Physio-Control LIFEPAK 20e - Manual (Page 86)

Therapy
4-16 LIFEPAK 20e Defibrillator/Monitor Operating Instructions
If the defibrillator is charged to 80 joules or more with paddles in the paddle wells, and then the
paddles are removed and placed on a patient, the defibrillator continues charging to the selected
energy and defibrillation may be completed as usual. When charging the defibrillator with the
paddles on the patient’s chest, the defibrillator automatically adjusts the waveform voltage and
current duration based on the patient's impedance. It is important to understand that this
automatic adjustment does not occur when the defibrillator is charged with the paddles seated in
the paddle wells.
When the paddles or QUIK-COMBO electrodes are on the patient's chest when the defibrillator is
charged and the defibrillator measures an impedance of 15 ohms or less, the defibrillator disarms
the capacitor and automatically recharges to a lower energy setting. When this condition occurs,
the
LOW IMPEDANCE-RECHARGING message appears on the display. When charging is
complete, defibrillation may be completed as usual.
Defibrillation Procedure
You can configure the LIFEPAK 20e defibrillator/monitor to automatically sequence energy
levels. Refer to
"Manual Mode Setup Menu," page 8-5 .
1 Press ON .
2 Identify the electrode or paddle sites on the patient. Use either the anterior-lateral or anterior-
posterior position as described on page 4-3 .
3 Prepare the patient’s skin for electrode application:
• If possible, place the patient on a firm surface away from standing water.
• Remove clothing from the patient’s upper torso.
• Remove excessive hair from the electrode sites; if shaving is necessary, avoid cutting the
skin.
• Clean the skin and dry it briskly with a towel or gauze.
• Do not apply alcohol, tincture of benzoin, or antiperspirant to the skin.
4 Connect the therapy electrodes to the therapy cable, and confirm cable connection to the
defibrillator.
Note: When in PADDLES lead, if the REMOVE TEST PLUG message appears, disconnect
test plug and connect therapy electrodes to QUIK-COMBO therapy cable.
5 Apply therapy electrodes to the patient in anterior-lateral or anterior-posterior position. If using
standard paddles, apply conductive gel to the paddles and place paddles on the patient’s
chest.
6 Press ENERGY SELECT .
7 Press CHARGE. While the defibrillator is charging, a charging bar appears and a ramping tone
sounds, indicating the charging energy level. When the defibrillator is fully charged, an overlay
appears (refer to
"Defibrillation Procedure," page 4-16 ).
8 Make certain all personnel, including the operator, stand clear of the patient, bed, and any
equipment connected to the patient.
9 Confirm ECG rhythms and available energy.
10 Press the SHOCK button on the defibrillator or the SHOCK buttons on the standard paddles to
discharge energy to the patient. For standard paddles, apply firm pressure with both paddles to
the patient’s chest, and press both paddle buttons simultaneously to discharge energy to the
patient. For safety reasons, the
SHOCK button on the defibrillator front panel is disabled when
using standard paddles.
Note: To disarm (cancel the charge), press the Speed Dial. The defibrillator disarms
automatically if shock buttons are not pressed within 60 seconds, or if you change the
energy selection after charging begins. Press
CHARGE to restart charging.