ZOLL R Series User manual

©2013 ZOLL Medical Corporation. All rights reserved.
OneStep, R Series, Real CPR Help, See-Thru CPR,
Stat-padz, and ZOLL are trademarks or registered trademarks
of ZOLL Medical Corporation in the United States and/or
other countries. All other trademarks are the property of their
respective owners.
9650-1001-01 Rev E
ZOLL Medical Corporation
Worldwide Headquarters
269 Mill Road
Chelmsford, MA 01824 USA
800-348-9011
[phone]
www.zoll.com
ZOLL International Holding B.V.
Newtonweg 18
6662 PV ELST
The Netherlands
[phone]
www.zoll.nl

R Series®
Quick Reference Guide

R Series®
Quick Reference Guide
This Quick Reference Guide is intended to provide easy access to
most common uses of the ZOLL®R Series.
®The user must read and
completely understand the intended use warnings, cautions, and
instructions in the R Series Operator’s Guide before using the
R Series unit.
TABLE OF CONTENTS
Applying Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Page 2
Details for applying OneStep™Electrodes, ECG cables, and paddles with the R Series
Adult Defibrillation.........................................Page 3
Step-by-step defibrillation for the R Series ALS and BLS/Plus models
CPR ......................................................Page 5
Real CPR Help®and See-Thru CPR®technology
Pacing/Cardioversion ......................................Page 6
Step-by-step instructions for Pacing and Cardioversion with the R Series
Monitoring ................................................Page 7
SpO2, EtCO2, NIBP monitoring parameters and alarm functions on the R Series
Managing Data and Cable Connections ......................Page 9
Printing summary reports, using WiFi and Compact Flash Cards

Page 2
Applying Therapy
Proper Electrode or Paddle Placement
Paddle Placement
1. Grasp paddles on each side of unit.
2. Press down on RELEASE latches with thumbs and remove the paddles from their holders.
3. Apply gel to electrode surfaces or gel patches to patient. If using gel, rub electrodes
together to spread gel.
4. Place sternum paddle to the right of sternum, just below clavicle.
5. Place apex paddle left of nipple on anterior-axillary line.
6. Press paddles firmly against patient’s skin.
BACKFRONT
OneStep Complete Resuscitation Electrode
Anterior/Posterior Placement
OneStep CPR Anterior/Anterior
Electrode Placement
BACKFRONT
Atrial Arrhythmias
Cardioversion Electrode
Anterior/Posterior Placement
BACKFRONT
Ventricular Arrhythmias
Cardioversion Electrode
Anterior/Posterior Placement
Electrode shown is OneStep CPR Anterior/Anterior

Page 3
Adult Defibrillation
R Series BLS/Plus Model
Defibrillation (AED)
1. Apply electrodes.
2. Turn selector switch to ON.
3. System will begin to analyze or
instruct PERFORM CPR, depending
upon configuration chosen.
4. Once analysis begins, stand clear.
5. If rhythm is shockable, defibrillator
will charge and red SHOCK button
will illuminate.
6. If shock button illuminates, shout “Clear” –
once all are clear, press SHOCK.
7. If no shock advised, start CPR immediately.
Defibrillation (Advisory)
1. Apply electrodes.
2. Turn selector switch to ON.
3. Press Manual then Confirm softkeys.
4. Press ANALYZE to start advisory function
and follow the instructions.
5. If rhythm is shockable, defibrillator
will charge and red SHOCK button
will illuminate.
6. If shock button illuminates, shout “Clear” –
once all are clear, press SHOCK.
7. If no shock advised, start CPR immediately.
Defibrillation (Manual)
1. Apply electrodes.
2. Turn selector switch to ON.
3. Press Manual, then Confirm softkeys. System will switch to ALS mode
(depending upon configuration, your defibrillator may not require a second key
press to activate ALS mode).
4. Energy select will automatically display the correct adult energy per configuration.
5. If desired, energy may be adjusted up or down.
6. If rhythm appears shockable, press CHARGE button.
7. When red SHOCK button illuminates, shout “Clear” and verify others are clear.
8. Press SHOCK button.
9. Check pulse – if no pulse, resume CPR immediately.

