ZOLL PD 1200 Manual

(NTP) 23
ECG MONITORING 29
OPERATION W ITH MULTI-FUNCTION ELECTRODES 33
OPERATIONAL CHECKS AND PROCEDURES 39
EXTENDED DIAGNOSTICS 47
TROUBLESHOOTING GUIDES
51
11
EM ERGENCY DEFIBRILLATION PROCEDURE
15
SYNCHRONIZED CARDIOVERSION 19
NONINVASIVE TEM PORARY PACING zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA
TABLE OF CONTENTS
SECTION DESCRIPTION PAGE
I.
II.
III.
IV.
V.
VI.
VII.
VIII.
IX.
X.
GENERAL INFORMATION 1
OPERATING CONTROLS AND INDICATORS

incidences of cardiac arrest or other arrhythmias. Pacemaker
patients should be carefully observed. Do not rely solely on heart rate
meters.
I’D will automatically discharge internally if it has been
left charged for more than 60 seconds.zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA
WARNINGS
l This instrument is for use by authorized personnel only.
l Do not use the ZOLL PD in the presence of flammable agents (such as
gasoline1 or anesthetics.
Using the instrument near the site of a gasoline
spill may cause an explosion.
l Do not discharge with paddles shorted together or in open air. Stand clear of
patient when defibrillating.
l Do not discharge into multi-function electrodes that are not properly placed
on a patient.
l Using the device near or within puddles of water is a shock hazard to the
operator, patient, and nearby personnel.
l Internal pacemakers may cause the heart rate meter to count the pacemaker
rate during
(PD). Before using the instrument, CAREFULLY read this
entire manual.
SAFETY CONSIDERATIONS
The ZOLL PD is a high energy device and is capable of delivering up to 360 joules.
Disconnecting the line cord of an operating PD from an AC power outlet will not remove
power since the instrument is battery-powered. To completely deactivate the PD, you must
turn the SELECTOR SWITCH to the OFF position.
In order to disarm a charged defibrillator:
. Turn the SELECTOR SWITCH at least one position in either direction.
or
l If using paddles, place them in their holders and depress both DISCHARGE
buttons.
As a safety feature, the ZOLL
GENERAI, INFORMATION
This operating guide provides instructions for the safe use and proper care of the ZOLL PD
1200 Pacemaker/ Defibrillator
GENERAL INFORMATION
SECTION I

* May also be referred to as “ transcutaneous pacing” , “ noninvasive external pacing” , or
“ transcutaneous cardiac stimulation” .
2
b-
blockers, verapamil, etc.), and unexpected circulatory arrest (due to anesthesia,
surgery, angiography, and other therapeutic or diagnostic procedures). It is safer, more
reliable, and more rapidly applied in an emergency than endocardial or other tempo-
rary electrodes.
2. As a standby when standstill or bradycardia might be expected
As a stand-by when arrest or symptomatic bradycardia might be expected, the external
pacer is used especially in pacemaker procedures (e.g., acute myocardial infarction,
drug toxicity, anesthesia, or surgery, especially when disturbances of rhythmicity or
(ECG) on the monitor during external pacing, without offset or distortion.zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA
Intended Use -- Pacemaker
This product may be used for cardiac pacing for any purpose in conscious or unconscious patients
for up to a few hours duration as an alternative to endocardial stimulation. The purposes of
pacing include:
1. Resuscitation from standstill or bradycardia of any etiology
Noninvasive pacing has been used for resuscitation from standstill or temporary accel-
eration of bradycardia in Stokes-Adams disease, sick-sinus syndrome, reflex vagal
standstill and drug-induced standstill (due to procainamide, quinidine, digitalis,
(ppm).
The pacing output pulse is delivered to the heart by specially designed ZOLL NTP pacing elec-
trodes or ZOLL PD multi-function electrodes placed on the back and the precordium.Only
ZOLL NTP or ZOLL PD electrodes should be connected to this instrument.
The characteristics of the output pulse, together with the design and placement of the elec-
trodes, minimize cutaneous nerve stimulation, lower cardiac stimulation thresholds, and reduce
discomfort due to skeletal muscle contraction.
The unique design of the ZOLL PD allows clear viewing and interpretation of the electrocardi-
ogram
mA and the rate is continuously variable from 30 to 180 pulses per minute
(PD) contains a demand pacemaker consisting of a pulse
generator and ECG sensing circuitry. The output current of the pacemaker is continuously variable
up to 140
WTP)*
is an established and proven technique. This therapy is
safe and is easily and rapidly applied in both emergency and non-emergency situations when
temporary cardiac stimulation is indicated.
The ZOLL Pacemaker/ Defibrillator
OPERATOR’S GUIDE
PRODUCT DESCRIPTION
The ZOLL PD 1200 Pacemaker/ Defibrillator combines a patented noninvasive temporary
pacemaker, a DC defibrillator, a non-fade monitor, and an annotating strip chart recorder in an
integral, self-contained instrument. The PD 1200 is lightweight, compact, and can be
transported with a patient. It can be operated by either an AC line or batteries. Built-in
batteries are kept at full charge when the unit is connected to line power. The batteries are
rechargeable and can be easily replaced by the user.
PACEMAKER FUNCTION
Noninvasive temporary pacing

