Zoll Propaq M User manual
Propaq® M Operator’s Guide
REF: 9650-000820-01 Rev. K
SW VER: 02.30.01.00
.
0123
ZOLL Medical Corporation
269 Mill Road
Chelmsford, MA USA
01824-4105
ZOLL International Holding B.V.
Newtonweg 18
6662 PV ELST
The Netherlands
The issue date for the Propaq M Operator's Guide (
REF 9650-000820-01 Rev. K) is November, 2016.
Copyright © 2016 ZOLL Medical Corporation. All rights reserved. RescueNet, SurePower, and ZOLL are
trademarks or registered trademarks of ZOLL Medical Corporation in the United States and/or other countries.
All other trademarks are the property of their respective owners.
Masimo, Rainbow, SET, SpCO, SpMet, SpHb, SpOC, and PVI are trademarks or registered trademarks of
Masimo Corporation in the United States and/or other countries.
Propaq is a registered trademark of Welch Allyn Inc.
®
Oridion Microstream FilterLine
and Smart CapnoLine® are registered trademarks of Medtronic plc.
Table of Contents
Chapter 1 General Information
Product Description ............................................................................................................ 1-1
Propaq M Optional Features ....................................................................................... 1-2
How to Use This Manual..................................................................................................... 1-2
Operator’s Guide Updates .................................................................................................. 1-2
Unpacking...........................................................................................................................1-2
Symbols Used on the Equipment ....................................................................................... 1-3
Conventions........................................................................................................................ 1-6
Propaq M Indications for Use..............................................................................................1-6
ECG Monitoring .......................................................................................................... 1-6
Non-Invasive Blood Pressure Monitoring ................................................................... 1-6
Temperature Monitoring ............................................................................................. 1-7
SpO2 Monitoring ......................................................................................................... 1-7
Respiration Monitoring ................................................................................................ 1-7
CO2 Monitoring ........................................................................................................... 1-7
Invasive Pressure Monitoring ..................................................................................... 1-7
12-Lead Analysis ........................................................................................................ 1-7
Propaq M Product Functions .............................................................................................. 1-8
ECG Monitoring .......................................................................................................... 1-8
Batteries ......................................................................................................................1-8
Ready For Use (RFU) Indicator .................................................................................. 1-9
Warnings........................................................................................................................... 1-10
General .....................................................................................................................1-10
ECG Monitoring ........................................................................................................ 1-11
Pulse Oximeter ......................................................................................................... 1-11
Noninvasive Blood Pressure ..................................................................................... 1-12
IBP ............................................................................................................................1-12
CO2 ..........................................................................................................................1-12
Respiration ................................................................................................................1-13
Ferromagnetic Equipment ........................................................................................ 1-13
Battery ...................................................................................................................... 1-13
Operator Safety ........................................................................................................ 1-13
Patient Safety ........................................................................................................... 1-14
Cautions............................................................................................................................ 1-14
Restarting the Monitor....................................................................................................... 1-15
Notification of Adverse Events .................................................................................. 1-15
Software License .............................................................................................................. 1-16
Service..............................................................................................................................1-16
The ZOLL Serial Number.................................................................................................. 1-18
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Chapter 2 Product Overview
Propaq M Controls and Indicators ..................................................................................... 2-2
Propaq M with Printer (Optional) Control and Indicators .................................................... 2-3
The Front Panel .................................................................................................................. 2-4
Display Screen ............................................................................................................ 2-6
Battery Status and Auxiliary Power Indicators ............................................................ 2-7
Patient Cables and Connectors .......................................................................................... 2-8
Auxiliary Power Adapter ..................................................................................................... 2-9
Navigating the Display Screen.......................................................................................... 2-10
Quick Access Keys ................................................................................................... 2-10
Navigation Keys ....................................................................................................... 2-12
Display Brightness Modes ........................................................................................ 2-13
Common Tasks ................................................................................................................. 2-13
Setting the Date and Time ........................................................................................ 2-13
Changing the Display Brightness .............................................................................. 2-14
Replacing a Battery Pack on the Propaq M Unit (No Printer) ................................... 2-15
Replacing a Battery Pack on the Propaq M Unit with Printer ................................... 2-16
Using Treatment Buttons .......................................................................................... 2-17
Chapter 3 Monitoring Overview
Propaq M Monitoring Functions.......................................................................................... 3-1
ECG ............................................................................................................................3-2
Heart Rate .................................................................................................................. 3-2
Respiration Rate ......................................................................................................... 3-2
Temperature ...............................................................................................................3-2
Invasive Pressures (IBP) ............................................................................................ 3-2
Non-Invasive Blood Pressure (NIBP) ......................................................................... 3-2
Capnography (CO2) ................................................................................................... 3-3
Pulse Oximetry (SpO2) ............................................................................................... 3-3
Monitoring Display Options................................................................................................. 3-4
Configuring the Waveform Display ..................................................................................... 3-6
Chapter 4 Trends
Displaying the Trends Status Window ................................................................................ 4-2
Printing Trend Information .................................................................................................. 4-3
Printing Trend Summary ............................................................................................. 4-3
Printing an Individual Trend Snapshot ........................................................................ 4-3
Printing The 10 Most Recent Trend Snapshots .......................................................... 4-3
Printing Specific Trend Snapshots .............................................................................. 4-3
Changing the Trends Status Window Display..................................................................... 4-3
Continuous Waveform Recording ............................................................................... 4-4
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Chapter 5 Alarms
Visual Alarm Indicators ....................................................................................................... 5-2
Audible Alarm Indicators..................................................................................................... 5-2
Alarm Indicator Self-Test..................................................................................................... 5-2
Patient Alarm Display ......................................................................................................... 5-3
Life Threatening Rhythm Alarms ........................................................................................ 5-4
Equipment Alert Display ..................................................................................................... 5-4
Responding to Active Alarms -- Silencing the Alarm .......................................................... 5-5
Re-enabling an Alarm ................................................................................................. 5-5