Page 4
Adult Defibrillation – Pediatric Defibrillation
R Series ALS Model
Defibrillation (Advisory)
1. Apply electrodes.
2. Turn selector switch to DEFIB.
3. The energy will be displayed as configured by
your institution.
4. Shout “Clear, Analyzing”; stop CPR and
ensure patient is motionless.
5. Press ANALYZE button.
6. Read display message. If SHOCK ADVISED
is displayed, shout “Clear” and verify others
are clear.
7. Press SHOCK button.
8. If NO SHOCK ADVISED, check for a pulse
and if no pulse, resume CPR immediately.
Defibrillation (Manual)
1. Apply electrodes.
2. Turn selector switch to red area labeled
DEFIB.
3. Energy selected will be as configured by
institution protocol. You may change settings
if desired by using the ENERGY SELECT
▲(UP) and ▼(DOWN) arrow keys.
4. If the rhythm appears to be shockable, press
the CHARGE button.
5. Shout “Clear” and verify others are clear.
6. Press SHOCK button.
Pediatric Defibrillation
Follow the instructions as outlined above for your unit with the following exceptions:
• OneStepPediatricelectrodesshouldbeusedonchildrenupto8yearsofage.Forchildrenover
8 years of age, use adult electrodes.
• WhentheOneStepPediatricelectrodeisconnected,theRSerieswillautomaticallyset
the energy delivered to 50, 70, and 85 J increments. These levels are appropriate for children
from 25 kg or greater.
• When using OneStep Pediatric electrodes on children under 25 kg, an energy of 2 J per kg
is recommended and will need to be set manually using the ENERGY SELECT ▲(UP) and
▼(DOWN) arrow keys.
• Forallotherelectrodes,selectthedesiredenergymanuallybasedupon2Jperkg.
• DonotuseAEDorAdvisorymodeinchildrenunder8yearsofageunlessOneStepPediatric
electrodes are attached or energy has been manually selected in advisory mode.

Page 5
CPR
CPR Dashboard with Real CPR Help
1. Place ZOLL electrodes with CPR Sensor (OneStep
™
Complete, OneStep
™
CPR, OneStep Pediatric CPR,
or CPR Stat-padz
®
) on patient.
2. The CPR sensor should be placed on the sternum where
your hands would normally be placed for CPR.
3. Place the heel of your hand on the sensor and begin compressions normally.
4. If your compression rate and depth are appropriate to AHA/ERC Guidelines, the
diamond (PPI) on the screen of the R Series will begin to fill with color and remain filled.
If enough time is allowed for chest recoil, the depth bar will also be filled with color.
5. Adult electrodes only: If the depth of compression is insufficient, the message PUSH
HARDER will be heard and the indicator word “Depth” will be displayed next to the PPI.
When compressions are correct, the message GOOD COMPRESSIONS will be heard and
the indicator word “Depth” will disappear from the display.
6. If compression rate is too slow, the indicator word “Rate” will be displayed next to the
index and a 100 bpm metronome will be heard until rate is correct. The indicator word
“Rate” will then disappear from the screen.
7. If your R Series does not display a PPI, your defibrillator has only basic CPR
feedback and only voice prompts, as outlined above, will be available.
PPI
See-Thru CPR
See-Thru CPR is a proprietary algorithm that filters the
CPR artifact from the ECG to allow users to see a close
approximation of a patient’s organized underlying rhythm
during CPR compressions, reducing interruptions in CPR. Unfiltered ECG signal during CPR
Using See-Thru CPR:
1. During CPR, view the filtered ECG
(second trace) on display to determine
if an organized rhythm appears to be
developing.
2. If rhythm appears to be organized
and shockable, press CHARGE while
continuing compressions.
3. Pause compressions and visually
confirm a shockable rhythm.
4. Shout “Clear” and verify others are clear.
5. Press SHOCK button.
6. Resume CPR immediately for 2 minutes
before stopping CPR to check rhythm. If
non-shockable, resume compressions.
Signal filtered by See-Thru CPR
Activating See-Thru CPR:
1. Press Options softkey.
2. Press Traces softkey.
3. Press Trace 2 softkey.
4. Press Filt ECG softkey.
Release Bar
Rate and Depth Indicators

Page 6
Pacing/Cardioversion
Pacing
1. Place OneStep Pacing or OneStep Complete Electrodes on
patient. To pace with other defibrillation electrodes, they must
be placed on the patient and the three- or five-lead cable
attached to the defibrillator.
2. Turn Selector Switch to green area labeled PACER.
3. Turn the pacer RATE knob to desired rate.
4. Turn the pacer OUTPUT knob clockwise slowly until capture.
5. Slowly decrease output by turning OUTPUT knob counter-
clockwise until capture disappears, then increase by 10%.
6. Check pulse to verify mechanical capture.
7. To check patient’s underlying rhythm; press and hold 4:1 button.
Note: When using BLS or Plus models, manual mode must be activated to pace.
Examples of paced rhythms
Synchronized Cardioversion
1. Apply electrodes or paddles to patient.
2. Turn selector switch to DEFIB. If using BLS or Plus device,
press Manual then Confirm softkeys instead.
3. Press Sync On/Off softkey.
4. Verify that arrows (i) display over R-waves and display reads SYNC.
Do not cardiovert if SYNC is OFF.
5. Follow Manual Defibrillation instructions as described on page 4 and
institution protocol for energy settings.
Dial settings for
R Series Pacing

