ZOLL Propaq MD User Manual

Propaq® MD Operator’s Guide

9650-0805-01 Rev. A

The issue date for the Propaq MD Operator's Guide (REF 9650-0805-01 Rev. A) is March, 2012.

0197

ZOLL Medical Corporation

269 Mill Road Chelmsford, MA USA 01824-4105

ZOLL International Holding B.V.

Newtonweg 18 6662 PV ELST The Netherlands

If more than 3 years have elapsed since the issue date, contact ZOLL Medical Corporation to det ermine if additional product information updates are available.

Copyright © 2012 ZOLL Medical Corporation. All righ ts reserved. pedi-padz, Rectilinear Biphasic, stat-padz, SurePower, and ZOLL are trademarks or registered trademarks of ZOLL Medical Corporation in the United States and/or other countries.

Propaq, Smartcuf, and SureBP are trademarks or registered trademarks of Welch Allyn or its subsidiaries in the United States and/or other countries.

Nellcor and OxiMax are trademarks or registered trademarks of Covidien in the United States and/or other countries.

Oridion, Microstream, FilterLine, and CapnoLine are trademarks or registered trademarks of Oridion Systems, Ltd. in the United States and/or other countries.

Table of Contents

Ch a p t e r 1 General Information

Product Description ............................................................................................................1-1

Propaq MD 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 MD Indications for Use...........................................................................................1-6

Manual Defibrillation ...................................................................................................1-7

ECG Monitoring ..........................................................................................................1-7

External Transcutaneous Pacing ................................................................................1-7

Non-Invasive Blood Pressure Monitoring ...................................................................1-7

Temperature Monitoring .............................................................................................1-8

SpO2 Monitoring .........................................................................................................1-8

Respiration Monitoring ................................................................................................1-8

CO2 Monitoring ...........................................................................................................1-8

Invasive Pressure Monitoring .....................................................................................1-8

Propaq MD Product Functions............................................................................................1-9

Defibrillator Function ...................................................................................................1-9

Defibrillator Output Energy .........................................................................................1-9

External Pacemaker ...................................................................................................1-9

ECG Monitoring ..........................................................................................................1-9

Electrodes .................................................................................................................1-10

Batteries ....................................................................................................................1-10

Ready For Use (RFU) Indicator ................................................................................1-12

Safety Considerations.......................................................................................................1-13

Warnings...........................................................................................................................1-13

General ..................................................................................................................... 1-13

ECG Monitoring ........................................................................................................1-14

Defibrillation .............................................................................................................. 1-15

Pacing ....................................................................................................................... 1-16

Pulse Oximeter .........................................................................................................1-17

Noninvasive Blood Pressure .....................................................................................1-18

IBP ............................................................................................................................1-18

CO2 ..........................................................................................................................1-19

Respiration ................................................................................................................1-19

Ferromagnetic Equipment ........................................................................................1-19

Battery ......................................................................................................................1-19

Operator Safety ........................................................................................................1-20

Patient Safety ...........................................................................................................1-21

Cautions............................................................................................................................1-22

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Restarting the Defibrillator................................................................................................1-23

FDA Tracking Requirements.............................................................................................1-23

Notification of Adverse Events ..................................................................................1-24

Software License..............................................................................................................1-24

Service..............................................................................................................................1-25

The ZOLL Serial Number..................................................................................................1-26

Ch a p t e r 2 Product Overview

Defibrillator Controls and Indicators....................................................................................2-1

The Front Panel ..........................................................................................................2-2

Display Screen ............................................................................................................2-4

Battery Status and Auxiliary Power Indicators ............................................................2-6

Patient Cables and Connectors ..................................................................................2-7

External Paddles .........................................................................................................2-9

Auxiliary Power Adapter ...........................................................................................2-11

Navigating the Display Screen..........................................................................................2-12

Quick Access Keys ...................................................................................................2-12

Navigation Keys .......................................................................................................2-15

Display Brightness ....................................................................................................2-15

Common Tasks.................................................................................................................2-16

Changing the Display Brightness ..............................................................................2-16

Replacing a Battery Pack on the Propaq MD ...........................................................2-16

Using Treatment Buttons ..........................................................................................2-17

Ch a p t e r 3 Monitoring Overview

Propaq MD 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.................................................................................................3-3

Configuring the Waveform Display.....................................................................................3-7

Chapter 4 Trends

Displaying the Trends Status Window ................................................................................4-1

Displaying and Printing Trend Information..........................................................................4-2

Changing the Trends Status Window Display.....................................................................4-3

Continuous Waveform Recording ...............................................................................4-3

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Chapter 5 Alarms

Visual Alarm Indicators.......................................................................................................5-1

Audible Alarm Indicators.....................................................................................................5-2