Latching Alarms .......................................................................................................... 5-5
Pausing (Suspending) Alarms ............................................................................................ 5-6
Alarm Reminders ........................................................................................................ 5-7
Alarm Options ..................................................................................................................... 5-7
Selecting Default Alarm Limits .................................................................................... 5-8
Setting Alarm Limits Relative to the Patient -- Stat Set Option ................................... 5-8
Chapter 6 Monitoring ECG
ECG Monitoring Setup........................................................................................................ 6-3
Preparing the Patient for Electrode Application .......................................................... 6-3
Applying Electrodes to the Patient .............................................................................. 6-4
Connecting the ECG Cable To the Propaq M Unit ..................................................... 6-6
Selecting ECG Waveforms for Display ....................................................................... 6-6
Selecting the Waveform Trace Size ........................................................................... 6-8
ECG Monitoring and Pacemakers ...................................................................................... 6-9
ECG System Messages...................................................................................................... 6-9
Chapter 7 Monitoring Respiration (Resp) and Heart Rate (HR)
Respiration/Breath Rate Meter ........................................................................................... 7-2
Using Impedance Pneumography to Measure Respiration ........................................ 7-2
Configuring Respiration (RR/BR) Alarms and Settings ......................................................7-3
Enabling/Disabling RR/BR Alarms and Setting Alarm Limits ...................................... 7-3
Using the Resp Parameter Control Panel ................................................................... 7-4
Heart Rate Meter ................................................................................................................7-5
Configuring Heart Rate (HR) Meter Alarms ........................................................................ 7-5
Enabling/Disabling HR Alarms and Setting Alarm Limits ............................................ 7-5
Life Threatening Rhythm Alarms ................................................................................ 7-6
Using the Heart Rate Parameter Control Panel .......................................................... 7-8
RESP System Message ..................................................................................................... 7-8
Chapter 8 Monitoring Non-Invasive Blood Pressure (NIBP)
How does NIBP Work? ....................................................................................................... 8-3
The NIBP Numeric Display .................................................................................................8-4
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NIBP Setup and Use........................................................................................................... 8-4
Selecting the NIBP Cuff ...................................................................................................... 8-5
Connecting the NIBP Cuff................................................................................................... 8-6
Applying the Cuff to the Patient .......................................................................................... 8-8
Ensuring Correct Cuff Inflation Settings............................................................................ 8-10
Configuring NIBP Alarms and Settings............................................................................. 8-11
Enabling/Disabling NIBP Alarms and Setting Alarm Limits ...................................... 8-11
Using the NIBP Parameter Control Panel ................................................................. 8-13
NIBP System Messages ...................................................................................................8-16
Chapter 9 Monitoring CO2
Overview.............................................................................................................................9-1
CO2 Monitoring Setup and Use.......................................................................................... 9-2
Selecting the CO2 Sampling Line ............................................................................... 9-3
Connecting the CO2 Sampling Lines .......................................................................... 9-4
Applying a FilterLine Set ............................................................................................. 9-5
Applying a Smart CapnoLine Nasal or Nasal/Oral Cannula ....................................... 9-6
Measuring CO2...................................................................................................................9-7
Setting CO2 and Respiration Rate Alarms ......................................................................... 9-8
Enabling/Disabling Alarms and Setting CO2 Alarm Limits ......................................... 9-8
Using the CO2 Parameter Control Panel .................................................................. 9-10
System Messages ............................................................................................................ 9-11
Patents.............................................................................................................................. 9-12
Chapter 10 Pulse CO-Oximetry (SpO2)
Warnings -- SpO2 General................................................................................................ 10-3
Cautions............................................................................................................................ 10-5
SpO2 Setup and Use........................................................................................................ 10-6
Selecting the SpO2 Sensor............................................................................................... 10-6
Applying the SpO2 Sensor................................................................................................ 10-6
Applying a Two-Piece Single-Use Sensor/Cable ...................................................... 10-7
Applying a Reusable Sensor/Cable .......................................................................... 10-9
Cleaning and Reuse of Sensors ............................................................................... 10-9
Connecting the SpO2 Sensor ......................................................................................... 10-10
Displaying Measurements............................................................................................... 10-10
Enabling/Disabling SpO2 Alarms and Setting Alarm Limits............................................ 10-11
Setting Upper and Lower SpO2 Alarm Limits ......................................................... 10-11
Setting Upper and Lower SpCO and SpMet Alarm Limits ......................................10-12
Setting Upper and Lower SpHb Alarm Limits ......................................................... 10-12
Setting Upper and Lower SpOC Alarm Limits ........................................................ 10-13
Setting Upper and Lower PVI Alarm Limits ............................................................ 10-13
Setting Upper and Lower PI Alarm Limits ............................................................... 10-13
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Table of Contents
Using the SpO2 Parameter Control Panel ...................................................................... 10-14
SpCO and SpMet, and SpHb, SpOC, PVI and PI Monitoring ................................. 10-14
Specifying the SpO2 Averaging Time ..................................................................... 10-14
Selecting the SpO2 Sensitivity ................................................................................ 10-14
Selecting SpHb Venous Mode ................................................................................ 10-15
Specifying the SpHb Averaging Time ..................................................................... 10-15
Selecting the Heart Rate/ Pulse Rate (HR/PR) Tone ............................................. 10-15
SpO2 System Messages ................................................................................................ 10-15
Functional Testers and Patient Simulators ..................................................................... 10-16
Patents............................................................................................................................ 10-16
Chapter 11 Monitoring Invasive Pressures (IBP)
Invasive Pressure Transducers ........................................................................................ 11-1
IBP Setup.......................................................................................................................... 11-2
Attaching the Invasive Pressure Transducer .................................................................... 11-3
Zeroing the Transducer..................................................................................................... 11-4
Rezeroing a Transducer ................................................................................................... 11-5
Displaying IBP Measurements.......................................................................................... 11-5
Conditions Affecting IBP Measurements .................................................................. 11-5
Enabling/Disabling IBP Alarms and Setting Alarm Limits ................................................. 11-6
Setting Upper and Lower Systolic (SYS) Alarm Limits ............................................. 11-6
Setting Upper and Lower Diastolic (DIA) Alarm Limits ............................................. 11-7
Setting Upper and Lower Mean Arterial Pressure (MEAN) Alarm Limits .................. 11-7
Setting IBP Source Label .......................................................................................... 11-8
IBP System Messages...................................................................................................... 11-9
Chapter 12 Monitoring Temperature
Temperature Monitoring Setup ......................................................................................... 12-2
Selecting and Applying Temperature Probes.................................................................... 12-2
Connecting the Temperature Probe ..................................................................................12-2
Displaying Temperature .................................................................................................... 12-3
Enabling/Disabling Temperature Alarms and Setting Alarm Limits................................... 12-3
Setting Upper and Lower Temperature Alarm Limits ........................................................ 12-3