myocar-
dium. Only electrodes supplied by ZMI Corporation should be used.
There have been rare reports of burns under the anterior electrode when pacing adult patients
with severely restricted blood flow to the skin. Prolonged pacing should be avoided in these
cases and periodic inspection of the skin is advised.
(asystole),
the pacemaker should be used.
Ventricular or supraventricular tachycardias may be interrupted with pacing but in emergency
or circulatory collapse, synchronized cardioversion is faster and more certain. (See Section IV:
Synchronized Cardioversion.)
Electromechanical dissociation may occur following prolonged cardiac arrest or in other disease
states with myocardial depression. Pacing may then produce ECG responses without effective
mechanical contractions, and other treatment is required.
Pacing may evoke repetitive responses, tachycardia, or fibrillation in the presence of general-
ized hypoxia, myocardial ischemia, cardiac drug toxicity, electrolyte imbalance, and other
cardiac diseases.
Pacing by any method tends to inhibit intrinsic rhythmicity. Abrupt cessation of pacing, par-
ticularly at rapid rates, can cause ventricular standstill and should be avoided.
The Noninvasive Temporary Pacemaker may cause discomfort of varying intensity, which may
occasionally be severe and preclude its continued use in conscious patients. Similarly, unavoid-
able skeletal muscle contraction may be troublesome in very sick patients and may limit contin-
uous use to a few hours. Erythema of the skin under the electrodes often occurs but is inconse-
quential.
There are reports of transient inhibition of spontaneous respiration in unconscious patients with
previously available units when the anterior electrode was placed too low on the abdomen.
Pacing can be performed on pediatric patients using special electrodes (ZMI Part No. NTP 2100).
Prolonged pacing (in excess of 30 minutes), particularly in neonates, could cause burns. Caution
and periodic inspection of the underlying skin are recommended.
This device may not be connected to internal pacemaker electrodes in contact with the
GENERAL INFORMATION
conduction are present). Prophylactic placement of endocardial electrode, which car-
ries risks of displacement, infection, hemorrhage, embolization, perforation, phlebitis,
and mechanical or electrical stimulation of ventricular tachycardia and fibrillation,
can be avoided.
3. Suppression of tachycardia
An increase in heart rate from external pacing often suppresses ventricular ectopic ac-
tivity and may prevent tachycardia.zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA
Pacemaker Complications
Ventricular fibrillation will not respond to pacing and requires immediate defibrillation. (See
Section III: Emergency Defibrillation Procedure.) The patient’s dysryhthmia must therefore be
determined immediately, so that appropriate therapy can be employed. If the patient is in
ventricular fibrillation and defibrillation is successful, but cardiac standstill ensues