Alarm Indicator Self-Test.....................................................................................................5-2

Patient Alarm Display .........................................................................................................5-3

Equipment Alert Display .....................................................................................................5-3

Responding to Active Alarms -- Silencing the Alarm..........................................................5-4

Re-enabling an Alarm .................................................................................................5-5

Suspending Alarms.............................................................................................................5-5

The Alarm Suspension Timer .....................................................................................5-6

Alarm Options.....................................................................................................................5-7

Selecting Default Alarm Limits ....................................................................................5-8

Setting Alarm Limits Relative to the Patient -- Stat Set Option ...................................5-8

Ch a p t e r 6 Monitoring ECG

ECG Monitoring Setup........................................................................................................6-2

Preparing the Patient for Electrode Application ..........................................................6-2

Applying Electrodes to the Patient ..............................................................................6-3

Connecting the ECG Cable To the Propaq MD Unit ...................................................6-5

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

Ch a p t e r 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 ............................................7-6

Using the Heart Rate Parameter Control Panel ..........................................................7-7

Ch a p t e r 8 Monitoring Non-Invasive Blood Pressure (NIBP)

............................................................................................................................................8-2

How does NIBP Work?.......................................................................................................8-2

The NIBP Numeric Display.................................................................................................8-3

NIBP Setup and Use...........................................................................................................8-3

Selecting the NIBP Cuff......................................................................................................8-4

Connecting the NIBP Cuff...................................................................................................8-6

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Applying the Cuff to the Patient..........................................................................................8-8

Ensuring Correct Cuff Inflation Settings..............................................................................8-9

Configuring NIBP Alarms and Settings.............................................................................8-10

Enabling/Disabling NIBP Alarms and Setting Alarm Limits ......................................8-10

Using the NIBP Parameter Control Panel .................................................................8-12

NIBP System Messages...................................................................................................8-15

Chapter 9 Monitoring Pulse Oximetry (SpO2)

Warnings -- SpO2, General.................................................................................................9-2

Warnings -- SpO SpO

Setup and Use ..........................................................................................................9-3

Selecting the SpO Applying the SpO

Applying a Reusable SpO

, Oximeter Sensor...................................................................................9-2

Sensor.................................................................................................9-3

Sensor..................................................................................................9-3

Sensor .............................................................................9-4

Applying a Single-Use Sensor .................................................................................... 9-5

Connecting the SpO Displaying SpO Enabling/Disabling SpO

Sensor..............................................................................................9-6

Measurements.........................................................................................9-7

Alarms and Setting Alarm Limits................................................9-7

Setting Upper and Lower Systolic Alarm Limits ..........................................................9-8

Using the SpO

Parameter Control Panel ..........................................................................9-8

Selecting the Heart Rate/ Pulse Rate (HR/PR) Tone .................................................9-9

SpO

System Messages.....................................................................................................9-9

Functional Testers and Patient Simulators .......................................................................9-10

Chapter 10 Monitoring CO2

Overview...........................................................................................................................10-1

CO2 Monitoring Setup and Use........................................................................................10-2

Selecting the CO2 Sampling Line .............................................................................10-3

Connecting the CO2 Sampling Lines ........................................................................10-4

Applying a FilterLine Set ...........................................................................................10-5

Applying a Smart CapnoLine Nasal or Nasal/Oral Cannula .....................................10-6

Measuring CO2.................................................................................................................10-7

Setting CO2 and Respiration Rate Alarms.......................................................................10-8

Enabling/Disabling Alarms and Setting CO2 Alarm Limits .......................................10-8

Using the CO2 Parameter Control Panel ................................................................10-10

System Messages ..........................................................................................................10-11

Patents............................................................................................................................10-12

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Chapter 11 Monitoring Invasive Pressures (IBP)

Invasive Pressure Transducers........................................................................................ 11-1

IBP Setup..........................................................................................................................11-2

Attaching the Invasive Pressure Transducer.................................................................... 11-2

Zeroing the Transducer.............................................................................................. .......11-3

Rezeroing a Transducer................................................................................................... 11-4

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

Ch a p t e r 1 2 Monitoring Temperature

Te mperature Monitoring Setup .........................................................................................12-1

Selecting and Applying Temperature Probes....................................................................12-1

Connecting the Temperature Probe..................................................................................12-2

Displaying Temperature....................................................................................................12-2

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

Te mperature System Messages .......................................................................................12-5

Ch a p t e r 1 3 Monitoring 12-Lead ECG

Entering Patient Information.............................................................................................13-2

Entering the Patient Name and ID ............................................................................13-3

Entering Patient Age and Gender .............................................................................13-4

12-Lead ECG Monitoring Setup........................................................................................13-4

