly in this special situation and can optimally use the options given with the device, it is necessary for you to read through these operating instructions in your own time beforehand to familiarise yourself with the device, its functions and the areas of application.
Keep these operating instructions near the device so that you consult any queries which may arise.
If you should have any questions regarding the device or other PRIMEDIC™ products, we are at your entire disposal.
You will find our contact address on the masthead at the start of these operating instructions.
1.2 Validity
The information given in these operating instructions applies to all models in the defibrillator range
PRIMEDIC™ DefiMonitor XD made by METRAX GmbH.
Please note that, depending on its specific configuration, your device may not correspond in all details to the information given in these operating instructions. See the start dialogue of your PRIMEDIC™ DefiMonitor XD for the exact configuration of your device.
1.3 Warranty
The warranty period is 24 months, beginning on the date of purchase. Please keep the invoice as proof of purchase.
The general guarantee and warranty provisions of METRAX GmbH are applicable.
Any repairs or changes to the device may only be carried out by the manufacturer or by a person or company authorised by the manufacturer.
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Introduction
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1.4 Disclaimers
Liability claims in the event of damages to people or property are excluded if they are based on one or more of the following reasons:
Using the device in a manner for which it was not intended.
Improper use and maintenance of the device.
Operating the device with the protective covers removed or when there is obvious
damage to cables and/or electrodes.
Non-compliance with the instructions in these operating instructions with regard to
operation, maintenance and repair of the equipment.
Using accessories and spare parts made by other manufacturers.
Autonomous intervention, repairs or constructional changes to the device.
Autonomous overrunning of the performance limits.
Lack of monitoring parts that are subject to wear and tear.
Treatment of patients without prior indication.
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Introduction 8 / 116
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1.5 Symbols used in these operating instructions
DANGER
Texts marked DANGER indicate an extraordinarily serious, actual danger which will definitely lead to serious injury or even death if no preventative measures are adopted.
It is imperative that you follow these instructions!
WARNING
Texts marked WARNING indicate extraordinarily serious, possible dangers which, should no preventative measures be taken, may lead to serious injury or even death.
It is imperative that you follow these instructions!
CAUTION
Texts marked with CAUTION indicate a possible dangerous situation which could lead to minor injuries or damage to property.
It is imperative that you pay attention to these texts.
Note
This symbol indicates text which contains important advice / comments or tips.
This point identifies the first step of a sequence of actions you should take.
Second step of an action you should take. etc.
This line marks lists
(3) Numbers in brackets refer to items in diagrams.
< ... > The text in pointed brackets are acoustic instructions / arrangements of the
equipment which are simultaneously shown on the monitor, depending on the equipment variant.
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Introduction
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1.6 Pictograms on the device
IP33
Protection against foreign bodies > 2.5 mm Protection against spray water (60° to the vertical)
Please observe the operating instructions.
Do not dispose of device in domestic refuse. Dangerous electric voltage (high voltage)
Degree of protection CF in connection with ECG patient cable:
10µA patient leakage current (NC – normal condition) 50µA patient leakage current (SFC single fault condition) 100µA patient leakage current (SFC – defibrillation outputs)
according to IEC60601-1 and IEC60601-2-4
Fig. 1: Brief instructions on use of devices with AED mode
Fig. 2: Brief instructions on use of devices without AED mode
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Introduction 10 / 116
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1.7 Pictograms on SavePads
Not to be reused
Expiry date
Batch ID
Only for adults Order number
Storage temperature in Celsius and Fahrenheit
1.8 Image mark on the encompassing packaging
Sticker on the encompassing packaging for the PRIMEDIC™
AkuPak LITE for airfreight despatch
Sticker on the encompassing packaging for the PRIMEDIC™
AkuPak LITE for road/rail/marine despatch
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Intended use
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2 Intended use
This device is intended for use by appropriately trained medical personnel and doctors, both in emergency medical services and in everyday clinical applications, in compliance with applicable national legislation.
The device is frequently used in brief applications in the course of emergency medical treatment (typically up to 2 hours).
It can be powered either by a rechargeable internal power source (battery) or from the mains.
The device is used for transthoracic defibrillation. The main application is defibrillation in asynchronous manual mode, while a further possible application is the cardioversion of atrial fibrillation in synchronous manual mode after sedation of the patient. In manual mode, the user decides whether it is necessary to administer a shock, while in AED mode, the device automatically recommends defibrillation.
In automatic mode, the energy levels for the first, second and third shocks are predetermined by the set current values 20A, 25A and 30A and the capacitor voltage which depends on the patient impedance, while in manual mode, the energy levels 5J, 10J 20J, 30 J, 50J, 100J, 200J, 300J, 360 J can be selected in order to allow the doctor to define the defibrillation charge according to the weight of the patient. This means that in manual mode, defibrillation can also be carried out on children if suitable pads are used.
The device can also be used to record and display electrocardiograms. When the electrodes are used as intended, the derivation from the defibrillation electrodes is in the Einthoven II derivation. If an ECG cable and standard ECG electrodes are used instead of the defibrillation pads, dual channel monitoring is possible. A random (appropriate) selection of 2 signals from the Einthoven I, II, III or Goldberger aVR, aVL, aVF – analogue derivations can be displayed. This requires correct positioning of the electrodes as described in the operating instructions.
A further configuration of the device is to equip it with an SPO2 module and an SPO2 sensor to allow the oxygen saturation graph to be displayed in addition to the ECG function.
A printer allows documentation of the current ECG graphs before and where necessary, after defibrillation for comparison and evaluation in emergency medical treatment. The quality of the ECG printout corresponds to that shown on the display, as this was the only basis for deciding on the appropriate treatment in the specific emergency situation. Graphic evaluation of the ECG printout is possible by displaying a 1 mV calibration.
In a further configuration of the device, a pacer module with adjustable modes Fix (analogous to the S00 Mode), Demand (inhibiting, corresponds to SSI Mode) or Overdrive can be added in manual mode, allowing transthoracic stimulation via self-adhesive electrodes.
The transthoracic pacer can only be used Ii the event of bradycardia after sedating the patient.
A further area of application is transthoracic stimulation when the heart first begins to beat bradycardially after defibrillation, in order to allow the necessary oxygen saturation of the bloodstream to develop.
The device is designed for use anywhere, inside buildings and in the open and special mounting fixtures are available allowing it to be carried in emergency rescue vehicles, rescue helicopters or planes. It is designed to be able to accompany the patient from the site of an accident or emergency to the hospital without changing the electrodes.
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Intended use 12 / 116
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The device must not be used in locations where there is potential danger of an explosion (e.g. explosive anaesthetic gas mixes).
NMR equipment or the radio equipment used by emergency services personnel can cause interference as a result of the increased electromagnetic emission. In this case, the limitations described in the operating instructions apply or where possible, shut off or screen the sources of the interference.
WARNING
Any use above or beyond this is not considered as intended use and can lead to personal injury or damage to property.
The PRIMEDIC™ DefiMonitor XD may only be used as described
and under the conditions detailed in these operating instructions.
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Intended use
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2.1 Indication/Contraindication for Defibrillation
WARNING
The defibrillator unit of the PRIMEDIC™ DefiMonitor XD may only be
used when dysrhythmia, such as ventricular fibrillation/flutter or certain types of arterial and ventricular tachycardia occur, accompanied by the following symptoms (indication):
patient is unconscious
patient is not breathing normally
WARNING
The defibrillator unit of the PRIMEDIC™ DefiMonitor XD must not be
used if
the patient is conscious or
the patient is breathing normally or
a normal pulse can be felt or
asystolia or
electrical activity without a pulse is detected
For automatic mode: is a child under the age of 8 or
weighing less than 25 kg respectively.
2.2 Possible complications
WARNING
Irritation of the skin or even burns if, for example,
insufficient defibrillation gel is used.
Possible damage to the myocardium as a result of the
defibrillation charge
Cardiac arrhythmia (e.g. atrial fibrillation or flutter) may
occur after successful defibrillation or cardioversion.
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2.3 Users
In manual mode, the PRIMEDIC™ DefiMonitor XD is to be used exclusively by specially
trained medical personnel.
In automatic mode, the PRIMEDIC™ DefiMonitor XD can be used by trained medical
personnel. Use of the equipment must be ordered by a doctor.
Improper use of the defibrillator can lead to ventricular fibrillation, asystolia or other dangerous dysrhythmia.
The operator of the PRIMEDIC™ DefiMonitor XDs is responsible for ensuring that the PRIMEDIC™ DefiMonitor XD is only used by authorised and trained specialist personnel.
Note
The guidelines governing the application of emergency treatment in the event of cardiac arrest may change. The device described in this operating manual complies with the guidelines of the European Resuscitation Council with Guidelines 2010 Resuscitation.
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Safety information
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3 Safety information
3.1 General information
Both in conjunction with its accessories and the optional accessories, and also individually, the PRIMEDIC™ DefiMonitor XD fulfils the currently applicable safety standards and complies with the provisions of the medical products regulations 93/42/EC.
The device and its accessories are safe when used as intended and taking into account the descriptions and information detailed in these operating instructions.
Despite this, if used incorrectly, the device and its accessories can be dangerous to the user, the patient or third parties.
DANGER
For this reason, we emphatically advise that before using for the first time, all those who are supposed to use this device or want to use it
must be instructed in a training session about the medical
background of defibrillation and the indications or contraindications and thus need to be authorised.
need to read and take note of these operating
instructions and in particular the safety tips and warnings detailed in them.
WARNING
The PRIMEDIC™ DefiMonitor XD is not licensed for use in explosive
areas.
DANGER
Not using the device as intended or using it improperly, exposes the user, the patient or third parties to the danger
of an electric shock from the high voltage generated by
the device,
of influencing active implants,
of burns from incorrectly applied electrodes.
Apart from that, the device can be damaged or destroyed through improper use.
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Safety information 16 / 116
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Note
Observe the information and rules in the appendix on using the PRIMEDIC™ DefiMonitor XD.
When carrying the DefiMonitor XD in a vehicle, the paddles must be secured in the attachment provided and the device must be secured stored in a wall bracket.
Applicable for Europe:
The device complies with the Medical Device Directive (MDD).
Additionally, following apply to Federal Republic of Germany:
The device complies with the Medical Devices Law (MPG) and is subject to the
Ordinance on the Operation and Use of Medical Devices (MPBetreibV).
According to the Ordinance on the Operation and Use of Medical Devices
(MPBetreibV), the device is to be subjected to the regular checks explained in the appendix.
According to the Ordinance on the Operation and Use of Medical Devices
(MPBetreibV), a medical devices log needs to be kept for the device. Regular checks of the device are to be documented in it.
For the other states in the European Community, national regulations for operating medical devices apply.
3.2 General safety instructions
DANGER
The device may not be used in the vicinity of flammable materials (e.g. cleaning solvents or similar) or in an atmosphere enriched with oxygen or flammable gases/vapours.
Monitor the use of the device at all times.
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3.3 Safety notes for you, the user
WARNING
Only use the device on a patient if
You have ensured its operational safety before using it
and that it is in good condition.
the state of the patient requires or allows an application.
Before using the device, ensure that the temperature is within the operating temperature range. This applies for example, if the defibrillator is stored in a rescue vehicle.
Do not apply the device if it has been damaged or is defective (e.g. if the defibrillator cable is damaged or the housing has been damaged)
Do not touch the patient during defibrillation. Avoid any contact between
parts of the patient's body (such as bare skin on head or
legs), as well as
conductible liquids (such as gel, blood or salt solutions)
and
metal objects around the patient (such as the bedframe
or traction devices)
which present unintended paths for the defibrillation current!
Although the DefiMonitor XD and its original accessories are defibrillation-protected, we recommend that you do not touch them while defibrillation is being carried out with another device.
3.4 Safety notes for protection of the patient
DANGER
Do not use the device on a patient unless you have ensured its operational safety before using it and that it is in good condition!
Observe the patient during the entire period of treatment and regularly monitor display on equipment so as to recognise changes in patient's condition in a timely manner and to take appropriate counter-measures.
Before using the device, ensure that the temperature is within the operating temperature range. This is important, for example, when the device is stored in an emergency services vehicle in winter.
Do not use the device if it is defective (e. g. if the defibrillation cable is damaged).
Only use the device with accessories, wearing parts and disposable items which have proven to be completely safe to use by being tested
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by a testing authority licensed to test the device when equipped ready for use.
Use new, undamaged and unexpired defibrillation electrodes for every patient to avoid any possible burns to the skin!
Only connect the self-adhesive electrodes with the PRIMEDIC™ DefiMonitor XD. Use of the electrode system with other devices can lead to dangerous impedance currents for the patient!