* “ ELECTRODES” replaces PADDLES when the multi-function electrode cable is connected.
4
2cm/ mV
l pacemaker output in milliamps
l defibrillator output in joules
.
other operational prompts, messages, and diagnostic codes
The hard copy recorder is used to document events.
The recorder normally operates in the
delay mode (4 seconds) to insure capture of critical ECG information. It may be activated
manually by pressing the recorder START/ STOP or MARK buttons. It will also be activated
automatically whenever the defibrillator DISCHARGE buttons have been pressed or a
Heart Rate Alarm goes off.
lcm/ mV, 05cm/ mV, -
- I, II, III, PADDLES, or ELECTRODES*
l ECG size
mm/ set for a period of 4 seconds.
Also displayed on the monitor are:
. heart rate, derived from measuring R to R intervals
l lead selections
lo-12 kilograms must be
applied to each paddle in order to minimize skin impedance. If multi-function electrodes are
used, make sure that they are properly applied. (See Section VII.)zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA
MONITOR AND RECORDER FUNCTION
This product contains a non-fade monitor for observation of the patient’s cardiac rhythm.
The monitor displays the ECG in moving trace mode at 25
(VF), a cardiac rhythm incompatible with life, to sinus rhythm or
other cardiac rhythms capable of producing hemodynamically significant heart beats.
In addition, this product may be used in the synchronized mode to terminate certain atria1
and ventricular tachycardias and other arrhythmias resistant to drug therapy. A qualified
physician must decide when synchronized cardioversion is appropriate.
Defibrillator Complications
Inappropriate defibrillation or cardioversion on a patient (e.g., with no malignant arrhyth-
mia) may precipitate ventricular fibrillation, asystole, or other dangerous arrhythmias.
Defibrillation without proper application of paddle electrolyte gel may be ineffective and
cause burns, particularly when repeated shocks are necessary.
Defibrillator Output Energy
The ZOLL I’D delivers up to 360 joules into a 50 ohm impedance. The energy delivered
through the chest wall, however, is controlled by skin impedances. An adequate amount of
electrolyte gel must be applied to the paddles and a force of
- Defibrillator
This product is to be used only by qualified medical personnel for the purposes of converting
ventricular fibrillation
(PD) contains a standard DC defibrillator capable of
delivering up to 360 joules of energy. It may be used in synchronized mode for performance of
synchronized cardioversion by using the R-wave of the patient’s ECG as a timing reference.
The ZOLL I’D uses conventional paddles or disposable, pre-gelled, multi-function electrodes
for defibrillation.
Intended Use
OPERATOR’S GUIDE
DEFIBRILLATOR FUNCTION
The ZOLL Pacemaker/ Defibrillator

(1-800-348-9011).
International customers should contact the nearest ZMI authorized representative. If the
shipping container is damaged, also notify the carrier.zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA
SERVICE
The ZOLL Pacemaker/ Defibrillator will provide trouble free operation without periodic re-
calibration or adjustment. However, it is suggested that the hospital biomedical engineering
department perform a routine test of the device to verify proper operation. (See Section VIII.)
U.S.A. customers
Should the ZOLL PD require service, it should be returned, in its original container, to:
ZMI Corporation, 500 West Cummings Park, Wobum, MA 01801, Attn: Service Manager
Loan instruments are available for use while repairs are being completed. To request loan
equipment, contact ZMI at l-800-348-9011 (in Mass. l-617-933-9150). Please try to have the fol-
lowing information available to expedite service:
l A description of the problem
. Department where equipment is in use
l Sample ECG strips documenting problem (if available)
l A hospital Purchase Order to allow tracking of loan equipment
International customers
Should the Zoll PD require service, it should be returned, in its original zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA container, to the
nearest authorized ZMI service center.
I’D uses special medical grade, sealed, lead-acid batteries that, when fully
charged, can provide up to two hours of monitoring. Use of the defibrillator, pacemaker, and
recorder will reduce this time. A “ LOW BATTERY’ message appears on the monitor when the
instrument must be plugged into an AC power source to ensure continued proper operation.
INSTRUMENT DIAGNOSTICS
The computer contained within the ZOLL PD performs selfdiagnostic tests on critical circuits
when the instrument is initially turned on and periodically during operation. The “READY”
message that appears briefly on the monitor during initial power-up verifies proper operation
of these circuits. During operation, an “ ERROR” message will indicate if a problem has been
detected. If this occurs, contact authorized service personnel. In the U.S.A., contact ZMI
service, telephone l-800-348-901 1.
Special tests are also available through an extended diagnostic mode (see Section IX).
INITIAL INSPECTION
Carefully inspect each container for damage. If the shipping container or cushion material is
damaged, it should be kept until the contents have been checked for completeness and the in-
strument has been checked for mechanical and electrical integrity. The contents of the ship
ment should be as shown on the following pages. Procedures for installation and initial checks
are presented in Section VIII.
If the contents are incomplete, there is mechanical damage, or the instrument does not pass its
electrical self-test, U.S.A. customers should call ZMI Corporation
GENERAL INFORMATION
BATTERIES
The ZOLL

