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