Page 1 R Series ® Service Manual April 2016 9650-0903-01 Rev. L...
Page 2 ZOLL Medical Corporation shall not be responsible for any equipment defect, the failure of the equipment to perform any function, or any other nonconformance of the equipment, caused by or attributable to: (i) any modification of the equipment by the customer, unless such modification is made with the prior written approval of ZOLL Medical Corporation; (ii) the use of the equipment with any associated or complementary equipment, (iii) installation or wiring of the equipment other than in accordance with ZOLL Medical Corporation's instructions.
Page 3: Table Of Contents
TABLE OF CONTENTS Preface Safety Considerations ..............................i Additional Reference Material .............................ii Conventions ..................................ii Service Policy Warranty ..............................iii Technical Service.................................iii Technical Service Outside of the United States......................iv Chapter 1 Maintenance Tests Overview ..................................1-1 Before You Begin the Maintenance Tests....................... 1-2 Equipment You Need to Perform the Maintenance Tests..................
Page 4 NIBP Transducer Calibration Test ........................1-39 NIBP Monitor Test .............................. 1-41 Chapter 2 Troubleshooting Overview ..................................2-1 ZOLL R Series Error Messages ..........................2-1 Chapter 3 Disassembly Procedures Required Equipment..............................3-1 Safety Precautions..............................3-2 Removing the Cable Caddy ............................. 3-3 Removing the Handle ...............................
Page 5 Accessories................................5-5 Power Management Support Functions ......................... 5-5 WiFi .................................... 5-6 Appendix Interconnect Diagram for the R Series Biphasic Unit ................... A-2 Delivered Energy at Every Defibrillator Setting into a Range of Loads ..........................A-3 Sync Connector Diagrams ............................A-4 Maintenance Test Checklist .............................
Page 6 9650-0903-01 Rev. L...
Page 7: Overview
Safety and effectiveness data submitted by ZOLL Medical Corporation to the Food and Drug Administration (FDA) under section 510(K) of the Medical Device Act to obtain approval to market is based upon the use of ZOLL accessories such as disposable electrodes, patient cables and batteries. The use of external pacing/defibrillation electrodes and adapter units from sources other than ZOLL is not recommended.
Page 8 Do not discharge a battery pack except in a ZOLL SurePower Battery Charger Station. Do not use the R Series in the presence of flammable agents (such as gasoline), oxygen-rich atmospheres, or flammable anesthetics. Using the unit near the site of a gasoline spill may cause an explosion.
Page 9 Activity log file from the unit, if applicable (.RAL extension) • If the unit needs to be sent to ZOLL Medical Corporation, obtain a Service Request number from the Technical Service representative. Return the unit in its original container to:...
Page 10 Technical Service Outside of the United States Customers outside of the United States should return the unit in its original container to the nearest authorized ZOLL Medical Corporation Service Center. To locate an authorized service center, contact the International Sales Department at ZOLL Medical at the above address.
Page 11 The R Series has two checkout procedures: the R Series Operator’s Guide defibrillator testing checklist and the extensive 12-month maintenance test checkout procedures. Because the R Series units must be maintained ready for immediate use, regular readiness testing is required. It can either be performed manually or automatically. Refer to the R Series Operator’s Guide for details.
Page 12: Before You Begin The Maintenance Tests
Be sure to follow the manufacturer’s recommendations for conducting the maintenance tests. We recommend the use of the following equipment when performing R Series Maintenance Tests ZOLL Medical Electrode Adapter from Fluke Biomedical (DNI part number 3010-0378).
Page 13 R Series Service Manual 2 black miniature alligator to miniature alligator test leads. • DC power supply (15 Amp minimum). •  resistor (  ¼ W or greater). •  ¼ 1000 W resistor. • Fluke 75 multimeter or equivalent.
Page 14: Physical Inspection Of The Unit
R Series Service Manual 1.0 Physical Inspection of the Unit Tools Needed: None. Test Setup: None. Observe this... Pass/Fail/NA Housing o o o Is the unit clean and undamaged? Does the unit show signs of excessive wear? o o o...
