ZOLL E Series Monitor Defibrillator Rev D - Manual (Page 216)

E Series Operator’s Guide
9-2 9650-1210-01 Rev. R
The pacer rate increments or decrements by a value of
2 ppm on the display when you turn the knob.
Observe the pacing stimulus marker on the display or
stripchart (
) and verify that it is well-positioned in
diastole.
4
Set Pacer Output
Increase PACER OUTPUT mA until stimulation is
effective (capture). Output mA value is displayed.
The pacer output increments or decrements by a value
of 2 mA on the display as you turn the knob.
Note: When the device is switched out of Pacer mode
into Defib or Monitor mode for less than 10
minutes, and then switched back to Pacer mode,
the Pacer settings remain unchanged.
If the unit is turned off for more than 10 seconds, the
pacer default settings are restored.
5
Determine Capture
Capture refers to the state when the heart is being paced
by the unit rather than the body’s own pacemaker
mechanism. Capture consists of two parts: electrical and
mechanical capture. You must verify capture both
electrically and mechanically to ensure appropriate
circulatory support of the patient.
Electrical Capture
Electrical capture means that the unit is delivering
sufficient electrical current to stimulate the heart as seen
on the ECG trace.
The shape and size of the paced ECG waveforms can
vary depending on the ECG lead configuration chosen
and depending on the patient. Electrical capture is
indicated if:
• Each stimulus marker is followed by a wide QRS
complex
• There is no underlying intrinsic rhythm
• An extended, and sometimes enlarged, T-wave
appears.
The following figure shows ECG tracings that are typical
of effective pacing:
Intermittent capture is indicated when some stimulus
markers are not immediately followed by wide QRS
complexes; you can compensate for intermittent capture
0!#%2
2!4%
PPM
0!#%2
/54054
M!

Pacing Stimuli Pacing Stimuli
0!#%2
2!4%
PPM
0!#%2
/54054
M!

WARNING
• You should only assess electrical capture by
viewing the ECG on the screen with the ECG
unit’s cable directly attached to the patient.
• Use of other ECG monitoring devices may
provide misleading information due to the
presence of pacer artifacts.
large T-wave
widened,
positive R-wave
negative R-wave
inverted T-wave,
absence of
P-waves
Stimulus Marker