Do not use the device in the immediate vicinity of other sensitive equipment (e.g. measuring equipment that is sensitive to magnetic fields) or strong sources of interference which could affect the way the PRIMEDIC™ DefiMonitor XD works. Keep a sufficient distance away from other therapeutic and diagnostic energy sources (e.g. diathermy, high frequency surgery, magnetic resonance tomography).
These devices can affect the PRIMEDIC™ DefiMonitor XD and
disrupt the way it operates. For this reason, disconnect all other devices from the patient before carrying out defibrillation.
Prior to defibrillation, disconnect all other electrically-operated medical devices that are not defibrillation-proof and are used on the patient.
Keep the defibrillation electrodes and the ECG electrodes away from other electrodes, metal objects and earthed objects!
Do not use the device in AED mode on children under the age of 8 or children with an estimated body weight of less than 25 kg!
Position the electrodes precisely according to the description.
Dry the chest and carefully remove any large amount of hair on the patient before applying the defibrillation electrodes.
Do not place the defibrillation electrodes directly over an implanted pacemaker to avoid a possible misinterpretation by the device and to avoid any damage to the pacemaker from the defibrillation impulse.
Do not touch the patient during the ECG analysis and avoid any vibrations.
If the ECG analysis is being carried out in a vehicle, the vehicle has to stop and switch off the engine to guarantee a correct analysis.
Stop any reanimation while the PRIMEDIC™ DefiMonitor XD is
analysing the ECG.
In case of extreme fluctuations in the power supply, the device should be disconnected from the mains by pulling the mains plug out from its socket, and the device should be operated using the integrated PRIMEDIC™ AkuPak battery.
Strong sunlight may make it difficult to read the display.
The use of several medical devices simultaneously may present a
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Safety information
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danger to the patient as a result of the cumulation of patient currents.
3.5 Safety notes for the protection of third parties
DANGER
Warn people in the vicinity loudly and clearly before the defibrillation so that they step back from the patient and are no longer in contact with him.
3.6 Safety notes for protection of the device
CAUTION Damage to property
Repairs, changes, extensions and installations of the
PRIMEDIC™ DefiMonitor XD may only be carried out by
personnel authorised and trained by METRAX
The PRIMEDIC™ DefiMonitor XD does not have any
parts that can be repaired by the user.
Use only accessories which meet the requirements of the
relevant laws, EU directives and other standards. This applies in particular to the SPO2 sensor, self-adhesive electrodes and replacement batteries. These conditions
are fulfilled by all original PRIMEDIC™ accessories and
wearing parts.
Clean the device in the prescribed manner, i.e., only in its
power-off state and with the electrodes disconnected.
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4 Description of device
4.1 General description
The PRIMEDIC™ DefiMonitor XD is an external defibrillator with integrated 6-channel ECG. The ECG can be recorded either via the PRIMEDIC™ SavePads, the defibrillation paddles or
the three-pin patient cable with self-adhesive ECG electrodes. The PRIMEDIC™ DefiMonitor XD is available in various configurations. The respective model is displayed in the start dialogue on the monitor.
In automatic mode (Auto mode), the ECG is analysed via the implemented algorithm. If potentially fatal arrhythmia is detected, the device recommends defibrillation and generates the necessary electric shock for reanimation when enabled by the user. No electric shock is generated if the device does not detect an abnormal rhythm requiring defibrillation.
In manual mode, the doctor or trained user decides whether defibrillation is necessary.
The following models are available:
A. completely manual defibrillators:
DefiMonitor XD1 Model with Monitor and 6-channel ECG
DefiMonitor XD3 Model with monitor and 6 channel ECG and pulse oximeter
DefiMonitor XD10 Model with monitor and 6 channel ECG and pacer
DefiMonitor XD30 Model with monitor and 6 channel ECG, pulse oximeter and
pacer
B. Manual defibrillators with AED mode:
DefiMonitor XD100 Model with monitor and 6 channel ECG and automatic mode
DefiMonitor XD300 Model with monitor and 6 channel ECG, pulse oximeter and
automatic mode
DefiMonitor XD110 Model with monitor and 6 channel ECG, pacer and automatic
mode
DefiMonitor XD330 Model with monitor and 6 channel ECG, pacer, pulse oximeter
and automatic mode
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Description of device
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The PRIMEDIC™ DefiMonitor XD - Generation has been designed to be safe and quick to use in an emergency. All functional units are operating elements subject to the following principles:
Clear organisation of functional units
Reduction of functions to what is necessary
Intuitive and logical operator guidance
Clear, self-explanatory operating elements
Ergonomic layout.
The ECG monitor has a high-resolution graphics display which offers high image contrast even in difficult lighting conditions.
The display on the PRIMEDIC™ DefiMonitor XD is only intended for the purpose of identifying
ECG rhythms in the course of emergency medical treatment.
The defibrillator unit has been optimised to be safe and quickly ready to use.
PRIMEDIC™ DefiMonitor XD is powered by rechargeable batteries with nickel-cadmium cells or via a power supply unit, independent of the respective model. The charging electronics incorporate state-of-the-art technology, ensuring maximum service life of the batteries used.
The PRIMEDIC™ DefiMonitor XD can be stored on an optional wall bracket which can be affixed to a wall or in the ambulance. PRIMEDIC(TM) Basic / Comfort charger serves as a power supply for charging the batteries.
A wide range of accessories are available.
The wall bracket and accessories are described in separate operating instructions.
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4.2 Description of device details
A. completely manual defibrillators:
Fig. 3: PRIMEDIC™ DefiMonitor XD 1 / 3 – Front view
(1) Carrying handle
(2) Paddle
(3) Paddle cable, detachable
(4) Operating membrane
(5) Monitor
(6) Microphone
(7) Status display
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Fig. 4: PRIMEDIC™ DefiMonitor XD 10 / 30 – Front view
(1) Carrying handle
(2) Paddle
(3) Paddle cable, detachable
(4) Operating membrane
(5) Monitor
(6) Microphone
(7) Status display
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B. Manual defibrillators with AED mode:
Fig. 5: PRIMEDIC™ DefiMonitor XD 100 / 300 – Front view
(1) Carrying handle
(2) Paddle
(3) Paddle cable, detachable
(4) Operating membrane
(5) Monitor
(6) Microphone
(7) Status display
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Fig. 6: PRIMEDIC™ DefiMonitor XD 110 / 330 – Front view
(1) Carrying handle
(2) Paddle
(3) Paddle cable, detachable
(4) Operating membrane
(5) Monitor
(6) Microphone
(7) Status display
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Fig. 7: PRIMEDIC™ DefiMonitor XD – rear view
(1) Opening for hook of the one-hand quick release.
(2) Specification plate
(3) Quality seal
Fig. 8: PRIMEDIC™ DefiMonitor XD – view from below
(1) SaveCard cover
(2) Release button (to remove the power module)
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(3) Power module
Fig. 9: PRIMEDIC™ DefiMonitor XD – side view
(1) Loudspeaker
(2) Jack for electrode connectors
(3) Jack for SpO2 sensor (optional)
(4) Jack for paddle cable
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Fig. 10: PRIMEDIC™ DefiMonitor XD – side view
(1) Unlocking lever for printer cover
(2) Printer cover
(3) Mains connection jack
(4) Attachment device for bag (optional)
Fig. 11: PRIMEDIC™ DefiMonitor XD – status display
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Display.
Meaning
Action to be taken
PRIMEDIC™ AkuPak
sufficient capacity
Device ready to use.
Battery low
You can use the device, but
the PRIMEDIC™ AkuPak may
need to be charged or replaced.
Symbol also appears if no power module is inserted!
Insert power module.
Symbol also appears event hough use-by-date of power module has passed.
Check use-by-date, if necessary replace power pack.
Battery symbol flashes during operation
Internal buffer battery empty (The device is still operational!)
Send the device to the dealer for the replacement of the internal buffer battery
PRIMEDIC™ AkuPak
sufficient capacity
Carry out extensive self-test
by reinserting PRIMEDIC™
AkuPak or switching the device on again
Device defective
Have the device repaired by a dealer.
Battery fully discharged
Charge battery
Device defective
Carry out extensive self-test
by reinserting PRIMEDIC™
AkuPak or switching the device on again
Have device repaired by authorised dealer
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Fig. 12: Panel foil PRIMEDIC™ DefiMonitor XD 1/10/3/30 (completely manual defibrillators)
Fig. 13: Panel foil PRIMEDIC™ DefiMonitor XD 100 / 110 / 300 / 330
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1
Device On / Off button
2
Mode changeover switch AED/Manual with LED
3
SYNC button
4
Charging button for use with SavePads, can only be operated in manual mode
5
Energy level in joules (at 50 Ohm)
6
Menu keys
Select / confirm key
Selector switch to scroll upwards in the monitor menu alternatively to increase
the parameter alternatively to select the lead upper ECG curve
Selector switch to scroll downwards in the monitor menu alternatively to
decrease the parameter alternatively to select the lead lower ECG curve
7 Mains connection LED display
8
LED display Charge battery
9
Trigger button for defibrillation, Shock button
10
Printer On/Off (online print)
11
Paper feed
12
Event button
13
ECG source changeover switch
14
Alarm acknowledgement button, heart rate
15
Alarm acknowledgement button SpO2
16
Pacer XD On / Off button
17
Pacer mode changeover button DEMAND/FIX/OVERDRIVE
18
Stimulation rate +/-
19
Stimulation intensity +/-
20
Stimulation Start/Stop button with LED
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Fig. 14: Monitor display
(1) Indicator Swtich-on time/ Energy level / Pacer
(2) Mode AUTO/Manual
(3) ECG channel display
(4) Indicator heart rate and alarm limits
(5) Indicator Pulsoximeter and alarm limits
(6) Status line for indicating patient impedance, time, microphone, battery charge, pacer
status, CF card capacity, printer status, paper status
(7) Indicator ECG-channels (max.2 )
(8) SpO2 curve, messages, information
(9) Calibration peak, height corresponds to 1mV (display size depends upon the
sensitivity of the ECG)
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4.3 Capacity display
The charging status of the PRIMEDIC™ DefiMonitor XD is shown on the display. The different possible images displayed have the following meaning:
The charging status of PRIMEDIC™ AkuPak battery is monitored electronically to ensure
optimum display of the capacity.
In addition to this display, the PRIMEDIC™ DefiMonitor XD issues a warning when the battery charge is running very low.
If the PRIMEDI
C™
AkuPak battery is damaged (e.g. as a result of the memory effect), this is shown in the screened area on the left side of the capacity display.
If the device is being used, the corresponding audible warning will be repeated once a minute in the selected language.
Note
In order to ensure that the device is always ready for immediate operation, we recommend that you have a charged replacement battery with you at all times. Depending on the situation in which this voice message is issued, you should consider replacing the battery.
Image on display
Meaning
100 % charged
50 % discharged
partly discharged or with reduced capacity
0 % (device runs on until charge is exhausted)
PRIMEDIC™ AkuPak communication interrupted or operating life reached.
Voice message
Display on monitor
PRIMEDIC™
AkuPak
< Charging status battery low, please recharge >
Charging status battery low, please recharge
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4.4 Data management
Note
The device records all the data on a removable SaveCard and also records all noises in the surroundings via a microphone.
The saved data can be viewed with the help of a PC / laptop and the PRIMEDICTM ECG Viewer software, but must not be used for diagnosis or therapy of the patient! This data is only intended for administrative or legal purposes. In the software there is a deployment protocol into which further patient data can be entered.
Wherever possible, the data saved on the SaveCard should be downloaded and filed externally after each deployment. Once the storage capacity of the SaveCard is exhausted, no further data will be saved. The device remains ready for operation even if the memory is exhausted and even without a SaveCard.
The SaveCard supplied with the device is already formatted and can be used straight away. in case of problems with the present SaveCard, as well as in case of a new CF-card, it must be formatted using FAT16 or FAT32 file system. To attain the greatest possible degree of safety here, please proceed as follows:
For Windows 2000, Windows XP, Windows Vista, Windows 7
Start a command line window using "Start->Run" and in the entry field, enter
"cmd.exe". The command line window will then open.
There you enter the following:
for SaveCards up to 2GB= format f: /U /FS:FAT /X /V:savecard for SaveCards up to 2GB= format f: /U /FS:FAT32 /X /V:savecard (where f: stands for the drive letter of the of the CF card reading device which you may have to adjust).
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4.5 Description of the accessories
The accessories need to be secured appropriately before being transported.
4.5.1 Paddles
The PRIMEDIC™ DefiMonitor XD features ergonomically shaped defibrillation paddles with
integrated child paddles for the defibrillation of children.
To access the child paddles, unscrew the large electrodes on both paddles by turning them anticlockwise. You now have a reduced electrode surface suitable for children.