Setting Upper and Lower Temperature Alarm Limits ....................................................... 12-4
Selecting the Temperature Label ...................................................................................... 12-4
Temperature System Messages .......................................................................................12-5
Chapter 13 12-Lead ECG Interpretive Analysis
Entering Patient Information ............................................................................................. 13-3
Entering the Patient Name and ID ............................................................................ 13-3
Entering Patient Age and Gender ............................................................................. 13-4
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12-Lead ECG Monitoring Setup........................................................................................ 13-4
Preparing the Patient for Electrode Application ........................................................ 13-5
Applying Electrodes to the Patient ............................................................................ 13-5
Connecting the 12-Lead Cable ................................................................................. 13-7
Observing the 12-Lead Waveform Traces ................................................................ 13-7
12-Lead Interpretive Analysis ................................................................................... 13-8
Fault Conditions Affecting 12-Lead Interpretive Analysis ....................................... 13-11
Printing 12-Lead Waveform Traces ................................................................................ 13-12
12-Lead Print and Display Options ................................................................................. 13-13
Selecting 12-Lead Acquire ...................................................................................... 13-13
Specifying the Number of 12-Lead Print Copies ..................................................... 13-13
Specifying the 12-Lead Print Format ...................................................................... 13-14
Printing 10 Seconds of Waveform Traces .............................................................. 13-16
Specifying the 12-Lead Frequency Response ........................................................ 13-16
Enabling 12-Lead Analysis ..................................................................................... 13-16
Enabling Interpretive Text ....................................................................................... 13-16
Chapter 14 Patient Data
Storing Data ...................................................................................................................... 14-1
Log Capacity Indicator .............................................................................................. 14-2
Capturing a Data Snapshot............................................................................................... 14-2
Reviewing Snapshots ............................................................................................... 14-2
Printing Snapshots (Optional) ................................................................................... 14-2
Treatment Summary Report ............................................................................................. 14-3
Transferring Data to a USB Device...................................................................................14-3
Chapter 15 Communications
The Wireless Icon ............................................................................................................. 15-2
The Wireless Menu........................................................................................................... 15-4
Selecting a Pre-Configured Access Point Profile ...................................................... 15-5
Creating a Temporary Access Point Profile .............................................................. 15-6
Bluetooth Device Pairing ........................................................................................ 15-10
Sending a 12-Lead Report.............................................................................................. 15-12
Sending Disclosure Logs ................................................................................................ 15-13
Supervisor Communications Menu................................................................................. 15-14
Overview .................................................................................................................15-14
Accessing the Communications Menu .................................................................... 15-14
Wi-Fi Access Point Profiles ..................................................................................... 15-16
Setting up Cellular Communications ....................................................................... 15-23
Setting up an Ethernet Connection ......................................................................... 15-28
Configuring 12-Lead Report Transmissions ........................................................... 15-29
Configuring Disclosure Log Transmissions ............................................................ 15-31
Data Services ......................................................................................................... 15-33
Configuring Clock Synchronization .........................................................................15-35
Communications System Messages............................................................................... 15-37
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Table of Contents
Transmission Status Icons .............................................................................................. 15-38
Chapter 16 Printing
Printing Patient Data......................................................................................................... 16-1
Printer Setup ............................................................................................................. 16-2
Automatic Prints ........................................................................................................ 16-2
Printing Waveforms .................................................................................................. 16-3
Printing Reports ........................................................................................................ 16-3
Printing Trends ......................................................................................................... 16-4
Chapter 17 Cleaning and Maintenance
Inspection and Cleaning instructions ................................................................................ 17-1
Cleaning the Propaq M unit ...................................................................................... 17-2
Cleaning the NIBP Blood Pressure Cuff ................................................................... 17-2
Cleaning SpO2 Sensors ........................................................................................... 17-2
Cleaning Cables and Accessories ............................................................................ 17-3
Loading Recorder Paper ........................................................................................... 17-3
Cleaning the Print Head ............................................................................................ 17-4
Recommended Minimum Preventive Maintenance Schedule .......................................... 17-5
Guidelines for Maintaining Peak Battery Performance ..................................................... 17-6
Appendix A Specifications
Monitor/Display ...................................................................................................................A-2
Impedance Pneumography.................................................................................................A-3
Alarms.................................................................................................................................A-4
Printer (Recorder) ...............................................................................................................A-5
Battery ................................................................................................................................A-5
General ...............................................................................................................................A-6
CO2 ....................................................................................................................................A-7
Pulse Oximeter ...................................................................................................................A-8
Non-Invasive Blood Pressure ........................................................................................... A-11
Invasive Pressures ...........................................................................................................A-12
Temperature......................................................................................................................A-13
Electromagnetic Compatibility Guidance and Manufacturer’s Declaration .......................A-14
Wireless Output Guidance and Manufacturer’s Declaration.............................................A-18
RF Transmission Emitted (IEC 60601-1-2) ...............................................................A-18
FCC Notice ...............................................................................................................A-18
Canada, Industry Canada (IC) Notices .....................................................................A-18
Appendix B Accessories
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Product Description
The ZOLL® Propaq® M unit is an easy-to-use portable monitor that has the following
monitoring capabilities: ECG, CO-Oximeter, Non-invasive Blood Pressure, IBP, CO
Temperature, and Respiration. It has been designed for all resuscitation situations and its
rugged, compact, lightweight design makes it ideal for transport situations. It is powered by
auxiliary power and an easily replaced battery pack that is quickly recharged in the device
when it is connected to auxiliary power. In addition, the unit’s battery may be recharged and
tested using a ZOLL SurePower™ Battery Charger Station.
Note: Some of the monitoring functions are optional features. See the complete list of
options in Fig. Note:. All features are included in this manual, but only purchased
features will be available on your unit.
The product is designed for use in hospital, EMS, and rugged military environments. The unit
has a large colorful LCD display of numerics and waveform data that provides easy visibility
from across the room and at any angle. ECG, plethysmograph, and respiration waveform traces
can be displayed simultaneously, giving easy access to all patient monitoring data at once. The
display screen is configurable, so you can choose the best visual layout to fit your monitoring
needs.
Chapter 1
General Information
,
2
The Propaq M has a patient data review and collection system that allows you to view, store,
and transfer patient data. The Propaq M unit contains a USB port, which you can use to transfer
data to a PC and, optionally, a printer, that you can use to print patient data.