Page 15 R Series Service Manual Observe this... Pass/Fail/NA 1.15 Battery Place battery in battery well. 1.16 Is the battery seated in the battery well correctly? o o o Record your results on the Maintenance Test Checklist. 9650-0903-01 Rev. L...
Page 16: Front Panel Button Test
R Series Service Manual 2.0 Front Panel Button Test Tools Needed: Fluke Impluse 4000. Test Setup: Install strip chart paper into the printer compartment. Install a fully charged battery in the unit or connect the A/C power cord to the unit and then plug the cord into an electrical outlet.
Page 17 R Series Service Manual Do this... Observe this... Pass/Fail/NA Close the printer door. Strip chart paper flows out of printer compartment. Verify that the CHECK o o o RECORDER message no longer displays. Press RECORDER button. Press RECORDER button. Strip chart paper stops flowing out of printer compartment.
Page 18 R Series Service Manual Do this... Observe this... Pass/Fail/NA 2.19 Press the MANUAL MODE softkey, then select Verify the green AED LED turns off. o o o the CONFIRM softkey. 2.20 Turn selector switch to the OFF position. Verify the unit turns off.
Page 19 Tools Needed: Impulse 4000,3 lead adapter (part # 8009-0762-XX) or 3 lead cable, and 5 lead cable. If applicable, test each cable separately. Test Setup: 1. The R Series unit must be configured to display ECG LEAD OFF message. Connect the lead wires appropriate to each test to the Fluke Biomedical 4000 or equivalent.
Page 20: Power Supply Test (Optional)
Set the power supply voltage to 7V. Caution Be sure to connect the power supply properly to the R Series battery well terminals or damage to the unit may result. Do NOT raise the power supply voltage above 15V. 1-10...
Page 21 R Series Service Manual 15 Amp Battery Well Supply Black Do this... Observe this... Pass/Fail Turn the selector switch to MONITOR (for AED The unit should not turn on. units turn to ON.) Turn the unit off. Adjust the power supply voltage to 10.8V and The unit should turn on.
Page 22 R Series Service Manual Test Setup:  1. Remove red lead from power supply and connect to 0.1 resistor Connect other end of resistor to “+” terminal of power supply using a second red lead. Connect multimeter across the resistor.
Page 23 Test Setup: Set DVM to read DC Volts. Connect Postive lead to positive post of the R Series charger load fixture. Connect negative lead to negative post of the R Series charger load fixture. Verify the unit is plugged into AC Power.
Page 24 R Series Service Manual Do this... Observe this... Pass/Fail 4.13 Observe the voltage. Verify the charger voltage is 11.97V-12.43V. 4.14 On the Test Fixture set the switch to 20 Ohms. Verify the charger voltage is 9.50V-11.87V. 4.15 On the Test Fixture set the switch to 27 Ohms.
Page 25: Leakage Current Test
R Series Service Manual 5.0 Leakage Current Test Tools Needed: See the manufacturer’s instructions or supplied specifications for the leakage tester you use. Test Setup: See the manufacturer’s instructions or supplied specifications for the leakage tester you use. Repeat leakage test with applicable accessories: OneStep Cable, external paddles, internal paddles, and anterior/posterior paddles.
Page 26: Paddles Test
R Series Service Manual 6.0 Paddles Test Tools Needed: None. Test Setup: If applicable, connect the OneStep cable to the paddles and place the paddles in paddle wells. Do this... Observe this... Pass/Fail/NA Turn the selector switch to DEFIB (for AED The energy selection decreases to 1J.
Page 27: Heart Rate Display Test
R Series Service Manual 7.0 Heart Rate Display Test Tools Needed: Impulse 4000 • ECG Cable (3 or 5 leads). • Test Setup: 1. Turn the selector switch to MONITOR (for AED units turn to ON.) Press LEAD button until “I” displays.
Page 28: Calibrating Pulses On Strip Chart Test
R Series Service Manual 8.0 Calibrating Pulses on Strip Chart Test Tools Needed: None. Test Setup: None Do this... Observe this... Pass/Fail/NA Press the RECORDER button. Press and hold SIZE button to activate the The strip chart displays a signal of 300 ppm with an amplitude of 10 mm o o o calibration signal.
