ZOLL Propaq MD Manual

Propaq
®
MD Operator’s Guide
9650-0802-06 Rev. ADecember 2011

ZOLL, pedi•padz, and stat•padzare registered trademarks, and SurePower and Rectilinear Biphasic are
trademarks 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]

9650-0802-06 Rev. A Propaq MD Operator’s Guide i
Table of Contents
Chapter 1 General Information
Product Description ............................................................................................................1-1
Propaq MD 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........................................................................................................................1-6
Propaq MD Indications for Use...........................................................................................1-6
Manual Defibrillation ...................................................................................................1-7
ECG Monitoring ..........................................................................................................1-7
External Transcutaneous Pacing ................................................................................1-7
Non-Invasive Blood Pressure Monitoring ...................................................................1-8
Temperature Monitoring .............................................................................................1-8
Sp02 Monitoring ..........................................................................................................1-8
Respiration Monitoring ................................................................................................1-8
CO2 Monitoring ...........................................................................................................1-9
Invasive Pressure Monitoring .....................................................................................1-9
Propaq MD Product Functions............................................................................................1-9
Defibrillator Function ...................................................................................................1-9
Defibrillator Output Energy .........................................................................................1-9
External Pacemaker ...................................................................................................1-9
ECG Monitoring ........................................................................................................1-10
Electrodes .................................................................................................................1-10
Batteries ....................................................................................................................1-11
Ready For Use (RFU) Indicator ................................................................................1-12
Safety Considerations.......................................................................................................1-12
Warnings...........................................................................................................................1-13
General .....................................................................................................................1-13
ECG Monitoring ........................................................................................................1-14
Defibrillation ..............................................................................................................1-15
Pacing .......................................................................................................................1-16
Pulse Oximeter .........................................................................................................1-17
Noninvasive Blood Pressure .....................................................................................1-18
IBP ............................................................................................................................1-18
CO2 ..........................................................................................................................1-18
Respiration ................................................................................................................1-19
Ferromagnetic Equipment ........................................................................................1-19
Battery ......................................................................................................................1-19
Operator Safety ........................................................................................................1-20
Patient Safety ...........................................................................................................1-21
Cautions............................................................................................................................1-22

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Restarting the Defibrillator ................................................................................................1-22
FDA Tracking Requirements.............................................................................................1-23
Notification of Adverse Events ..................................................................................1-23
Software License ..............................................................................................................1-24
Service..............................................................................................................................1-24
The ZOLL Serial Number..................................................................................................1-26
Chapter 2 Product Overview
Defibrillator Controls and Indicators....................................................................................2-1
The Front Panel ..........................................................................................................2-2
Display Screen ............................................................................................................2-4
Battery Status and Auxiliary Power Indicators ............................................................2-6
Patient Cables and Connectors ..................................................................................2-7
External Paddles .........................................................................................................2-9
Auxiliary Power Adapter ...........................................................................................2-11
Navigating the Display Screen..........................................................................................2-12
Quick Access Keys ...................................................................................................2-12
Navigation Keys .......................................................................................................2-15
Display Brightness ....................................................................................................2-15
Common Tasks.................................................................................................................2-16
Changing the Display Brightness ..............................................................................2-16
Replacing a Battery Pack on the Propaq MD ...........................................................2-16
Using Treatment Buttons ..........................................................................................2-17
Chapter 3 Monitoring Overview
Propaq MD 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
Pulse Oximetry (SpO2) ...............................................................................................3-3
Monitoring Display Options.................................................................................................3-3
Configuring the Waveform Display .....................................................................................3-7
Chapter 4 Trends
Displaying the Trends Status Window ................................................................................4-1
Displaying and Printing Trend Information..........................................................................4-2
Changing the Trends Status Window Display.....................................................................4-3

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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
The Alarm Suspension Timer .....................................................................................5-6
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 MD 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...................................................................................................8-6
Applying the Cuff to the Patient ..........................................................................................8-8

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Ensuring Correct Cuff Inflation Settings..............................................................................8-9
Configuring NIBP Alarms and Settings.............................................................................8-10
Enabling/Disabling NIBP Alarms and Setting Alarm Limits ......................................8-10
Using the NIBP Parameter Control Panel .................................................................8-12
NIBP System Messages...................................................................................................8-15
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
Specifying the 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 Nasal or Nasal/Oral 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