The Propaq M unit can send data through a wireless connection to remote locations. The unit
can send 12-lead report snapshots (including trend data) or disclosure logs to a recipient via a
ZOLL server. In addition, full disclosure cases, which also contain trend data, can be
automatically retrieved from the Propaq M unit using ZOLL RescueNet
9650-000820-01 Rev. K Propaq M Operator’s Guide 1-1
®
or ePCR software.
Chapter 1 General Information
Propaq M Optional Features
The following features are optional in the Propaq M unit.
Note: All features are included in this manual, but only purchased features will be available
on your unit.
Optional Feature
12-Lead ECG with Interpretation
SpO2 (Masimo®) with SpCO® and SpMet
SpHb® (Masimo®) with SpOCTM, PVI® and PI
NIBP (with Smartcuf
EtCO
(Oridion® Microstream®)
2
Temperature (2 Channels)
Invasive Pressures (3 Channels)
Printer
®
and SureBPTM)
How to Use This Manual
®
The Propaq M Operator's Guide provides information operators need for the safe and effective
use and care of the Propaq M product. It is important that all persons using this device read and
understand all the information contained within.
Please thoroughly read the safety considerations and warnings section.
Procedures for daily checkout and unit care are located in the Chapter 17, "Cleaning and
Maintenance".
Operator’s Guide Updates
An issue or revision date for this manual is shown on the front cover. If more than three years
have elapsed since this date, contact ZOLL Medical Corporation to determine if additional
product information updates are available.
All users should carefully review each manual update to understand its significance and then
file it in its appropriate section within this manual for subsequent reference.
Product documentation is available through the ZOLL website at www.zoll.com. From the
Products menu, choose Product Manuals.
Unpacking
Carefully inspect each container for damage. If the shipping container or cushion material is
damaged, keep it until the contents have been checked for completeness and the instrument has
been checked for mechanical and electrical integrity. If the contents are incomplete, if there is
mechanical damage, or if the monitor does not pass its electrical self-test, U.S.A. customers
should call ZOLL Medical Corporation (1-800-348-9011). Customers outside of the U.S.A.
should contact the nearest ZOLL authorized representative. If the shipping container is
damaged, also notify the carrier.
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Symbols Used on the Equipment
Any or all of the following symbols may be used in this manual or on this equipment:
Symbol Description
Attention, consult accompanying documents.
Fragile, handle with care.
Keep dry.
This end up.
Temperature limitation.
Symbols Used on the Equipment
Conformité Européenne Complies with medical device directive 93/42/EEC.
Type CF patient connection.
Fusible link.
Alternating current (ac).
Direct current (dc).
Auxiliary power adapter operation.
Earth (ground).
Negative input terminal.
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Chapter 1 General Information
2%452.
,I)/.
RECYCLE
,I)/.
Symbol Description
Positive input terminal.
Power On/Off
Protective earth (ground).
Contains lithium. Recycle or dispose of properly.
Keep away from open flame and high heat.
Do not open, disassemble, or intentionally damage.
Do not crush.
Do not discard in trash. Recycle or dispose of properly.
Return to a collection site intended for waste electrical and electronic
equipment (WEEE). Do not dispose of in unsorted trash.
Date of manufacture.
Use by.
Latex-free.
Do not reuse.
Do not fold.
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Symbol Description
MR
Not sterile.
Manufacturer.
Authorized representative in the European Community.
Serial Number.
Catalogue number.
Consult instructions for use.
Symbols Used on the Equipment
Refer to instruction manual/booklet.
Prescription only.
Alarm audio is currently off.
Alarm audio is currently paused.
Pacer indicator disabled.
Battery charging status.
Do not use device, cables, or probes in an MRI environment.
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Chapter 1 General Information
Conventions
This guide uses the following conventions:
Within text, the names and labels for physical buttons and softkeys appear in boldface type (for
example, “Press the IBP quick access key”).
This guide uses uppercase italics for audible prompts and for text messages displayed on the
screen (for example, INITIALIZING).
Warning! Warning statements alert you to conditions or actions that can result in personal injury
or death.
Caution Caution statements alert you to conditions or actions that can result in damage to the unit.
Propaq M Indications for Use
The Propaq M is intended for use by trained medical personnel who are familiar with basic
monitoring, vital sign assessment, and the use of the Propaq M. The Propaq M is also intended
for use by (or on the order of) physicians at the scene of an emergency or in a hospital
emergency room, intensive care unit, cardiac care unit, or other similar areas of a hospital. The
usage may be in an ambulance or at the scene of an emergency. It is also intended to be used
during the transport of patients. The Propaq M will be used whenever it is required to monitor
any of those functions that are included (as options) in the device. The Propaq M unit can be
used on pediatric patients (as described in the following table) and on adult patients (21 years of
age or older) with and without heart dysfunction.
Pediatric Patient Subpopulation Approximate Age Range
Newborn (neonate) Birth to 1 month of age.
Infant 1 month to 2 years of age.
Child 2 to 12 years of age.
Adolescent 12 to 21 years of age.
ECG Monitoring
The Propaq M is intended for use to monitor and/or record 3-, 5-, or 12-lead ECG waveform
and heart rate, and to alarm when heart rate is above or below limits set by the operator. The
patient population will range from newborn (neonate) to adult, with and without heart
dysfunction.
Non-Invasive Blood Pressure Monitoring
The Propaq M unit’s NIBP option is intended for use to make non-invasive measurements of
arterial pressure and heart rate, and to alarm if either parameter is outside of the limits set by the
user. Measurements are made using an inflatable cuff on the patient's arm or leg. The patient
population will range from newborn (neonate) to adult.
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Temperature Monitoring
The Propaq M is intended for use to make continuous temperature measurements of rectal,
esophageal, or surface temperatures, and to alarm if the temperature is outside of the limits set
by the user. The patient population will range from newborn (neonate) to adult.
SpO2 Monitoring
The Propaq M pulse CO-oximeter, with Masimo Rainbow® SET® technology, is intended for
use for continuous noninvasive monitoring of functional oxygen saturation of arterial
hemoglobin (SpO
saturation (SpMet), total hemoglobin (SpHb), oxygen content (SpOC), pleth variability index
(PVI), and/or perfusion index (PI). The pulse CO-oximeter and accessories are indicated for
use on adult, pediatric, and neonatal patients during both no motion and motion conditions, and
for patients who are well or poorly perfused, in hospitals, hospital-type facilities, or in mobile
environments.
