ZOLL Propaq M Manual

Propaq
®
M Operator’s Guide
9650-0803-01 Rev. BMarch 2011

ZOLL is a registered trademark, and SurePower is a trademark of ZOLL Medical Corporation. Propaq and
Smartcuf are registered trademarks, and SureBP is a trademark of Welch Allyn Inc. Nellcor and OxiMax are
trademarks of Covidien. Oridion, Microstream, FilterLine, and CapnoLine are registered trademarks of Oridion
Systems, Ltd. All other trademarks and registered trademarks are property of their respective owners.
Copyright © 2011 ZOLL Medical Corporation. All rights reserved.
ZOLL International Holding B.V.
Newtonweg 18
6662 PV ELST
The Netherlands
Tel.: [phone]
Fax: [phone]

9650-0803-01 Rev. B Propaq M Operator’s Guide i
Table of Contents
Chapter 1 General Information
Product Description ............................................................................................................1-1
Propaq M Optional Features .......................................................................................1-2
How to Use This Manual.....................................................................................................1-2
Operator’s Guide Updates..................................................................................................1-2
Unpacking...........................................................................................................................1-2
Symbols Used on the Equipment .......................................................................................1-3
Conventions........................................................................................................................1-5
Propaq M Indications for Use..............................................................................................1-6
ECG Monitoring ..........................................................................................................1-6
Non-Invasive Blood Pressure Monitoring ...................................................................1-6
Temperature Monitoring .............................................................................................1-6
Sp02 Monitoring ..........................................................................................................1-6
Respiration Monitoring ................................................................................................1-7
CO2 Monitoring ...........................................................................................................1-7
Invasive Pressure Monitoring .....................................................................................1-7
Propaq M Product Functions ..............................................................................................1-7
ECG Monitoring ..........................................................................................................1-7
Batteries ......................................................................................................................1-8
Ready For Use (RFU) Indicator ..................................................................................1-9
Warnings...........................................................................................................................1-10
General .....................................................................................................................1-10
ECG Monitoring ........................................................................................................1-11
Pulse Oximeter .........................................................................................................1-11
Noninvasive Blood Pressure .....................................................................................1-12
IBP ............................................................................................................................1-13
CO2 ..........................................................................................................................1-13
Respiration ................................................................................................................1-13
Ferromagnetic Equipment ........................................................................................1-13
Battery ......................................................................................................................1-14
Operator Safety ........................................................................................................1-14
Patient Safety ...........................................................................................................1-14
Cautions............................................................................................................................1-15
Restarting the Monitor.......................................................................................................1-16
Notification of Adverse Events ..................................................................................1-16
Software License ..............................................................................................................1-16
Service..............................................................................................................................1-17
The ZOLL Serial Number..................................................................................................1-18

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Chapter 2 Product Overview
Monitor Controls and Indicators..........................................................................................2-1
The Front Panel ..........................................................................................................2-2
Display Screen ............................................................................................................2-4
Battery Status and Auxiliary Power Indicators ............................................................2-5
Patient Cables and Connectors ..................................................................................2-6
Auxiliary Power Adapter .............................................................................................2-7
Navigating the Display Screen............................................................................................2-8
Quick Access Keys .....................................................................................................2-8
Navigation Keys .......................................................................................................2-11
Display Brightness ....................................................................................................2-11
Common Tasks................................................................................................................. 2-11
Changing the Display Brightness ..............................................................................2-11
Replacing a Battery Pack on the Propaq M ..............................................................2-12
Using Treatment Buttons ..........................................................................................2-13
Chapter 3 Monitoring Overview
Propaq M Monitoring Functions..........................................................................................3-1
ECG ............................................................................................................................3-2
Heart Rate ..................................................................................................................3-2
Respiration Rate .........................................................................................................3-2
Temperature ...............................................................................................................3-2
Invasive Pressures (IBP) ............................................................................................3-2
Non-Invasive Blood Pressure (NIBP) .........................................................................3-2
Capnography (CO2) ...................................................................................................3-3
Monitoring Display Options.................................................................................................3-3
Configuring the Waveform Display .....................................................................................3-7
Chapter 4 Trends
Displaying the Trends Status Window ................................................................................4-1
Displaying Trend Information..............................................................................................4-2
Changing the Trends Status Window Display.....................................................................4-3
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 .....................................................................................................5-4
Responding to Active Alarms -- Silencing the Alarm ..........................................................5-4
Re-enabling an Alarm .................................................................................................5-5
Suspending Alarms.............................................................................................................5-5

