ZOLL R Series User Manual

Pulse Oximetry (SpO2)

9650-0901-01 Rev. DDecember 2008

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since this date, contact ZOLL Medical Corporation to determine if additional product information updates are
available.

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of ZOLL Medical Corporation. All other trademarks and registered trademarks are property of their respective
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Copyright © 2008 ZOLL Medical Corporation. All rights reserved.

Product Description

The R Series® pulse oximeter continuously and noninvasively measures the oxygen saturation
of arteriolar hemoglobin at a peripheral site (e.g., foot, toe, or finger). It is used to monitor
patients at risk of developing hypoxemia. SpO
circulatory and respiratory systems and supplies details of oxygen transportation in the body.
This option is widely used because it is noninvasive, co ntinuous, easily applied, and painless.

The oximeter sensor contains two emitters that transmit red and infrared light through the
monitored site. This light passes through t he patient’s tissues and is received by a photodetector
in the sensor. Because oxygen-saturated blood absorbs lig ht di f f erentl y tha n unsa tura ted b lood,
the amount of red and infrared light absorbed by blood flowing through the monitored site can
be used to calculate the ratio of oxygenated hemoglobin to total hemoglobin in arterial blood.
The monitor displays this ratio as percent SpO
100% at sea level.

Pulse Oximetry (SpO2)

monitoring provides information about the

2

. Normal values typically range from 95% to

2

The quality of SpO
sensor, adequate blood flow through the sensor site, and the sensor’s exposure to ambient light.
For correct placement and location of the sensors, refer to the Directions for Use contained in
all LNCS

®

oximetry sensor packages.

measurements depends on the correct size and application of the oximetry

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How to Use This Insert

This insert supplements your defibrillator’ s R Series Operator’s Guide and describes how to set
up, use, and maintain the R Series pulse oximeter. Keep this insert with your defibrillator’s
R Series Operator’s Guide and all other inserts for R Series options.

Your defibrillator’s R Series Operator’ s Guide provides informatio n that users need for the safe
and effective use and care of R Series products. Important safety information related to use of
the R Series pulse oximeter appears in “Safety Considerations” on page 3. Additional important
safety information is packaged with each oximetry sensor.

SpO2 Intended Use

The R Series pulse oximeter, with the Masimo® SET® technology and the LNCS series of
oximeter sensors, is indicated for the continuous noninvasive monitoring of functional oxygen
saturation of arterial hemoglobin (SpO

The R Series pulse oximeter is indicated for use with adult, pediatri c, and neonatal patients
during both no-motion and motion conditions, and for patie nts who are well or poorly perfused,
in hospitals, hospital-type facilities, and mobile environments.

) and pulse rate.

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9650-0901-01 Rev. D 1

R SERIES — PULSE OXIMETRY (SPO2) OPTION INSERT

Oxygen saturation measurements derived from pulse oximetry are highly dependent on patient
conditions and proper placement of the sensor. Patient conditions such as smoke inhalation
might result in erroneous oxygen sa turation readi ngs. If the a ccuracy of any reading is in doubt,
verify the reading using another clinically accepted method, such as arterial blood gas
measurements.

The R Series Pulse Oximetry option is intended for use only with ZOLL/Masimo LNCS
sensors.

Measurement Complications

If the accuracy of any reading is suspect, first check the patient’s vital signs by alternate means
and then check the R Series Pulse Oximeter for proper functioning.

Inaccurate measurements may be caused by:

• Incorrect sensor application or use.

• Significant levels of dysfunctional hemoglobins (for example, carboxyhemoglobin or

methemoglobin).

• Intravascular dyes, such as i ndocyanine green or methylene blue.

• Exposure to excessive illumination, such as surgical lamps (especially those with a xenon

light source), bilirubin lamps, fluorescent lights, infrared heating lamps, or direct sunlight.

• Excessive patient movement.

• Patient conditions, such as smoke inhalation.

• Venous pulsations.

• Certain nail aberrations, nail polish, fungus, and so on.

• Placement of a sensor on a limb with restricted blood flow , a blood pressure cuff, an arterial

catheter, or an intravascular line.