Preparing the Patient for Electrode Application ........................................................13-4

Applying Electrodes to the Patient ............................................................................13-5

Connecting the 12-Lead Cable .................................................................................13-7

Observing the 12-Lead Waveform Traces ................................................................13-8

Printing 12-Lead Waveform Traces ..................................................................................13-9

12-Lead Print and Display Options.................................................................................13-10

Selecting 12-Lead Acquire ......................................................................................13-10

Specifying the Number of 12-Lead Print Copies .....................................................13-10

Specifying the 12-Lead Print Format ......................................................................13-11

Printing 10 Seconds of the Lead ll Waveform Trace ..............................................13-11

Specifying the 12-Lead Frequency Response ........................................................13-11

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Chapter 14 Manual Defibrillation

Emergency Defibrillation Procedure with Paddles............................................................14-1

Determine the Patient’s Condition Following Local Medical Protocols .....................14-2

Begin CPR Following Local Medical Protocols .........................................................14-2

Turn Unit On .............................................................................................................14-2

1 Select Energy Level ...............................................................................................14-2

2 Charge Defibrillator ................................................................................................14-3

3 Deliver Shock .........................................................................................................14-4

Emergency Defibrillation Procedure with Hands-Free Therapy Electrodes......................14-5

Determine the Patient’s Condition Following Local Medical Protocols .....................14-5

Begin CPR Following Medical Protocols ..................................................................14-6

Prepare Patient .........................................................................................................14-6

Turn Unit On .............................................................................................................14-6

1 Select Energy Level ...............................................................................................14-7

2 Charge Defibrillator ................................................................................................14-7

3 Deliver Shock .........................................................................................................14-8

Internal Paddles................................................................................................................14-9

Verification Prior to Use ............................................................................................14-9

Synchronized Cardioversion...........................................................................................14-10

Synchronized Cardioversion Procedure......................................................................... 14-11

Determine the Patient’s Condition and Provide Care Following Local Medical

Protocols ..............................................................................................................14-11

Prepare Patient .......................................................................................................14-11

Turn the Unit On .....................................................................................................14-11

Press the Sync Key ................................................................................................14-11

1 Select Energy Level .............................................................................................14-12

2 Charge Defibrillator ..............................................................................................14-12

3 Deliver Shock .......................................................................................................14-13

Chapter 15 External Pacing

External Pacing.................................................................................................................15-2

Pacer Modes .............................................................................................................15-2

Pacing in Demand Mode ..................................................................................................15-2

Determine Patient Condition and Provide Care Following Local Medical Protocols. 15-2

Prepare the Patient ...................................................................................................15-2

1 Turn Unit On ..........................................................................................................15-2

2 Apply ECG Electrodes/Hands-Free Therapy Electrodes .......................................15-2

3 Press Pacer button ................................................................................................15-3

4 Set Mode ...............................................................................................................15-3

5 Set Pacer Rate ......................................................................................................15-4

6 Turn Pacer On .......................................................................................................15-4

7 Set Pacer Output ...................................................................................................15-4

8 Determine Capture ................................................................................................15-4

9 Determine Optimum Threshold ..............................................................................15-5

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Pacing in Fixed Mode .......................................................................................................15-5

1 Turn Unit On ..........................................................................................................15-5

2 Apply ECG Electrodes/Hands-Free Therapy Electrodes .......................................15-5

3 Press Pacer button ................................................................................................15-6

4 Set Mode ...............................................................................................................15-6

5 Set Pacer Rate ......................................................................................................15-7

6 Turn Pacer On .......................................................................................................15-7

7 Set Pacer Output ...................................................................................................15-7

8 Determine Capture ................................................................................................15-7

9 Determine Optimum Threshold ..............................................................................15-8

Pediatric Pacing ........................................................................................................15-8

Chapter 16 Patient Data

Storing Data......................................................................................................................16-1

Capturing a Data Snapshot...............................................................................................16-2

Reviewing and printing snapshots ............................................................................16-2

Treatment Summary Report.............................................................................................16-2

Printing Treatment Summary Report ........................................................................16-3

Transferring Data to a USB Device...................................................................................16-3

Clearing the Log .......................................................................................................16-4

Chapter 17 Printing

Printing Patient Data.................................................................................................. .......17-1

Printer Setup .............................................................................................................17-2

Automatic Prints ........................................................................................................17-2

Printing Waveforms ..................................................................................................17-2

Printing Reports ........................................................................................................17-3

Printing Trends ....................................................................................... ........... .......17-4

Chapter 18 Maintenance

Daily/Shift Check Procedure.............................................................................................18-2

Inspection .................................................................................................................18-2

Defibrillator/Pacing Test with Hands-Free Therapy Electrodes.........................................18-3

