ZOLL R Series Monitor Defibrillator Rev K Operators Guide - Manual (Page 17)

External Pacemaker (Optional)
9650-0904-01 Rev. K ZOLL R Series Operator’s Guide 1–9
Intended Use — Real CPR Help
The Real CPR Help function provides visual and audio feedback designed to encourage
rescuers to perform chest compressions at the AHA/ERC recommended rate of 100
compressions per minute. Voice and visual prompts encourage a compression depth in
accordance with AHA and/or ERC recommendations of 2 inches (5 cm) minimum for adult
patients.
Semiautomatic Operation Contraindications for Use
The rhythm analysis function may not reliably identify ventricular fibrillation in the presence of
an implanted pacemaker. Inspection of the electrocardiogram and clinical evidence of
cardiopulmonary arrest should be the basis for any treatment of patients with implanted
pacemakers.
Do not use the rhythm analysis function during patient movement on a stretcher or in an
ambulance or other conveyance. A patient must be motionless during ECG analysis. Do not
touch the patient during analysis. Cease all movement of the stretcher or vehicle prior to
analyzing the ECG. If you are using the R Series in an emergency vehicle, bring the vehicle to a
halt before activating the analysis function.
Defibrillator Complications
Inappropriate defibrillation or cardioversion of a patient (for example, with no malignant
arrhythmia) may precipitate ventricular fibrillation, asystole, or other dangerous arrhythmias.
Defibrillation without proper application of electrodes or paddle electrolyte gel might be
ineffective and cause burns, particularly when repeated shocks are necessary. Erythema or
hyperemia of the skin under the paddles, or electrodes often occurs; this effect is usually
enhanced along the perimeter of the paddles or electrodes. This reddening should diminish
substantially within 72 hours.
Defibrillator Output Energy
R Series defibrillators can deliver as much as 200 joules into a 50 ohm impedance. The energy
delivered through the chest wall, however, is determined by the patient’s transthoracic
impedance. An adequate amount of electrolyte gel must be applied to the paddles and a force of
10 to 12 kilograms (22 to 26.4 pounds) must be applied to each paddle in order to minimize this
impedance. If hands-free therapy electrodes are used, make sure that they are properly applied.
(Refer to the instructions on the electrode package).
External Pacemaker (Optional)
Some R Series products include an optional transcutaneous pacemaker consisting of a pulse
generator and ECG-sensing circuitry. Noninvasive transcutaneous pacing (NTP) is an
established and proven technique. This therapy is easily and rapidly applied in both emergency
and nonemergency situations when temporary cardiac stimulation is indicated.