Page 29: Notch Filter Test
R Series Service Manual 9.0 Notch Filter Test Tools Needed: Impulse 4000 (or equivalent). Test Setup: 1. Connect the ECG cable to the Impulse 4000. Connect the ECG cable to the unit Do this... Observe this... Pass/Fail/NA Turn the selector switch to MONITOR mode (for AED units turn to ON.)
Page 30: Heart Rate Alarm Test
R Series Service Manual 10.0 Heart Rate Alarm Test Tools Needed:Impulse 4000. Do this... Observe this... Pass Fail/NA 10.1 Turn the selector switch to MONITOR mode( for Lead II waveform displayed on monitor. o o o AED units turn to ON.) NSR ECG at 120 BPM +/- 2 displayed.
Page 31 R Series Service Manual Do this... Observe this... Pass Fail/NA 10.16 Remove a lead wire from the Impulse 4000. The bell symbol flashes and the heart symbol stops flashing. The ECG LEAD o o o OFF alarm tone sounds and the Heart Rate Value is highlighted. Recorder prints a stripchart showing a low heart rate, if enabled.
Page 32: Defibrillator Self Test
Test Setup: 1. Ensure the unit is turned off. Ensure the ECG cable is connected to the R Series unit and the defibrillator analyzer. Note: The OneStep cable should not be connected to any equipment at the beginning of this test.
Page 33 R Series Service Manual Do this... Observe this... Pass/Fail 11.3 Select energy level of 100J and press the The charge time is >2 second and <10 seconds and SELECT 30J FOR TEST CHARGE button. is displayed. 11.4 Press the SHOCK button.
Page 34: Synchronized Cardioversion Test
R Series Service Manual 12.0 Synchronized Cardioversion Test Tools Needed: Impulse 4000 or equivalent defibrillator analyzer. Test Setup: 1. Connect the OneStep cable via the adapter (D.N.I #3010-0378) to the defibrillator analyzer. Select cardioversion on analyzer. Input 1mV ECG signal at 60 BPM.
Page 35: Synchronized Cardioversion For Remote Ecg Monitoring Test (Optional)
Configuration Manual). Remote Sync should be tested as a complete system that includes the remote monitor and R Series defibrillator. Be sure that the remote device is connected to the Sync In/Marker Out connector on the R Series unit. The remote device must have a sync out connector and you must use a cable to connect the two devices.
Page 36: Shock Test
R Series Service Manual 14.0 Shock Test Tools Needed: Fluke Biomedical 4000 or equivalent defibrillator analyzer and a stop watch Test Setup: 1. Connect the OneStep cable via the adapter (D.N.I #3010-0378) to the defibrillator analyzer. Ensure that a fully charged battery is installed in the unit.
Page 37 R Series Service Manual Do this... Observe this... Pass/Fail/NA 14.11 Press the ENERGY SELECT up arrow until Verify that DEFIB 200J SEL is displayed. o o o 200J displays. 14.12 Press the CHARGE button. Wait for the Verify that DEFIB 200J READY is displayed.
Page 38: Summary Report Test
R Series Service Manual 15.0 Summary Report Test Tools Needed: Impulse 4000. Test Setup: 1. Connect the OneStep cable to the Impulse 4000 If you are using paddles, place the paddles on the analyzer’s discharge plates. Do this... Observe this...
Page 39: Advisory Message Test (Manual/Advisory Units)
R Series Service Manual 16.0 Advisory Message Test (Manual/Advisory Units) Tools Needed: Impulse 4000 Test Setup: 1. Connect the OneStep cable via the adapter (D.N.I #3010-0378) to the defibrillator analyzer. Do this... Observe this... Pass/Fail 16.1 Connect OneStep cable to the simulator.
Page 40: Pacer Test
Note that the analyzer pace load resistor must be less than 250 ohms. Test Setup: 1. Connect the One Step cable from the R Series to the External Pacer Load (TQA-17) of the Impulse 4000. Turn the Main Selector knob of the R Series to the Pacer mode.