(12 pair/ box)
Standard Apex/ Sternum defibrillator paddles
Electrophysiology external interface cable
Multi-function cable assembly for pacing/ defibrillation electrodes
Battery Pack
AAMI Standard 3-wire ECG cable
6
(6 pair/ box)
Pacer output cable
External interface cable
Test Load for Noninvasive Pacer
Multi-function pacing/ defibrillation electrodes
95OO-0002
Adult pacing electrodes (12 pair/ box)
Pediatric pacing electrodes
9145Mx)3
.
- supplied on request)zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA
Other Accessories
. NTP-2000
l NTP-2100
. NTP-3002
. N-l-P-3007
. NTP-4450
. I’D-2200
. I’D-3201
l I’D-3202
l I’D-3300
l
-4O’C to 75°C (storage and shipping)
Humidity: 5% to 95% relative humidity
Accessories (standard)
l Standard Apex/ Sternum defibrillator paddles
l 1 ECG cable
l 1 pacer cable
l 1 set adult pacer electrodes
l 1 set pediatric pacer electrodes
l 1 roll recorder paper
l 2 Operator’s Guides
.
Service Manual (not included in shipment
- 50 watts
(North American version)
In North America: 5 years, including use of a loaner. Outside North
America: consult ZMI authorized representative.
Meets or exceeds all AAMI specifications for defibrillators
Meets UL 544 and CSA standards for medical equipment
ECG patient connection is electrically isolated
Temperature: 0°C to 55°C (operating)
lbs.)
115 VAC, 60 HZ input. Maximum consumption
OPERATOR’S GUIDE
SPECIFICATIONS
General
Size:
Weight:
Power:
warranty:
Design
Standards:
Patient Safety:
Environmental:
18 cm high x 32 cm wide x 42 cm long (7 in. x 12.6 in x 16.5 in)
12 kg (27

pre-
gelled ZOLL PD multi-function pacing/ defibrillation electrodes,
packaged in pairs.
Integral Defibrillator Integral circuitry allows complete test of defibrillator charge and
Tester:
discharge without removing paddles from storage wells.
Identical circuitry allows complete test of unit configured with
multi-function electrode cable.
7
mA
Variable from 30 to 180 ppm
Fully defibrillator protected and isolated
Specifically designed anterior/ posterior pre-gelled ZOLL NTP or
ZOLL I’D multi-function pacing/ defibrillation electrodes, pack-
aged in pairs. Pediatric electrodes are available.zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA
Defibrillator
Waveform:
Output Energy
(delivered):
Damped sinusoid
Selectable at 2, 3, 5, 7, 10, 20, 30, 50, 100, 150, 200, 300, 360 joules
Charge Time:
Less than 10 seconds. Depleted batteries will result in a longer
defibrillator charge time
Delivered Energy
Display:
Monitor displays energy
Synchronized Mode: Synchronizes defibrillator pulse to patient’s R-wave. “ SYNC”
message displayed on monitor. Marker on monitor and on recorder
identifies R-wave.
Charge Control:
Paddles:
Control on apex paddle and on front panel.
Standard paddles are anterior/ anterior adult and pediatric.
Adult paddles slide off to expose pediatric paddles.
Defib Electrodes:
Specifically designed anterior/ posterior or anterior/ anterior
GENERAL INFORMATION
Pacemaker
Type:
Pulse Type:
Pulse Duration:
Pulse Amplitude:
Pacing Rate:
Output Protection:
Pacer Electrodes:
WI demand; asynchronous when used without ECG leads
Rectilinear, constant current
40 milliseconds
Variable to 140