The adult paddles are screwed on in clockwise direction over the child paddles.
Clean the child paddles after use and before screwing on the adult paddles again.
Make sure that the adult paddles engage securely over the child paddles to ensure good contact
Fig. 15: Locking the adult paddles in place over the electrodes for children
Note
Do not use the child-sized electrodes on adults, as they will not provide adequate defibrillation.
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4.5.2 PRIMEDIC
TM
SavePads Connect cable
Fig. 16: PRIMEDIC™ SavePadsConnect cable, 2-pin
(1) Connector
(2) Connecting clips for SavePads Connect
4.5.3 PRIMEDIC
TM
SavePads
Fig. 17: PRIMEDICTM SavePads Connect
Defibrillation electrodes with protective film
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4.5.4 ECG patient cable, 3-pin
Fig. 18: ECG patient cable, 3-pin
(1) 3-pin ECG electrode cable with connector
(2) Electrode clips (red, green, yellow)
(3) ECG electrodes (Ag/AgCl)
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4.5.5 SpO
2
-Sensor (only for PRIMEDIC™ DefiMonitor
XD3/XD30/XD300/XD330)
Fig. 19: SpO2 sensor and adapter cable
(1) Cable for SpO2 sensor
(2) Reusable SpO2 sensor
(3) Plug (for connecting the sensor cable to the adapter cable)
(4) Jack (with locking device)
(5) Plug (for connecting the adapter cable to the device)
(6) Adapter cable
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5 Preparatory measures before (initial) start-up
5.1 Unpacking
After delivery, first of all check the packaging and the device for transport damage.
If you notice any damage to the device, immediately contact your transport company, dealer or directly contact technical services at METRAX GmbH, stating the device number and describing the damage to the device.
DANGER
Definitely do not use the device if you know of any damage. Endangering health cannot be ruled out.
Satisfy yourself that the scope of delivery is complete in accordance with the enclosed delivery note.
5.2 Inserting / Changing the SaveCard
Fig. 20: PRIMEDIC™ DefiMonitor XD – SaveCard
(1) SaveCard slot
(2) SaveCard removal button
(3) Cover
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Procedure:
Lay the device on its back and remove the power module
Open the SaveCard slot by sliding the cover towards the power module slot (3)
Push the SaveCard into the slot (1) provided. Press the SaveCard in carefully until
button (2) protrudes from the opening. To remove the SaveCard, press button (2) in fully – the SaveCard now protrudes from the holder. The SaveCard can now be removed.
Then close the cover.
Replace the power module in the device. The device now boots and performs a self-
test.
Note
Wherever possible, the data saved on the SaveCard should be downloaded and filed externally after each deployment. Once the storage capacity of the SaveCard is exhausted, no further data will be saved. The device remains ready for operation even if the memory is exhausted and even without a SaveCard.
5.3 Power supply
PRIMEDIC™ DefiMonitor XD has two possibilities of power supply:
Rechargeable power module “PRIMEDIC™ AkuPak“
with power cable plugged into the mains.
Note
If you operate the PRIMEDIC™ DefiMonitor XD exclusively via power from the mains, then you must ensure that the PRIMEDIC™ AkuPak is inserted in the power module slot. Without this, the PRIMEDIC™ DefiMonitor XD is not operational.
WARNING
Whenever the device has been used, check the power level. If necessary, PRIMEDIC™ AkuPak should be recharged. If this is not possible, make sure you always have a second, fully charged PRIMEDIC™ AkuPak at hand.
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5.3.1 Inserting PRIMEDIC™ AkuPak
Fig. 21: PRIMEDIC™ DefiMonitor XDInserting PRIMEDIC™ AkuPak
Procedure:
Lay the device on its back.
Push the (new) power module into the device in the direction shown by the arrow (1)
until it rests against the left-hand stop.
Press the front of the power module into the slot in the direction shown by the arrow (2)
until you hear a "click" as the unlocking device engages securely with the tongue on the power module.
The power module should now be in fully inserted position, flush with the front housing of the device. It should not fall out when the device is moved. If it does, it is not securely engaged.
Note
The device switches on automatically when the PRIMEDIC™ AkuPaks battery is
inserted and performs an automatic self-test.
Monitor the Status Display. If the display is showing "OK", the device is ready to use.
Switch it off (if required) by pressing the On / Off button.
CAUTION
If the display does not read "OK" or if a fault message appears on the monitor, remedy the cause or contact your nearest service station. The device will switch itself off.
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5.3.2 Removing PRIMEDIC™ AkuPak
Fig. 22: PRIMEDIC™ DefiMonitor XD – Removing the power module
Note
Only change the power module when the device is switched off and electrode plug is disconnected.
Procedure:
Lay the device on its back and press the release button in the direction shown by the
arrow (1.) until the tongue on the power module is released and the power module snaps out of the slot.
Turn the power module in the direction of arrow 2 and then pull it out of the device.
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5.4 Loading the PRIMEDIC™ AkuPak
PRIMEDIC™ AkuPak can be charged in two different ways:
in DefiMonitor XD when connected to the mains
in PRIMEDIC™ ChargerBasis / ChargerComfort (optional).
The integrated detection of charge endpoint detection protects the battery from harmful deep discharge. If the battery charge is too low, both a visual and an acoustic signal are issued.
In case an AkuPak is stored outside the equipment, its charge status can be checked by pressing button (2).
Fig. 23: PRIMEDIC™ AkuPak Battery charge indicator
(1) Battery charge indicator
(2) push button to activate battery charge indicator
Battery charge indicator (1) means:

81 % - 100 % charged

41 % - 60 % charged
1 % - 20 % charged
Note
Of the two charging possibilities mentioned above, PRIMEDIC™ AkuPak, will be
automatically recharged in case the charge should fall below 80 % of its charging capacity.
This 80 %-limit can temporarily be made inoperative by pressing 3 seconds on push
button (2), i.e., the PRIMEDIC™AkuPak can be recharged even before reaching
this limit. This, for example, is practical if you wish to fully recharge PRIMEDIC™AkuPak prior to next use, independent of its current charge status. After recharging, the programmed 80 %-limit is operative for the next automatic full recharge.
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Note
A completely discharged PRIMEDIC™ AkuPak battery must be charged for at least
2.5 hours. Too short a charge duration can lead to misinterpretation of charge by the equipment. Trouble-free functioning of the equipment cannot be assured.
Ensure that the ambient temperature is between 0 - 45°C during charging.
Note
Charging PRIMEDIC™ AkuPak battery pack at operating temperatures outside the
prescribed range can damage the battery. Allow the battery to reach the ambient temperature before charging it, or charging may be interrupted prematurely.
Charging of PRIMEDIC™ AkuPaks is interrupted in case the equipment senses a higher temperature. It resumes once the temperature is within the valid range. This prevents harmful
overcharging of the PRIMEDIC™ AkuPaks battery. If the PRIMEDIC™ AkuPak battery is not charged, the PRIMEDIC™ DefiMonitor XD can be operated using the integrated mains power pack. The PRIMEDIC™ AkuPaks are charged automatically during operation of the PRIMEDIC™ DefiMonitor XD.
For further information on NiCd batteries and how to charge them, see chapter 22.
5.4.1 Charging the AkuPak in the optional PRIMEDIC™ Charger Basis /
Charger Comfort
Please refer to the separate operating instructions for the charger Basic / Comfort.
5.5 Connecting the mains cable
Procedure:
Plug the cable into the jack on the device.
Plug the mains plug into a properly earthed safety socket with the correct voltage.
Note
Ensure that the PRIMEDIC™ AkuPak battery is inserted in the power module slot. This is vital to ensure fault-free operation of the PRIMEDIC™ DefiMonitor XD via the mains. The 3-pin cable provided must be used.
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5.6 Inserting paper in the printer
Procedure:
Press the release button above the paper compartment. The printer cover can now be
folded forward.
Prepare the roll of paper provided (remove adhesive strip, unroll approx. 5cm of paper)
Insert the roll of paper into the printer so that the side with the check pattern faces
upwards.
Close the cover.
Note
The cover is designed to spring out of its position without damage if great pressure is exerted from the outside.
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6 Device self-test
6.1 Self-test when the PRIMEDIC™ DefiMonitor XD is switched on
The self-test is triggered by switching on the PRIMEDIC™ DefiMonitor XD or by inserting the PRIMEDIC™ AkuPak battery in the device. The self-test checks all important functions and signalling devices. Automatically full self-test is initiated in case an internal error is found by the equipment. Please proceed to follow the device instructions.
6.2 Automatic, periodic self-tests
The device carries out automatic self-tests to ensure that it is always ready for operation. Self-
testing is only possible if the PRIMEDIC™ DefiMonitor XD is either connected to the mains or if a charged PRIMEDIC™ AkuPak has been inserted.
Frequency
Scope of test
SHORT
Daily
Software, operating membrane, ECG calibration, clock, internal voltage supply and HV part at 0 V
MEDIUM
First day of the month
Software, operating membrane, ECG calibration, clock, internal voltage supply and HV part at 300 V
LONG
On the 1st. July and on the 1st. January each year
Software, operating membrane, ECG calibration, clock, internal voltage supply and HV part at 1600 V
FULL
After identifying an internal error
Software, operating membrane, ECG calibration, clock, internal voltage supply and HV part at 1600 V, microphone test
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7 Operating the PRIMEDIC™ DefiMonitor XD
7.1 Switching on / off
7.1.1 Switching the PRIMEDIC™ DefiMonitor XD on
The device is switched on by pressing the On / Off button. Directly after switching it on, an internal self-test is carried out to check important functions and signal devices. If the self-test is successful, the device is immediately ready for operation in the corresponding mode (manual
for the DefiMonitor XD1, XD3, XD10, XD30 or automatic for the PRIMEDIC™ DefiMonitor
XD100, XD110, XD300, XD330).
Standby is confirmed by a beep.
7.1.2 Switching the PRIMEDIC™ DefiMonitor XD off
The device can be switched off in different ways:
By pressing the On / Off button for approximately 2 seconds. A continuous
warning beep will sound simultaneously.
The device switches off automatically, if it does not detect any signal source for 10
minutes or no button is pressed.
If the device detects a fault it will automatically switch off to avoid possible injuries.
7.2 Selecting the operating mode
7.2.1 Operating modes
Depending on the specific model, it is possible to select one of two operating modes:
the AUTO mode (AED-Mode) and
manual mode (MAN Mode)
7.2.2 Auto mode (AED mode)
In this operating mode, the device automatically analyses the cardiac rhythm.
If potentially fatal arrhythmia is detected, the device recommends defibrillation and generates the necessary electric shock for reanimation when enabled by the user. No electric shock is generated if the device does not detect an abnormal rhythm requiring defibrillation. The device recommends cardio pulmonary resuscitation. For further information, see Chapter 9.
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7.2.3 Manual mode (MAN Mode)
Pressing the MAN/AUTO button switches the PRIMEDIC™ DefiMonitor XD to manual
operating mode. Manual mode is now activated. Illuminated LED is the identification of this state. For further information, see chapter 10.
Note
The device switches over to Auto mode:
when it is switched off and back on again or
when the MAN button is pressed
7.3 Changing the configuration/setup
The device is configured at the factory.
Certain parameters can be changed in the setup menu. The new configuration remains stored until it is changed again, irrespective of whether the device is switched off or the power module replaced.
Press the selection / confirmation key during operation to open the setup menu  .
Press the key (up) or the key (down) to navigate within the menu and to increase or reduce a selected parameter value and press the  key to select a parameter and confirm the new entry.
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7.4 Parameter list menu
Page 1:
Alarm SpO2:
Lower limit, upper limit of SPO2 alarm
Alarm SpO2:
[0 % / 25 % / 50 % / 75 % / 100 %]
Alarm ECG:
Lower limit, upper limit of ECG alarm
Alarm ECG:
[0 % / 25 % / 50 % / 75 % / 100 %]
Print form:
[ 1-channel / 3-channel / 6-channel]
Sensitivity
[5 mm/mV, 10mm/mV, optimal, 15mm/mV]
Derivation:
I II III aVL aVR aVF
Page 2:
Contrast:
from 60 to 180
Microphone:
[On / Off]
BLS information:
[On / Off]
HLW cycles:
Number can be selected 1-15
HLW sounds:
[0 % / 25 % / 50 % / 75 % / 100 %]
Volume:
[0 % / 25 % / 50 % / 75 % / 100 %]
Systole sound:
[0 % / 25 % / 50 % / 75 % / 100 %]
Page 3:
Auto print:
[On / Off]
Memo print-out:
Printing from printer memory, see chapter 7.9
Printing speed:
[25 mm/s / 50 mm/s]
Language:
(depends on installed language packages)
Time:
00:00 in 24 h format
Date:
in format DD/MM/YYYY
MMI-Test:
Interactive testing of operating membrane, see chapter 7.4.2
Page 4:
ARM SW:
Version number – Check sum Date (e.g. Jul. 11 2005)
DSP SW:
Version number – Check sum Date (e.g. Jul. 11 2005)
MSP SW:
Version number - check sum Date (e.g. Jul. 11 2005)
ULF:
Check sum 8-digit
Serial No.:
xxxxxxx
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Page 5:
BQ SW Version:
x.x
BQ serial number:
xxxxxxx
Ext. MSP SW:
Version number - check sum
Ext. MSP HW:
Version number
SpO2 Version:
xxxx
Pacer Version SW:
xxxx
Pacer Version HW:
xxxx
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7.4.1 Changing the configuration – Example: time
If, for example, you want to update the time, move the highlighted section upward by pressing the  button repeatedly until the menu item Time is highlighted.
