ZOE 740 SELECT User manual

21-22-0335 Rev D Page 1 of 40
740 SELECT™
Multi-Parameter Monitor
User Manual Addendum - ECG & Resp Parameters
This User Manual Addendum describes the features and operations of
the 740 SELECT Multi-Parameter monitor: Software Version 2.3 or above.

Overview 740 SELECT
21-22-0335 Rev D Page 2 of 40
1. Overview
TRADEMARKS
Trademarked names appear throughout this document. Instead of inserting a trademark symbol
with each mention of the trademarked name, the publisher states that it is using the names only
for editorial purposes and to the benefit of the trademark owner with no intention of improperly
using that trademark.
is a registered trademark of Zoe Medical, Inc.
740 SELECT ™
is a trademark of Zoe Medical, Inc.
Refer to the 740 SELECT User Manual, Zoe Medical PN 21-22-0316, for a list of trademarks.

Overview 740 SELECT
21-22-0335 Rev D Page 3 of 40
CONTACT ADDRESSES
Zoe Medical, Inc.
460 Boston Street
Topsfield, MA 01983 U.S.A.
Phone:
[phone]
Fax:
[phone]
E-Mail:
[e-mail]
Web:
www.zoemedical.com

Overview 740 SELECT
21-22-0335 Rev D Page 4 of 40
CONVENTIONS USED IN THIS MANUAL
Warning: Directions that warn of conditions that put the patient or the caregiver at risk.
Caution: Directions that help to avoid damaging the 740 SELECT monitor or losing data.
Note: Directions that make it easier to use the 740 SELECT monitor.
IMPORTANT:
Read the 740 SELECT User Manual, Zoe Medical PN 21-22-0316 carefully
before patient use of the Monitor.
This Manual addresses all optional ECG parameters of the 740 SELECT
monitor.
Read this Manual carefully before patient use of the Monitor.
Zoe Medical reserves the right to make changes to this Manual and improvements to
the product it describes at any time without notice or obligation.
Copyright ©2021 Zoe Medical. All rights reserved
REVISION HISTORY
This Manual has a revision number located at the bottom of each page. It changes whenever
the Manual is updated.
Rev A
October 2015
Rev B
March 2019
Rev C
April 2020
Rev D
October 2021
WARRANTY
Refer to the 740 SELECT User Manual, Zoe Medical PN 21-22-0316, for full Warranty Policy for
Zoe Medical 740 SELECT monitor. In all cases, policy applies from date of purchase from Zoe
Medical or its authorized distributors or agents.
ECG Accessories: Out-of-box failure only

Overview 740 SELECT
21-22-0335 Rev D Page 5 of 40
TABLE OF CONTENTS
1. Overview..............................................................................................................2
TRADEMARKS............................................................................................................2
CONTACT ADDRESSES.............................................................................................3
CONVENTIONS USED IN THIS MANUAL...................................................................4
REVISION HISTORY...................................................................................................4
WARRANTY ................................................................................................................4
2. INTENDED USE...................................................................................................8
INTENDED USE..........................................................................................................8
OVERVIEW OF HEART RATE MONITORING ............................................................8
OVERVIEW OF RESPIRATION RATE MONITORING ................................................9
PEDIATRIC CONSIDERATIONS.................................................................................9
3. ECG MONITORING............................................................................................10
WARNINGS...............................................................................................................10
CAUTIONS ................................................................................................................11
NOTES ......................................................................................................................11
GETTING STARTED WITH ECG...............................................................................12
CHECKING THE ECG SIGNAL .................................................................................15
ELECTRODE PLACEMENT ......................................................................................16
STANDARD PLACEMENT (AHA)..........................................................................16
STANDARD PLACEMENT (IEC) ...........................................................................16
PLACEMENT FOR PACED PATIENTS (AHA).......................................................17
PLACEMENT FOR PACED PATIENTS (IEC)........................................................17
VERIFYING PROPER PACEMAKER HANDLING .....................................................18
FREEZING WAVEFORMS.........................................................................................18
ECG SETUP..............................................................................................................19
ECG LEAD WAVEFORM.......................................................................................19
ECG SIZE..............................................................................................................19
SWEEP SPEED.....................................................................................................19
ECG CASCADE.....................................................................................................20
HR PARAMETER SETUP..........................................................................................21
HR ALARM LIMITS:...............................................................................................21
HR AUTO (set) ALARM LIMITS.............................................................................21
HR SOURCE .........................................................................................................22
ANALYZE PACERS...............................................................................................23
PULSE TONE........................................................................................................23
ECG LEAD.............................................................................................................23
SIZE.......................................................................................................................23
ECG FILTER..........................................................................................................24
CAL PULSE...........................................................................................................24
TESTING HR ALARMS..............................................................................................24
ECG AND HEART RATE MONITORING MESSAGES ..............................................25
4. RESPIRATION MONITORING...........................................................................26
WARNINGS...............................................................................................................26
NOTES ......................................................................................................................26
ENABLING DISPLAY OF RESPIRATION..................................................................27
GETTING STARTED WITH RESPIRATION...............................................................27
CHECKING THE RESPIRATION SIGNAL.................................................................27
FREEZING WAVEFORMS.........................................................................................28