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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
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
Printing 12-Lead Waveform Traces ..................................................................................13-9
12-Lead Print and Display Options.................................................................................13-10
Selecting 12-Lead Acquire ......................................................................................13-10
Specifying the Number of 12-Lead Print Copies .....................................................13-10
Specifying the 12-Lead Print Format ......................................................................13-11
Printing 10 Seconds of the Lead ll Waveform Trace ..............................................13-11
Specifying the 12-Lead Frequency Response ........................................................13-11

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Chapter 14 Manual Defibrillation
Emergency Defibrillation Procedure with Paddles............................................................14-1
Determine the Patient’s Condition Following Local Medical Protocols .....................14-2
Begin CPR Following Local Medical Protocols .........................................................14-2
Turn Unit On .............................................................................................................14-2
1 Select Energy Level ...............................................................................................14-2
2 Charge Defibrillator ................................................................................................14-3
3 Deliver Shock .........................................................................................................14-4
Emergency Defibrillation Procedure with Hands-Free Therapy Electrodes......................14-5
Determine the Patient’s Condition Following Local Medical Protocols .....................14-5
Begin CPR Following Medical Protocols ..................................................................14-6
Prepare Patient .........................................................................................................14-6
Turn Unit On .............................................................................................................14-6
1 Select Energy Level ...............................................................................................14-7
2 Charge Defibrillator ................................................................................................14-7
3 Deliver Shock .........................................................................................................14-8
Internal Paddles................................................................................................................14-9
Verification Prior to Use ............................................................................................14-9
Synchronized Cardioversion...........................................................................................14-10
Synchronized Cardioversion Procedure ......................................................................... 14-11
Determine the Patient’s Condition and Provide Care Following Local Medical
Protocols ..............................................................................................................14-11
Prepare Patient .......................................................................................................14-11
Turn the Unit On .....................................................................................................14-11
Press the Sync Key ................................................................................................14-11
1 Select Energy Level .............................................................................................14-12
2 Charge Defibrillator ..............................................................................................14-12
3 Deliver Shock .......................................................................................................14-13
Chapter 15 External Pacing
External Pacing.................................................................................................................15-2
Pacer Modes .............................................................................................................15-2
Pacing in Demand Mode ..................................................................................................15-2
Determine Patient Condition and Provide Care Following Local Medical Protocols..15-2
Prepare the Patient ...................................................................................................15-2
1 Turn Unit On ..........................................................................................................15-2
2 Apply ECG Electrodes/Hands-Free Therapy Electrodes .......................................15-3
3 Press Pacer button ................................................................................................15-3
4 Set Mode ...............................................................................................................15-4
5 Set Pacer Rate ......................................................................................................15-4
6 Turn Pacer On .......................................................................................................15-4
7 Set Pacer Output ...................................................................................................15-4
8 Determine Capture ................................................................................................15-4
9 Determine Optimum Threshold ..............................................................................15-5

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Pacing in Fixed Mode .......................................................................................................15-6
1 Turn Unit On ..........................................................................................................15-6
2 Apply ECG Electrodes/Hands-Free Therapy Electrodes .......................................15-6
3 Press Pacer button ................................................................................................15-7
4 Set Mode ...............................................................................................................15-7
5 Set Pacer Rate ......................................................................................................15-7
6 Turn Pacer On .......................................................................................................15-7
7 Set Pacer Output ...................................................................................................15-7
8 Determine Capture ................................................................................................15-8
9 Determine Optimum Threshold ..............................................................................15-8
Pediatric Pacing ........................................................................................................15-9
Chapter 16 Patient Data
Storing Data......................................................................................................................16-1
Capturing a Data Snapshot...............................................................................................16-2
Reviewing and printing snapshots ............................................................................16-2
Treatment Summary Report .............................................................................................16-2
Printing Treatment Summary Report ........................................................................16-3
Transferring Data to a USB Device...................................................................................16-3
Clearing the Log .......................................................................................................16-4
Chapter 17 Printing
Printing Patient Data.........................................................................................................17-1
Printer Setup .............................................................................................................17-2
Automatic Prints ........................................................................................................17-2
Printing Waveforms ..................................................................................................17-2
Printing Reports ........................................................................................................17-3
Printing Trends .........................................................................................................17-4
Chapter 18 Maintenance
Daily/Shift Check Procedure.............................................................................................18-2
Inspection .................................................................................................................18-2
Defibrillator/Pacing Test with Hands-Free Therapy Electrodes.........................................18-3
Defibrillator Testing with External Paddles........................................................................18-5
Recommended Minimum Preventive Maintenance Schedule..........................................18-7
Annually ....................................................................................................................18-7
Guidelines for Maintaining Peak Battery Performance.....................................................18-7
Cleaning instructions ........................................................................................................18-8
Cleaning the Propaq MD unit ....................................................................................18-8
Cleaning the NIBP Blood Pressure Cuff ...................................................................18-8
Cleaning SpO2 Sensors ...........................................................................................18-9
Cleaning Cables and Accessories ............................................................................18-9
Loading Recorder Paper ...........................................................................................18-9
Cleaning the Print Head ..........................................................................................18-10