Defibrillator Te sting with External Paddles........................................................................18-5

Recommended Minimum Preventive Maintenance Schedule..........................................18-7

Annually .................................................................................................................... 18-7

Guidelines for Maintaining Peak Battery Performance.....................................................18-7

Cleaning instructions ........................................................................................................18-8

Cleaning the Propaq MD unit ....................................................................................18-8

Cleaning the NIBP Blood Pressure Cuff ...................................................................18-8

Cleaning SpO2 Sensors ...........................................................................................18-9

Cleaning Cables and Accessories ............................................................................18-9

Loading Recorder Paper ...........................................................................................18-9

Cleaning the Print Head ..........................................................................................18-10

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Ap p e n d i x A Specifications

Defibrillator..........................................................................................................................A-2

Monitor/Display.................................................................................................................A-14

Impedance Pneumography...............................................................................................A-15

Alarms...............................................................................................................................A-16

Recorder...........................................................................................................................A-17

Battery .............................................................................................................................A-17

General.............................................................................................................................A-18

Pacer ................................................................................................................................A-19

CO2 ..................................................................................................................................A-19

Pulse Oximeter.................................................................................................................A-20

Non-Invasive Blood Pressure...........................................................................................A-21

Invasive Pressures ...........................................................................................................A-22

Te mperature......................................................................................................................A-22

Clinical Trial Results for the Biphasic Waveform ..............................................................A-23

Randomized Multicenter Clinical Trial for Defibrillation of Ventricular Fibrillation

(VF) and Ventricular Tachycardia (VT) ...................................................................A-23

Randomized Multi-Center Clinical trial for Cardioversion of

Atrial Fibrillation (AF) ..............................................................................................A-24

Synchronized Cardioversion of Atrial Fibrillation ......................................................A-26

Electromagnetic Compatibility Guidance and Manufacturer’s Declaration.......................A-27

Appendix B Accessories

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Product Description

The ZOLL® Propaq® MD unit is an easy-to-use portable defibrillator that combines defibrillation and external pacing with the following monitoring capabilities: ECG, Pulse Oximeter, Non-invasive Blood Pressure, IBP, CO2, 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 recharge d in the device when it is connected to aux iliary power . In addit ion, the unit’s battery may be recharged and tested using a ZOLL SurePower™ Battery Charger Station.

Note: The Propaq MD has defibrillation and pacing functionality , but some of the monitoring

functions are optional features. See the complete list of options in Fig. 1-1. Optional

features are specified as “optional” within this guid e. 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. The Propaq MD includes a transcutaneous pacemaker consisting of a pulse generator and ECG sensing circuitry . Pacing supports both deman d and fixed noninvasive pacing for adult patients and adolescent, child, and infant pediatric patients.

Chapter 1

General Information

The Propaq MD has a patient data review and collection system that allows you to view, store, and transfer patient data. The Propaq MD unit contains a printer and USB po rt , whi ch you can use to print the data and transfer it to a PC.

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CHAPTER 1GENERAL INFORMATION

Propaq MD Optional Features

The following features are optional in the Propaq MD unit.

Figure 1-1 Propaq MD Optional Features

Optional Feature

12 Lead ECG

(NellcorTM)

SpO

NIBP (with Smartcuf EtCO2 (Oridion

Temperature Invasive Pressures (3 Channels) Printer

and SureBPTM)

Microstream®)

How to Use This Manual

The Propaq MD Operator's Guide provides information operators need for the safe and effective use and care of the Propaq MD 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 18, "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 defibrillator does n ot pass its electrical self-t est, 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

Dangerous voltage.

Attention, consult accompanying documents.

Fragile, handle with care.

Keep dry.

This end up.

Symbols Used on the Equipment

Temperature limitation.

Conformité Européenne Complies with medical device directive 93/42/EEC.

Type B patient connection.

Type BF patient connection.

Type CF patient connection.

Defibrillator-proof type BF patient connection.

Defibrillator-proof type CF patient connection.

Fusible link.

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CHAPTER 1GENERAL INFORMATION

2%452.

,I)/.

RECYCLE

,I)/.

Symbol Description

Equipotentiality.

Alternating current (ac).

Direct current (dc).

Auxiliary power adapter operation.

Caution, high voltage.

Earth (ground).

Negative input terminal.

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.

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Symbol Description

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.

Symbols Used on the Equipment

Do not fold.

Not sterile.

Manufacturer.

Authorized representative in the European Community.

Serial Number.

Catalogue number.

Consult instructions for use.

Prescription only.

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CHAPTER 1GENERAL INFORMATION

Symbol Description

Battery charging status.

Do not use device, cables, or probes in an MRI environment.