Select the highlighted menu item Time by pressing the  key. The hour is then highlighted.
Change the hour by pressing the or key.
Confirm the correct value with the  key. The minute is now highlighted.
Change this entry as described above. When this value is confirmed by pressing  , the menu item Time is highlighted again.
If required, you can now make other changes in the same way.
To exit the setup menu, use the key or to move the highlighted section to the menu item END and confirm with
.
The device is now ready for operation again.
7.4.2 MMI Test (Man-Machine Interaction)
In the MMI Test, the buttons, the display and the acoustic system of the DefiMonitor are tested for correct functioning. This function is mainly used for safety inspections and servicing purposes.
7.5 Alarms
Depending on the equipment, the PRIMEDIC™ DefiMonitor XD monitors the heart rate from
the ECG signal and the oxygen saturation of the patient from the data of SPO2 sensor. If the SPO2 sensor only is connected to the patient, the heart rate displayed is that determined from the SPO2 signal. Accordingly the equipment ECG, VF Alarm and SPO2 Alarm differ.
The alarms are always activated when the PRIMEDIC™ DefiMonitor XD is switched on. The alarm limits can be specifically configured by the user in the Setup menu and are retained after the monitor has been switched off. Generally the alarm is both acoustic and visual, but departures from this may occur, depending on the operating situation, and these are explained in the following sections.
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7.5.1 ECG Alarm
The range of adjustment of the ECG Alarm is from 30 – 300 beats per minute [bpm]. The lower alarm limit can be selected in the range 30 – 99 beats per minute. The upper alarm limit cannot be lower than the lower limit and the value selected can be up to 300 beats per minute. The lower and upper alarm limits are displayed on the monitor. Changes can only be made in the Setup menu. When one of the set limits is attained an ECG Alarm is initiated. If no valid heart rate can be obtained (e.g. on the occurrence of an asystole (cardiac arrest) an alarm is likewise initiated. In this case the heart rate is indicated in the form of dashes.
The Alarm in the event of an asystole (cardiac arrest) and on exceeding the set ECG limits takes the form of a loud tone, alternating quickly between 2 pitch levels of approx. 5 seconds duration. This alarm is repeated every 20 seconds. At the same time a bell symbol and the heart rate flash on the display.
The ECG Alarm button is used to acknowledge the ECG Alarm. The acoustic Alarm is suppressed for the duration of one minute. During this period of time the bell symbol on the display is crossed out. Pressing the button again during this period reactivates the Alarm. The alarm limits are retained.
The ECG Alarm can be deactivated in the Setup menu. When the ECG Alarm (= 0 %) is deactivated the bell symbol is permanently crossed out. If in this case the alarm limits are exceeded no acoustic alarm is initiated, but the bell symbol and heart rate flash, in order to inform the user.
Note: If the equipment is operated with PRIMEDIC™ SavePads Connect-Electrodes on the patient, in auto mode the bell symbol for the ECG Alarm is always crossed out, in order to indicate that in this condition no ECG Alarm occurs. By this means interfering messages are avoided during the repetition of the HLW request.
7.5.2 VF Alarm
The VF Alarm only occurs during ECG monitoring with ECG electrodes / ECG cable, by means of which shocks cannot be applied. With the VF Alarm eight "gong-type" muffled tones are heard over a period of approx. 5 seconds, which are repeated every 20 seconds and accompanied by the verbal message < Analysis recommended, use SavePads >.
If the ECG Alarm is activated, the acoustic Alarm takes place with the ECG Alarm tone. The speech output is always provided.
The VF Alarm requires, that the ECG cable and the ECG electrodes are replaced by the PRIMEDIC™ SavePads Connect-Cable with SavePads Connect defibrillation electrodes, or otherwise no defibrillation can take place. Whilst defibrillation can take place via the paddles parallel to the ECG electrodes in the manual mode, in the Auto mode defibrillation is only possible via SavePads Connect-Electrodes.
The VF Alarm cannot be suppressed by the Mute button.
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WARNING
Warning: Defibrillation cannot take place via an ECG monitoring cable. If shock-driven rhythms (e.g. VF) occur during the ECG monitoring, the use of the SavePad Connect-Cable with defibrillation electrodes is necessary.
7.5.3 SPO
2
Alarm
The SPO2 Alarm is only available for equipment with SPO2 functionality. The adjustment range for the SpO2 alarm is 70-100 %. The lower and upper alarm limits of the SpO2 value are displayed on the monitor. Changes can only be made in the Setup menu. When one of the set limits is exceeded the SpO2 Alarm is initiated.
The Alarm on exceeding the set SPO2 limits takes place in the form of a deep interval tone, quickly alternating between 2 pitch levels of approx. 5 seconds duration. This alarm is repeated every 20 seconds. At the same time the bell symbol and the SpO2 value flash on the display.
The SpO2 Alarm button is used to acknowledge the SpO2 Alarm. The acoustic Alarm is suppressed for the duration of one minute. During this period of time the bell symbol on the display is crossed out. Pressing the button again during this period reactivates the Alarm. The alarm limits are retained.
The SpO2 Alarm can be deactivated in the Setup menu. When the SpO2 Alarm (= 0 %) is deactivated the bell symbol is permanently crossed out. If in this case the alarm limits are exceeded no acoustic alarm is initiated, but the bell symbol and heart rate flash, in order to inform the user.
DANGER
There is no acoustic warnings if the alarms are turned off in case one of the monitored parameters is beyond the permissible range. Hence, regularly check the patients and the equipment indicators so as to react rapidly to changes.
7.6 Event button
Pressing the event button puts a mark on the ECG which triggers storage of the ECG for 5 seconds before and 5 seconds after the event. This ECG sequence can then be printed out later from the event memory and/or viewed on the computer monitor in the stored patient file via the ECG Viewer.
Note
The printing format for the Memo print is always 3-channel print. The signal graphs displayed on the monitor at the time of the event are printed out.
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7.7 Operating the printer
Note
The printer can only be operated or used in manual mode.
7.7.1 Log of the ECG signal
The PRIMEDIC™ DefiMonitor XD is equipped with a high-resolution printer. ECG printout of 3 to 6 channels simultaneously is possible. Printing speeds of 25 and 50 mm/s can be selected.
The online print function for logging the ECG graph during monitoring is activated by pressing the printer On/Off button.
Pressing the printer On/Off button again stops the log printout. ECG printout is made with the parameters selected in the setup menu. The following settings can be selected:
Printing parameter
Meaning
1 channel print
prints the upper ECG channel displayed on the monitor. If SpO
2
measurement is active, the SpO2 pulse graph is also displayed.
3 channel print
Prints 2 ECG channels + 1 channel SpO2 simultaneously, depending on which monitoring is displayed.
6 channel print
Prints the maximum possible number of derivations I, II, III, aVR, aVL, aVF simultaneously, depending on the electrodes attached, with a maximum of 3 derivations, each 5 seconds before and 5 seconds after pressing the button.
25 mm/s - printer speed
Printout is produced at 25 mm/s.
50 mm/s - printer speed
Printout is produced at 50 mm/s.
The following relevant parameters are printed out in a header:
Date, time
Speed
Scale
Heart rate
Energy (Joule)
Mode
SpO
2
value (only on models XD3, XD30, XD300 and XD330)
There is a time lag of 7 seconds between the monitor display and the printout, i.e. events which occurred before activation of the printout function can be displayed. If the printout is stopped, printout also ends with data recorded 7 seconds previously.
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On models with SpO2 measurement, it is possible to show the SpO2 pulse graph in the log printout.
Use the integrated cutting edge on the printer cover to tear off the ECG log printout. Tear off the strip upwards and to the side.
Note
Careful selection of data to be printed out and keeping printing time to a minimum saves energy and paper and means that the device can be operated for a longer not on the mains. This applies especially to printing at a speed of 50 mm/s.
Note
Charging interrupts all print modes.
If the ECG monitoring is changed during online printing, the printer is stopped immediately, the header is reprinted and the printout is then continued. Data still stored at the time of the changeover are discarded, the new printout starts at the time of the changeover.
7.8 Automatic printout after each shock (Autoprint)
The PRIMEDIC™ DefiMonitor XD allows you to record the event automatically each time
defibrillation or cardioversion is performed. Data from 5 seconds before and 5 seconds after the shock was administered are recorded.
The Autoprint function can be switched on and off in the setup menu. When the device is delivered, the function is switched off.
If the Autoprint function is activated in the setup menu, it remains active even if the defibrillator is switched off or the battery replaced.
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7.9 Printing out the Event Memory
The PRIMEDIC™ DefiMonitor XD automatically stores the last 30 defibrillations /
cardioversions / events in an Event Memory. It stores the ECG (5 seconds before and 5 seconds after each shock) and the pulse graph (only on XD 3, XD30, XD300 or XD330 if SpO2 active) as well as all relevant parameters.
A new event will then "push" the oldest event out of the memory.
The memory content, starting with the last recorded event, is printed out in the setup menu.
Procedure:
Open the setup menu and select the menu item "Memo Print" with the cursor keys.
Press Enter.
The Memo Print function is activated. To stop the printout, press the printer On/Off button. Printout is produced at 25 mm/s.
Note
Data in the Event Memory remains stored even after printout. It can be printed out as often as required.
Fault messages on the display:
Symbol on the display
Cause
No paper Printer error
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8 Applying the electrodes
8.1 Undressing the patient
If during your preliminary examination, you have ascertained that the patient needs defibrillation, undress his upper body to be able to place the electrodes.
8.2 Positioning
8.2.1 Positioning self-adhesive electrodes and paddles
Fig. 24: Positions of defibrillation electrodes (SavePads Connect) on the patient
The defibrillation electrodes are positioned
On the right chest area, below the collar bone (1) and
On the left chest area above the apex of the heart on the axillary line (2).
Incorrectly positioned electrodes can lead to faulty readings.
CAUTION
Medicinal plasters must be removed before attaching the defibrillation electrodes.
Note
The PRIMEDIC™ DefiMonitor XD carries out automatic impedance measurement. Defibrillation can only be carried out if the patient is within the permissible
impedance range. See Chapter "Technical Data“. Ensure that the electrodes have
good contact.
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8.2.2 Positioning the ECG self-adhesive electrodes
Fig. 25: Positions of ECG electrodes on the patient
The correct positions for the ECG self-adhesive electrodes are:
1 Red (R) directly under the middle of collar bone (midclavicular)
2 Green (F) directly under the left pectoral muscle on the midclavicular line
3 Yellow (L) directly under the middle of left collar bone (midiclavicular)
Note
Incorrect positioning of the electrodes, defective or dry electrodes can lead to faulty readings. For this reason, always use ECG self-adhesive electrodes approved by Metrax.
8.2.3 Positioning the PRIMEDIC™SavePads Connect for pacing
Two different electrode positions have proved effective for cardiac stimulation:
anterior - posterior position.
anterior - anterior position,
The positioning and the polarity of the electrodes has a significant influence on the intensity of the stimulation required.
The preferred position is the anterior - posterior position.
Position
Anterior
Green (F) ( - )
front left of chest, between sternum and left nipple and (roughly V2/V3 position)
Posterior
Red (R) ( + )
back left of chest, between tip of shoulder blade and spine
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The anterior-posterior position offers the advantage that the intensity of the stimulation required is often lower, which means that the chest muscles are subjected to less stimulation.
If the anterior-posterior position is contraindicated (e.g. if ventricular fibrillation is expected to occur), the anterior - anterior position can be used as an alternative.
The positions correspond to those of the self-adhesive electrodes for defibrillation.