Page 41 Pacer rate on Impulse 4000 is 29-31 ppm. Decrease the rate to 30 ppm. 17.9 Connect the ECG cable to the R Series and ECG at 60 BPM is seen on the display and no stimulus markers. Impulse 4000. Select the ECG at 60 BPM on the Impulse 4000.
Page 42 18.3 Press the 02+ or 02- softkey of the simulator The R Series 2 reading of 98 +/- 1% appears on the R Series monitor. until the SpO output is at 98%. Note that you may need to wait up to 2 minutes for the information to appear on the ZOLL display.
Page 43 2 Simulator, press the 2 saturation of 96-100% displays on the unit. BPM- softkey until the heart rate is 50 BPM. The heart rate of 46-54 BPM displays on the R Series monitor. 18.6 Using the Index 2 Simulator, press the 02+ 2 saturation of 69-74% displays on the unit.
Page 44 NOTE: Make sure the airway adapter is installed in the CO cable. cable with airway adapter attached to the yellow connector at the back of the R Series. 19.2 Set the front panel switch to MONITOR or ON. WARM UP message appears on the display.
Page 45: Barometric Pressure Calibration Check
Observe this... Pass/Fail/NA 20.1 Connect the CAPNOSTAT 5 CO Sensor to the yellow connector at the back of the R Series unit, and connect an airway adapter to the sensor. 20.2 While pressing and holding the second softkey The unit displays EtCO Calibration screen.
Page 46 Observe this... Pass/Fail/NA 21.1 Connect the CAPNOSTAT 5 CO Sensor to the yellow connector at the back of the R Series unit, and connect an airway adapter to the sensor. 21.2 While pressing and holding the second softkey The unit displays EtCO Calibration screen.
Page 47 R Series Service Manual Do this... Observe this... Pass/Fail/NA 21.10 Set the Gas Balance settings of the CAPNOSTAT 5 CO Sensor to that of the calibration gas mixture (N O, or He). The default gas balance is N 21.11 Allow a few seconds for the gas mixture to The expected value is 5% ±...
Page 48: Nibp Volume Leak Test
R Series Service Manual 22.0 NIBP Volume Leak Test The volume leak test verifies the integrity of the pneumatic system on the R Series NIBP module. This test should be performed annually or every 10,000 readings, whichever comes first. Tools Needed: NIBP simulator (the values and procedure provided in this manual are specific to the BP Pump 2) Test Setup: 1.
Page 49 • displays no Volume Leak reading, but maintains a stable pressure reading at or above 200 mmHg, then the R Series unit has passed the test; there is no volume leak. In addition, the R Series displays the simulator’s pressure reading in the “Cuff Pressure”...
Page 50: Nibp Transducer Calibration Test
Tools Needed: NIBP simulator (The values and procedure provided in this manual are specific to the BP Pump 2) Test Setup: 1. Connect the simulator’s hose to the NIBP connector on the R Series unit. Configure the NIBP simulator to simulate cuff pressure. For example, on the BP Pump 2 Press the MODE button three (3) times to go into Tests mode.
Page 51 ±3 mmHg of the pressure parameter set on the NIBP simulator. 23.9 On the R Series unit, press the EXIT softkey The R Series returns to the main NIBP Service Mode screen, then to normal twice. Monitor mode operation. Record your results on the Maintenance Test Checklist.
Page 52: Nibp Monitor Test
NIBP Simulators may produce a reading on the NIBP monitor that is shifted from the simulator's setting. The offset value must be established based on a statistical sample of monitors and readings. Please contact ZOLL Technical Support if you require assistance establishing the offset of the simulator and test set-up that you are utilizing.
Page 53 These values only apply for test set-ups utilizing the BP Pump 2 Simulator. Variations of the test set-up or different simulators may produce readings outside the provided values and will require end-user facility to establish the appropriate offset and tolerances. Please contact ZOLL Technical Support if you require assistance establishing the offset of the simulator and test set-up that you are utilizing.
Page 54 R Series Service Manual 1-44 9650-0903-01 Rev. L...