Overview 740 SELECT
21-22-0335 Rev D Page 6 of 40
RESPIRATION SETUP..............................................................................................28
RESPIRATION WAVEFORM.................................................................................28
RR PARAMETER SETUP..........................................................................................29
RR ALARM LIMITS:...............................................................................................29
RR AUTO (set) ALARM LIMITS.............................................................................29
TESTING RR ALARMS..............................................................................................30
RESPIRATION RATE MONITORING MESSAGES....................................................31
5. ACCESSORIES..................................................................................................32
ECG - AAMI...............................................................................................................32
ECG - IEC..................................................................................................................33
6. DISPOSAL .........................................................................................................34
ACCESSORIES.........................................................................................................34
MONITOR..................................................................................................................34
GUIDANCE................................................................................................................34
7. MAINTENANCE .................................................................................................35
EQUIPMENT..............................................................................................................35
FUNCTIONAL TESTS................................................................................................35
8. CLEANING.........................................................................................................36
9. SPECIFICATIONS..............................................................................................37
ECG AND HR ............................................................................................................37
RESPIRATION AND RR............................................................................................38
PARAMETER ALARM LIMITS & SETTINGS.............................................................38

Overview 740 SELECT
21-22-0335 Rev D Page 7 of 40
TABLES
Table 1: HR Auto Alarm Limit Adjustment 21
Table 2: HR Monitoring Messages 25
Table 3: RR Auto Alarm Limit Adjustment 29
Table 4: Resp Monitoring Message 31
Table 5: AAMI ECG parts and accessories 32
Table 6: IEC ECG parts and accessories 33
Table 7: ECG - HR & RR Parameter Functional Test Steps 35
Table 8: ECG Accessory Cleaning Instructions 36
Table 9: ECG & HR Specifications 37
Table 10: Respiration & RR Specifications 38
Table 11: HR & RR Parameter Alarm Limit Ranges 38
Table 12: ECG, HR & RR Parameter Setting Ranges 39
FIGURES
Figure 1: ECG Patient Cable Receptacle on left side of Monitor 12
Figure 2: ECG Patient Cable connected on Monitor 13
Figure 3: ECG Lead Set connected on ECG Patient Cable Yoke 14
Figure 4: ECG Waveform section of Main screen 15
Figure 5: Standard AHA Electrode Placement 16
Figure 6: Standard IEC Electrode Placement 16
Figure 7: Paced AHA Electrode Placement 17
Figure 8: Paced IEC Electrode Placement 17
Figure 9: Waveform Frozen - Touch Area is under blue line 18
Figure 10: ECG Waveform Setup screen 19
Figure 11: ECG Cascade Enabled 20
Figure 12: HR Setup Menu 21
Figure 13: Analyze Pacers Enabled 23
Figure 14: ECG Cal Pulse 24
Figure 15: Setup Home Screen 27
Figure 16: RR Waveform and Numeric Value 27
Figure 17: Resp Waveform Setup screen 28
Figure 18: RR Setup Menu 29