9650-0803-01 Rev. B Propaq M Operator’s Guide iii
Alarm Options.....................................................................................................................5-7
Selecting Default Alarm Limits ....................................................................................5-8
Setting Alarm Limits Relative to the Patient -- Stat Set Option ...................................5-8
Chapter 6 Monitoring ECG
ECG Monitoring Setup........................................................................................................6-2
Preparing the Patient for Electrode Application ..........................................................6-2
Applying Electrodes to the Patient ..............................................................................6-3
Connecting the ECG Cable To the Propaq M 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
Chapter 7 Monitoring Respiration (Resp) and Heart Rate (HR)
Respiration/Breath Rate Meter...........................................................................................7-2
Using Impedance Pneumography to Measure Respiration ........................................7-2
Configuring Respiration (RR/BR) Alarms and Settings ......................................................7-3
Enabling/Disabling RR/BR Alarms and Setting Alarm Limits ......................................7-3
Using the Resp Parameter Control Panel ...................................................................7-4
Heart Rate Meter ................................................................................................................7-5
Configuring Heart Rate (HR) Meter Alarms........................................................................7-5
Enabling/Disabling HR Alarms and Setting Alarm Limits ............................................7-6
Using the Heart Rate Parameter Control Panel ..........................................................7-7
Chapter 8 Monitoring Non-Invasive Blood Pressure (NIBP)
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...................................................................................................8-5
Applying the Cuff to the Patient ..........................................................................................8-7
Ensuring Correct Cuff Inflation Settings..............................................................................8-8
Configuring NIBP Alarms and Settings...............................................................................8-9
Enabling/Disabling NIBP Alarms and Setting Alarm Limits ........................................8-9
Using the NIBP Parameter Control Panel .................................................................8-11
NIBP System Messages...................................................................................................8-14

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Chapter 9 Monitoring Pulse Oximetry (SpO2)
Warnings -- SpO2, General.................................................................................................9-2
Warnings -- SpO2, Oximeter Sensor...................................................................................9-2
SpO2Setup and Use ..........................................................................................................9-3
Selecting the SpO2Sensor.................................................................................................9-3
Applying the SpO2Sensor..................................................................................................9-3
Applying a Reusable SpO2Sensor .............................................................................9-4
Applying a Single-Use Sensor ....................................................................................9-5
Connecting the SpO2Sensor..............................................................................................9-6
Displaying SpO2Measurements.........................................................................................9-7
Enabling/Disabling SpO2Alarms and Setting Alarm Limits................................................9-7
Setting Upper and Lower Systolic Alarm Limits ..........................................................9-8
Using the SpO2Parameter Control Panel ..........................................................................9-8
SpO2Response Time .................................................................................................9-9
Selecting the Heart Rate/ Pulse Rate (HR/PR) Tone .................................................9-9
SpO2System 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 Oral/Nasal 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
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

9650-0803-01 Rev. B Propaq M Operator’s Guide v
Enabling/Disabling IBP Alarms and Setting Alarm Limits................................................. 11-6
Setting Upper and Lower Systolic (SYS) Alarm Limits .............................................11-6
Setting Upper and Lower Diastolic (DIA) Alarm Limits .............................................11-7
Setting Upper and Lower Mean Arterial Pressure (MEAN) Alarm Limits ..................11-7
Setting IBP Source Label ..........................................................................................11-8
IBP System Messages...................................................................................................... 11-9
Chapter 12 Monitoring Temperature
Temperature Monitoring Setup .........................................................................................12-1
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
Temperature System Messages .......................................................................................12-5
Chapter 13 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
12-Lead Display Options ..................................................................................................13-9
Specifying the 12-Lead Frequency Response ..........................................................13-9
Chapter 14 Patient Data
Storing Data......................................................................................................................14-1
Capturing a Data Snapshot...............................................................................................14-2
Reviewing snapshots ................................................................................................14-2
Treatment Summary Report .............................................................................................14-2
Transferring Data to a USB Device...................................................................................14-3
Clearing the Log .......................................................................................................14-4