Page 55: Zoll R Series Error Messages
ZOLL R Series Error Messages The following is a list of ZOLL R Series error messages that may appear on your display. The “User Advisory” column informs you about an action in progress or provides feedback on a user correctable situation that typically does not require further technical support. The “Technical Action” column describes what you as a technician can do to correct the situation.
Page 56 R Series Service Manual Error Message Explanation User Technical Action Advisory  ALARM SET ALARM SET status message when setting alarms.  ANALYSIS HALTED ECG analysis halted due to user interaction such as: • Lead/size change • Analyze button was pressed again •...
Page 57 R Series Service Manual Error Message Explanation User Technical Action Advisory CF TRANSFER FAILED Summary/DVCK/ALOG data file transfer error – either no Reseat CF Communication cable or replace CF card or CF card transfer failed Communication Module.  CHANGE LEADS Unit is in Defib Sync mode and heart rate is less than 20 BPM.
Page 58 CO2 MODULE NOT VALID Sidestream sensor connected (not supported by the Use mainstream sensor. R Series unit’s operating software) CO2 OUT OF RANGE The calculated CO value is greater than 150 mmHg. If error persists, perform a mainstream airway adapter zero, as described in “Zeroing the...
Page 59 The EtCO sensor or module has detected a hardware Check that the sensor is properly plugged in. Re-insert the sensor. Turn R Series unit off, then error. on again to reset. perform a mainstream airway adapter or module zero, as described in “Zeroing...
Page 60 R Series Service Manual Error Message Explanation User Technical Action Advisory  DEFIB NOT CHARGED Discharge button is pressed in a Defib mode but the unit is not charged. DEFIB OVERUSE More than 50 shocks were delivered in less than 20 Unit needs to cool down, wait approximately minutes.
Page 61 R Series Service Manual Error Message Explanation User Technical Action Advisory  ENERGY INCREMENTED Defib energy has been automatically incremented to the next configured level after shock 1 or 2 has been delivered and the unit is configured for Basic Energy Auto Escalation.
Page 62 • Verify that you are using proper size cuff. • Inflation is too fast. • Check for cuff and hose blockage.\ • R Series is unable to find systolic value for 180 • Confirm that the unit was not charging. seconds.
Page 63 R Series Service Manual Error Message Explanation User Technical Action Advisory  NO QRS DETECT Unit is in sync mode and heart rate is < 20 BPM or QRS Increase ECG size and/or change lead. amplitude is too low for proper synchronization.
Page 64 R Series Service Manual Error Message Explanation User Technical Action Advisory POOR PAD CONTACT Electrode impedance exceeds threshold. • Ensure pads are coupled to patient. • Check/replace pads or universal cable. • Check impedance circuit calibration. • Replace system board.
Page 65 Real time clock failure: invalid date or time. • Set time and date information. • Verify that the internal lithium battery has been replaced within the last 5 years. Contact ZOLL Technical Service Department for assistance.  SET PACE MA Multiple copy errors are the product of intended software Set pace current.
Page 66 R Series Service Manual Error Message Explanation User Technical Action Advisory  SHOCK ADVISED Advisory message when Analysis finds a shockable rhythm. Followed by PRESS SHOCK in Manual Advisory Defib with auto-charge enabled or in Auto Defib mode, or by PRESS CHARGE in Manual Advisory Defib with auto- charge disabled.
Page 67 R Series Service Manual Error Message Explanation User Technical Action Advisory SYSTEM FAULT 36 Filtered sum of all the supply voltages is out of range. Replace analog board or digital board. SYSTEM FAULT 37 1/2 scale reference voltage is out of range.
Page 68 Error Message Explanation User Technical Action Advisory  ZERO FAILED The zero operation did not complete successfully. Clear the occlusion, remove any source of CO and try zeroing again. If problem persists, contact ZOLL Technical Support. 2-14 9650-0903-01 Rev. L...
Page 69: Required Equipment
R Series Service Manual Chapter 3 Disassembly Procedures This chapter provides instructions on how to disassemble and reassemble the R Series unit, and includes the following sections: “Removing the Cable Caddy” on page 3-3 “Removing the Handle” on page 3-6 “Removing the Recorder, AC Charger and Battery Well”...