Respiration Monitoring
The Propaq M is intended for use to continuously monitor respiration rate and to alarm if the
rate falls outside of the range set by the operator. Because the measurement method actually
measures respiratory effort, apnea episodes with continued respiratory effort (such as
obstructive apnea) may not be detected. It is not intended to be used as an apnea monitor. The
patient population will range from newborn (neonate) to adult.
Propaq M Indications for Use
), pulse rate, carboxyhemoglobin saturation (SpCO), and/or methemoglobin
2
CO2 Monitoring
The Propaq M is intended for use to make continuous noninvasive measurement and
monitoring of carbon dioxide concentration of the expired and inspired breath and breath rate.
The patient population will range from newborn (neonate) to adult.
Invasive Pressure Monitoring
The Propaq M is intended for use to display and make continuous invasive pressure
measurements from any compatible pressure transducer. The primary intended uses are arterial
blood pressure, central venous pressure and intracranial pressure monitoring. Any contraindications of the particular transducer selected by the user shall apply. The patient population
will range from newborn (neonate) to adult.
12-Lead Analysis
The 12-lead ECG Analysis is intended for use in acquiring, analyzing and reporting ECG data,
and to provide interpretation of the data for consideration by caregivers. The interpretations of
ECG data offered by the device are only significant when used in conjunction with caregiver
overread as well as consideration of all other relevant patient data. The 12-lead ECG Analysis
is intended for use on adults (> 18 years of age).
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Chapter 1 General Information
Propaq M Product Functions
ECG Monitoring
The patient’s ECG is monitored by connecting the patient to the unit via a 3-, 5-, or 12-lead
patient cable. The ECG waveform is presented on the display along with the following
information:
• averaged heart rate, derived by measuring R to R intervals
• lead selection - I, II, III, aVR, aVL, aVF, V1, V2, V3, V4, V5, V6 (with ECG cable).
• ECG size - 0.125, 0.25, 0.50, 1.0, 2.0, 4.0 cm/mV, AUTO
• status messages
The ECG bandwidth is user selectable.
Batteries
Propaq M models use an easily replaced rechargeable lithium-ion battery pack (the SurePower
II Battery Pack). A new, fully charged battery pack typically delivers more than 8 hours of ECG
monitoring. Use of other functions (such as higher screen brightness or shorter NIBP intervals)
reduces this time.
When a LOW BATTERY icon appears on the display and the unit emits three beeps in
conjunction with the displayed battery icon, the battery must be replaced and recharged.
You can charge the battery by either of the following methods:
• Internal charging — plug the Propaq M into an auxiliary power adapter to automatically
begin charging the installed battery pack. The front panel battery indicator operates as
follows:
When the indicator is: It means:
Steady yellow Battery is charging.
Steady green Battery is charged.
Alternating yellow and
green
Not lit No battery in device.
The charge state cannot be
determined or a battery charging
fault has been detected.
Note: Upon power up, it takes approximately 45 seconds for the LEDs on the battery to
accurately display run time.
• External charging — use the ZOLL SurePower Battery Charger with the Propaq M/MD
Charger Adaptor to charge the battery pack and test the battery’s capacity. For details, refer
to the SurePower II Battery Pack Guide.
The Recalibration LED icon ( ) lights for approximately 10 seconds (after you press and
release the Display button) if the battery needs to be calibrated. If the Recalibration LED lights,
the runtime indicator will not display run time for that battery. For best performance of the
battery, you should recalibrate the battery as soon as possible.
To manually recalibrate the SurePower II Battery Pack, you can insert the battery into the
SurePower Charger Station and perform a Manual Test (for more information, see the ZOLL
SurePower Charger Station Operator’s Guide).
After you recalibrate the battery, the Recalibration LED will only flash when you press the
Display button.
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Ready For Use (RFU) Indicator
The Propaq M has an RFU indicator on the front panel that indicates if the device is ready for
use. The RFU indicator has three states which are described in the following table.
State Description Action
Propaq M Product Functions
Ready for Use The device is ready for use. Patient
monitoring is functional and the
battery is above the low battery
capacity.
Note: If the device is plugged into
the auxiliary power adapter, the
Ready for Use indicator may display
even if the battery is depleted.
Check the status of the battery
before removing the device from the
auxiliary power adapter.
Flashing One or more of the following has
occurred:
• The battery is not properly
installed.
• A low battery is installed.
• A battery fault has occurred.
• There is no battery installed
while connected to auxiliary
power.
• One or more patient monitoring
parameters have failed self-test
(NIBP, SpO
Temp).
• The front panel button self-test
failed.
• The speech database self-test
failed.
, CO2, IBP, or
2
None required.
Install a fully charged battery in the
unit and check the RFU indicator
again. If the RFU indicator
continues to flash, remove the unit
from service and contact the
appropriate technical personnel or
the ZOLL Technical Service
Department.
Do Not Use One or more of the following has
occurred:
• The battery is not properly
installed.
• No battery is installed and
auxiliary power is not present.
• A very low battery (below
software shutdown limit) was
installed.
• ECG self-tests have failed, or
other critical self-tests have
failed.
Install a fully charged battery in the
unit and check the RFU indicator
again. If the RFU indicator
continues to display the Do Not
Use symbol, remove the unit from
service and contact the appropriate
technical personnel or the ZOLL
Technical Service Department.
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Chapter 1 General Information
Warnings
General
• These operating instructions describe the functions and proper operation of the Propaq M
products. They are not a substitute for a formal patient care training course. Operators
should obtain formal training from an appropriate authority before using this monitor for
patient care.
• Proper operation of the unit and correct electrode placement is critical to obtaining optimal
results. Operators must be thoroughly familiar with proper device operation.
• Allow ample slack in cables to make sure that cables do not tug at electrodes.
• Do not disassemble the unit. A shock hazard exists. Refer all problems to authorized service
personnel.
• Follow all recommended maintenance instructions. If a problem occurs, obtain service
immediately. Do not use the monitor until it has been inspected by appropriate personnel.
• The Propaq M unit might not perform to specifications when stored at the upper or lower
extreme limits of storage temperature and then immediately put into use. The Propaq M unit
should not be stored or used outside of the environmental limits provided in Appendix A of
this manual.
• Avoid using the Propaq M adjacent to, or stacked on, other equipment. If unavoidable,
verify that the unit operates normally in this configuration before clinical use.