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 Charge button or press the Pacer button”). This guide uses uppercase italics for audible prompts and for text messages displayed on the

screen (for example, LEAD FAULT).

War ning ! Warning statements alert yo u to cond itions o r actio ns 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 MD Indications for Use

The Propaq MD is intended for use by trained medical personnel who are familiar with basic monitoring, vital sign assessment, emergency cardiac care and the use of the Propaq MD. The Propaq MD 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 MD will be used primarily on patients experiencing symptoms of cardiac arrest or in post trauma situation. It may also be used whenever it is required to monitor any of th ose functions that are included (as options) in the device. The Propaq MD 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.

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When the pediatric patient is less than 8 years of age or weighs less than 55 lbs. (25 kg.), use ZOLL pedi-padz

patient’s exact age or weight.

Manual Defibrillation

Use of the Propaq MD in the manual mode for external and internal defibrillation is indicated on victims of cardiac arrest wher e there is apparent lack of circulation as indicated by:

• Unconsciousness.

• Absence of breathing.

• Absence of pulse.

This product should be used only by qualified medical personnel for converting ventricular fibrillation and rapid ventricular tachycardia to sinus rhythm or other cardiac rhythms capable of producing hemodynamically significant heart beats.

The unit can also be used for synchronized cardioversion of certain atrial or ventricular arrhythmias. Qualified medical personnel must decide when synchronized cardioversion is appropriate.

The patient population will range from newborn (neonate) to adul t.

Propaq MD Indications for Use

pediatric defibrillation electrodes. Do not delay therapy to deter m ine the

ECG Monitoring

The Propaq MD 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.

External Transcutaneous Pacing

This product can be used for temporary external cardiac pacing in conscious or unconscious patients as an alternative to endocardial stimulation.

The purposes of pacing include:

• Resuscitation from standstill or bradycardia of any etiology:

• As a standby when standstill or bradycardia might be expected:

• Suppression of tachycardia.

• Pediatric pacing.

Non-Invasive Blood Pressure Monitoring

The Propaq MD is intended for use to make no n-invasive measurement s 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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CHAPTER 1GENERAL INFORMATION

Temperature Monitoring

The Propaq MD 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 MD is intended for use to monitor pulse rate and oxygen saturation of arteriolar hemoglobin, and to alarm if either parameter is outside of the limits set by the user. Measurements are made non-invasively at remote sites such as a finger, toe, ear lobe, bridge of nose, etc. The patient population will range from newborn (neonate) to adult.

Respiration Monitoring

The Propaq MD is intended for use to continuously monitor respiration rate an d to ala r m 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.

CO2 Monitoring

The Propaq MD is intended for use to make continuous noninvasive measurement and monitoring of carbon dioxide concentration of the expired and inspired breath and breat h rate. The patient population will range from newborn (neonate) to adult.

Invasive Pressure Monitoring

The Propaq MD 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.

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Propaq MD Product Functions

Defibrillator Function

The Propaq MD contains a direct current (dc) defibrillator capable of delivering up to 200 joules. It may be used in synchronized mode to perform synchronized cardioversion using the patient’s R-wave as a timing reference. The unit uses paddles or disposable, pregelled electrodes for defibrillation.

Defibrillator Output Energy

Propaq MD defibrillators can deliver biphasic energy from 1 joule to 200 joules. The energy delivered through the chest wall, however, is determined by the patient’s transthoracic impedance. An adequate amount of e lectrolyte gel mu st be applied t o the paddles and a force of 10 to 12 kilograms (22 to 26.4 pounds) must be applied to each paddle in order to minimize this impedance. If hands-free therapy electrodes are used, make sure that they are properly applied. (Refer to the instructions on the electrode package).

Propaq MD Product Functions

External Pacemaker

Propaq MD defibrillators include a transcutaneous pacemaker consisting of a pulse generator and ECG-sensing circuitry. Noninvasive transcutaneous pacing (NTP) is an established and proven technique. This therapy is easily and rapidly applied in both emergency and nonemergency situations when temporary cardiac stimulation is indicated.

The output current of the pacemaker is continuously variable from 10 to 140 mA (the output current is 0 mA when paused). The rate is continuously variable from 30 to 180 pulses per minute (ppm), by increments of 5 ppm (10 bpm when greater than 100 ppm).

The pacing output pulse is delivered to the heart via ZOLL hands-free defibrillation/pacing electrodes placed on the patient’s back and the precordium.

Proper operation of the device, together with correct electrode placeme nt, is critical to obtaining optimal results. Every operator must be thoroughly familiar with these operating instructions.

ECG Monitoring

The patient’s ECG is monitored by connecting the patient to the unit via a 3-, 5-, or 12-lead patient cable or hands-free therapy electrodes. 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),

PADDLES, or PADS.