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Appendix A Specifications
Defibrillator..........................................................................................................................A-2
Monitor/Display.................................................................................................................A-14
Impedance Pneumography...............................................................................................A-15
Alarms...............................................................................................................................A-15
Recorder...........................................................................................................................A-16
Battery .............................................................................................................................A-17
General.............................................................................................................................A-17
Pacer ................................................................................................................................A-18
CO2 ..................................................................................................................................A-18
Pulse Oximeter .................................................................................................................A-19
Non-Invasive Blood Pressure ...........................................................................................A-20
Invasive Pressures ...........................................................................................................A-21
Temperature......................................................................................................................A-22
Clinical Trial Results for the Biphasic Waveform ..............................................................A-23
Randomized Multicenter Clinical Trial for Defibrillation of Ventricular Fibrillation (VF)
and Ventricular Tachycardia (VT) ...........................................................................A-23
Randomized Multi-Center Clinical trial for Cardioversion of
Atrial Fibrillation (AF) ..............................................................................................A-24
Synchronized Cardioversion of Atrial Fibrillation ......................................................A-25
Electromagnetic Compatibility Guidance and Manufacturer’s Declaration.......................A-27
Appendix B Accessories

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Chapter 1
General Information
Product Description
The ZOLL®Propaq®MD unit is an easy-to-use portable defibrillator that combines
defibrillation and external pacing with the following monitoring capabilities: ECG, Pulse
Oximeter, Non-invasive Blood Pressure, IBP, CO2, Temperature, and Respiration. It has been
designed for all resuscitation 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: The Propaq MD has defibrillation and pacing functionality, but some of the monitoring
functions 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 MD includes a transcutaneous pacemaker consisting of a
pulse generator and ECG sensing circuitry. Pacing supports both demand and fixed noninvasive
pacing for adult patients and adolescent, child, and infant pediatric patients.
The Propaq MD has a patient data review and collection system that allows you to view, store,
and transfer patient data. The Propaq MD unit contains a printer and USB port, which you can
use to print the data and transfer it to a PC.

CHAPTER 1GENERAL INFORMATION
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Propaq MD Optional Features
The following features are optional in the Propaq MD unit.
Figure 1-1 Propaq MD Optional Features
How to Use This Manual
The Propaq MD Operator's Guide provides information operators need for the safe and
effective use and care of the Propaq MD 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 the Chapter 18, "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 defibrillator does not pass its electrical 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(NellcorTM)
NIBP (with Smartcuf®and SureBPTM)
EtCO2 (Oridion®Microstream®)
Temperature
Invasive Pressures (3 Channels)
Printer

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
Dangerous voltage.
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.
Type B patient connection.
Type BF patient connection.
Type CF patient connection.
Defibrillator-proof type BF patient connection.
Defibrillator-proof type CF patient connection.
Fusible link.

CHAPTER 1GENERAL INFORMATION
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Equipotentiality.
Alternating current (ac).
Direct current (dc).
Auxiliary power adapter operation.
Caution, high voltage.
Earth (ground).
Negative input terminal.
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.
Symbol Description
2%452.
,I)/.
RECYCLE
,I)/.

Symbols Used on the Equipment
9650-0802-06 Rev. A Propaq MD Operator’s Guide 1-5
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.
Not sterile.
Manufacturer.
Authorized representative in the European Community.
Serial Number.
Catalogue number.
Consult instructions for use.
Symbol Description