rnrn/ sec
Delay: 4 seconds
Annotations: Time, date, energy, heart rate, pacer output, sync, event marker,
ECG size, lead, alarm, defib test OK/ Fail
Writing Method: High resolution, thermal array print head
Print-out Modes: Manual, automatic
Automatic 15 second recording initiated by alarm conditions and
Function: defibrillator discharge
- Self test mode)zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA
Recorder
Type: Single wave form channel
Paper: Standard 40 mm thermal (grid width). 50 mm (paper width)
Speed:
25
- Self test mode)
Pace Rate and Output: (Extended info
- Self test mode)
Peak Delivered Defib Current:
(Extended info
- Self test mode)
Defibrillator Charge Time:
(Extended info
- display on monitor
Display on monitor
Message display on monitor
Message display on monitor
Message display on monitor
Defibrillator Electrode Fault: Message display on monitor
Recorder Paper Out: Message display on monitor
Low Battery Voltage: Message display on monitor
Battery Charger Operational: (Extended info
mA
Display on monitor
.5x, lx, 2x
mm/ set
4 seconds
Digital display on monitor O-300 BPM
Digital display on monitor O-140
25
(-3dB) standard
Non-fade, moving trace, with freeze capability.
5 inches diagonally (108 mm x 85 mm, viewing area)
0.3-40 HZ
OPERATOR’S GUIDE
Monitor and Display
Patient Connection:
Input Protection:
Bandwidth:
Display Format:
Screen Size:
Sweep Speed:
Viewing Time:
Heart Rate:
Output Current:
Lead Selection:
ECG Size:
Alarm On/ Off Status:
ECG Lead Fault:
Pacer Electrode Fault:
Defibrillator Paddle Fault:
Via 3 lead ECG cable and paddles/ electrodes.
Selectable by front panel switch.
Fully defibrillator protected. Special circuit prevents
distortion of ECG by pacer pulse.

mA, 80 beats/ mm.
9
(36OJ), or 2 hours of
continuous monitoring, or 1.5 hours of continuous monitoring/ pacing
at 60
GENERAL INFORMATION
Type:
Voltage:
Recharge Time:
Charger:
Service:
Low Battery
Indicator:
Operating Time:
Rechargeable, sealed lead acid, medical grade
2.5 V/ cell; 6 cells
Two (2) hours for depleted pack to 90% of battery capacity (Unit off
and plugged into AC power).
Integral to instrument; no separate charger unit required.
Battery pack is easily removed as a unit.
Message displayed on monitor. The time from display of the LOW
BATTERY message until the instrument shuts down will vary
depending on the battery condition. For a battery in good condition
(fully charged prior to initiating battery operation), the message
display-to-shut down time will be approximately 20 minutes. The
instrument will operate on AC when batteries are depleted.
Defibrillator charge time may be extended when batteries are
depleted.
50 Defibrillator chargings to maximum energy

-
PD WITH STANDARD DEFIB PADDLES AND PACING-ONLY ELECTRODES
STANDARD DEFIB PADDLES
PD WITH MULTI-FUNCTION ELECTRODES

azyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA
10
14,34,40
14,31,41,43
14
Indicates batteries are charging.
14
Tests defibrillation output when using multi-function
electrodes.
“ PEDI” button and
slide adult paddles off
v decrements limit. (Located inside
paper compartment. See photo page 31)
Located under adult paddles. Push
14,41,42
Changes heart rate alarm limits. Sets time and date.
A increments limit;
13,31,32,40,
41
13
14
42,43,44
13,31,39,41,
13,31,45
13,30,45
45)
Recorder paper storage and alarm limit controls.
13,30,41,45
Adjusts audible tone of detected beat.
l-volt output. (Located on back panel. See photo page
13,16,29,30,
45
12,26,40
12,24,40,45,
47
12,25,40,48
12,19,20,45,
47
cm/ mV
Holds ECG trace stationary.
Starts and stops recorder.
36,40,48
Synchronizes discharge to patient’s R-wave.
Activates or deactivates heart rate alarms. Alarm limit
controls are inside recorder paper compartment.
Varies size of ECG: 0.5, 1.0, 2.0
12,17,22,34,
- press simultaneously. (See
Section VII for defibrillation discharge with multi-
function electrodes.)
33,34,36,40
Located on each paddle
12,17,21,22,
39,40,45,48
Indicates defibrillator is charged and ready.
11,17,21,36,
panel.
43,45,47,48
Charges defibrillator.
Located on apex paddle and front
36,37,39,40,
,21,24,30,34,
1,11,15,17,20
4:l Every 4th beat is paced beat.
Lead
Selects ECG source: I, II, III, PADDLES, ELECTRODES
ECG Beeper
ECG Out
Paper
Compartment
Alarm Set
19 Pediatric
Paddles
20 Battery Charge
Indicator Light
21 Multi-Function
Electrode Test
Load Port
DESCRIPTION
PAGES
Turns power on, selects defibrillator energy, turns pacer on,
simultaneously turns on monitor.
mA Controls amount of current to pacing electrodes.
Rate ppm Sets rate of pacemaker.
sync
Output
#
CONTROL
1 Selector Switch
2 Charge
3 Charge
Indicator Light
4 Discharge
5
6
7
8
9
10
Alarm On
11 ECG Size
12 Freeze
13 start/ stop
14 Mark
Places mark on recorder paper. Starts recorder if off.
15
16
17
18
OPERATOR’S GUIDE