Page 70: Safety Precautions
R Series Service Manual Wooden stick • Needlenose pliers • Exacto knife • Compressed air • 1/2” Nut Driver • 3M Scotch-Weld Hot Melt Adhesive 3779 TC Amber • Safety Precautions Warning! SHOCK HAZARD! Caution TAKE THE NECESSARY PRECAUTIONS TO GUARD AGAINST SHOCK OR INJURY BEFORE YOU CONDUCT DEFIBRILLATOR TESTS OR REPAIRS.
Page 71: Removing The Cable Caddy
R Series Service Manual Removing the Cable Caddy 1. Unplug all cables from the R Series. 2. There are 6 screws securing the cable caddy (3 at the rear of the R Series and 3 at the bottom). 9650-0903-01 Rev. L...
Page 72 R Series Service Manual 3. Remove the 3 bottom screws completely. 4. Loosen the 3 screws at the back. It is not necessary to remove the screws completely or to remove the mesh. 9650-0903-01 Rev. L...
Page 73 R Series Service Manual 5. Unplug the AC Line Cord Extension Cable from the AC input receptacle when removing the cable caddy. 9650-0903-01 Rev. L...
Page 74: Removing The Handle
R Series Service Manual Removing the Handle 1. Remove the 4 hex screws securing the handle. 2. Lift the handle to remove. Note: During reassembly, torque to 10 in-lbs. 9650-0903-01 Rev. L...
Page 75 R Series Service Manual Removing the Recorder, AC Charger and Battery Well 1. Using a #2 Philips screwdriver, remove the 4 2. Remove the AC Charger assembly from the chassis by screws securing the AC Charger Assembly. lifting straight up. Unplug the cable from the charger to the PD Engine as shown.
Page 76 R Series Service Manual 3. If removing the battery well, disconnect the high and 4. Remove the label from the battery well as shown (peel low current cables from the PD Engine as shown. from back to front). It may be necessary to use a new label upon Note: reassembly (Part # 9305-0901-01).
Page 77 R Series Service Manual 5. Remove the 3 screws securing the battery well. 6. Lift the battery well from the front of the R Series, tilting towards the rear. DO NOT disconnect the low and high current harnesses. Feed them up through the chassis to remove the battery well.
Page 78 R Series Service Manual 7. Open the recorder door. Using a wooden stick (or 8. Remove the two screws that secure the recorder tray. similar tool) press in on the hinge to release the door as shown. Note: During reassembly, torque to 6 in-lbs.
Page 79 9. Lift up on the recorder tray from the rear of the 10.Rotate device so the display is facing you. Lift up on the R Series to release it. paper tray to expose cables. Disconnect the recorder interconnect cable from the print head and the motor/ sensor board.
Page 80 R Series Service Manual Removing the Front Panel Assembly 1. Remove 3 Phillips screws from the top of the rear 2. Remove the 3 hex screws from the bottom front of the Front Panel Assembly. Front Panel Assembly. Note: During reassembly, torque to 6 in-lbs.
Page 81 R Series Service Manual 3. Tilt the front panel carefully as shown. 4. Using needlenose pliers, carefully remove the hot melt glue from the Recorder and Controls cables. Carefully disconnect the 4 cables shown. Note: During reassembly, reapply hot melt glue (3M Scotch- Weld Hot Melt Adhesive 3779 TC Amber.)
Page 82 R Series Service Manual Front Panel Disassembly 1. Remove 5 screws securing the metal shield. 1. Lift display assembly straight out from the front panel. (See pages 4-38 thru 4-41 for display assembly parts breakdown) Note: During reassembly, torque to 6 in-lbs.
Page 83 R Series Service Manual 2. Remove the main selector and pacer knobs by 3. Remove 9 screws securing the control board to the front pulling them straight out, then remove nuts securing panel. them to the front panel. Note: During reassembly, torque to 6 in-lbs.