Position
Anterior
Green (F) ( - )
corresponding apex position, left side of chest, above the apex of the heart on the axillary line
Anterior
Red (R) ( + )
corresponding sternum position, right side of chest below the clavicle
Note
Pacing is only advisable and possible in manual mode with self-adhesive electrodes
DANGER
It is important to attach the self-adhesive electrodes in the following order to avoid danger to the user as a result of the stimulation pulse:
1. First, connect the SavePads Connect cable with the electrode clip to the self-adhesive electrodes placed on the patient. To do this, open the locking lever on the clip and insert the metal-plated connection tab into the slit in the electrode clip
2. Snap the upper part of the clip back in place to fix the connection.
3. Observe the colour marking showing the polarity of the electrode chips when attaching them to the respective electrodes
4. Connect the cable with the PRIMEDIC™ DefiMonitor XD.
Note
If it should become necessary during pacing to defibrillate the patient, defibrillation can be carried out via the self-adhesive electrodes. Make sure the electrodes are correctly positioned for defibrillation.
DANGER
Adults must only be paced with the appropriate self-adhesive electrodes for adults, children only with smaller, child-sized self-adhesive electrodes.
Always use original PRIMEDIC™ SavePads (Connect).
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8.3 Removing hair growth from chest
Hair at the point of attachment of the electrodes increases the transition resistance and impairs the adhesion of the electrodes. If the patient has a lot of hair growing where the electrodes need to be positioned, you must remove it.
Use a razor to remove the hair from the electrode positions.
8.4 Drying the skin
In certain situations (e.g. after an acute myocardial infarction), it may be necessary to dry the skin in the respective positions. A dry surface is essential for the adhesive electrodes to adhere.
8.5 Placing the electrodes
Fig. 26: Removing the protective film from the electrodes
(1) Protective film
(2) Electrode coated with electrolyte gel
In automatic mode, the PRIMEDIC™ DefiMonitor XD gives voice commands instructing you to attach the defibrillation electrodes to the patient.
Please proceed as follows:
Open the SavePads packaging by tearing open the protective cover along the tear
strip.
First, remove the protective film (1) from one electrode (2) and them immediately place
the electrode on the position you had ascertained previously.
Proceed to remove the protective film from the second electrode and place it in its
position.
Smooth the electrodes onto the patient ensuring there are no air bubbles under the
electrodes!
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Connect the self-adhesive electrodes to the SavePadsConnect cable using electrode
clips. See also chapter 8.2.3
Plug the connector of the SavePads Connect cable into the socket of the device, which
is switched on. Make sure that the locking pin locks into place.
The message < Check electrodes > should no longer be displayed.
Note
To be able to unplug the electrode plug, you have to push on the top part of the locking pin while at the same time pulling the plug out.
Note
Do not touch the floor, other objects, clothing or other parts of the body with the exposed electrodes – this could remove the conducting layer of gel from the electrodes.
WARNING
A reduced layer of gel could cause irritation or burns to the skin under the electrodes during defibrillation!
Observe the brief instructions for use on the packaging of the self-adhesive electrodes.
8.6 Checking the electrodes
CAUTION
The message <Check electrodes> can be issued by the device for several reasons:
There is contact between the defibrillation electrodes or a
conductive gel connection.
Patient's body hair if, not properly removed, leads to poor
contact resistance.
Air pockets between skin and defibrillation electrodes cause a
bad contact.
Dried out electrodes.
Electrode plugs not plugged in
Remedy the cause of the fault.
Note
With the model SpO2, message < check electrodes > is supressed in the display.
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8.7 Changeover of ECG source
The ECG can be recorded via the defibrillation paddles or via the self-adhesive electrodes. Press the ECG source changeover button to switch to paddles or self-adhesive electrodes.
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9 Auto mode (AED mode)
Equipment fitted with AED mode starts after powering it on in AUTO mode. This enables lay person and skilled emergency medical technician to provide care.
The sequence of the reanimation should be in according to the guidelines of European Resuscitation Council (ERC) or of the American Heart Association (AHA).
Note
In case of PRIMEDIC
TM
DefiMonitor XD, the ERC-guidelines for the sequence have
been preconfigured in the factory.
When the device is switched on and has successfully completed self-testing, it is ready for operation.
Note
In automatic mode, defibrillation is exclusively enabled by the PRIMEDIC™
DefiMonitor XD after it has detected ventricular fibrillation (VF). The paddles, energy level selection buttons, source selection buttons, pacer buttons, the printer and charging buttons are disabled in AUTO mode. An acoustic warning signal is sounded if these buttons are pressed while the device is in automatic mode.
9.1 Voice output by the device / Preliminary examination of the
patient
During the course of the voice output, you will be asked to examine the patient.
After the self-test has been successfully performed by the device, the following instructions are given:
< Call emergency services >
< Apply electrodes one after the other to patient's bare chest >
< Plug in electrode cables >
The last two spoken instructions are repeated for a period of one minute. If the device cannot recognise a patient impedance at that time, the device will give instructions for one cycle of cardio pulmonary resuscitation:
< Give 30 chest compressions >
< Give 2 rescue breaths >
Afterwards the device will give instructions to attach the electrodes for maximum one minute. This procedure will go on until the device recognises a valid patient impedance and starts with the rhythm analysis.
The initial instruction (< Call emergency services >) can also be suppressed in the setup menu through "BLS information off“. In this case, the first instruction issued by the device is
< Check electrodes >.
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9.2 Carrying out ECG analysis in Auto mode
If the defibrillation electrodes have been applied, the device will automatically start the analysis. Automatic analysis can only be carried out via the self-adhesive defibrillation electrodes (SavePads).
Now the patient has to be put in an immobile position and may no longer be touched.
The device issues the instruction:
< Do not touch the patient, analysing rhythm >
The algorithm of the device programming now checks the ECG for a shockable rhythm. This process can take up to 12 seconds. If the device detects ventricular fibrillation (VF), it recommends defibrillation.
DANGER
Take care that during the analysis phase, the Auto switch is not continuously pressed as otherwise safety shutdown of the equipment is effected.
DANGER
Observe the patient during the entire reanimation.
It is possible at any time that the patient may regain consciousness and does not need to be defibrillated.
If that is the case, do not carry out the defibrillation under any circumstances.
The rhythm identification detector continuously analyses the ECG in the background, even after a rhythm in need of defibrillation has been identified. If a rhythm which does not require defibrillation is detected while the capacitor is charging or when the required charge is already pending, internal safety discharge is triggered.
9.3 Defibrillation required
If the device has detected VF, it recommends defibrillation and automatically makes the necessary preparations.
The device issues the instruction:
< Shock advised >
< Device is charging >
< Do not touch the patient >
< Device is charging >
< Do not touch the patient >
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Once the capacitor is charged, power for the defibrillation pulse is available for 15 seconds. This is signalled by a continuous acoustic warning, the voice message
< Stand clear of patient. Deliver shock now >,
signalled by a continuous beep and the trigger button lighting up green. If you do not defibrillate within this period, an internal safety discharge will follow and the ECG will be analysed again.
Turn on green lit trigger key to give shock.
Hold the button pressed until the shock has been administered. Avoid contact with the jacks on the device during defibrillation.
Note
Pressing the trigger key during power charging (before it turns green) does not result in release of shock, rather it leads to internal safety discharge.
DANGER
Before pressing the trigger button, disconnect all equipment which is not defibrillation-proof from the patient!
Before and during energy discharge, all persons involved in reanimation must step clear of the patient and avoid touching the patient or conductive objects (e. g. parts of the stretcher)!
After defibrillation, the device once again undertakes cardio pulmonary resuscitation (CPR)
cycle, before carrying out renewed analysis. The CPR time is shown on the PRIMEDIC™
DefiMonitor in the form of a display bar.
The charge time of the capacitor for defibrillation depends on the available battery capacity. Charging may take longer if the power module is partly discharged.
Note
If a fault occurs during capacitor charging, an intermittent warning signal is sounded and the device automatically carries out internal discharge of the capacitor.
CAUTION
When the message < Charge battery >, the device still has enough energy for at least 3 discharges at maximum power. The power module should be replaced immediately once this message appears.
Note
If, when the device is switched on, for 10 minutes no ECG is done, no SpO2 signal is recorded or no button is pressed, the device automatically switches off. Approx. 30 seconds before the switch-off this is signalised by an interrupted warning tone. Pressing any button will abort the switching off process.
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In basic state, a dashed line appears on the display and the acoustic message < Check electrodes > is issued if the electrodes are not connected up. As soon as a reading is activated via the electrodes, the ECG signal appears on the monitor.
9.4 Defibrillation not required
If the device cannot find a shockable rhythm, then it recommends two minutes of cardio pulmonary resuscitation (CPR).
< No shock advised >
< Cardiopulmonary resuscitation >
< Give 30 chest compressions >
< Give 2 rescue breaths >
etc.
When the CPR time (defined by the set number of CPR cycles) has elapsed, the device resumes ECG analysis.
9.5 Keeping the defibrillator ready for use
After a reanimation, clean the device, replace the SavePads, check and if necessary replace the power supply unit to ensure that the device is ready for operation again as quickly as
possible. Charge the PRIMEDIC™ AkuPak to ensure that sufficient energy is available for the
device to be used again.
If any malfunctions or noticeable problems occur, please contact your nearest service station.
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10 Manual mode (MAN Mode)
All variants of PRIMEDIC™ DefiMonitor XD have manual mode.
The manual mode presupposes medical knowledge is therefore not suitable for lay helpers. Only doctors and trained medical personnel should operate the defibrillator in manual mode.
In case of the equipment with Auto mode, MAN/AUTO switch must be pressed once in order to activate the manual mode. The monitor confirms the "MAN" mode. All keys which are disabled in automatic mode are now enabled. The LED above the MAN/AUTO button lights up to indicate that the device is in manual mode.
Equipment that can be operated only manually can be recognised by the continuously lit LED above MAN switch. It cannot be toggled. Acoustic alarm to signal error sounds when MAN switch is pushed.
Note
When the device is switched on and has successfully carried out a self-test, it is in Auto mode. If your device is only equipped with manual mode (XD1, XD3. XD10, XD30), you will not need to change mode.
10.1 Carrying out defibrillation
Unlike automatic mode, where the device programming algorithm analyses the ECG and recommends defibrillation, in manual mode, the user must examine the ECG to determine whether it displays a shockable rhythm. There are two ways of triggering the defibrillation pulse.
Via the SavePads Connect
Via the paddles
10.1.1 Power selection
First, select a suitable energy level of 5, 10, 20, 30, 50, 100, 200, 300 or 360 joules for defibrillation.
The selected energy level is displayed on the monitor to confirm your selection.
CAUTION
Check that the energy level you have selected is shown on the display.
Note
The energy level required for defibrillation / cardioversion depends on the size, weight and condition of the patient.
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10.1.2 Charging
Note
The way in which the shock is administered depends on where you initiate charging. If you load a charge by pressing a paddle button, the shock can only be administered via the paddles. If you press the charge button on the membrane keyboard, the shock is administered via the SavePads Connect.
Press the charge button for your chosen method (see above) (paddle button or charge
button). A shock of the preset energy level is charged by pressing the power charging button, and shortly afterwards, the device is ready to perform defibrillation.
If the shock is to be administered via the SavePads Connect, and the charging operation has ended, the green trigger button lights up and a warning signal is sounded.
If the shock is to be administered via the paddles, a warning signal is sounded.
In both cases, the following voice message is also issued:
< Deliver shock now >
The selected charge is available for 15 seconds. If defibrillation is not carried out within this space of time, internal safety discharge is performed. The energy can also be discharged internally by pressing the energy charging button again during the 15 seconds.
DANGER
Before pressing the trigger button, disconnect all equipment which is not defibrillation-proof from the patient!
Before and during energy discharge, all persons involved in reanimation must step clear of the patient and avoid touching the patient or conductive objects (e. g. parts of the stretcher)!
Capacitor charging time for defibrillation depends on the available battery capacity. Charging may take longer if the power module is partly discharged.
If an error occurs during charging, an intermittent warning signal is sounded, followed by the voice message "Internal error". The capacitor is discharged internally and the devices switches off automatically. The Service symbol appears on the display.
10.1.3 Triggering defibrillation
Press the trigger button or the two paddle buttons simultaneously to enable
defibrillation, which is carried out immediately after the button is pressed. Hold the button pressed until the shock has been administered. Avoid contact with the jacks on the device during defibrillation.
If the charge is loaded via the charge button on the device, the shock can only be administered via the SavePads Connect. If the charge is loaded via the paddle buttons, the shock can only be administered via the paddles.
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CAUTION
Before defibrillation, the contact surfaces of the paddles must be coated with sufficient defibrillation gel to prevent skin burns.