CONTROLS AND INDICATORS
SECTION II
OPERATING CONTROLS AND INDICATORSzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA
1. SELECTOR SW ITCH
The SELECTOR SWITCH allows selection of any of the three operating modes:
1. MONITOR ON,
2. DEFIB ON (with various energy selections), and
3. PACER ON.
It also turns the power off. The monitor is always on except in the OFF position.
2. CHARGE
Press the CHARGE button on the front panel or, if using paddles, on the apex paddle
handle, to charge the defibrillator to the energy level selected with the SELECTOR
SWITCH control. When the CHARGE button is pressed, the defibrillator charges to
the selected energy level in 10 seconds or less when the batteries are fully charged.
To change the selected energy level after the CHARGE button has been pressed, simply
reposition the SELECTOR SWITCH, and press CHARGE again.
11

4:l BUTTONzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA
This control is used optionally to test for threshold or to determine the underlying
rhythm. When depressed, approximately every 4th beat is a paced beat. Releasing
the control will cause the instrument to resume normal operation.
12
mA (PACEMAKER OUTPUT)
This switch is used to control the amount of current to the pacemaker electrodes. For
conscious patients it should be gradually increased until capture is recognized. The
output is displayed digitally on the monitor.
RATE ppm
When pacing is selected, this control sets the rate at which the pacemaker will
operate. It must be set above the patient’s intrinsic rate in order for the pacemaker to
provide stimulation.
R-
wave after both DISCHARGE buttons are pressed and held down. This mode is
typically used for cardioversion procedures.
The SYNC button can be used in the DEFIB ON or the MONITOR ON mode.
For synchronized operation, press the SYNC button once; the “SYNC DEFIB” or
“ SYNC MONITOR” message appears on the display and the light within the SYNC
button is illuminated. A distinctive marker appears on the monitor with each detected
R-wave.
To return to standard defibrillation mode for instant discharge, press the SYNC button
again.
The ZOLL PD is designed to leave SYNC mode and revert to standard defibrillation
mode after discharge.
OUTPUT
OPERATOR’S GUIDE
3.
4.
5.
6.
7.
8.
CHARGE INDICATOR LIGHT
Located on the apex paddle, this light turns on when the defibrillator is charged and
ready. When using the multi-function electrode cable, the indicator light is located on
the cable connector.
DISCHARGE
Each paddle has a DISCHARGE button located near the forward end of the handle.
Press and briefly hold both buttons simultaneously to discharge the defibrillator. The
multi-function electrode cable (not shown) has two DISCHARGE buttons mounted in the
instrument connector. Both must be pressed to discharge the defibrillator. (See Section
VII.)
SYNC
In SYNC mode, the unit synchronizes defibrillator discharge with the first detected