• 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.

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Electrodes

The Propaq MD will defibrillate, cardiovert, and monitor ECG using hands-free therapy electrodes. The Propaq MD will pace using ZOLL hands-free therapy electrodes.

Energy Select, Charge and Shock controls are located on the paddles and front panel. When using hands-free therapy electrodes, you must use the controls on the front panel of the unit. To switch between paddles and hands-free therapy electrodes, remove the multifunction cable (MFC) from the apex paddle and connect the hands-free therapy electrodes to the cable.

You should always check the expiration date on the electrode packaging. Do not use expired electrodes, which might result in false patient impedance readings and affect the level of delivered energy, or cause burns.

This symbol on the electrode package is accompanied by the expiration date. For stat-padz® II, this symbol does not appear; the expiration date appears on the

lower right corner of the label, below the lot number.

Note: ZOLL electrodes contain no hazardous materials and may be disposed of in general

trash unless contaminated with pathogens. Use appropriate precautions when

disposing of contaminated electrodes.

Batteries

Propaq MD 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 6 hours of ECG monitoring. Use of other functions (such as the defibrillator, printer, or pacemaker) 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 MD 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.

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Propaq MD Product Functions

• External charging — use the ZOLL SurePower™ Battery Charger with the Propaq MD

battery adapter 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 calibra ted. If the Recalibrat ion 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 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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CHAPTER 1GENERAL INFORMATION

Ready For Use (RFU) Indicator

The Propaq MD has an RFU indicator on the front panel that indicate s if the device is ready for use. The RFU indicator has three states which are described in the following table.

State Description Action

Ready for Use The device is ready for use. Patient

monitoring, defibrillation, and pacing parameters are 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, SpO2, CO2, IBP, or Temp).

• The front panel button self-test failed.

• The speech database self-test failed.

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, defibrillator, or pacer selftests 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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Safety Considerations

All operators should review these safety considerations before using the Propaq MD unit. Propaq MD units are high-energy defibrillators capable of delivering 200 joules. To completely

deactivate the unit, press the power switch to turn the unit off. To manually disarm a charged (or charging) defibrillator, do one of the following:

• Press the Disarm quick access key .

• Change the selected energy.

• Press the power switch to turn the unit off.

For safety , the Propaq MD a utomatically disarms i f left char ged for more than 60 seconds if the shock button ( ) is not pressed.

Warnings

General

Federal (U.S.A.) law restricts this defibrillator to sale by or on the order of a physician.

Safety Considerations

Only appropriately trained, skilled personnel who are familiar with equipment operation should perform emergency defibrillation. The prescribing physician should determine what training, such as Advanced Cardiac Life Support (ACLS) or Basic Life Support (BLS) certification, is appropriate.

Only skilled personnel trained in Advanced C ardiac Life Support (ACLS) and who are familiar with equipment operation should perform synchronized cardioversion. The precise cardiac arrhythmia must be determined before attempting defi bril lat io n.

These operating instructions describe the functions and proper operation of the Propaq MD 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 defibrillator 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.

The use of external pacing/defibrillation electrodes, accessories, or adapter devices from sources other than ZOLL is not recommended. ZOLL makes no representations or warranties regarding the performance or effectiveness of its products when used with pacing/defibrillation electrodes or adapter devices from other sources. Defibrillator failures attributable to the use of pacing/defibrillation electrodes or adapters not manufactured by ZOLL might void ZOLL’s warranty.

At receipt of shipment, check pacing/defibrillation electrodes to ensure compatibility. 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 defibrillator until it has been inspected by appropriate personnel.

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CHAPTER 1GENERAL INFORMATION

The Propaq MD 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 unit should not be stored or used outside of the environmental limits p rovided in Appendix A of this manual.

Avoid using the Propaq MD adjacent to, or stacked on, other equipmen t. If unav oidab le, verify that the unit operates normally in this configuration before clinical use.

The Propaq MD should be installed and put into service according to the EMC information in Appendix A of this manual.

Do not use internal paddles while the Propaq MD auxiliary power source is connected to an aircraft AC power operating at a frequency of 400 Hz.

The use of accessories, transducers, and cables other than those specified in this manual and related Propaq MD option manual inserts may result in increased emissions or decreased immunity of the Propaq MD.

Perform functional test of internal paddles prior to use. 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 cabl es to avoid tri pping over the m, or inadverte ntly pulli ng 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.

ECG Monitoring

Implanted pacemakers might cause the heart rate meter to count the pac emak er 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-15 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.

Prior to attempting synchronized cardioversion, ensure the ECG signal quality is good and that sync markers are displayed above each QRS complex.

Do not place electrodes directly over an implanted pacemaker. The Propaq MD 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 pat ient has a pulse.