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Chapter 15 Cleaning and Maintenance
Inspection and Cleaning instructions................................................................................15-1
Cleaning the Propaq M unit ......................................................................................15-2
Cleaning the NIBP Blood Pressure Cuff ...................................................................15-2
Cleaning SpO2 Sensors ...........................................................................................15-2
Cleaning Cables and Accessories ............................................................................15-3
Recommended Minimum Preventive Maintenance Schedule..........................................15-3
Guidelines for Maintaining Peak Battery Performance.....................................................15-4
Appendix A Specifications
Monitor/Display...................................................................................................................A-2
Impedance Pneumography.................................................................................................A-3
Alarms.................................................................................................................................A-3
Battery ...............................................................................................................................A-4
General...............................................................................................................................A-4
CO2 ....................................................................................................................................A-6
Pulse Oximeter ...................................................................................................................A-7
Non-Invasive Blood Pressure .............................................................................................A-7
Invasive Pressures .............................................................................................................A-8
Temperature........................................................................................................................A-9
Electromagnetic Compatibility Guidance and Manufacturer’s Declaration.......................A-10
Appendix B Accessories

9650-0803-01 Rev. B Propaq M Operator’s Guide 1-1
Chapter 1
General Information
Product Description
The ZOLL®Propaq®M unit is an easy-to-use portable monitor that has the following
monitoring capabilities: ECG, Pulse Oximeter, Non-invasive Blood Pressure, IBP, CO2,
Temperature, and Respiration. It has been designed for all portable monitoring situations and its
rugged, compact, lightweight design makes it ideal for transport situations. It is powered by
auxiliary power and an easily replaced battery pack that is quickly recharged in the device
when it is connected to auxiliary power. In addition, the unit’s battery may be recharged and
tested using a ZOLL SurePower™ Battery Charger Station.
Note: Some of the monitoring functions of the Propaq M are optional features. See the
complete list of options in Fig. 1-1. Optional features are specified as “optional” within
this guide.
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 M has a patient data review and collection system that allows you to view, store,
and transfer patient data. The Propaq M unit contains a USB port, which you can use to transfer
data to a PC.

CHAPTER 1GENERAL INFORMATION
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Propaq M Optional Features
The following features are optional in the Propaq M unit.
Figure 1-1 Propaq M Optional Features
How to Use This Manual
The Propaq M Operator's Guide provides information operators need for the safe and effective
use and care of the Propaq M product. It is important that all persons using this device read and
understand all the information contained within.
Please thoroughly read the safety considerations and warnings section.
Procedures for daily checkout and unit care are located in Chapter 15: “Cleaning and
Maintenance.”
Operator’s Guide Updates
An issue or revision date for this manual is shown on the front cover. If more than three years
have elapsed since this date, contact ZOLL Medical Corporation to determine if additional
product information updates are available.
All users should carefully review each manual update to understand its significance and then
file it in its appropriate section within this manual for subsequent reference.
Product documentation is available through the ZOLL website at www.zoll.com. From the
Products menu, choose Product Manuals.
Unpacking
Carefully inspect each container for damage. If the shipping container or cushion material is
damaged, keep it until the contents have been checked for completeness and the instrument has
been checked for mechanical and electrical integrity. If the contents are incomplete, if there is
mechanical damage, or if the monitor does not pass its self-test, U.S.A. customers should call
ZOLL Medical Corporation (1-800-348-9011). Customers outside of the U.S.A. should contact
the nearest ZOLL authorized representative. If the shipping container is damaged, also notify
the carrier.
Optional Feature
12 Lead ECG
SpO2(Nellcor™)
NIBP (with Smartcuf®and SureBP™)
EtCO2 (Oridion®Microstream®)
Temperature
Invasive Pressures (3 Channels)

Symbols Used on the Equipment
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Symbols Used on the Equipment
Any or all of the following symbols may be used in this manual or on this equipment:
Symbol Description
Attention, consult accompanying documents.
Fragile, handle with care.
Keep dry.
This end up.
Temperature limitation.
Conformité Européenne Complies with medical device directive 93/42/EEC.
Defibrillator-proof type CF patient connection.
Fusible link.
Alternating current (ac).
Direct current (dc).
Auxiliary power adapter operation.
Earth (ground).
Negative input terminal.