INTENDED USE AND INTRODUCTION 740 SELECT
21-22-0335 Rev D Page 8 of 40
2. INTENDED USE
INTENDED USE
Full Indications for Use and Contraindications may be found in the 740 SELECT User
Manual, Zoe Medical PN 21-22-0316.
The 740 SELECT monitor facilitates the monitoring of:
ECG and heart rate (HR) with the ECG option for adult and pediatric patients;
Impedance pneumography to detect respiration rate (RR) or absence of respiratory effort
with the ECG option for adult, adolescent, child and infant patients.
The 740 SELECT monitor is a prescription device intended to be used by healthcare professionals
in all areas of a healthcare facility.
OVERVIEW OF HEART RATE MONITORING
ECG Monitoring works through the sensing the electrical signals generated by the electrical
activity of the heart as it beats. These signals are acquired from chest electrodes, and the 740
SELECT monitor amplifies the signals so they can be displayed on the screen. The patient’s heart
rate (HR) is calculated and continuously updated based on running average of the R to R
intervals between each QRS complex.
The ECG and HR monitoring capabilities of the 740 SELECT monitor include:
3-wire cable monitoring capabilities
Calculating the average heart rate (HR) in beats per minute
Detecting asystole and ventricular fibrillation
Pacer pulse detection
Generating an audible pulse tone for each detected beat

INTENDED USE AND INTRODUCTION 740 SELECT
21-22-0335 Rev D Page 9 of 40
OVERVIEW OF RESPIRATION RATE MONITORING
Respiration (Resp) monitoring works by measuring the impedance between the LL and RA
electrodes (or the R and F electrodes for IEC lead designations). The impedance changes as the
patient's chest expands and contracts during the breath cycle. To measure the changes in
impedance, the 740 SELECT monitor passes a very small, high-frequency current between the
electrodes. This current is too small to cause any harm to the patient or any interference with
ECG monitoring
The Respiration monitoring capabilities of the 740 SELECT monitor include:
Calculating the average Respiration Rate (RR) in respirations per minute
Displaying the Respiration waveform continuously
The same electrodes are used for both ECG and Respiration monitoring.
Note: A 740 SELECT monitor configured with capnography modules are also able to calculate
RR from the CO2waveform. In this case the Resp/RR feature from ECG is disabled.
Refer to User Manual Addendum - ETCO2Parameter, Zoe Medical PN 21-22-0333 for more
information.
PEDIATRIC CONSIDERATIONS
Cardiogenic artifact (heart rate pulsations that appear as "breaths" in the respiration signal) can
be quite pronounced in Pediatric patients. This can cause the respiration rate to be artificially high
(approaching the heart rate). To reduce cardiogenic artifact, move the White RA electrode (AHA
lead designation) or the Red R electrode (IEC lead designation) from the right clavicle down to
the right mid-clavical line, 4th intercostal space.

ECG MONITORING 740 SELECT
21-22-0335 Rev D Page 10 of 40
3. ECG MONITORING
Note: The following Warnings and Cautions are directed toward the ECG monitoring function.
Additional Warnings and Cautions for the 740 SELECT monitor are found in the 740 SELECT
User Manual, Zoe Medical PN 21-22-0316.
WARNINGS
Warning:The monitor is not intended for use in the following cases:
Apnea monitoring
In an MRI environment
Applications requiring automated arrhythmia detection
Applications requiring diagnostic-quality ECG
Warning: –DEFIBRILLATION. To avoid the possibility of serious injury or death during
patient defibrillation, do not come into contact with patient monitor or patient cables.
Additionally, proper placement of defibrillator paddles in relation to the ECG electrodes is
required to minimize harm to the patient. Only use accessories approved by Zoe Medical for
use with the monitor.
Warning: PACEMAKER PATIENTS. Rate meters may continue to count the pacemaker rate
during occurrences of cardiac arrest or some arrhythmias. Do not rely entirely upon heart rate
meter alarms. Keep pacemaker patients under close surveillance. See the Technical Data
chapter for disclosure of the pacemaker pulse rejection capability of this instrument.
Warning: PACEMAKER PATIENTS. When Analyze Pacers is disabled, the Heart Rate may
continue to count the pacemaker rate during occurrences of cardiac arrest. Keep pacemaker
patients under close surveillance and do not rely entirely upon Heart Rate alarms.
Warning: ELECTROSURGERY. The monitor is suitable for use in the presence of
electrosurgical (ESU) equipment. The following precautions should be taken:
To minimize the risk of patient burns, only use ESU equipment that monitors the
impedance of the ESU return wires.
Users should be properly trained in the operation of the ESU equipment.
Keep patient-applied cables (e.g., ECG lead wires) off of earth ground and away from the
ESU knife and return wires to prevent burns to measurement sites.
To prevent burns to the patient in the event of a defective neutral ECG electrode of the
device, it is necessary to place ECG electrodes far from the neutral electrode, and as
equidistant as possible from the blade-neutral axis of the surgical patient monitor.
When activating the ESU device, the ECG signals may be distorted or may disappear, and
Lead Fail or Noise alarms might be present. The signal should return once the ESU
activation stops.
When activating the device, using the SpO2 parameter as the heart rate source rather than
the ECG parameter to determine heart rate may be clinically preferred.
Only use accessories approved by Zoe Medical for use with the monitor.
Warning: ARRHYTHMIA PATIENTS. The monitor is designed to operate in the presence of
cardiac arrhythmias. However, the heart rate meter may be adversely affected in some
cases.

