ZOLL E Series Monitor Defibrillator Rev R - Manual (Page 53)

9650-1210-01 Rev. R 6-1
SECTION 6
SYNCHRONIZED CARDIOVERSION
Certain arrhythmias, such as ventricular tachycardia
(VT), atrial fibrillation, and atrial flutter, require
synchronizing the defibrillator discharge with the
ECG R-wave to avoid the induction of ventricular
fibrillation. In this case, a synchronizing circuit within the
instrument detects the patient’s R-waves. When the
SHOCK buttons are pressed and held, the unit
discharges with the next detected R-wave, thus avoiding
the vulnerable T-wave segment of the cardiac cycle.
When SYNC mode is turned on, the unit places markers
above the ECG trace to indicate the points in the cardiac
cycle where discharge will occur. The sync markers
appear as arrows (

) above the ECG trace.
The synchronized cardioversion procedure for MFE
Pads is identical to that for paddles with the exception of
the SHOCK button location.
Synchronized Cardioversion
Determine patient condition and provide care
following medical protocols.
Prepare Patient
Remove all clothing covering the patient’s chest. Dry
chest if necessary. If the patient has excessive chest
hair, clip it to ensure proper adhesion of electrodes.
Attach the following to the patient as appropriate:
• ECG electrodes (recommended for ECG source) as
described in “ECG Monitoring” on page 10-1.
• MFE pads described in “MFE Pad Application/
Connection” on page 1-9.
A standard ECG cable and ECG electrodes are
recommended for monitoring during cardioversion.
You can use MFE Pads as an ECG source; signal
quality is equal to that of standard leads except
immediately following a discharge when there may be
more noise due to muscle tremors, especially if a pad
is not in complete contact with the skin.
• Paddles as described in “Emergency Defibrillation
Procedure with Paddles or MFE Pads” on page 3-1.
Note, however, that synchronized discharge with
PADDLES as an ECG source is discouraged since
artifacts induced by moving the paddles may
resemble an R-wave and trigger defibrillator
discharge at the wrong time.
Standard ECG leads are recommended during
cardioversion since they provide signal quality that is
typically superior to that of paddles.
Note: An ECG LEAD OFF condition does prevent
synchronized discharge if leads are selected as
the ECG source. It does not, however, prevent
the use of the defibrillator; it simply prevents use
in a synchronized manner.
Paddles are a defibrillation-protected Type BF patient connection.
ECG leads are a defibrillation-protected Type CF patient connection.
WARNING
• Only skilled personnel trained in ACLS (Advanced Cardiac Life Support) and familiar with equipment operation
should perform synchronized cardioversion. The precise cardiac arrhythmia must be determined before
attempting defibrillation.
• Prior to attempting synchronized cardioversion, ensure that the ECG signal quality is sufficient to minimize risk
of synchronizing on artifact.
• Synchronized cardioversion is disabled when the E Series unit is connected to the AutoPulse Plus and the
AutoPulse Plus is compressing.