CHAPTER 1GENERAL INFORMATION
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Positive input terminal.
Power On/Off
Protective earth (ground).
Contains lithium. Recycle or dispose of properly.
Keep away from open flame and high heat.
Do not open, disassemble, or intentionally damage.
Do not crush.
Do not discard in trash. Recycle or dispose of properly.
Return to a collection site intended for waste electrical and electronic
equipment (WEEE). Do not dispose of in unsorted trash.
Date of manufacture.
Use by.
Latex-free.
Do not reuse.
Do not fold.
Symbol Description
2%452.
,I)/.
RECYCLE
,I)/.

Conventions
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Conventions
This guide uses the following conventions:
Within text, the names and labels for physical buttons and softkeys appear in boldface type (for
example, “Press the IBP quick access key”).
This guide uses uppercase italics for audible prompts and for text messages displayed on the
screen (for example, INITITALIZING).
Warning! Warning statements alert you to conditions or actions that can result in personal injury
or death.
Caution Caution statements alert you to conditions or actions that can result in damage to the unit.
Not sterile.
Manufacturer.
Authorized representative in the European Community.
Serial Number.
Catalogue number.
Consult instructions for use.
Battery charging status.
Symbol Description

CHAPTER 1GENERAL INFORMATION
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Propaq M Indications for Use
The Propaq M is intended for use by trained medical personnel who are familiar with basic
monitoring, vital sign assessment, and the use of the Propaq M. The Propaq M is also intended
for use by (or on the order of) physicians at the scene of an emergency or in a hospital
emergency room, intensive care unit, cardiac care unit, or other similar areas of a hospital. The
usage may be in an ambulance or at the scene of an emergency. It is also intended to be used
during the transport of patients. The Propaq M will be used whenever it is required to monitor
any of those functions that are included (as options) in the device. The Propaq M unit can be
used on pediatric patients (as described in the following table) and on adult patients (21 years of
age or older) with and without heart dysfunction.
ECG Monitoring
The Propaq M is intended for use to monitor and/or record 3-, 5-, or 12-lead ECG waveform
and heart rate, and to alarm when heart rate is above or below limits set by the operator. The
patient population will range from newborn (neonate) to adult, with and without heart
dysfunction.
Non-Invasive Blood Pressure Monitoring
The Propaq M is intended for use to make non-invasive measurements of arterial pressure and
heart rate, and to alarm if either parameter is outside of the limits set by the user. Measurements
are made using an inflatable cuff on the patient's arm or leg. The patient population will range
from newborn (neonate) to adult.
Temperature Monitoring
The Propaq M is intended for use to make continuous temperature measurements of rectal,
esophageal, or surface temperatures, and to alarm if the temperature is outside of the limits set
by the user. The patient population will range from newborn (neonate) to adult.
Sp02Monitoring
The Propaq M 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.
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.

