Welch Allyn Vital Signs Monitor, Propaq Encore - Quick Reference Guide - Manual (Page 41)

Reference Guide Patient monitoring 35
Using the Propaq Encore with pacemaker patients
Pacemaker signals
If the patient being monitored has a pacemaker, the Propaq Encore detects and can
indicate the occurrence of pacemaker signals. With the Propaq, pacemaker signals are
not counted as heart beats as long as the pacemaker signal meets the pulse amplitude,
pulse width, and overshoot/undershoot specifications listed in Appendix B.
Pacer display
On the Propaq Encore display, vertical dashed lines indicate each time a pacemaker signal
is detected when the Propaq Encore PACER function is turned on. The waveform “spike”
produced by the pacemaker will also be displayed if it contains sufficient energy. Whether
the pacer is atrial, ventricular, or both, the indicator and the spike appear. If the PACER
function is turned off, only the pacemaker spike is displayed:
Turn the pacemaker indicator on and off
The status of the pacer display is shown in the ECG status window. Turn PACER DISPLAY
on or off using the NEXT and CHANGE buttons.
Noise on the signal
Noise on the ECG signal may be detected as pacer signals, causing the pacer indicator to
appear on the display. If you don't need to indicate pacemaker signals, you may want to
turn off the pacemaker indicator for a better display of the ECG waveform.
Note The Propaq Encore counts as “breaths” respiratory efforts that are larger than
two times background Cardiovascular Artifact (CVA).
Since RESP is derived from the same leads as the ECG channel, the Propaq
Encore determines which signals are cardiovascular artifact and which signals are
a result of respiratory effort. If the breath rate is within five percent of the heart
rate or a multiple or sub-multiple of the heart rate, the monitor may ignore breaths
and trigger an apnea alarm.
WARNING Pacemaker signals can differ from one pacemaker to the next. The
Association for Advancement of Medical Instrumentation (AAMI) cautions that “in
some devices, rate meters may continue to count the pacemaker rate during
occurrences of cardiac arrest or some arrhythmias. Do not rely entirely upon rate
meter alarms. All pacemaker patients should be kept under close or constant
observation.”
HR 18:45:28
III
1
mV
cm
MON
80
WARNING The presence of much pacer-like noise can cause the displayed heart
rate to be erratic even though the ECG trace may look clean with the pacer
indicator off. Fix the noise problem by using fresh ECG electrodes and an ECG
cable whose lead wires make good connections.