cm/ mV and is indicated on the monitor in the upper left center of the display.zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA
FREEZE
The freeze control allows the operator to capture and hold on the display a full four (4)
seconds of ECG trace for viewing important or interesting ECG morphology. Normal
monitoring is continued
when the control is released.
START/STOP (RECORDER)
This pushbutton starts and stops the hard copy recorder.
MARK (RECORDER)
The MARK control places a distinctive mark on the recorder margin the instant the
button is pressed. MARK also triggers a 15 second recorder run if the recorder had been
off.
ECG BEEPER VOLUME
The VOLUME control at the left front of the instrument (below the recorder) allows
manual adjustment of the systole beeper tone from maximum volume to inaudible. (The
Heart Rate Alarm and Charge-Ready volumes are not adjustable.)
13
.5,
1.0, and 2.0
” “ PADDLES” monitoring may not be used in
PACER ON mode or, with the optional PD 1210, in “ EXT TRIG” mode. ECG
monitoring through multi-function electrodes is accomplished by selecting
“ ELECTRODES” .
Note: When using multi-function electrodes, the word “ PADDLES” is replaced with
the word “ ELECTRODES.”
10. ALARM ON
The ALARM ON button is used to activate and deactivate the Heart Rate Alarm. A
bell symbol appears on the monitor when the alarms are activated and the light
within the button is illuminated. When the ALARM ON is deactivated, the bell
symbol disappears and the light within the button goes off. When the ALARM ON is
active and an alarm condition is detected, an audible alarm sounds and the bell symbol
flashes. To avoid possible confusion with the “ DEFIBRILLATOR CHARGED” tone,
the Heart Rate Alarm tone is suppressed when the defibrillator is on (SELECTOR
SWITCH is turned to any of the defib settings).
11.
12.
13.
14.
15.
ECG SIZE
This control allows the operator to vary the size of the ECG signal at
- I, II, III,
“ PADDLES” (defibrillator paddles), or “ ELECTRODES” (multi-function electrodes).
“ PADDLES” or “ ELECTRODES’ is automatically selected when the instrument powers
up in DEFIB ON or MONITOR ON. Lead II is automatically selected when the
instrument powers up in PACER ON. ECG monitoring through the paddles is
accomplished by selecting “ PADDLES.
CONTROLS AND INDICATORS
9. LEAD
Selection of the ECG source is accomplished through the LEAD button. Pressing the
button will sequentially select and display each option on the monitor

v button decrements the displayed value. (Alarm set button is
located inside the recorder paper compartment.)zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA
PEDIATRIC PADDLES
Pediatric size paddles are built into the paddle assembly. They lie directly under the
adult electrode surface and are accessed by pushing the PEDI button on the side of each
paddle and sliding the adult surface forward.
20.
21.
Adult paddles slide off to expose pediatric paddles.
BATTERY CHARGING INDICATOR LIGHT
This light indicates that the batteries are charging. It should always be lit when the
unit is connected to an AC power source.
TEST LOAD PORT
The test port is used to test the defibrillator output circuitry when using the multi-
function electrode cable.
14
30). The A button increments the
displayed value. The
(preset at 150) and Low Heart Rate Alarm setting
(preset at
OPERATOR’S GUIDE
16. ECG OUT
The ECG out phone jack provides a high-level l-volt ECG signal from the
Pacemaker/ Defibrillator and is configured to provide the analog ECG signal on the jack
“ tip,” with the jack “ sleeve” as signal ground reference. (ECG jack is located on the
back panel.)
17.
18.
19.
PAPER COM PARTMENT
Opens recorder paper storage. Heart Rate Alarm adjustment controls are located within
the paper compartment.
ALARM SET
This control allows the user to change the High Heart Rate Alarm setting

- I, II, III.
15
maintain battery charge, keep instrument plugged in when not in use.zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA
SELECT ENERGY
l
Turn the SELECTOR SWITCH to
the desired energy level. This
action automatically turns the
power ON.
Note: Defibrillator “ PADDLES” or “ ELECTRODES” , when using multi-function
electrodes, is selected as the ECG source when the instrument is turned to MONITOR
ON or DEFIB ON. You may then select any of the ECG leads
to
(ACLS) and familiar with equipment operation. The
precise cardiac arrhythmia (e.g., ventricular fibrillation) must be determined before
attempting defibrillation.
l Do not touch the bed, patient, or any equipment connected to the patient during
defibrillation.
l All persons in attendance of the patient must be warned to “ STAND CLEAR” prior to
defibrillator discharge.
l In order
EMERGENCY DEFIBRILLATION PROCEDURE
SECTION III
EMERGENCY DEFIBRILLATION PROCEDURE
1.
WARNINGS
Before proceeding, CAREFULLY read the following:
l Emergency defibrillation should only be attempted by skilled personnel trained in
advanced cardiac life support