Page 84 R Series Service Manual Removing the Side Panels 1. Remove the 4 hex screws from right side panel. 2. Remove the 4 hex screws from left side panel. Note: During reassembly, torque to 10 in-lbs. Note: During reassembly, torque to 10 in-lbs.
Page 85 R Series Service Manual 3. Remove the right panel by pulling towards you. The 4. Remove the left panel by pulling towards you. Remove the speaker may or may not come off with the panel. shorting wire from the panel by taking off the nut.
Page 86 R Series Service Manual Removing the Connector Panel and Bezel 5. Remove the label covering the connector panel 6. Using a #1 Phillips screwdriver, remove the 9 screws bezel. It may be necessary to use a new label upon securing the connector panel bezel.
Page 87 R Series Service Manual 7. Remove the connector panel by lifting straight up. Note: Below is the connector panel with the EtCO and NIBP options. See the diagram on page 4-17 for further disassembly. Note: Depending on the options, the RS232 connector may be...
Page 88 R Series Service Manual Removing the ECG Input Connector Carefully lift the ECG Connector by tilting the rear of the connector up first. Then carefully remove the cable from the connector as shown, using a wooden stick. Remove the connector from the chassis.
Page 89 R Series Service Manual Removing the NIBP Assembly 1. Disconnect the hose from the manifold and cut the 2. Disconnect the cable from the NIBP assembly from cable tie securing the pump to the chassis. parameter power supply by pushing down on latch at the top of the connector.
Page 90 R Series Service Manual 3. Slide the NIBP assembly out of the chassis. 3-22 9650-0903-01 Rev. L...
Page 91 R Series Service Manual Removing the System Brick Assembly Note: See the safety precautions on 3-2 before removing the system brick assembly. 1. Remove the printer housing barrier from the chassis. 2. Remove the ECG retainer pad. Note: During reassembly, the barrier may be reused if the adhesive...
Page 92 R Series Service Manual 3. Carefully disconnect the speaker harness (1), the 4. Carefully disconnect the sync cable by pulling straight sync cable (2), and the patient impedance cable (3). up from top. Note: Disconnect the speaker on the opposite side of the brick assembly if you have not done this already.
Page 93 R Series Service Manual 5. From the top of the device, disconnect the USB and 6. Carefully pull back the USB and compact flash compact flash cables by lifting connector straight up cables and disconnect the MFC cable. from the board.
Page 94 R Series Service Manual 7. In applicable, disconnect the EtCO2 cable from the 8. Carefully pull the brick assembly out slightly through parameter power supply by pushing down on the front; disconnect the SpO connector cable. connector latch. 3-26 9650-0903-01 Rev. L...
Page 95 R Series Service Manual 9. Ensuring that all cables are disconnected from the brick, slide the entire brick out of the front of the chassis. 9650-0903-01 Rev. L 3-27...
Page 96 R Series Service Manual Disassembling the System Brick Assembly Note: See the safety precautions on page 3-2 before removing the system brick assembly. The system brick assembly consists of three primary boards attached together, Units equipment with SpO and/or EtCO &...
Page 97 R Series Service Manual 3. Lift isolated power supply board and shield out of tray. 9650-0903-01 Rev. L 3-29...
Page 98 R Series Service Manual Removing the SpO Module 1. Use a prying tool to lift up on the board to release adhesive. (The SpO module is held in place with adhesive strips.) Note: Plastic isolator tray, part # 9310-0889, may be damaged during disassembly and need to be replaced.
Page 99 R Series Service Manual Removing Digital Board 1. Remove 9 screws holding digital board to assembly. 2. Tilt assembly up, and carefully pull board toward you to disconnect from connectors. Note: During reassembly, inspect standoffs and corner post to verify they...
Page 100 R Series Service Manual Removing Pace Defibrillator Engine 1. PD Engine: Remove 9 screws holding PD Engine to 2. Carefully remove cable from PD Board. assembly. Note: During reassembly, inspect standoffs and corner post to verify they Note: Use a rocking motion to unseat connector from board.
Page 101 R Series Service Manual 3. Lift up on PD board to disconnect from analog board. Note: Since ferrite beads on connector are loose, make sure they are in place during reassembly. 9650-0903-01 Rev. L 3-33...