ECG MONITORING 740 SELECT
21-22-0335 Rev D Page 11 of 40
Warning: Conductive parts of the ECG patient cables, electrodes, and associated
connections of type CF applied parts, including the neutral conductor of the patient cable and
electrode should not come into contact with other conductive parts including earth ground.
Warning: Read safety instructions provided with a defibrillator. The monitor is designed to
withstand defibrillation and will recover within 5 seconds, per IEC 60601-1. Only use
accessories approved by Zoe Medical for use with the monitor.
Warning: Operating the monitor with HR/PR limit alarms disabled means that no low or high
HR/PR alarm conditions will produce alarm notifications. Use this feature with extreme
caution. Patients must be closely observed if HR/PR limit alarms are disabled.
Warning: Care should be taken to ensure that the total patient-applied current across all
patient-connected equipment is less than 10 microamperes (uA). The monitor applies
approximately 2½ uA to the patient.
CAUTIONS
Caution: Line isolation monitor transients may resemble actual cardiac waveforms and thus
inhibit heart rate alarms. To avoid the risk of this happening, follow the directions for proper
electrode placement, and keep the ECG lead wires away from sources of line noise.
Caution: To avoid large offset potentials due to polarization of electrodes, be sure to use
pregelled, Ag/AgCl disposable electrodes, and be sure that all electrodes used on a patient
are of the same type.
NOTES
Note: The HR/PR numeric is displayed in green when sourced from ECG (default). The color
changes to cyan or green respectively when sourced from SpO2.
Note: If an ECG waveform is not displayed, follow the instructions in the chapter GETTING
STARTED WITH ECG to select the ECG waveforms for display.
Note: Visually inspect the ECG cables on a daily basis and follow the instructions in the
Cleaning and Maintenance chapters as needed. Also, check for an inoperable ECG circuit
which would manifest itself as a blank ECG waveform and a "HR lead off" message.

ECG MONITORING 740 SELECT
21-22-0335 Rev D Page 12 of 40
GETTING STARTED WITH ECG
To begin monitoring ECG, use the following procedure:
1. Connect the ECG Patient Cable to the Monitor
Locate the ECG Patient Cable Receptacle on the side of the Monitor. Refer to Figure 1.
ECG Patient Receptacle on Monitor
Receptacle key
Figure 1: ECG Patient Cable Receptacle on left side of Monitor
Note: The ECG Receptacle is keyed so that the ECG Patient Cable can only be inserted
into the monitor in one orientation. The key on the Receptacle is located towards rear of
monitor.

ECG MONITORING 740 SELECT
21-22-0335 Rev D Page 13 of 40
Insert the ECG Patient Cable to the ECG Patient Cable Receptacle located on the on the
left side of the Monitor. Refer to Figure 2.
Note: The ECG Receptacle is keyed so that the ECG Patient Cable can only be inserted
into the monitor in one orientation. The key on the ECG Patient Cable Receptacle is located
towards rear of monitor.
ECG Patient Cable connector
Connector key
ECG Patient Cable connected to Monitor
Receptacle and Connector key mated
Key is towards rear of monitor
(not shown)
Figure 2: ECG Patient Cable connected on Monitor