After performing defibrillation, you must examine the ECG again for shockable heart rhythms and if necessary, trigger further defibrillation(s) (or carry out further reanimation procedures).
Note
If the wrong energy level has been selected and the shock already charged, the fault can be corrected by pressing the new energy level. The device automatically adjusts the charge to the level selected.
Alternatively, you can trigger internal discharge by pressing the charge button on the membrane keyboard again. An internal safety discharge is performed. Then select the correct energy level and press the charge button again.
CAUTION
When the message < Charge battery > appears for the first time, the device still has enough energy for at least 3 discharges at maximum power. The power module should be replaced immediately once this message appears.
10.2 SYNC and ASYNC mode
If the medical emergency requires cardioversion (operation of the defibrillator in synchronous mode), this mode must be consciously selected by pressing the SYNC button. The defibrillator must be returned to manual mode before you can switch to SYNC mode. Then, SYNC mode can be activated by pressing the SYNC button. Synchronous operation mode is indicated on the ECG monitor with "SYNC".
Note
Synchronous mode is possible in manual mode only.
It is recommended to carry out the operation via defibrillation self-adhesive electrodes so as to ensure synchronisation in R-wave synchronised shock (synchronisation). This largely excludes movement artefacts. However, synchronisation is also possible via the paddles. To do this, the ECG must be recorded via the paddles, as far as possible without movement artefacts, in order to ensure undistorted synchronisation. It is vital to ensure that the energy is applied using the same method used to record the ECG.
After synchronised energy transfer (cardioversion), the equipment switches back to asynchronous mode.
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Note
In synchronous mode, ECG markings are displayed on the monitor. To ensure safe synchronous operation, these cardioversion markers must appear directly next to an R-wave in each QRS complex. Precondition for this is a clear, artefact-free ECG signal.
Synchronisation is performed exclusively via derivation II.
The delay time between detection of a QRS complex (synchronous pulse) and energy transfer is less than 60 ms.
DANGER
Before initiating cardioversion, observe the monitor display to check that the cardioversion markers are clearly assigned to the R waves and not, for example, reacting to pacemaker pulses or artefacts.
In synchronous mode, the trigger button must be held pressed until the cardioversion time is reached. An acoustic signal sounds during this time. If the trigger button is released during this time, cardioversion is not performed. If the button is held pressed and synchronisation is not performed within 3 seconds, internal discharge is effected. If the trigger button is pressed only briefly or no synchromarker has emerged while the button is pressed, the energy is retained in the capacitor for 15 seconds and is then automatically discharged within the equipment.
The energy levels used for cardioversion are usually lower than for asynchronous defibrillation, as it is not necessary to depolarise all heart muscle cells.
The energy required depends roughly on the weight of the patient. However, the indications remain the decisive factor. The following rules of thumb apply:
Ventricular tachycardia with instable pulse:50 Joule, for each further cardioversion, select the next highest energy level (100 J, 200 J, 300J,...) supraventricular tachycardia: 50 - 100 Joule Atrial flutter: 50 Joule Atrial fibrillation: 100 Joule
The values given above are merely recommendations for possible procedure in the event of the corresponding indications.
Note
If the cardioversion markers do not appear on the screen or appear in the wrong position, this may be the result of extreme fluctuations in the mains supply. In this case, the device should be disconnected from the mains, i.e. the mains plug should
be pulled out of the socket and the device operated via the integrated PRIMEDIC™
AkuPak battery.
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10.3 Keeping the defibrillator ready for use
After a reanimation, clean the device, replace the SavePads, check and if necessary replace the power supply unit to ensure that the device is ready for operation again as quickly as
possible. Charge the PRIMEDIC™ AkuPak to ensure that sufficient energy is available for the
device to be used again.
In the event of faults or doubts, contact your nearest service station as soon as possible.
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11 Attaching the SpO
2
sensor
Fig. 27: Attaching the SpO2 sensor
(1) Bend protection sleeve
(2) SpO2 sensor
(3) Surfaces for opening the sensor
Procedure:
Insert the plug of the SpO2 sensor into the device so that the arrow on the plug is in
line with the arrow on the device jack. Ensure that the connector is fully inserted.
Press the two surfaces (3) on the SpO2 sensor together and slide the opened sensor
over any of the patient's fingers with the cable / jack side of the sensor on the fingernail side of the finger.
The sensor can remain in one measuring point for a maximum of 4 hours, provided that the skin characteristics and the correct seating of the sensor are checked regularly. As on some patients, the sensor may cause skin irritation at the measuring point after a while, it may be necessary to move the sensor more frequently.
Note
To disconnect from the device, first lift the sleeve with the arrow slightly and then pull the connector out of the jack.
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12 Operating the pacer
12.1 General information on operating the Pacer XD
The following operating sequence must be observed when using the PRIMEDIC™ Pacer XD:
Switch the PRIMEDIC™ DefiMonitor XD on. The pacer can only be used in manual
mode. Set the mode accordingly.
Apply self-adhesive electrodes (SavePads Connect) on the patient.
Connect the self-adhesive electrodes to the SavePadsConnect cable using electrode
clips. See Chap. 8.2.3
Insert SavePads Connect cable in the PRIMEDIC™ DefiMonitor XD jack.
Activate the Pacer XD unit by briefly pressing the Pacer On / Off button
(At this point, Pacer XD is not yet emitting stimulation pulses).
Set parameters:
- Operating mode
- Stimulation rate
- Stimulation intensity
Activate Pacer by pressing the START/STOP button
The Pacer XD is switched off by pressing the Pacer On /Off button. At the same time, a warning signal is sounded.
When the Pacer unit is switched on, "Pacemaker Init" may appear on the top left of the Pacer display, together with a progress bar. This indicates that the Pacer is currently performing an internal self-test routine. After a few seconds, the Pacer is ready for configuration.
Note
If you try to activate the Pacer XD when the SavePads Connect cable is not yet plugged into the socket on the Pacer, a warning signal is sounded and the message "Check electrodes" appears on the screen (only on devices without SpO2 module).
Note
If the device detects a deviation of ± 30 % from the set intensity, it automatically interrupts the pacing process. One possible cause is that patient resistance is too high.
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DANGER
If, for example, the QRS-markers do not appear on the screen or appear in the wrong position, this may be the result of extreme fluctuation in the mains supply. In this case, the device should be disconnected from the mains, i.e. the mains plug should be pulled out of the socket and the device operated via the integrated PRIMEDIC™ AkuPak battery. Keep an eye on the capacity reading on the display during pacing.
If the message < Charge battery > appears, the battery must be recharged or replaced before stimulation can continue. If this is not done, there may be danger to the patient as a result of the device failing.
Note
If more than 3 minutes elapse without the PRIMEDIC™ Pacer being operated, it
switches off automatically.
12.2 Setting the Pacer operating modes
The Pacer can be operated in three different modes:
DEMAND (default setting)
FIX
OVERDRIVE
Operating mode
Meaning
DEMAND (Default)
Stimulation is only carried out “as required”. i.e. only if the
spontaneous heart rate falls below the set DEMAND rate.
FIX
Fixed-rate stimulation. Independent of the spontaneous heart rate, a fixed heart rate is imposed.
OVERDRIVE
Overstimulation of the heart with high-frequency fixed-rate stimulation (max. 250 1/min) to stop, for example, ventricular tachycardia.
The operating mode DEMAND is automatically activated when the Pacer is switched on. The operating mode is displayed in clear text on the monitor.
To select a different operating mode, press the operating mode button once or repeatedly until the desired operating mode appears on the monitor.
No stimulation pulses are emitted while the operating modes are being set.
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Note
The operating mode cannot be changed during pacing. For example, in order to change from FIX to DEMAND mode, the Pacer must be stopped first.
If the Pacer is started up again without the operating mode having been changed, the last set stimulation values are applied. If the Pacer operating mode is changed or if the Pacer is switched off and then back on, the basic setting is activated again.
WARNING
If for some reason, DEMAND pacing is not possible, the FIX mode can be used. Thereby, it is necessary to synchronise the stimulation frequency to the present status. This should be carried out by a doctor.
Note
Too slow and not effective stimulation in FIX mode can lead to ventricular fibrillation if the pacemaker impulse is released during heart's vulnerable phase.
12.3 Setting the stimulation rate
Depending on the Pacer operating mode, various stimulation rates (number of Pacer pulses per minute) are available:
FIX, DEMAND 30 ... 180 1/min (beats power minute)
OVERDRIVE 30 ... 250 1/min
The following values are preset when the respective modes are activated:
FIX, DEMAND 70 1/min
OVERDRIVE 200 1/min
To select a different stimulation rate, this value can be changed by pressing the Rate Pulse/min button.
Each time the button is pressed, the value is increased or decreased in steps of 5 (each of 5 1/min). The stimulation rate can also be changed during pacing.
The stimulation rate should only be changed if this is absolutely necessary.
WARNING
The ECG should be monitored closely when the stimulation rate is changed to observe possible reactions of the patient to the new stimulation parameters.
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12.4 Setting the stimulation intensity
When the Pacer is switched on, a current of 10 mA (peak value) is preset, independent of the selected operating mode or stimulation rate.
The stimulation intensity can be changed within a range of (+) 10 mA to 180 mA using the buttons stimulation intensity + and stimulation intensity (-). (also see chapter 15) The intensity can be raised or lowered by 5ma with every key stroke. The stimulation intensity can also be changed during pacing.
The selected stimulation intensity depends on the patient's physical constitution. The current selected should result in the effect of the stimulation being clearly visible on the monitor.
The stimulation intensity is a compromise between good and effective stimulation of the heart and the possible necessity of sedating the patient. Once the effect of the stimulation is clearly recognisable on the ECG, the intensity can carefully be reduced to find the "optimum" intensity.
Pacing results in a contraction of the skeletal muscles. This is not a sign of effective heart stimulation. Watch the ECG on the monitor to determine when the intensity is sufficient.
12.5 Starting and stopping pacing
Note
The Pacer operating mode must be selected before pacing is started. The operating mode cannot be changed once pacing has started. The operating mode is displayed on the monitor.
Procedure:
Press the Start/Stop button. Stimulation with the preset values. A signal tone is issued
to confirm this.
The operating mode display text on the monitor starts to flash. When stimulation pulses
are emitted, the LED next to the Start/Stop button lights up.
To enable better ECG monitoring, the display of the first ECG channel automatically jumps to derivation II.
To stop stimulation, briefly press the Start/Stop button. This is confirmed by a short acoustic signal. The display text stops flashing.
Note
Limited duration of stimulation in OVERDRIVE mode:
To prevent dangerous, overlong stimulation in OVERDRIVE mode, stimulation time without intervention by the operator is limited to 15 seconds.
After starting stimulation using Start/Stop switch, stimulation is effected with the preset values Stimulation ends after 15 seconds if neither the pacer intensity nor the pacer rate are changed. If one of these buttons is pressed, the 15 seconds are counted again.
Stimulation can be stopped before the 15 seconds have elapsed by pressing the Stimulation Start/Stop button.
Page 77
Operating the pacer
METRAX GmbH
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Note
Both, the frequency as well as the intensity can be changed during pacing by pressing the buttons.
During pacing, the ECG alarm is effective provided it was not earlier deactivated in the setup menu. However, it is not possible to make changes in the setup menu during pacing.
DANGER
To prevent danger to the user as a result of the stimulation pulse, do not touch the conductive surfaces of the electrodes or the patient during pacing. After completing the treatment, remove the self-adhesive electrodes from the patient or ensure that the Pacer / defibrillation cable (SavePadsConnect cable) is no longer connected to the device.
If the SavePads Connect cable is unplugged from self-adhesive electrodes or pulled out from the device during pacing, stimulation is immediately stopped. A warning signal sounds, the cause of the fault is displayed on the monitor and a voice message is issued:
< Check electrodes>
When the fault has been remedied and the device restarted, the Pacer is reactivated.
If an energy button is pressed during pacing, pacing is interrupted and a warning signal sounds to indicate that the process has been interrupted.
The selected energy can thereafter be immediately be loaded.
The patient's ECG must be monitored continually during pacing to ensure that the stimulation is effective.
The patient must not be left unattended during pacing.
The actual active patient current is monitored. If it falls below 70 % of the set current, the pulse emission is stopped and a fault message issued.
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12.6 Defibrillation during pacing / Defibrillation via self-adhesive
electrodes
If ventricular fibrillation occurs during pacing, it must be stopped immediately through defibrillation. Defibrillation can also be done through the applied self-adhesive electrodes (PRIMEDIC™ SavePads Connect).
Press the required energy button. A warning signal sounds, as pressing the energy selection button stops stimulation.
Press the Charge button on the control panel to prepare the defibrillation charge. Trigger defibrillation via the self-adhesive electrodes by pressing the green-lit trigger button on the control panel.