• The Propaq M unit should be installed and put into service according to the EMC
information in Appendix A of this manual.
• The use of transducers and cables other than those specified in this manual and related
Propaq M option manual inserts may result in increased emissions or decreased immunity of
the Propaq M.
• Do not use or place the unit in service if the Ready For Use indicator (at the upper right of
the front panel) displays a red circle with a line through it.
• Carefully route patient cables to avoid tripping over them, or inadvertently pulling the unit
onto the patient.
• Always inspect the unit for damage if it has been dropped.
• Only authorized personnel should use the Supervisor menus.
• If uncertain about the accuracy of any measurement, first check the patient’s vital signs by
alternate means, and then make sure the monitor is functioning correctly.
• Before disposing equipment, in order to avoid contaminating or infecting personnel, the
environment, or other equipment, it is important to disinfect and decontaminate the monitor
and any appropriate device accessories appropriately and remove the batteries. Then dispose
of the device and accessories in accordance with your country’s regulations for equipment
containing electronic parts.
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ECG Monitoring
• Implanted pacemakers might cause the heart rate meter to count the pacemaker rate during
incidents of cardiac arrest or other arrhythmias. Dedicated pacemaker detection circuitry
may not detect all implanted pacemaker spikes. Check the patient's pulse; do not rely solely
on heart rate meters. Patient history and physical examination are important factors in
determining the presence of an implanted pacemaker. Pacemaker patients should be
carefully observed. See “Pacemaker Pulse Rejection:” on page A-3 of this manual for
disclosure of the pacemaker pulse rejection capability of this instrument.
• Use only ECG electrodes that meet the AAMI standard for electrode performance
(AAMI EC-12). Use of electrodes not meeting this AAMI standard could cause the ECG
trace recovery after defibrillation to be significantly delayed.
• Do not place electrodes directly over an implanted pacemaker.
• The Propaq M unit detects ECG electrical signals only. It does not detect a pulse (effective
circulatory perfusion). Always verify pulse and heart rate by physical assessment of the
patient. Never assume that the display of a nonzero heart rate means that the patient has a
pulse.
• Excessive artifact can result due to improper skin preparation of the electrode sites. Follow
skin preparation instructions in Chapter 6: “Monitoring ECG.”
• Equipment such as electrocautery or diathermy equipment, RFID readers, electronic article
surveillance (EAS) systems, or metal detectors that emit strong radio frequency signals can
cause electrical interference and distort the ECG signal displayed by the monitor, thereby
preventing accurate rhythm analysis. Ensure adequate separation between such emitters, the
device, and the patient when performing rhythm analysis.
• Shock Hazard: Use of accessories, other than those specified in the operating instructions,
may adversely affect patient leakage currents.
• Certain line-isolation monitors may cause interference on the ECG display and may inhibit
heart rate alarms.
Warnings
Pulse Oximeter
• Keep the ZOLL finger probe clean and dry.
• SpO
tricuspid regurgitation or obstructed venous return.
• SpO
vasoconstriction or hypovolemia or under conditions where there is no pulsating arterial
vascular bed.
• SpO
devices, IR lamps, bright lights, improperly applied sensors; the use of non-ZOLL sensors,
or damaged sensors; in patients with smoke inhalation, or carbon monoxide poisoning, or
with patient movement.
• Tissue damage can result if sensors are applied incorrectly, or left in the same location for an
extended period of time. Move sensor every 4 hours to reduce possibility of tissue damage.
• Do not use any oximetry sensors during MRI scanning. MRI procedures can cause
conducted current to flow through the sensors, causing patient burns.
• Do not apply SpO
sound when the arterial circulation is cut off during NIBP measurements, and may affect
SpO
• In some instances, such as obstructed airway, the patient's breathing attempts may not
produce any air exchange. These breathing attempts can still produce chest size changes,
creating impedance changes, which can be detected by the respiration detector. It is best to
use the pulse oximeter whenever monitoring respirations, to accurately depict the patient's
respiratory condition.
measurements may be affected by certain patient conditions: severe right heart failure,
2
measurements may be affected when using intravascular dyes, in extreme
2
measurements may be affected in the presence of strong EMI fields, electrosurgical
2
sensor to the same limb that has an NIBP cuff. The SpO2 alarm may
2
measurements.
2
9650-000820-01 Rev. K Propaq M Operator’s Guide 1-11
Chapter 1 General Information
Noninvasive Blood Pressure
• Only a physician can interpret pressure measurements.
• Blood pressure measurement results may be affected by the position of the patient, his or her
physiological condition and other factors.
• Substitution of a component different from that supplied by ZOLL (e.g., cuff, hoses, etc.)
may result in measurement error. Use only ZOLL-approved cuffs and hoses. To avoid the
risk of intravenous line misconnection and possible introduction of air into a patient’s blood,
do not modify the NIBP system or hoses with Luer Lock adapters.
• Do not use a blood pressure cuff on the limb being used for IV infusion or for SpO
monitoring.
• Accurate pressure readings may not be achieved on a person experiencing arrhythmias,
shaking, convulsions or seizures. Medication may also affect pressure readings. The correct
size cuff is essential for accurate blood pressure readings.
• Blood pressure hoses must be free of obstructions and crimps.
• If the patient’s cuff is not at heart level, an error in measurement may result.
• When monitoring blood pressure at frequent intervals, observe the cuffed extremity of the
patient for signs of impeded blood flow.
• Do not monitor one patient’s NIBP while monitoring another patient’s ECG.
• Blood pressure measurement may be inaccurate if taken while accelerating or decelerating
in a moving vehicle.
• If an NIBP measurement result is questionable or “motion” indication is displayed, repeat
the measurement. If the repeated measurement result is still questionable, use another blood
pressure measurement method.
• Do not use the NIBP on cardiopulmonary bypass patients.
2
IBP
CO
• To ensure compatibility and electrical safety, accessory pressure sensors should comply with
ANSI/AAMI BP-22 and IEC 60601-2-34 for IBP or ANSI/AAMI NS28 for ICP.
• Follow instructions supplied with any accessory pressure sensor regarding calibration and
removal of trapped air.
• Avoid touching metal parts of any transducer while it is in contact with the patient.
• Do not reuse any components that are labeled for single use only.
• Transducers should be rated to withstand an accidental drop of at least a meter onto a hard
surface.
• Transducers that are subject to immersion in liquids should be rated as watertight.