ECG MONITORING 740 SELECT
21-22-0335 Rev D Page 14 of 40
2. Connect the ECG Lead Set to ECG Patient Cable
Connect an appropriate ECG 3-Lead Set (1 meter length) to the ECG Patient Cable (2
meter length). ECG 3-Lead Sets are available in AAMI or IEC colors, snaps
(adult/pediatric), or mini-clip (neo) lead sets that to attach to the ECG electrodes.
Note: The ECG Lead Set and ECG Patient Cable Yoke Receptacle are keyed so that they
can only be inserted in one orientation. Refer to Figure 3.
ECG Patient Cable Yoke Receptacle
ECG Lead Set
ECG Lead Set inserted into ECG Cable Yoke
Match colored dots on Yoke and Lead Set
Figure 3: ECG Lead Set connected on ECG Patient Cable Yoke
Note: Once the ECG Lead Set and ECG Patient Cable are connected the colored dots on
the Yoke and Lead Set should match. The label on the Yoke is also a quick guide to general
electrode placement. Refer to the ELECTRODE PLACEMENT section for additional
information for electrode placement.
3. Select and prepare the electrodes.
Pregelled, Ag/AgCl disposable electrodes are recommend.
Depending on the situation, you may want to use either the short-term (foam-backed) or
long-term (cloth-backed) electrodes.
Do not use electrodes after their expiration date, or if the gel has dried out.
4. Prepare the patient's skin for applying the electrodes.
Getting a good quality ECG signal depends largely on how good the contact is between the
electrodes and the patient's skin.
To help assure this, you should first clip or shave any excess hair and remove any skin
residue or oils using an alcohol pad.
To reduce skin impedance, mildly abrade only the electrode contact site using ultrafine
sandpaper (220-400 grit).
For diaphoretic patients, use a benzoin prep to assure tighter adherence of the electrode.
5. Apply the electrodes to the patient.
Apply the pad by using a circular motion on the adhesive area first, then pressing on the gel
area gently, to avoid squeezing out the gel.
Please refer to the diagrams on the following pages for guidance on proper electrode
placement.
You should change the electrodes every 24-48 hours to maintain a good quality ECG
signal.

ECG MONITORING 740 SELECT
21-22-0335 Rev D Page 15 of 40
CHECKING THE ECG SIGNAL
When you have connected the patient following the steps listed above, you should be able to see
a clean ECG signal similar to the Figure 4 below on the monitor display.
If the ECG contains artifact or noise, review the steps for proper electrode site preparation and
placement (see following pages).
The Monitor should display a value for the patient's heart rate (HR) and alarm limit settings.
Alarm Limits
Name
Units
Value
Figure 4: ECG Waveform section of Main screen
The ECG and Heart Rate Monitoring settings and specifications may be found in the
SPECIFICATIONS chapter of this manual.
Procedures for changing configuration settings, such as sourcing pulse rate (PR) from SpO2
while still displaying an ECG waveform, enabling a Pulse tone, displaying multiple ECG
waveforms, or adjusting alarm limits, may be found in the ECG SETUP chapter.
The fixed square reference wave to the left of the ECG waveform indicates the height
of a 1mV QRS associated for the current lead selection.
The size of the 1mV ref is dependent on ECG waveform Size selected
Another verification method is the ability to inject a 1 mV pulse on the ECG Waveform, refer to
CAL PULSE under the HR PARAMETER SETUP Section, starting on page 24.

ECG MONITORING 740 SELECT
21-22-0335 Rev D Page 16 of 40
ELECTRODE PLACEMENT
STANDARD PLACEMENT (AHA)
For ECG cable lead sets with AHA (USA) lead designations, position the electrodes as
shown in Figure 5 below:
Figure 5: Standard AHA Electrode Placement
1. Position the right arm (RA) electrode on the right mid-clavicular line, directly below the
clavicle.
2. Position the left arm (LA) electrode on the left mid-clavicular line, directly below the
clavicle.
3. Position the left leg (LL) electrode on the left mid-clavicular line, 6th and 7th intercostal
space.
STANDARD PLACEMENT (IEC)
For ECG cable lead sets with IEC (Europe) lead designations, position the electrodes as
shown in Figure 6 below:
Figure 6: Standard IEC Electrode Placement
1. Position the right arm (R) electrode on the right mid-clavicular line, directly below the
clavicle.
2. Position the left arm (L) electrode on the left mid-clavicular line, directly below the clavicle.
3. Position the left leg (F) electrode on the left mid-clavicular line, 6th and 7th intercostal
space.
LA (Black)
LL (Red)
RA (White)
L (Yellow)
F (Green)
R (Red)