To reactivate the Pacer after defibrillation, it must be switched on again.
Note
Defibrillation can also be carried out via the paddles, even though the adhesive electrodes are attached. Load the selected energy charge by briefly pressing one of the paddle trigger buttons and trigger defibrillation by pressing the buttons simultaneously.
Page 79
Cleaning, maintenance and dispatch
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13 Cleaning, maintenance and dispatch
13.1 Cleaning
WARNING
Only clean the device when it is switched off and with the electrodes unplugged. Before cleaning, remove the power module from the device or unplug the mains plug!
Do not use any dripping wet cloths to clean it. Never pour liquids over the device and do not immerse it in any liquids!
Clean the device and all its accessories, such as the wall bracket, with commercially available household cleaners.
Use a slightly damp, clean cloth.
Use normal disinfectant to disinfect it (e.g. Gigasept FF, Bacillol or Spitacid).
WARNING
Clean the paddles after every use. Soiling as a result of gel residue can result in danger to the user and patients. Always remove all traces of gel from the paddles.
13.2 Servicing
Independently of the use of the device, we recommend regular visual inspection / servicing of
the PRIMEDIC™ DefiMonitor XD and the accessories by the user / service technician at least
once a year.
Make sure that the housing, cable, SavePads and all the other accessories are undamaged.
13.2.1 Servicing check list
Check the expiry date
o the SavePads Connect o the PRIMEDIC™ AkuPaks, and o if necessary replace the parts.
Check whether
o the status display "OK" is showing. o you can switch on the device. o the device automatically carries out the self-test after being switched on. o the slot for the power supply is clean. o the device is fully equipped.
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Cleaning, maintenance and dispatch 80 / 116
DefiMonitor XD 21324 / GB / K05
METRAX GmbH
When doing so, pay attention to the following:
DANGER
If parts of the housing or insulation are damaged, they must be
repaired or exchanged immediately.
If parts of the housing or insulation are damaged, do not use the
device or switch it off immediately.
Have the device repaired as soon as possible by the
manufacturer.
Note
For more detailed information on the regular safety and metrological checks in accordance with the Ordinance on the Operation and Use of Medical Devices (MPBetreibV), refer to Chapter 24
13.3 Dispatching the PRIMEDIC™ DefiMonitor XD
Note
If the equipment is to be sent out for upgrading or servicing, in that case the power module must always be removed from the device and must be sent in with the device, but packaged separately.
Where possible, use the original box.
Page 81
List of error codes
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14 List of error codes
The following table lists all messages that the unit emits when it switches off because of a severe error. This switch-off is carried out with the spoken message "Internal Error"; the cause of the error is displayed with the error code number from the first column and the text from the second column. The other columns list the possible causes of the error and the remedial measures that can be carried out by the user themselves
Error code
Error text
Cause(s)
User action
50
HV, Internal FSM error
Error during the shock appliance
- return the device for servicing
51
HV, CPLD error
Error during the shock appliance
- return the device for servicing
52
HV, +5V voltage failed
Error in the voltage supply, possibly due to an empty accumulator/battery
- charge and/or replace the power module
- if the error persists: Return the device for servicing
53
HV, +5VSW voltage failed
Error in the voltage supply, possibly due to an empty accumulator/battery
- charge and/or replace the power module
- if the error persists: Return the device for servicing
54
HV, +24V voltage failed
Error in the voltage supply, possibly due to an empty accumulator/battery
- charge and/or replace the power module
- if the error persists: Return the device for servicing
55
HV, VREF voltage failed
Error in voltage reference
- return the device for servicing
56
HV, HVPWR voltage failed
Error in the voltage supply, possibly due to an empty accumulator/battery
- charge and/or replace the power module
- if the error persists: Return the device for servicing
57
HV, RLPWR voltage failed
Error in the voltage supply, possibly due to an empty accumulator/battery
- charge and/or replace the power module
- if the error persists: Return the device for servicing
58
HV, Current setup DAC failed
Error when setting the current specifications - Failure in the high voltage section
- return the device for servicing
59
HV, RTCCLK error was detected
Error in generation of system cycle
- restart the device
- if the error persists: Return the device for servicing
60
HV, MCLK error was detected
Dropout in system cycle
- restart the device
- if the error persists: Return the device for servicing
61
HV, HVHALT event was detected
Emergency shutdown during the shock application
- return the device for servicing
62
HV, HVHALT net error was detected
Error during the test of the emergency shutdown
- return the device for servicing
63
HV, Disarm cannot be performed
Error during the internal discharge, impossible to
- return the device for servicing
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METRAX GmbH
discharge the condenser 64
HV, HV capacitor overvoltage was detected
Error during the high voltage load, voltage on condenser too high
- return the device for servicing
65
HV, HV charger error was detected
Error during the high voltage load, impossible to load the high voltage
- return the device for servicing
66
HV, Error of HV measurement circuit
Error during measurements in high voltage section
- return the device for servicing
67
HV, HV charge time is too big
Error during the high voltage load, impossible to load the high voltage
- return the device for servicing
68
HV, Too big current was detected
Current too high during shock application
- return the device for servicing
69
HV, Too low current at shock was detected
Current too low during shock application, possibly due to failure in final stage
- return the device for servicing
70
HV, Current sensor error
Error in the current regulation
- return the device for servicing
71
HV, SHKEN net error
Error during the safety test before the shock application
- return the device for servicing
72
HV, START net error
Error during shock release
- restart the device
- if the error persists: Return the device for servicing
75
HV, HV hardware protection error
Error during shock release
- restart the device
- if the error persists: Return the device for servicing
76
HV, Residual voltage after disarm error
Residual current to high on the condensator after the discharge
- restart the device
- if the error persists: Return the device for servicing
77
HV, Capacitor voltage does not match energy level
Wrong condensator voltage with respect to current/energy requirements
- return the device for servicing
78
HV, Capacitor voltage is not constantly increasing
Error during the high voltage charge, voltage on the condensator does not increase in a continuous manner
- return the device for servicing
79
HV, error in calculation of charge voltage
Error during the high voltage charge, defective voltage values for the condensator
- return the device for servicing
80
HV, Shock mode error
Defective switching between synchronous and asynchronous shock modality
- restart the device
- if the error persists: Return the device for servicing
84
PRWIN fail > 100 ms
Error in the voltage supply, possibly due to an empty accumulator/battery
- charge and/or replace the power module
- if the error persists: Return the device for servicing
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List of error codes
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87
Program update error
Error during program update, the update will be interrupted
- return the device for servicing
90
Tasks start/run error
Error during internal processing
- restart the device
- if the error persists: Return the device for servicing
91
Menu init error
Defective display in the Setup menu
- return the device for servicing
92
Critical key error
Error during the check of input elements (e.g. shock button)
- restart the device
- if the error persists: Return the device for servicing
93
Charge time-out error
The high voltage charge lasts too long, possibly due to a failure in the final stage
- return the device for servicing
94
Disarm time-out error
Impossible to discharge the residual energy in the condensator, possibly due to a failure in the final stage
- return the device for servicing
96
AVDD exceed
Error in the voltage supply, possibly due to an empty accumulator/battery
- charge and/or replace the power module
- if the error persists: Return the device for servicing
97
AVDD drop
Error in the voltage supply, possibly due to an empty accumulator/battery
- charge and/or replace the power module
- if the error persists: Return the device for servicing
98
CVDD exceed
Error in the voltage supply, possibly due to an empty accumulator/battery
- charge and/or replace the power module
- if the error persists: Return the device for servicing
99
CVDD drop
Error in the voltage supply, possibly due to an empty accumulator/battery
- charge and/or replace the power module
- if the error persists: Return the device for servicing
100
DVDD exceed
Error in the voltage supply, possibly due to an empty accumulator/battery
- charge and/or replace the power module
- if the error persists: Return the device for servicing
101
DVDD low
Error in the voltage supply, possibly due to an empty accumulator/battery
- charge and/or replace the power module
- if the error persists: Return the device for servicing
102
5V exceed
Error in the voltage supply, possibly due to an empty accumulator/battery
- charge and/or replace the power module
- if the error persists: Return the device for servicing
103
5V drop
Error in the voltage supply, possibly due to an empty accumulator/battery
- charge and/or replace the power module
- if the error persists: Return the
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METRAX GmbH
device for servicing 104
24V exceed
Error in the voltage supply, possibly due to an empty accumulator/battery
- charge and/or replace the power module
- if the error persists: Return the device for servicing
105
24V drop
Error in the voltage supply, possibly due to an empty accumulator/battery
- charge and/or replace the power module
- if the error persists: Return the device for servicing
106
PWRIN exceed
Error in the voltage supply, possibly due to an empty accumulator/battery
- charge and/or replace the power module
- if the error persists: Return the device for servicing
107
PWRIN drop
Error in the voltage supply, possibly due to an empty accumulator/battery
- charge and/or replace the power module
- if the error persists: Return the device for servicing
108
Battery exceed
Internal battery voltage too high
- restart the device
- if the error persists: Return the device for servicing
110
Temperature exceed
Operating temperature too high
- operate the device in a cooler environment
111
Temperature drop
Operating temperature too low
- operate the device in a warmer environment
116
HDQ interface fail
Error communicating with power module
- restart the device
- if the error persists: Return the device for servicing
117
CYCLE time error
Error during the shock appliance
- return the device for servicing
118
VREF exceed
Error in the voltage supply, possibly due to an empty accumulator/battery
- charge and/or replace the power module
- if the error persists: Return the device for servicing
119
VREF drop
Error in the voltage supply, possibly due to an empty accumulator/battery
- charge and/or replace the power module
- if the error persists: Return the device for servicing
120
Battery/accumulator fail
Power module voltage too low
- charge and/or replace the power module
121
DSP timeout error
Internal communication error
- restart the device
- if the error persists: Return the device for servicing
122
Previous error detected ­need full test
General description of error detected during auto-diagnosis
- restart the device
- if the error persists: Return the device for servicing
123
Program code area corrupt
Error in the program memory
- return the device for servicing
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List of error codes
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124
Keyboard error
Error in the membrane keyboard
- restart the device
- if the error persists: Return the device for servicing
125
ECG calibration error
Error during the ECG calibration
- restart the device
- if the error persists: Return the device for servicing
127
Clocks (32 kHz or
3.6864 MHz) error
Error in system clock generation
- restart the device
- if the error persists: Return the device for servicing
129
Wrong hardware platform
Error during the hardware detection
- return the device for servicing
130
SPI communication error
Internal communication error
- restart the device
- if the error persists: Return the device for servicing
133
Switch ECG source error
Error when switching the paddles
- detach completely the device from the current supply: Disconnect the power plug, remove the power module from the device; Restart the device after an average time of 30 seconds
- if the error persists: Return the device for servicing
134
XtBoard err - power source
Error during the current supply of the expansion board
- charge and/or replace the power module
- if the error persists: Return the device for servicing
135
XtBoard err - paddle logic
Error during the test of the paddles
- do not press any paddle buttons when starting the device
- remove and reinsert the paddles
- restart the device
- if the error persists: Return the device for servicing
136
XtBoard err - key logic
Error during the test of the paddle buttons
- restart the device
- do not press any paddle buttons when starting the device
- if the error persists: Return the device for servicing
137
XtBoard err - unknown
General fault message expansion board
- restart the device
- if the error persists: Return the device for servicing
138
Protected variable error
Defective storage of important variables
- return the device for servicing
139
XtBoard err - runtime error
Error during the expansion board runtime check
- restart the device
- if the error persists: Return the device for servicing
140
Impedance measurement
Error during the impedance
- return the device for servicing
Page 86
List of error codes 86 / 116
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error
measurement
141
XtBoard err - platform
Error during the hardware detection
- return the device for servicing
Page 87
Disposal
METRAX GmbH
DefiMonitor XD 21324 / GB / K05
87 / 116
15 Disposal
Fig. 28: Disposal
In accordance with the founding principles of the company Metrax GmbH, your product has been developed and made using high quality materials and components which are recyclable.
At the end of its serviceable life, recycle the device through disposal companies registered under public law (council recycling facilities). Proper disposal of this product helps with environmental protection.
Through registration of Metrax GmbH with the responsible authorities, we ensure that the disposal and utilisation of electronics devices introduced onto the market by us is secure in accordance with the EU directive on the disposal of electronic and electrical equipment (WEEE-directive).
In Germany, in accordance with legislation on the sale, return and environmentally friendly disposal of electrical and electronic devices (Elektro- und Elektronikgerätegesetz – ElektroG),
(Electrical and Electronic Equipment Act– ElektroG) Metrax is registered with EAR (register of old electronic equipment) under the number: 73450404.