Propaq M Product Functions
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Respiration Monitoring
The Propaq M is intended for use to continuously monitor respiration rate and to alarm if the
rate falls outside of the range set by the operator. Because the measurement method actually
measures respiratory effort, apnea episodes with continued respiratory effort (such as
obstructive apnea) may not be detected. It is not intended to be used as an apnea monitor. The
patient population will range from newborn (neonate) to adult.
CO2Monitoring
The Propaq M is intended for use to make continuous noninvasive measurement and
monitoring of carbon dioxide concentration of the expired and inspired breath and breath rate.
The patient population will range from newborn (neonate) to adult.
Invasive Pressure Monitoring
The Propaq M is intended for use to display and make continuous invasive pressure
measurements from any compatible pressure transducer. The primary intended uses are arterial
blood pressure, central venous pressure and intracranial pressure monitoring. Any contra-
indications of the particular transducer selected by the user shall apply. The patient population
will range from newborn (neonate) to adult.
Propaq M Product Functions
ECG Monitoring
The patient’s ECG is monitored by connecting the patient to the unit via a 3-, 5-, or 12-lead
patient cable. The ECG waveform is presented on the display along with the following
information:
•averaged heart rate, derived by measuring R to R intervals
•lead selection - I, II, III, aVR, aVL, aVF, V1, V2, V3, V4, V5, V6 (with ECG cable)
•ECG size - 0.125, 0.25, 0.50, 1.0, 2.0, 4.0 cm/mV, AUTO
•status messages
The ECG bandwidth is user selectable.

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Batteries
Propaq M models use an easily replaced rechargeable lithium-ion battery pack (the Propaq
Battery Pack). A new, fully charged battery pack typically delivers more than 8 hours of ECG
monitoring. Use of other options (such as higher screen brightness or shorter NIBP intervals)
reduces this time.
When a LOW BATTERY icon appears on the display and the unit emits three beeps in
conjunction with the displayed battery icon, the battery must be replaced and recharged.
You can charge the battery by either of the following methods:
•Internal charging — plug the Propaq M into an auxiliary power adapter to automatically
begin charging the installed battery pack. The front panel battery indicator operates as
follows:
Note: Upon power up, it takes approximately 45 seconds for the LEDs on the battery to
accurately display run time.
•External charging — use the ZOLL SurePower™ Battery Charger with the Propaq M
battery adapter to charge the battery pack and test the battery’s capacity. For details, refer to
the Propaq Battery Pack Guide.
The Recalibration LED icon ( ) lights for approximately 10 seconds (after you press and
release the Display button) if the battery needs to be calibrated. If the Recalibration LED lights,
the runtime indicator will not display run time for that battery. For best performance of the
battery, you should recalibrate the battery as soon as possible.
To manually recalibrate the SurePower 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.
When the indicator is: It means:
Steady yellow Battery is charging.
Steady green Battery is charged.
Alternating yellow and
green The charge state cannot be determined or a battery charging
fault has been detected.
Not lit No battery in device.

Propaq M Product Functions
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Ready For Use (RFU) Indicator
The Propaq M has an RFU indicator on the front panel that indicates if the device is ready for
use. The RFU indicator has three states which are described in the following table.
State Description Action
Ready for Use The device is ready for use. Patient
monitoring is functional and the bat-
tery is above the low battery capac-
ity.
None required.
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.
Install a fully charged battery in the
unit and check the RFU indicator
again. If the RFU indicator contin-
ues 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 auxil-
iary power is not present.
•A very low battery (below soft-
ware shutdown limit) was
installed.
•ECG 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 contin-
ues to display the Do Not Use sym-
bol, remove the unit from service
and contact the appropriate techni-
cal personnel or the ZOLL Techni-
cal Service Department.

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Warnings
General
These operating instructions describe the functions and proper operation of the Propaq M
products. They are not a substitute for a formal patient care training course. Operators should
obtain formal training from an appropriate authority before using this monitor for patient care.
Proper operation of the unit and correct electrode placement is critical to obtaining optimal
results. Operators must be thoroughly familiar with proper device operation.
Allow ample slack in cables to make sure that cables do not tug at electrodes.
Do not disassemble the unit. A shock hazard exists. Refer all problems to authorized service
personnel.
Follow all recommended maintenance instructions. If a problem occurs, obtain service
immediately. Do not use the monitor until it has been inspected by appropriate personnel.
The Propaq M unit might not perform to specifications when stored at the upper or lower
extreme limits of storage temperature and then immediately put into use. The Propaq unit
should not be stored or used outside of the environmental limits provided in Appendix A of this
manual.
Avoid using the Propaq M adjacent to, or stacked on, other equipment. If unavoidable, verify
that the unit operates normally in this configuration before clinical use.
The Propaq M should be installed and put into service according to the EMC information in
Appendix A of this manual.
The use of transducers and cables other than those specified in this manual and related Propaq
M option manual inserts may result in increased emissions or decreased immunity of the
Propaq M.
Do not use or place the unit in service if the Ready For Use indicator (at the upper right of the
front panel) displays a red circle with a line through it.
Carefully route patient cables to avoid tripping over them, or inadvertently pulling the unit onto
the patient.
Always inspect the unit for damage if it has been dropped.
Only authorized personnel should use the Supervisor menus.
If uncertain about the accuracy of any measurement, first check the patient’s vital signs by
alternate means, and then make sure the monitor is functioning correctly.