Excessive artifact can result due to improper skin preparation of the electrode site s. Follow skin preparation instructions in Chapter 6: “Monitoring ECG.”

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Equipment such as electrocautery or diathermy equipment, RFID readers, electronic ar ticle 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.

Monitoring ECG through the paddles may result in inaccurate heart rate display due to artifact.

Defibrillation

The ZOLL Propaq MD can deliver 200 joules of electrical energy . If this electrical ener gy is not discharged properly, as described in the this manual, the electrical energy could cause persona l injury or death to the operator or bystander.

To avoid possible damage to the Propaq MD unit, turn off pacing before defibrillating the patient with a second defibrillator.

Warnings

After a synchronized cardioversion, the SYNC mode may be cleared after each shock or disarm. The user may have to reselect (press) the SYNC button after each synchronized cardioversion shock performed on a patient. In Defib/Pacer Default settings in the Supervisor Setup menu, the Propaq MD can be configured to remain in the SYNC mode after each synchronized cardioversion.

Synchronized cardioversion can be performed in the paddle monitoring mode. However, it is possible that artifact can be produced by the moving paddles, which could cause the defibrillator to trigger on the artifact. It is recommended that monitoring in leads I, II or III be used during synchronized cardioversion. Paddle monitoring should not be used for elective cardioversions procedures.

To avoid stress to the defibrillator or the tester, never attempt to repeatedly charge and discharge the defibrillator in rapid succession. If a need for repetitive testing arises, allow a waiting period of at least 2 minutes after every third discharge.

In the SYNC mode, the defibrillator does not discharge without a command signal (R-w ave detection) from the ECG monitor indicate d by a SYNC marker on the trace and a flashing SYNC indicator.

If conductive gel forms a continuous path between the defibrillator electrodes, delivered energy may be dramatically reduced to zero. In this case, reposition the electrodes to eliminate the shunting path before attempting additional shocks.

Improper defibrillation technique can cause skin burns. To limit possible skin burns, use only ZOLL defibrillation gel on paddles, ensure the gel covers the entire paddle surface and press firmly against patient’s chest.

If a new energy level is selected after the CHARGE button is pushed and while the defibrillator is charging or charged, the defibrillator will disarm. The CHARGE button will need to be pressed again to charge to the new energy level.

Prior to defibrillation, disconnect from the patient any medical electronic device that is not labeled “defibrillation protected.”

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CHAPTER 1GENERAL INFORMATION

Before charging the defibrillator, verify that the energy selected on the display is the desired output.

Defibrillation takes priority over external pacing. Should the defibrillator be charged during the administration of external pacing, the pacer turns off and the defibrillator charges to the selected energy.

Pacing

Ventricular fibrillation does not respond to pacing and requires immediate defibrillation. Therefore, the patient’s dysrhythmia must be determined immediately, so that you can employ appropriate therapy . If t he patient is in ventricula r fibrillation and defibrilla tion is successful but cardiac standstill (asystole) ensues, you should use the pacemaker.

Ventricular or supraventricular tachycardias can be interrupted with pacing, but in an emergency or during circulatory collapse, synchronized cardioversion is faster and more certain.

Pulseless electrical activity (PEA) can occur following prolonged cardiac arrest or in other disease states with myocardial depression. Pacing might then produce ECG responses wi th out effective mechanical contractions, making other effective treatment necessary.

Pacing can evoke undesirable repetitive resp onses, tachycardia, or fibrillation in the presence of generalized hypoxia, myocardial ischemia, cardiac drug toxicity, electrolyte imbalance, or other cardiac diseases.

Pacing by any method tends to inhibit intrinsic rhythmicity. Abrupt cessation of pacing, particularly at rapid rates, can cause ventricular standstill and should be avoided.

Noninvasive temporary pacing can cause discomfort of varying intensity, which occasionally can be severe and preclude its continued use in conscious patients.

Similarly, unavoidable skeletal muscle contraction might be troublesome in very sick patients and might limit continuous use to a few hours. Erythema or hyperemia of the skin under the hands-free therapy electrodes often occurs; this effect is usually enhanced along the perimeter of the electrode. This reddening should lessen substantially withi n 72 hours.

There have been reports of burns under the anterior electrode when pacing adult patients with severely restricted blood flow to the skin. Prolonged pacing should be avoided in these cases and periodic inspection of the underlying skin is advised.

There are reports of transient inhibition of spontaneous respiration in unconscious patients with previously available units when the anterior electrode was placed too low on the abdomen.

The pacing rate determination can be adversely affecte d by arti fact. If the patient’s pulse and the heart rate display are sig nificantly different, external pacing pulses may not be delivered when required.