2
• During MRI scanning, the monitor must be placed outside the MRI suite. When the monitor
is used outside the MRI suite, EtCO2 monitoring can be implemented using a long
FilterLine
• When using the monitor with anesthetics, nitrous oxide or high concentrations of oxygen,
®
which permits placement of the monitor outside the MRI suite.
connect the gas outlet to a scavenger system.
• Use only Oridion Microstream CO
• Microstream CO
sampling lines are labeled for single patient use only. Do not reuse
2
sampling lines.
2
sampling lines.
• If using the CO
Monitor for extended critical care, replace the airway adapter every 24
2
hours or when it becomes occluded.
• CO
readings and respiratory rate can be affected by sensor application errors, certain
2
ambient environmental conditions, and certain patient conditions.
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Respiration
• Do not operate the Propaq M with any other monitor with respiration measurements on the
same patient. The two devices could affect the respiration accuracy.
• The device should not be used as an apnea monitor.
Ferromagnetic Equipment
Biomedical equipment and accessories, such as ECG electrodes, cables, and oximeter probes
contain ferromagnetic materials. Ferromagnetic equipment must not be used in the presence of
high magnetic fields created by magnetic resonance imaging (MRI) equipment.
The large magnetic fields generated by an MRI device can attract ferromagnetic equipment
with an extremely violent force, which could cause serious personal injury or death to persons
between the equipment and the MRI device.
Battery
• Although the device can operate with auxiliary power alone, ZOLL strongly recommends
that you operate the unit with a battery installed at all times. Operating the unit with a
battery provides a backup in case of AC power shortage, and results in faster charge time.
The battery can be automatically recharged while it is installed in the unit. Keep a fully
charged spare battery pack with the monitor at all times.
• Test battery packs regularly. A battery that does not pass the ZOLL charger’s capacity test
might cause the Propaq M unit to shut down unexpectedly.
• If the Low Battery indication occurs at any time during operation, immediately replace the
battery pack.
• If the LOW BATTERY icon appears, plug the Propaq M unit into a power source or install a
fully charged battery pack. When the warning low battery shutdown prompt appears,
immediately replace the battery pack with a fully charged pack or plug the Propaq M unit
into a power source, as unit shut down due to a low battery condition is imminent.
• If mistreated, a battery pack might explode. Do not disassemble a battery pack or dispose of
it in fire.
Warnings
Operator Safety
• Do not use the Propaq M in the presence of oxygen-rich atmospheres, flammable
anesthetics, or other flammable agents (such as gasoline). Using the unit in such
environments might cause an explosion.
• Do not use the unit near or within standing water. Electrical safety might be compromised
when the monitor is wet.
• The use of accessory equipment that does not comply with the equivalent safety
requirements of the Propaq M monitor could reduce the level of safety of the combined
system. When choosing accessory equipment, consider the following:
• Use of the accessory in the patient vicinity.
• Evidence that the safety certification of the accessory has been performed in accordance
with the appropriate IEC (EN) 60601-1 and/or IEC (EN) 60601-1-1 harmonized
national standards.
• Always check that the equipment functions properly and is in proper condition before use.
• To avoid the risk of electrical shock, do not allow printer to come into contact with other
conductive parts, such as equipment connected to the USB port.
9650-000820-01 Rev. K Propaq M Operator’s Guide 1-13
Chapter 1 General Information
Patient Safety
• This equipment should be connected to only one patient at a time.
• To ensure patient safety, do not place the monitor in any position that might cause it to fall
on the patient.
• To ensure patient safety, connect the Propaq M only to equipment with circuits that are
electrically isolated.
• Use only high-quality ECG electrodes.
• Do not use ECG electrodes if the gel is dried, separated, torn or split from the foil; patient
burns may result from using such electrodes.
• Check the expiration date on the electrode packaging. Do not use electrodes after their
expiration date.
• Excessive body hair or wet, diaphoretic skin can inhibit electrode coupling to the skin. Clip
excess hair and dry any moisture from the area where an electrode is to be attached.
• Carefully route the patient cables away from the patient’s neck to reduce the possibility of
patient entanglement or strangulation.
• To avoid electrosurgery burns at monitoring sites, ensure proper connection of the
electrosurgery return circuit so that a return path cannot be made through monitoring
electrodes or probes.
• During electrosurgery, observe the following guidelines to minimize electrosurgery unit
(ESU) interference and provide maximum operator and patient safety:
• Keep all patient monitoring cables away from earth ground, ESU knives, and ESU
return wires.
• Use electrosurgical grounding pads with the largest practical contact area.
• Always ensure proper application of the electrosurgical return electrode to the patient.
• Check electrical leakage levels before use. Leakage current might be excessive if more than
one monitor or other piece of equipment is connected to the patient.
Cautions
• If the unit is to be stored longer than 30 days, remove the battery pack.
• Do not sterilize the monitor, or its accessories unless the accessories are labelled as
sterilizable.
• Do not immerse any part of the monitor in water.
• Do not use the monitor if excessive condensation is visible on the device. Wipe only the
outside with a damp cloth.
• Do not use ketones (such as acetone or MEK) on the monitor.
• Avoid using abrasives (including paper towels) on the display window.
• To achieve the specified level of protection against spilled or splashed liquids, thoroughly
dry all exposed surfaces of this device prior to operation or connections to auxiliary power.
• If liquids enter the device connectors, remove all liquid from the connectors and allow the
device to dry thoroughly prior to use.
• Grounding reliability can be achieved only when the equipment is connected to a receptacle
marked “HOSPITAL ONLY,” “HOSPITAL GRADE,” or equivalent. If the grounding
integrity of the line cord or ac receptacle is questionable, operate the monitor using battery
power only.
• Do not connect to an electrical outlet controlled by a wall switch or dimmer.
• For accurate ECG information, and to protect against noise and other interference, use only
internal current-limiting ECG cables specified or supplied by ZOLL.
• For continued safety and EMI performance, use only the line cord supplied by ZOLL.
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• Electrical installation of the room or the building in which the monitor is to be used must
comply with regulations specified by the country in which the equipment is to be used.
• Dispose of battery packs in accordance with national, regional and local regulations. Battery
packs should be shipped to a reclamation facility for recovery of metal and plastic
compounds as the proper method of waste management.
Restarting the Monitor
Certain events require the Propaq M products to be restarted after they shut off or become
inoperative (for example, when the battery runs down and the unit shuts off).