CAUTION
Improper disposal of the device or its individual parts can lead to injury.
For business customers in the European Union
Please contact your dealer or supplier if you want to dispose of electrical and electronic equipment. He will have further information on this for you.
Information for disposal in countries outside the European Union
This symbol is only applicable within the European Union.
Page 88
Technical Data 88 / 116
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16 Technical Data
Defibrillation
Operating modes
asynchronous, external in Auto/Manual mode
Patient impedance:
23 – 200 Ohm
Synchronisation:
SYNC only in manual mode
Impulse shape:
Biphasic, current regulated (CCD)
Output power in AUTO
mode at:
Patient
impedance
Tolerance
1. stage
2. stage
3. stage
25 Ohm
± 15 %
143 J
201 J
277 J
50 Ohm
± 15 %
281 J
350 J
360 J
75 Ohm
± 15 %
348 J
360 J
360 J
100 Ohm
± 15 %
344 J
343 J
343 J
125 Ohm
± 15 %
314 J
316 J
317 J
150 Ohm
± 15 %
290 J
293 J
293 J
175 Ohm
± 15 %
269 J
272 J
272 J
Output energy in MAN
mode depending upon
the patient impedance:
Energy
to:
Tolerance
25
50Ω
75Ω
100Ω
125Ω
150Ω
175Ω
5 J
± 3 J
5 J
5 J
5 J
5 J
5 J
5 J
5 J
10 J
± 3 J
10 J 10 J 10
J
10 J
10 J
10 J
10 J
20 J
± 3 J
20 J 20 J 20
J
20 J
19 J
16 J
15J
30 J
± 15 %
30 J 30 J 30
J
30 J
28 J
24 J
23 J
50 J
± 15 %
50 J 50 J 50
J
50 J
41 J
38 J
34 J
100 J
± 15 %
98 J 100 J 100 J 100
J
83 J
75 J
68 J
200 J
± 15 %
195 J 200 J 200 J 200 J 170 J 154 J 141
J
300 J
± 15 %
290 J 300 J 300 J 300 J 262 J 236 J 214
J
360 J
± 15 %
340 J 360 J 360 J 360 J 314 J 287 J 242
J
Page 89
Technical Data
METRAX GmbH
DefiMonitor XD 21324 / GB / K05
89 / 116
Impulse length:
Positive phase 11.25 ms, negative phase 3.75 ms
Discharges:
70 discharges at 20 °C with new, fully charged battery with energy
level of 200J.
40 discharges at 20 °C with new, fully charged battery with energy
level of 360J.
Charge time:
12 +/-3 seconds in operating mode with rated voltage in mains
12 +/-3 seconds in operating mode with fully charged, new AkuPak
12 +/-3 seconds in operating mode with 90 % rated voltage
12 +/-3 seconds in operating mode with an AkuPak after energy
removals for 15 shocks
≤ 25 seconds from switching on the unit up to charging the
maximum energy in manual mode
≤ 33 seconds from switching on the unit up to charging the
maximum energy in automatic mode
Pacemaker (Pacer)
Operating modes
Fix, Demand, Overdrive
- Stimulation rate
30-180 pulses/min, in Fix and Demand mode
30-250 pulses/min, in OverDrive mode
Tolerance: ± 0.5 %
- Stimulation intensity
10mA-180mA, tolerance: ± 10 % or +3/-1 mA
Pulse width:
20ms, tolerance: ± 100 µs
Refractory period:
340ms for stimulation rate < 100 beats/min
240ms for stimulation rate >= 100 beats/min
Tolerance: ± 10ms
ECG
Derivation:
2 derivations from I, II, III, aVL, aVR, aVF
Heart frequency:
30 – 270 min-1
Input:
Class CF, defibrillation-proof
Input resistance:
> 5 MOhm @ 10 Hz
CMRR:
> 85 dB
Input d.c. voltage:
± 0.5 V
Bandwidth:
0.5 – 40 Hz (- 3 dB) SR = 101 samples/s
Page 90
Technical Data 90 / 116
DefiMonitor XD 21324 / GB / K05
METRAX GmbH
SpO2 NELLCOR®
Pulse oximetry module
Indication range:
100 %
Calibration range:
100 ... 50 %
Accuracy:
SpO2
Adults 100 ... 70 % +/- 3 digits
New-born babies 95 ... 70 % +/- 3 digits
Contact the manufacturer for further details on test procedures.
Wavelength:
Red: 660 nm, Infrared: 890 nm
Light intensity:
0.5 lumen/cm2
Operating mode:
continuous
Refreshing time:
< 2 sec.
Impedance
measurement
Defibrillation/Pacing:
23 ... 200 Ohm
Monitoring:
500 – 2500 Ohm
Measurement
frequency:
30 kHz Measuring precision:
±15 %
Alarms
System:
EKG, SpO2,, defibrillator, power supply, data memory
Physiological:
schockable rhythm
Analysis duration: one
battery
approx. 7 sec to identify schockable rhythm for a battery with 90 %
of the nominal capacity
Monitor
Monitor type:
high-resolution LCD monitor
Monitor size:
115 x 86 mm (diagonal 144 mm, 5.7")
Resolution:
320 x 240 pixels (pixel size 0.36 x 0.36 mm)
Displays:
Heart rate, number of defibrillations, number of detected VF,
reanimation duration, date, time, battery capacity
Defibrillation / pacing
electrodes
SavePads, SavePads
Connect
Pacing: 1h pacing, operation at 120 pulses/min at 140 mA
8h pacing, operation at 60 pulses/min at 70 mA
10 minutes, operation OverDrive pacing at 200
pulses/min at 180 mA
Page 91
Technical Data
METRAX GmbH
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Defibrillation: Up to 50 defibrillations and/or 24h monitoring
Monitoring: Up to 24 h
Power supply
PRIMEDIC™ AkuPak:
NiCd, 12 V / 1.4 Ah
Integrated mains power
pack:
100 ... 240 Volt, 50 / 60 Hz
Power consumption:
129W
Data storage
Memory type:
CompactFlashCard 32MB – 4GB possible
Safety
Classification:
Medical product of class IIb, protection class I, Type CF, defi-proof,
Identification:
0123
The device is a medical product and complies with the
EC Directive 93 / 42 / EEC
Other
operating conditions:
0 ... 50 °C, 30 ... 95 % rel. humidity, but without condensation
700 hPa ... 1060 hPa continuous mode
Storage conditions:
- 20 ... 70 °C, 20 ... 95 % rel. humidity, but without condensation
500 hPa ... 1060 hPa continuous mode
Dimensions:
33 x 16 x 29 cm (W x D x H)
Weight:
5.3 kg (without power module)
Standards applied
Standards (for licensing in the EU the corresponding harmonised
European standards EN were used instead of the IEC standards):
IEC 60601-1:1988 + A1:1991 + A2:1995
IEC 60601-1-2:2001
IEC 60601-1-4:1996 + A1:1999
IEC 60601-2-4:2002
CEN EN ISO 9919:2005 (only for XD3,XD30,XD300,XD330)
EN1789:2003
Subject to change without notice.
Page 92
Accessories 92 / 116
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17 Accessories
The PRIMEDIC™ DefiMonitor XD is supplied with the following accessories fitted at the
factory:
Paddle set
PRIMEDIC™ SavePads Connect
Power module: PRIMEDIC™ AkuPak
For details of further accessories, see separate list of accessories / price list.
Page 93
Warranty conditions
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DefiMonitor XD 21324 / GB / K05
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18 Warranty conditions
The warranty period is 24 months, beginning on the date of purchase. Please keep the invoice as proof of purchase.
Within this time period, METRAX will remedy any defects in the device free of charge if they are based on material or manufacturing errors. The device can be reinstated to its original condition as selected by METRAX either by repair or replacement.
A claim under warranty does not extend the original warranty period.
Warranty claims and also legally entitled warranty claims are not applicable if the usefulness of the device is only negligibly affected, or in the case of normal wear and tear (e.g. consumables
such as PRIMEDIC™ AkuPak) or damages caused after transfer of risk as a result of incorrect
or negligent handling, excessive wear or caused by special external influences which are not provided for according to the contract. The same applies if inappropriate changes or incorrect repair work is carried out by the buyer or by a third party.
All other claims against METRAX are excluded out unless such claims are based on intent or gross negligence or compulsory legal liability standards.
Warranty claims made by the buyer against the seller (dealer) are not affected by this guarantee.
In the case of a warranty claim, please return the device with proof of purchase (e.g. invoice) stating your name and address to your dealer or to METRAX.
METRAX After-Sales Service is glad to be at your disposal, even after the warranty period has expired.
Page 94
Depiction of the current time function 94 / 116
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19 Depiction of the current time function
The following diagrams show the graphs for the defibrillation pulse in manual mode, depending on the load resistance.
Time / ms
Time / ms
Time / ms
I / A
5 Joule @ 25 Ohm
5 Joule @ 50 Ohm
5 Joule @ 75 Ohm
I / A
5 Joule @ 100 Ohm
5 Joule @ 125 Ohm
5 Joule @ 150 Ohm
I / A
5 Joule @ 175 Ohm
10 Joule @ 25 Ohm
10 Joule @ 50 Ohm
I / A
10 Joule @ 75 Ohm
10 Joule @ 100 Ohm
10 Joule @ 125 Ohm
Page 95
Depiction of the current time function
METRAX GmbH
DefiMonitor XD 21324 / GB / K05
95 / 116
I / A
10 Joule @ 150 Ohm
10 Joule @ 175 Ohm
20 Joule @ 25 Ohm
I / A
20 Joule @ 50 Ohm
20 Joule @ 75 Ohm
20 Joule @ 100 Ohm
I / A
20 Joule @ 125 Ohm
20 Joule @ 150 Ohm
20 Joule @ 175 Ohm
I / A
30 Joule @ 25 Ohm
30 Joule @ 50 Ohm
30 Joule @ 75 Ohm
I / A
30 Joule @ 100Ohm
30 Joule @ 125 Ohm
30 Joule @ 150 Ohm
Page 96
Depiction of the current time function 96 / 116
DefiMonitor XD 21324 / GB / K05
METRAX GmbH
I / A
30 Joule @ 175 Ohm
50 Joule @ 25 Ohm
50 Joule @ 50 Ohm
I / A
50 Joule @ 75 Ohm
50 Joule @ 100 Ohm
50 Joule @ 125 Ohm
I / A
50 Joule @ 150 Ohm
50 Joule @ 175 Ohm
100 Joule @ 25 Ohm
I / A
100 Joule @ 50 Ohm
100 Joule @ 75 Ohm
100 Joule @ 100 Ohm
I / A
100 Joule @ 125 Ohm
100 Joule @ 150 Ohm
100 Joule @ 175 Ohm
Page 97
Depiction of the current time function
METRAX GmbH
DefiMonitor XD 21324 / GB / K05
97 / 116
I / A
200 Joule @ 25 Ohm
200 Joule @ 50 Ohm
200 Joule @ 75 Ohm
I / A
200 Joule @ 100 Ohm
200 Joule @ 125 Ohm
200 Joule @ 150 Ohm
I / A
200 Joule @ 175 Ohm
300 Joule @ 25 Ohm
300 Joule @ 50 Ohm
I / A
300 Joule @ 75 Ohm
300 Joule @ 100 Ohm
300 Joule @ 125 Ohm
I / A
300 Joule @ 150 Ohm
300 Joule @ 175 Ohm
360 Joule @ 25 Ohm
Page 98
Depiction of the current time function 98 / 116
DefiMonitor XD 21324 / GB / K05
METRAX GmbH
I / A
360 Joule @ 50 Ohm
360 Joule @ 75 Ohm
360 Joule @ 100 Ohm
I / A
360 Joule @ 125 Ohm
360 Joule @ 150 Ohm
360 Joule @ 175 Ohm
Page 99
Depiction of the current time function
METRAX GmbH
DefiMonitor XD 21324 / GB / K05
99 / 116
The following diagrams show the graphs for the defibrillation pulse in AUTO mode, displayed depending on the load resistance.
Time / ms
Time / ms
Time / ms
25 Ohm I / A
1. Shock
2. Shock
3. Shock
50 Ohm I / A
1. Shock
2. Shock
3. Shock
75 Ohm I / A
1. Shock
2. Shock
3. Shock
100 Ohm I / A
1. Shock
2. Shock
3. Shock
125 Ohm I / A
1. Shock
2. Shock
3. Shock
Page 100
Depiction of the current time function 100 / 116
DefiMonitor XD 21324 / GB / K05
METRAX GmbH
150 Ohm I / A
1. Shock
2. Shock
3. Shock
175 Ohm
1. Shock
2. Shock
3. Shock
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