ZOLL M Series Defibrillator Rev YH - Manual (Page 55)

Non-Invasive Temporary Pacing (Pacer Version Only)
8-3
6
Determining Optimum Threshold
The ideal output current is the lowest value that will
maintain capture. This is usually about 10% above
threshold. Typical threshold currents are between 40 and
80 mA. Location of the MFE Pads will affect the current
required to obtain ventricular capture. The MFE Pad
placement that offers the most direct current pathway to
the heart while avoiding large chest muscles will usually
produce the lowest threshold. Low stimulation currents
produce less skeletal muscle contraction and are better
tolerated.
4:1 Mode
Pressing and holding the 4:1 button can be used to
temporarily withhold pacing stimuli thereby allowing the
operator to observe the patient’s underlying rhythm and
morphology. When depressed this button causes pacing
stimuli to be delivered at ¼ the indicated ppm setting.
Pace Fault
If the unit is attempting to deliver pacing therapy and one
of the following conditions are true:
• the Multi-Function cable is not connected to the device,
• the cable is defective,
• MFE Pads are not connected to the Multi-Function cable,
or
• the MFE Pads are not making good skin contact.
The messages “CHECK PADS” and “POOR PAD
CONTACT” are alternately displayed on the screen and
an audible alarm sounds. The alarm will continue to
sound until the left-most softkey (Clear Pace Alarm) is
pressed.
Special Pacing Applications
Noninvasive Temporary Pacing may be performed in the
Cardiac Cath Lab, either for emergency pacing or in
standby mode. Radiolucent stat•padz are available to
facilitate pacing in X-ray and fluoroscopic applications.
Noninvasive Temporary Pacing may also be performed
in the Operating Room using Sterile stat•padz.
Observe the device carefully for evidence of proper
operation.
Standby Pacing
For certain patients at risk of developing symptomatic
bradycardia, it may be advisable to use the unit in
standby mode. When used in standby mode, the unit
automatically provides a pacing stimulus whenever the
patient’s heart rate drops below a predetermined level.
Patient’s ECG must be monitored using ECG leads and
patient cables for this application. To use the device in
standby mode:
1. Establish effective pacing (see instructions on previ-
ous pages). Note the mA output at capture and run
an ECG strip to document ECG morphology during
capture.
2. Set the mA output 10% higher than the minimum mA
output necessary to effect consistent ventricular
capture.
3. Turn the pacing rate (ppm) below the patient’s heart
rate. This suppresses pacing unless the patient’s own
rate drops below the set pacing rate. The pacing rate
should be set at a level sufficient for adequate
cardiac output.
4. Check the threshold periodically.
PACER
RATE
ppm
PACER
OUTPUT
mA
4:1
PACE
Clear
Pace
Alarm
00:01
Async
Pacing
On/Off
50 mA 70 PPM
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
ECG
CHECK PADS
CAUTION
• Under certain conditions it may not be possible to properly
monitor or pace while electrosurgical apparatus is
operating.