A weak pulse signal on the display might indicate a poorly applied sensor or a poorly chosen
monitoring site. Loss of pulse signal can occur when:

• The sensor is applied too tightly.

• There is excessive illumination from light sources, such as a sur gical lamp , a bilirubin lamp,

or sunlight.

• A blood pressure cuff is inflated on the limb used for the oximeter sensor.

• Excessive patient movement.

• The patient has hypotension, severe vasoconstriction, or hypothermia.

• An arterial occlusion exists proximal to the sensor.

• The patient is in cardiac arrest or shock.

SPO2 Connector and Sensors

The SpO2 connector is located on the rear panel of the R Series unit. Use only ZOLL or
Masimo accessories and sensors with the R Series Pulse Oximetry option.

Each sensor is designed for application to a specific anatomical site on pa tients within a cert ain
weight range. To ensure optimal performance, use an appropriate sensor, apply it as described
in the sensor’s Directions for Use, and always observe all warnings and cautions.

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Safety Considerations

Warnings

General

Carefully read your defibrillator’s R Series Operator’s Guide, these operating instructions, and
the Directions for Use that accompany the Masimo oximeter sensors.

Only qualified personnel should operat e the R Series pulse oximeter.
Do not use the pulse oximeter as an apnea monitor.
Do not immerse the R Series defibrillator, cables, or sensors in water, solvents, or cleaning

solutions.
Consider a pulse oximeter an early warning device. When a trend toward patient deoxygenation

is indicated, blood samples should be analyzed by a laboratory co-oximeter to completely
understand the patient’s condition.

If an alarm occurs while audible alarms are suspended, only visual alarm indicators are
provided.

Safety Considerations

Interfering substances: Carboxyhemoglobin and methemoglobin can erroneously alter SpO
readings. The level of change is approximately equal to the amount of carboxyhemoglobin or
methemoglobin present. Dyes or any substance containing dyes that alter arterial pigmentation
might cause erroneous readings.

Do not use the R Series pulse oximeter or oximeter sensors during magnetic resonance imaging
(MRI). Induced current could cause burns. The pulse oximeter might affect the MRI image and
the MRI unit might interfere with the accuracy of oximetry measurements.

Carefully arrange patient cabling to reduce the possibility of patient entanglement or
strangulation.

Use only the line cord supplied by ZOLL Medical Corporation for continued safety and EMC
performance.

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Oximeter sensors

Use only ZOLL/Masimo LNCS oximeter sensors. Other manufacturers’ senso rs might not
perform properly with the R Series oximeter.

Tissue damage can result from incorrect application or use of a sensor (for example, wrapping
the sensor too tightly, applying supplemental tape, failing to periodically inspect the sensor
site). To ensure skin inte grity, correct positioning, and sensor adhesion, inspect the sensor site
as directed in the Directions for Use provided with the sensor.

Do not use damaged sensors or cables.
Do not use a sensor with exposed optical components.
Do not sterilize a sensor by irradiation, steam, or ethylene oxide. Refer to the cleaning

instructions in the Directions for Use for reusable LNCS sensors.
Do not allow the sensor to remain on the same site for a prolonged period, especially when

monitoring neonates. Check the application site at regular intervals (at least every 2 hours) and
change the site if any compromise in skin quality occurs.

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R SERIES — PULSE OXIMETRY (SPO2) OPTION INSERT

Do not attach the oximeter sensor to a limb being monitored with a pressure cuff or with
restricted blood flow.

A poorly applied sensor might give incorrect saturation readings. A weak pulse signal on the
display might indicate a poorly applied sensor or a poorly chosen monitoring site.

Choose a site with sufficient perfusion to ensure accurate oximetry values.
Certain nail aberrations, nail polish, fungus, and so on might cause inaccurate oximetry

readings. Remove any nail polish or move the sensor to an unaffected digit.
Exposure to high ambient light from surgical lamps (especially those with a xenon light

source), bilirubin lamps, fluorescent lights, infrared heating lamps, or direc t sunlight can af fe ct
the accuracy of oximetry readings. To prevent interference from ambient light, ensure that the
sensor is properly applied. If necessary, cover the sensor with opaque material.

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