Warnings
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ECG Monitoring
Implanted pacemakers might cause the heart rate meter to count the pacemaker rate during
incidents of cardiac arrest or other arrhythmias. Dedicated pacemaker detection circuitry may
not detect all implanted pacemaker spikes. Check the patient's pulse; do not rely solely on heart
rate meters. Patient history and physical examination are important factors in determining the
presence of an implanted pacemaker. Pacemaker patients should be carefully observed. See
“Pacemaker Pulse Rejection:” on page A-3 of this manual for disclosure of the pacemaker
pulse rejection capability of this instrument.
Use only ECG electrodes that meet the AAMI standard for electrode performance
(AAMI EC-12). Use of electrodes not meeting this AAMI standard could cause the ECG trace
recovery after defibrillation to be significantly delayed.
Do not place electrodes directly over an implanted pacemaker.
The Propaq M unit detects ECG electrical signals only. It does not detect a pulse (effective
circulatory perfusion). Always verify pulse and heart rate by physical assessment of the patient.
Never assume that the display of a nonzero heart rate means that the patient has a pulse.
Excessive artifact can result due to improper skin preparation of the electrode sites. Follow skin
preparation instructions in Chapter 6: “Monitoring ECG.”
Do not operate the Propaq M in conjunction with electrocautery or diathermy equipment. Such
equipment, as well as equipment that emits strong radio frequency signals, can cause electrical
interference and distort the ECG signal displayed by the monitor, thereby preventing accurate
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.
Pulse Oximeter
Keep the ZOLL finger probe clean and dry.
SpO2measurements may be affected by certain patient conditions: severe right heart failure,
tricuspid regurgitation or obstructed venous return.
SpO2measurements may be affected when using intravascular dyes, in extreme
vasoconstriction or hypovolemia or under conditions where there is no pulsating arterial
vascular bed.
SpO2measurements 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.

CHAPTER 1GENERAL INFORMATION
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Do not apply SpO2sensor to the same limb that has an NIBP cuff. The SpO2alarm may sound
when the arterial circulation is cut off during NIBP measurements, and may affect SpO2
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.
Noninvasive Blood Pressure
Only a physician can interpret pressure measurements.
Blood pressure measurement results may be affected by the position of the patient, his or her
physiological condition and other factors.
Substitution of a component different from that supplied by ZOLL (e.g., cuff, hoses, etc.) may
result in measurement error. Use only ZOLL-approved cuffs and hoses. To avoid the risk of
intravenous line misconnection and possible introduction of air into a patient’s blood, do not
modify the NIBP system or hoses with Luer Lock adapters.
Do not use a blood pressure cuff on the limb being used for IV infusion or for SpO2monitoring.
Accurate pressure readings may not be achieved on a person experiencing arrhythmias,
shaking, convulsions or seizures. Medication may also affect pressure readings. The correct
size cuff is essential for accurate blood pressure readings.
Blood pressure hoses must be free of obstructions and crimps.
If the patient’s cuff is not at heart level, an error in measurement may result.
When monitoring blood pressure at frequent intervals, observe the cuffed extremity of the
patient for signs of impeded blood flow.
Do not monitor one patient’s NIBP while monitoring another patient’s ECG.
Blood pressure measurement may be inaccurate if taken while accelerating or decelerating in a
moving vehicle.
If an NIBP measurement result is questionable or “motion” indication is displayed, repeat the
measurement. If the repeated measurement result is still questionable, use another blood
pressure measurement method.
Do not use the NIBP on cardiopulmonary bypass patients.