- This could
cause burns and reduce the amount of energy delivered to the heart
l The paddles may be used for ECG monitoring. Use of paddles for ECG monitoring is for
emergency situations when time does not allow connection of monitoring electrodes.
The
unit automatically pre-selects “PADDLES’ when it is initially turned on. Pressing the
LEAD button will allow selection of the desired ECG source (I, II, III, PADDLES,
ELECTRODES). Paddles monitoring is NOT possible when in PACING mode.
Note: If you are using multi-function electrodes, do the following:
l Remove electrodes from the storage pouch and place the round one marked “ FRONT”
directly over the cardiac apex, as shown on the diagram on the pouch.
l Place the rectangular electrode marked “ BACK” on the back between the patient’s left
scapula and the spine at heart level (see diagram on pouch).
Note: zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAThe “ BACK” electrode may be placed over the patient’s right sternal zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAarea if it
is not possible to access the patient’s posterior. Effective defibrillation will result, but
pacing will usually be less effective.
16
OPERATOR’S GUIDE
Prepare Paddles (For multi-function electrodes, see note below or Section VII.)
l Remove the paddles from their holders by grasping the handles and lifting the
paddles straight up.
l Apply a liberal amount of electrolyte gel to the electrode surface of each paddle.
To avoid risk of electrical shock to the operator, do not allow electrolyte gel to
accumulate on hands or paddle handles.
l Rub the electrode surfaces together to evenly distribute the applied gel.
Apply Paddles to Chest
l Apply the paddles firmly to the anterior wall of the chest. The sternum paddle should
be placed to the right (patient’s right) of the sternum, just below the clavicle. The apex
paddle should be placed on the chest wall, just below and to the left of the patient’s
left nipple, along the anterior-axillary line.
l If external pacing electrodes are applied, it is not necessary to remove them. Simply
ensure that the paddles contact skin. There should be ample room for the apex paddle.
l Rub the paddles against the skin to maximize the paddle-to-patient contact. Do not
permit gel to accumulate between the paddle electrodes on the chest wall

The
defibrillator is now ready. All persons attending patient should be warned to STAND
CLEAR.zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA
3. DISCHARGE DEFIBRILLATOR
l
Verify that no one is in contact with the patient, monitoring cable or leads, bed rails, or
any other potential current pathway.
l Simultaneously press and briefly hold both DISCHARGE buttons (one on each paddle)
to deliver energy to the patient.
l If you are using multi-function electrodes, simultaneously press and briefly hold both
DISCHARGE buttons located on the cable connector assembly.
NOTES:
lIf zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAthe defibrillator is not discharged within 60 seconds of reaching the selected energy
level, it will automatically dump the stored energy internally.
l During the ten seconds prior to this internal dump, the “ CHARGE READY” tone will
beep intermittently. When the internal dump is complete, the “ CHARGE READY”
tone will stop, the CHARGE INDICATOR LIGHT will go off, and the monitor
delivered energy display will go off.
lShould you need to disarm the defibrillator when it is charged, simply turn the
SELECTOR SW ITCH to MONITOR ON or any other energy setting. This will cause the
defibrillator to dump its charge internally.
17
EMERGENCY DEFIBRILLATION PROCEDURE
l
When placing electrodes, be sure to press firmly on the adhesive area around the
electrode periphery. Gently press the gel area to remove any trapped air. This ensures
good skin coupling.
l Connect the electrodes to the multi-function cable.
2. CHARGE DEFIBRILLATOR
l Press the CHARGE button on the front panel, or if using paddles, on the apex paddle
handle.
l To increase or decrease the selected energy after the CHARGE button has been pressed,
move the SELECTOR SWITCH to the new energy level, and press CHARGE again.
. After 6-10 seconds of charging to the selected level, the CHARGE INDICATOR LIGHT
will light on the apex paddle or the multi-function cable connector. A distinctive
audible tone will go on and the energy selected will be displayed on the monitor.

OPERATOR’S GUIDE
lzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAA “ PADDLE FAULT” message will appear on the monitor whenever the paddles or
multi-function cable are not connected or are improperly seated in the instrument.
The
instrument will also disarm itself zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA
if such a fault occurs during charge or after the charge
is ready.
l
An “ ELECTRODES OFF” message will appear on the monitor if, on an attempt to
discharge with multi-function electrodes, the electrodes are not connected or contact
with the patient is poor.
lCAUTION: The unit does not disarm itself for an “ ELECTRODES OFF” failure. As a
safety feature, the operator must press the DISCHARGE buttons again after correcting
the “ ELECTRODES OFF” condition to discharge the defibrillator.
lPaddle Cleaning: Paddle plates and handles must be thoroughly cleaned after each
use.
18