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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 Charge button or press the Pacer button”).
This guide uses uppercase italics for audible prompts and for text messages displayed on the
screen (for example, LEAD FAULT).
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.
Propaq MD Indications for Use
The Propaq MD is intended for use by trained medical personnel who are familiar with basic
monitoring, vital sign assessment, emergency cardiac care, and the use of the Propaq MD.
The Propaq MD 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 MD will be used
primarily on patients experiencing symptoms of cardiac arrest or in post trauma situation. It
may also be used whenever it is required to monitor any of those functions that are included (as
options) in the device. The Propaq MD 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.
Prescription only.
Battery charging status.
Symbol Description
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 MD Indications for Use
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When the pediatric patient is less than 8 years of age or weighs less than 55 lbs. (25 kg.), use
ZOLL pedi•padz®pediatric defibrillation electrodes. Do not delay therapy to determine the
patient’s exact age or weight.
Manual Defibrillation
Use of the Propaq MD in the manual mode for external and internal defibrillation is indicated
on victims of cardiac arrest where there is apparent lack of circulation as indicated by:
•Unconsciousness.
•Absence of breathing.
•Absence of pulse.
This product should be used only by qualified medical personnel for converting ventricular
fibrillation and rapid ventricular tachycardia to sinus rhythm or other cardiac rhythms capable
of producing hemodynamically significant heart beats.
The unit can also be used for synchronized cardioversion of certain atrial or ventricular
arrhythmias. Qualified medical personnel must decide when synchronized cardioversion is
appropriate.
The patient population will range from newborn (neonate) to adult.
ECG Monitoring
The Propaq MD 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.
External Transcutaneous Pacing
This product can be used for temporary external cardiac pacing in conscious or unconscious
patients as an alternative to endocardial stimulation.
The purposes of pacing include:
•Resuscitation from standstill or bradycardia of any etiology:
Noninvasive pacing has been used for resuscitation from cardiac standstill, reflex vagal
standstill, drug-induced standstill (due to procainamide, quinidine, digitalis, b-blockers,
verapamil, etc.) and unexpected circulatory arrest (due to anesthesia, surgery, angiography,
and other therapeutic or diagnostic procedures). It has also been used for temporary
acceleration of bradycardia in Stokes-Adams disease and sick-sinus syndrome. It is safer,
more reliable, and more rapidly applied in an emergency than endocardial or other
temporary electrodes.

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•As a standby when standstill or bradycardia might be expected:
Noninvasive pacing can be useful as a standby when cardiac arrest or symptomatic
bradycardia might be expected due to acute myocardial infarction, drug toxicity, anesthesia,
or surgery. It is also useful as a temporary treatment in patients awaiting pacemaker implants
or the introduction of transvenous therapy. In standby pacing applications, noninvasive
pacing might provide an alternative to transvenous therapy that avoids the risks of
displacement, infection, hemorrhage, embolization, perforation, phlebitis, and mechanical
or electrical stimulation of ventricular tachycardia or fibrillation associated with endocardial
pacing.
•Suppression of tachycardia.
Increased heart rates in response to external pacing often suppress ventricular ectopic
activity and might prevent tachycardia.
•Pediatric pacing.
Pacing can be performed on pediatric patients weighing 33 lbs. (15 kg.) or less using ZOLL
pediatric hands-free therapy electrode pads. Prolonged pacing (in excess of 30 minutes),
particularly in neonates, could cause burns. Periodic inspection of underlying skin is
recommended.
Non-Invasive Blood Pressure Monitoring
The Propaq MD 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 MD 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 MD 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.
Respiration Monitoring
The Propaq MD 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.

Propaq MD Product Functions
9650-0802-06 Rev. A Propaq MD Operator’s Guide 1-9
CO2Monitoring
The Propaq MD 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 MD 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 MD Product Functions
Defibrillator Function
The Propaq MD contains a direct current (dc) defibrillator capable of delivering up to 200
joules. It may be used in synchronized mode to perform synchronized cardioversion using the
patient’s R-wave as a timing reference. The unit uses paddles or disposable, pregelled
electrodes for defibrillation.
Defibrillator Output Energy
Propaq MD defibrillators can deliver biphasic energy from 1 joule to 200 joules. The energy
delivered through the chest wall, however, is determined by the patient’s transthoracic
impedance. An adequate amount of electrolyte gel must be applied to the paddles and a force of
10 to 12 kilograms (22 to 26.4 pounds) must be applied to each paddle in order to minimize this
impedance. If hands-free therapy electrodes are used, make sure that they are properly applied.
(Refer to the instructions on the electrode package).
External Pacemaker
Propaq MD defibrillators include a transcutaneous pacemaker consisting of a pulse generator
and ECG-sensing circuitry. Noninvasive transcutaneous pacing (NTP) is an established and
proven technique. This therapy is easily and rapidly applied in both emergency and
nonemergency situations when temporary cardiac stimulation is indicated.
The output current of the pacemaker is continuously variable from 10 to 140 mA (the output
current is 0 mA when paused). The rate is continuously variable from 30 to 180 pulses per
minute (ppm), by increments of 5 ppm (10 bpm when greater than 100 ppm).
The pacing output pulse is delivered to the heart via ZOLL hands-free defibrillation/pacing
electrodes placed on the patient’s back and the precordium.