Artifact and ECG noise can make R-wave detection unreliable, affecting the HR meter and the demand mode pacing rate. Always observe the patient closely during pacing operations. Consider using asynchronous pacing mode if a reliable ECG trace is unob tai nab le .

Transcutaneous pacing should not be used to treat V FIB (ventricular fib rillation). In cases of V FIB, immediate defibrillation is advised.

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Warnings

Transcutaneous pacing may cause discomfort ranging from mild to severe, depending on the patient’s tolerance level, muscle contractions and electrode placement. In certain cases, discomfort may be decreased by slightly relocating the pacing pads.

It is important to monitor the patient closely to verify that both mechanical and electrical capture are occurring. Electrical capture can be verified by observing the presence of a large ectopic beat after the pacing pulse is delivered. The size and morphology of the beat are dependent on the patient. In some instances the be at may appe ar as a rel ati vel y normal looking QRS pulse. Mechanical capture can be verified by checking for signs of increased blood flow i.e., reddening of the skin, palpable pulses, increased blood pressure, etc. Continuously observe the patient during pacing administration , to insure capture retention. Do not leave the patient unattended when administering external pacing therapy.

Warning! This device can only be used for external pacing of patients and cannot be used for

internal pacing. Do not conn ect internal pacing lead wires to the Propaq MD defibrillator.

Pulse Oximeter

Keep the ZOLL finger probe clean and dry. SpO2 measurements may be affected by certain patient conditions: severe right heart failure,

tricuspid regurgitation or obstructed venous return. SpO

measurements may be affected when using intravascular dyes, in extreme

vasoconstriction or hypovolemia or under conditions where there is no pulsating arterial vascular bed.

SpO

measurements may be affected in the presence of strong EMI fields, electrosurgical

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 when the arterial circulation is cut off during NIBP measurements, and may affect SpO

sensor to the same limb that has an NIBP cuff. The SpO2 alarm may sound

measurements. 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.

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CHAPTER 1GENERAL 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.

IBP

Do not use a blood pressure cuff on the limb being used for IV infusion or for SpO 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 tak en while acc elera ting or decelera ting 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.

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.

monitoring.

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.

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Warnings

During MRI scanning, the monitor must be placed outside the MRI suite. When the monitor is used outside the MRI suite, EtCO which permits placement of the monitor outside the MRI suite.

When using the monitor with anesthetics, nitrous ox ide or high concentrations of oxygen, connect the gas outlet to a scavenger system.

monitoring can be implemented using a long FilterLine®

Use only Oridion Microstream CO Microstream CO

lines. If using the CO

or when it becomes occluded. CO

readings and respiratory rate can be affected by sensor application errors, certain ambient

environmental conditions, and certain patient co nd itions.

sampling lines are labeled for single patient use onl y. Do not reuse sampling

Monitor for extended critical care, replace the airway adapter every 24 hours

Respiration

Do not operate the Propaq MD 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 mu st no t be used in the presence of high magnetic fields created by magnetic resonance imaging (MRI) equipment.

sampling lines.

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 defibrillator at all times.

Test battery packs regularly. A battery that does not pass the ZOLL charger’s capacity test might cause the Propaq MD unit to shut down unexpectedly.

If the Low Battery indication occurs at any time during operation, immediately replace the battery pack.

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CHAPTER 1GENERAL INFORMATION

If the LOW BATTERY icon appears, plug the Propaq MD 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 char ged pack or plug the Propaq MD 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.

Operator Safety

The Propaq MD can deliver 200 joules of electrical energy. If this electrical energy is not discharged properly, as described in this manual, the electrical energy could cause personal injury or death to the operator or bystanders.

Do not use the Propaq MD 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 wh en the defibrillator is wet.

Never discharge the unit with the defibrillation electrodes or paddles shorted together or in open air.

Do not discharge the defibrillator except as indicated in the instructions. Discharge the defibrillator only when defibrillation electrodes or paddles are properly applied to the patient.

To avoid risk of electrical shock, do not touch the gelled area of the hands-free therapy electrodes during pacing or defibrillation.

T o avoid risk of electrical shock, do not allow electrolyte gel to accumulate on hands or paddle handles.

To avoid risk of electrical shock, do not allow pa tie nt connectors to contact other conductive parts, including earth.

For defibrillation using paddles, use only high-conductivi ty electrolyte gel specified for such use by the manufacturer.

When using paddles for defibrillation, use your th umb s to operat e th e SHOCK buttons. Doing so avoids inadvertent shock to the operator.

The use of accessory equipment that does not comply with the equivalent safety requirements of the Propaq MD defibrillator 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. Disconnect all electro-medical equipment that is not defibrillation-protected from the patient

prior to defibrillation. Before discharging the defibrillator, warn everyone to STAND CLEAR of the patient.

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