In such a case, always try to restore monitor operation as follows:
1. Press the power switch on the top of the unit to turn it off.
2. If necessary, replace a depleted battery with a fully charged pack, or connect the monitor to
auxiliary power.
3. Press the power switch on the top of the unit to turn it back on.
This sequence is necessary to restart the monitor and can also be used to clear some fault
messages when immediate use of the monitor is required.
If the Propaq M unit is powered off for less than 2 minutes, all patient monitoring parameter
settings will be retained. If the unit has been powered off for at least two minutes, it will be
considered a New Patient and all of the patient-specific parameters (alarm limits, etc.) will be
reset to their default values.
Restarting the Monitor
Notification of Adverse Events
As a health care provider, you may have responsibilities under the Safe Medical Devices Act
(SMDA), for reporting to ZOLL Medical Corporation, and possibly to the FDA, the occurrence
of certain events.
These events, described in 21 CFR Part 803, include device-related death and serious injury or
illness. In addition, as part of our Quality Assurance Program, ZOLL Medical Corporation
requests to be notified of device failures or malfunctions. This information is required to ensure
that ZOLL Medical Corporation provides only the highest quality products.
9650-000820-01 Rev. K Propaq M Operator’s Guide 1-15
Chapter 1 General Information
Software License
Note: Read this Operator’s Guide and License agreement carefully before operating any of
the Propaq M products.
Software incorporated into the system is protected by copyright laws and international
copyright treaties as well as other intellectual property laws and treaties. This software is
licensed, not sold. By taking delivery of and using this system, the Purchaser signifies
agreement to and acceptance of the following terms and conditions:
1. Grant of License: In consideration of payment of the software license fee which is part of
the price paid for this product ZOLL Medical Corporation grants the Purchaser a nonexclusive license, without right to sublicense, to use the system software in object-code
form only.
2. Ownership of Software/Firmware: Title to, ownership of and all rights and interests in the
system software and all copies thereof remain at all times vested in the manufacturer, and
Licensors to ZOLL Medical Corporation and they do not pass to purchaser.
3. Assignment: Purchaser agrees not to assign, sublicense or otherwise transfer or share its
rights under the license without the express written permission of ZOLL Medical
Corporation.
4. Use Restrictions: As the Purchaser, you may physically transfer the products from one
location to another provided that the software/firmware is not copied. You may not disclose,
publish, translate, release or distribute copies of the software/firmware to others. You may
not modify, adapt, translate, reverse engineer, decompile, crosscompile, disassemble or
create derivative works based on the software/firmware.
Service
NO IMPLIED LICENSE
Possession or purchase of this device does not convey any express or implied license to use the
device with replacement parts which would, alone, or in combination with this device, fall
within the scope of one or more of the patents relating to this device.
The Propaq M only requires recalibration of the CO2 module. Service is required after 20,000
hours of use of the CO
module. Appropriately trained and qualified personnel should,
2
however, perform periodic tests of the monitor functionality to verify proper operation.
If a unit requires service, contact the ZOLL Technical Service Department.
For customers In the U.S.A. For customers outside the U.S.A.
Telephone:
Fax:
1-800-348-9011
1-978-421-9655
1-978-421-0010
Call the nearest authorized ZOLL Medical Corporation
representative.
To locate an authorized service center, contact the
International Sales Department at
ZOLL Medical Corporation
269 Mill Road
Chelmsford, MA 01824-4105
Telephone: 1-978-421-9655
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Service
When requesting service, please provide the following information to the service
representative:
• Unit serial number
• Description of the problem
• Department using the equipment and name of the person to contact
• Purchase order to allow tracking of loan equipment
• Purchase order for a unit with an expired warranty
• Sample ECG or other stripcharts demonstrating the problem (if available and applicable),
less any confidential patient information.
Returning a unit for service
Before sending a unit to the ZOLL Technical Service Department for repair, obtain a service
request (SR) number from the service representative.
Remove the battery pack from the unit. Pack the unit with its cables and battery in the original
containers (if available) or equivalent packaging. Be sure the assigned service request number
appears on each package.
For customers Return the unit to
In the U.S.A. ZOLL Medical Corporation
269 Mill Road
Chelmsford, MA 01824-4105
Attention: Technical Service Department (SR number)
Telephone: 1-800-348-9011
In Canada ZOLL Medical Canada Inc.
1750 Sismet Road, Unit #1
Mississauga, ON L4W 1R6
Attention: Technical Service Department (SR number)
Telephone: 1-866-442-1011
In other locations The nearest authorized ZOLL Medical Corporation representative.
To locate an authorized service center, contact the International Sales
Department at
ZOLL Medical Corporation
269 Mill Road
Chelmsford, MA 01824-4105
Telephone: 1-978-421-9655
9650-000820-01 Rev. K Propaq M Operator’s Guide 1-17
Chapter 1 General Information
The ZOLL Serial Number
Each ZOLL product displays a serial number that contains information about that product.
From left to right, ZOLL serial numbers are structured as follows:
• A two-character product code
• A three-character date-of-manufacture code
• A product serial number of six or more alphanumeric characters
The first two characters of the date-of-manufacture code give the last two digits of the year (for
example, “06” appears for products manufactured in 2006). The last character of the date-ofmanufacture code gives the month in which the product was manufactured. The month appears
in the form of a single alphanumeric character: “A” for January, “B” for February, “C” for
March, and so on through “L” for December.
The product serial number is a unique set of alphanumeric characters that ZOLL assigns to each
individual unit.
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Chapter 2
Product Overview
This chapter provides an overview of the Propaq M unit’s features, controls, and indicators. It
provides illustrations of the Propaq M unit both with and without the optional printer.
9650-000820-01 Rev. K Propaq M Operator’s Guide 2-1
Chapter 2 Product Overview
2
1
4
6
7
3
5
4
8
Propaq M Controls and Indicators
Item Description
1 Handle Integrated carrying handle.
2 Front panel Includes the display screen and primary controls.
3 Speaker Emits R-wave detection beeps and alarm tones.
4 Patient connectors For details, refer to “Patient Cables and Connectors” on
page 2-8.
5 USB device connector For connecting the Propaq monitor to a USB device. For
details, refer to “Transferring Data to a USB Device” on
page 14-3“.
6 Battery compartment Holds a rechargeable lithium ion battery pack.
7 Auxiliary power connector For connecting the device to an auxiliary power adapter.
8 Dock connector For connecting the device to a docking station.
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