ECG MONITORING 740 SELECT
21-22-0335 Rev D Page 17 of 40
PLACEMENT FOR PACED PATIENTS (AHA)
For ECG cable lead sets with AHA (USA) lead designations, the optimal electrode placement
for patients with pacemakers may be as illustrated in Figure 7 below:
Figure 7: Paced AHA Electrode Placement
1. Position the right arm (RA) electrode on the right mid-clavicular line, 5th intercostal space.
2. Position the left arm (LA) electrode on the left mid-clavicular line, directly below the
clavicle.
3. Position the left leg (LL) electrode on the left mid-clavicular line, 6th and 5th intercostal
space.
PLACEMENT FOR PACED PATIENTS (IEC)
For ECG cable lead sets with IEC (Europe) lead designations, the optimal electrode
placement for patients with pacemakers may be as illustrated in Figure 8 below:
Figure 8: Paced IEC Electrode Placement
1. Position the right arm (R) electrode on the right mid-clavicular line, directly below the clavicle.
2. Position the left arm (L) electrode on the left mid-clavicular line, directly below the clavicle.
3. Position the left leg (F) electrode on the left mid-clavicular line, 6th and 7th intercostal space.
LA (Black)
LL (Red)
RA (White)
L (Yellow)
F (Green)
R (Red)

ECG MONITORING 740 SELECT
21-22-0335 Rev D Page 18 of 40
VERIFYING PROPER PACEMAKER HANDLING
For paced patients, proper electrode placement results in pacer tick marks along the top of each
ECG waveform channel. These tick marks occur at the point where the monitor detects a pacer
pulse.
The monitor rejects pacer pulses rather than calling them a QRS complex (per IEC 60601-2-27).
However, it is important to keep paced patients under close surveillance and not to entirely rely
on rate meters for these patients (as indicated in the warning at the start of this manual).
FREEZING WAVEFORMS
In some clinical environments the user may want to freeze the displayed waveforms.
Touching the right side of the waveform area (under the blue line) will cause all displayed
waveforms to be frozen (refer to Figure 9 - ECG & SpO2 waveforms frozen).
Only the waveforms are frozen. Numeric values will continue to be updated, and alarm
conditions continue to be generated as they occur.
To unfreeze the displayed waveforms perform one of the following:
Touch the right side of the waveform area again.
OR
Touch anywhere on the screen that will open a menu (e.g., most buttons, numerics, left
side of waveform area)
Touching Alarm Silence or Home button will not unfreeze displayed waveforms
Figure 9: Waveform Frozen - Touch Area is under blue line

ECG MONITORING 740 SELECT
21-22-0335 Rev D Page 19 of 40
ECG SETUP
To begin ECG monitoring use the following procedure:
ECG LEAD WAVEFORM
a. Touch the left side of the waveform area
b. Touch the adjacent to the Waveform 1 selection (Refer to Figure 10);
b. Touch I(II or III) and touch OK; and
c. Touch Home to return to the Main screen.
Figure 10: ECG Waveform Setup screen
ECG SIZE
a. Touch the left side of the waveform area
b. Touch the adjacent to the Waveform 1 Size selection;
c. Touch (2.5, 5, 10, 15 or 20 mm/mV) and Touch OK; and
d. Touch Home to return to the Main screen.
SWEEP SPEED
e. Touch the left side of the waveform area
f. Touch the adjacent to the Sweep Speed selection;
g. Touch (6.26, 12.5 or 25 mm/sec) and Touch OK; and
h. Touch Home to return to the Main screen.

ECG MONITORING 740 SELECT
21-22-0335 Rev D Page 20 of 40
ECG CASCADE
i. Touch the left side of the waveform area
j. Touch the Yes adjacent to the ECG Cascade selection to Enable;
OR
k. Touch the No adjacent to the ECG Cascade selection to Disable;
l. Touch Home to return to the Main screen.
Figure 11: ECG Cascade Enabled