ZOLL R Series User manual

R Series ALS/ Plus In-service Script
Device
-Color Coded Operating System: Start with the dial. Three different colored
coded areas. RED for Defib, GREEN for Pacing, GREY for monitoring.
-Setup on Code Cart
-An Adult OneStep CPR Electrode should ALWAYS be connected to the therapy
cable.
-This allows “Code-Readiness” and allows the device to pass its Automated
Daily Test.
-Power LED lights
1. Battery Indicator: GREEN=Charged, AMBER=Charging
FLASHING=Problem (Battery Check)
2. A/C Power Indicator GREEN=Device is plugged in
3. No lights=Not plugged in
-Code Readiness Indicator: GREEN Check mark= Code Ready RED “X”= Not Code
Ready
-Self Test- Every 24 hours, the device will do a 100 point test and will display a if the
device
is ready for use, or if it failed a part of the test.
-Failed Test- The device will display “Readiness Test Failed” on the screen and will
highlight what needs to be fixed.
-These are usually easily fixable problems (No pads plugged in, no battery, no A/C power, etc)
-If the device reads “DEFIB FAILURE”, call BioMed.
-Battery- Indicator lights show 30 min. incriminates for total of 4 hours of runtime.
- If orange light appears on “?” section of battery, call BioMed
-Recorder Tray
Press button to open door, insert the paper with the black arrow facing towards the back of the
device. Pull a strip or two forward and let paper drop. Then close the door on top of the strip.
-Cables/Caps
1. Electrotherapy Cable- (Is bolted down)
2. SpO2 (Blue/If Applicable)
3. 3 Lead EKG/One-Step Cable
4. EtCO2 (Yellow/If Applicable)
5. NIBP- Non-Invasive Blood Pressure (Black/If Applicable)
6. Cable Compartment for all cables attached.
One-Step Cable: Comes out the side and is 8 feet in length.

Using the Device- Everything will be pre connected and ready for use. This means it is ready for a CODE and
TESTING.
Connecting and Disconnecting Pads
Locking lever holds pads and cable into place. Press on the
far end of the lever to release.
Using the Pads
It is important to prep the skin as best as you possibly can.
Wipe the patient down, remove as much hair as possible, “press and roll” the pad into place.
-Pads: Used for anterior and posterior positions and have a built in 3-
lead (if Applicable)
-Placement
1. Posterior Pad (RED) Place 1st
2. Anterior Pad (BLUE) Place 2nd
RED is placed posterior sub-scapular to the left.
BLUE is placed with the CPR sensor- Mid Sternal/Mid Nipple in the
center of the sternum
Placing- Take the pad from packaging and then “Press and Roll” the
pad in to place
Alternate Placement: A/A Positioning (If A/P is not applicable)
1. Posterior Pad- Put Posterior Pad in Anterior positon
2. Anterior Pad- Position in the Lateral position (under
arm), tear CPR sensor from pad and place in center of
chest
Pediatric Pads: 0-8 Years and >25kg (55lbs) Any defibrillation that is done
will be adjusted by the device by an internal algorithm. (50J, 70J, 85J)
Integrated 3-Lead
-The OneStep CPR Electrode (Adults Only) has an integrated 3-Lead for pacing needs. No need to attach a
separate cable to your patient
-If attempting to Pace in A/A placement, it is recommended to attach a separate 3-Lead when using the
OneStep Pads as the ECG signal may be faint

Converting To Manual Mode (R Series Plus Model ONLY)
-Depending on how your facility configures the device, you can convert the R Series Plus in to Man-
ual Mode by one of the two ways:
1. Press the Manual Mode Key (bottom left corner)
2. Press the Manual Mode key, and then the Confirm Key (bottom right corner)
Defibrillation Mode- Red Zone- (Simulator should be turned to “VT HI”)
-Can be used as AED or Manual Defib
-AED (Automated External Defibrillator)
1. Turn to DEFIB mode,
2. Press “ANALYZE”,
3. Upon a shockable rhythm, the “SHOCK”button will illuminate red,
clear, press shock.
-Auto Escalation- The device will increase the energy automatically
-Energy will start at 120J, then to 150J, then to 200J for Adult Patients
-Energy for Pediatrics starts at 50J, 70J, 85J
-Energy Select Key- Changes energy level
Note: if you manually change the energy, you will have to manually change it
again for the next energy level/shock
-Manual Mode- To do a Manual Defibrillation
1. ENERGY SELECT
2. CHARGE
3. SHOCK
CPR Sensor, Compressions, and Feedback
CPR Sensor: Is built in to the pad
CPR Feedback: Lets us know how we are doing with our compressions based on RATE,
DEPTH, and RECOIL
Idle Timer: Will display after 3 seconds on inactivity in the “Purple” Zone of the monitor.
Rate and Depth Numerical Values: Will display once you start compressions.
Release Bar: Checks the status of your release and recoil off the chest. Full Bar=Great!
Diamond/PPI (Perfusion Performance Index): Mimics
perfusion pressure and will begin to fill up.
What we want to see:
1. Rate (compressions per minute) 100-120 CPM
2. Depth: At least 2.0-2.4 inches for adults
3. Recoil: Release Bar needs to be full
-Scenario 1) Not doing fast compressions to proper rate
-The device will begin to sound. Match the metronome to get back to the right rate of 100cpm.
-Scenario 2) Not going deep enough
-The device will say “Push Harder” to get you above 2 inches in depth.
Positive Confirmation: Once you have sufficient depth, the device will say “Good Compressions”.