Page 7
Monitoring
End Tidal CO2(EtCO2) –Mainstream
1. Plug EtCO2cable into the back of the unit in the yellow port marked CO2.
2. Attach sensor to patient’s ET tube.
3. Turn selector switch to grey area labeled MONITOR. If using BLS or Plus device,
turn ON, then press Manual then Confirm softkeys to use in ALS mode.
4. Press the Param softkey.
5. Press the CO2softkey.
6. Press the Enable EtCO2softkey.
7. If properly attached, the EtCO2values will display on the screen.
8. To display waveform: Press Options softkey. Press Traces softkey.
Press Trace 2 or Trace 3 softkey. Select CO2softkey.
ECG Monitoring
Using OneStep ECG Cable
1. Disconnect OneStep electrode from the OneStep therapy cable.
2. Plug the OneStep ECG cable into the OneStep therapy cable.
3. Remove all clothing covering the patient’s chest. Dry chest if necessary. Clip
or shave excessive chest hair to ensure proper adhesion of the electrodes.
4. Snap leads onto each electrode.
5. Peel off protective backing from electrode.
6. Apply electrodes to patient’s skin.
Using Standard ECG cable
1. Unplug OneStep ECG cable from back of unit.
2. Plug ECG cable connector into back of unit.
3. Remove all clothing covering the patient’s chest.
Dry chest if necessary. Clip or shave excessive chest
hair to ensure proper adhesion of the electrodes.
4. Snap leads onto each electrode.
5. Peel off protective backing from electrode.
6. Apply electrodes to patient’s skin.
ECG Display
1. Turn selector switch to MONITOR on the R Series ALS unit. If using BLS or Plus
device, press Manual then Confirm softkeys to activate ALS mode.
2. Press LEAD button to change leads.
3. Press SIZE button to change size of display.
Dial settings for
R Series Monitoring

Page 8
Monitoring (Cont.)
SpO2
1. Connect the SpO2cable to the patient sensor and to
the blue SpO2port on the rear of the unit labeled SpO2.
2. Attach sensor to patient’s finger.
3. Turn selector switch to grey area labeled MONITOR on
the R Series ALS. If using BLS or Plus device, turn ON,
then press Manual then Confirm softkeys to use
in ALS mode.
4. If properly attached, the SpO2values will display
on the screen.
5. To display waveform: Press Options softkey.
Press Traces softkey. Press Trace 2 or Trace 3
softkey. Select SpO2softkey.
NIBP
1. Plug NIBP cable into the back of the unit in silver port marked NIBP.
2. Attach appropriate BP cuff to patient’s arm or thigh.
3. Turn selector switch to grey area labeled MONITOR. If using BLS or Plus device,
press Manual then Confirm softkeys to use in ALS mode.
4. For ALS: Press the Param softkey, then press the NIBP soft key.
5. On BLS or Plus device, press illuminated blood pressure icon on
bottom left to take measurement.
Alarms
1. Press the Alarms softkey to select alarms.
2. Press Return softkey to activate alarms.
3. To mute for 90 seconds: Press ALARM SUSPEND button.
4. To reactivate muted alarm: Press ALARM SUSPEND button.
5. To disable: Press and hold ALARM SUSPEND for 3 seconds.
Note: Alarms are still active, but silent.

Page 9
Managing Data and Cable Connections
For the R Series ALS, BLS, and Plus
Printing a Summary Report:
1. Press the Report Data softkey.
2. Press the Print Log or the Print Chart softkey.
Press the Print All or the Print Range softkey for specific events.
Transferring Full Disclosure Files to a Compact Flash Card or by WiFi:
1. Press the Report Data softkey.
2. Press the Transfer Mode softkey.
3. Press the Report To Card softkey to transfer to a Compact Flash Card or press the Report To
WiFi sofkkey to transfer by WiFi.
Erasing Summary Report and Full Disclosure:
• PresstheReport Data softkey.
• PresstheErase, then Erase All softkeys.
Mode
Selector
Six Softkeys
Shock
Button
Display
Screen
Battery
Indicator
AC Power
Indicator
Code Readiness
Indicator