Pediatric Feedback: Will only display Rate and Depth- you will not hear the “Push Harder” voice prompt.
—————————————-BLS USERS ARE NOW EXCUSED FROM TRAINING———————————
See-Thru CPR Technology (Simulator is Changed to VF Artifact)
-Two Wave Forms
1) Raw EKG-Same waveform with artifact
2) Filtered EKG- Internal algorithm that filters out any artifact allowing you to see the underlying
rhythm.
-As you are doing compressions, you can analyze the rhythm without letting off
the chest.
-Allows you to charge WHILE doing
compressions.
Pacing-Green Zone (Simulator is changed to “3rd”)
-Leads are built in to the pads (Only One Step Complete Pacing Pads)
-Pacing zone is labeled GREEN
-Dials: Two dials
1. Output
2. Rate
-Default Settings: 0mA and 70PPM
-What we see: Downward pacing markers
-How can we see capture?: We should see Pacer Marker followed by widened QRS.
-How do we confirm capture? Check the pulse of the patient.
-Capture 40-80mA. (Good starting point)
- 10% above the threshold.
-Underlying Rhythm: Press and hold the 4:1 button at the button of the screen
-4:1 Button: Suppresses the pacer to 1/4 the set rate allowing us to see the underlying rhythm w/out loosing
capture.
Cardioversion- (Synchronized Cardiover-
sion) (Simulator should be in “AFIB”)
-We need to be Synchronized
-Dial: Should be in the RED Zone (Defib)
-Sync: Press Sync button which is located to the far right
of screen
-Arrow: Wait to see SYNC indicators on top of the “R”
wave
-Charge and Shock- When we shock on a Cardioversion,
we need to “Press and Hold” until the device shocks

Monitor Mode
-Lead Key: Can change the lead by pressing lead- Circulates through Lead I-III and PADS
-Size Key: The gain of the trace. Makes the waveform bigger or smaller.
-Alarm Suspend: Alarms a default to be “Off”. (Unless otherwise Configured)
1. Alarm Off- Press and hold for 3-4 seconds and the alarm will be SILENCED until oth-
er wise activated by the user.
2. Temporary Silence- Press alarm suspend and it will be temp disabled (15 for Lethal and 90 for non-
lethal).
3. If the patient is in VFib, Vtac, or Asystole, the alarms will automatically sound after 5
seconds.
-Recorder: Starts or stops the paper recorder at anytime.
-Soft-keys
1. Options: Includes:
- QRS Vol On: Turns tone on or off.
- Low Bright: Adjust Screen Brightness
- Traces: Waveforms you can bring up. Options——Traces——Trace 2,3.
- More: Reveals “Clock Set” to change time the Defib displays.
2. Param: To deploy EtCO2, place Single Patient Airway Adapter in to place
-No Need to ZERO between each use
-No need to warm-up
-Everything happens automatically… “Plug and Play”
-To Bring up the waveform: Options———Traces———Trace 3—
——EtCO2
-NIBP: Param—Setting—Auto Interval (set time for Auto Interval)
3. Code Marker: Varies with which zone you are in (Defib, Pacer, Monitor)
-Allows you to time stamp different clinical actions and retrieve
later on.
4. Report Data: Transcript of the entire code start to finish
Print Chart: All codes start to finish, including waveforms during the
code.
Print Range: Select and print specific event.
Print Log: Time stamp of everything that has happened since the device
has been on for the current code and previous codes that are stored
Test Log: Holds the last 1000 tests performed and can be retrieved here.
5. Alarms: Set highs and lows for different parameters.
-The alarms will be defaulted back once the device is off for 8 Seconds.
NIBP Key (If purchased)- One, NIBP reading. Press again to abort reading.
-Press and hold for 2 Seconds for Auto Interval reading
Data Transfer and Test Log

It is very important to transfer the code data after an event as you have a limited amount of time (30 min to 3
days per hospital configuration) before the R Series will erase all content. Follow these steps for WiFi Transfer
or Compact Flash Card Transfer:
WiFi Transfer
•Monitor Mode———Report Data———Transfer Mode———Report to WiFI
Compact Flash Card
•Monitor Mode———Report Data———Transfer Mode———Report to Card
Test Log
The R Series can hold the last 999 Tests performed (manual or automatic) and can be reviewed/printed out for
verification at anytime. Test Log will never become “full” as once the memory reaches 999 and a new test is
entered, the oldest test will be deleted to make room. Follow the steps to review the Test Log:
•Monitor Mode———Report Data———Test Log