Page 102 R Series Service Manual Discharging Capacitor WARNING! This unit may contain lethal voltages. You MUST completely discharge the high voltage capacitor before removing from unit. DO NOT SHORT THE TERMINAL ENDS OF THE CAPACITOR. 1. While capacitor is connected to the PD Engine...
Page 103 R Series Service Manual Removing the Communication Module 1. Peel back the foam pads from the housing. 2. Remove 2 screws from the bottom of the housing. Note: During reassembly, torque to 4 in-lbs. 9650-0903-01 Rev. L 3-35...
Page 104 R Series Service Manual 3. Remove foam pads from cables and ferrite beads. 4. Remove 3 screws and slide board back to remove. Lift module up and route cables through slot in housing. Note: During reassembly, reapply foam pieces and secure it to the Note: During reassembly, torque to 2 in-lbs.
Page 105: Replacement Parts
This section contains a listing of the replacement parts available for the ZOLL R Series devices. Replacement parts may be ordered through an authorized ZOLL distributor or directly from ZOLL Medical Corporation. The prices for parts are available from ZOLL Medical Corporation’s Technical Service Department.
Page 106: List Of Replacement Parts
R Series Service Manual List of Replacement Parts Item numbers refer to the diagrams beginning on page 4-11. For the System Brick Assembly see page 4-41. Part Number Description Item number Main Housing 9310-2787-99 Rework, Main Housing 9301-0525-01 Assembly, PCB, PCB, Beeper Connector...
Page 107: Back Panel
R Series Service Manual Part Number Description Item number 9310-0894 Isolator, ECG Back Panel 0140-0202 Ferrite Core Flat Cable Type 0162-0033 Washer.Ribbed Lock.M14. 15mm ID.x 22mm OD.x 2mm.ZINC. 0163-0029 Washer.Lock Int.7/16.0.456"ID.0.765"OD.0.036"THK.SS 0163-0286 Scr. #2-56, MCH, 5/16", PNH, PHL, STL, Int 0163-0401 Scr.
Page 108 R Series Service Manual Part Number Description Item number 0163-0286 Scr. #2-56, MCH, 5/16", PNH, PHL, STL, Int 0163-1231 Scr. PHH PNH. #6.0.500" Lg.STL/ZN.ZI.Hi/Lo 0501-0002 Cable tie, 8" X 0.1" Black UV 1009-0901-01 Assembly, System Brick 1009-0901-02 Assembly, Options, System Brick...
Page 109 R Series Service Manual Part Number Description Item number 1009-0917-04 Assembly, Kit, SpO , Digital Board, ALS/Plus 1009-0917-05 Assembly, Kit, Digital Board, ALS/Plus, Nellcor 1009-0917-08 Assembly, Kit, Digital Board, SpO /EtCO /NIBP 1009-0917-09 Assembly, Kit, Digital Board, SpO /EtCO /NIBP, Nellcor...
Page 110 R Series Service Manual Part Number Description Item number 9310-1784-02 Cap, End, Left, Assembly 0163-0353 Scr. 8-32 X 7/16" SHCS SS Pass Black 0190-0100 Spring, Compression.0.210"X.0.375" SS 9320-0747 Spring, Paddle, Grounding 9310-0785 Latch, Paddle 9310-1515 Retainer, Latch, Paddle Release 0163-0401 Scr.
Page 111 R Series Service Manual Part Number Description Item number 1009-0904-05 Assembly, Display Panel, ALS, EtCO 1009-0904-06 Assembly, Display Panel, BLS 1009-0933-01 Assembly, Handle 9302-0524-01 Assembly, Printer Interconnect Flex Cable 0155-0001 Magnetic.Sphere.Neodimium.0.187" dia 0163-2504 Scr. PPH.#2-32.X 0.312".STL.ZN.Hi/Lo 1009-0920-01 Assembly, Inner Frame BLS...
Page 112 R Series Service Manual Part Number Description Item number 9500-0748 Cable, Assembly, Main Switch 9500-0772 Cable Assembly, Main Switch, Non-Pacing 9305-0928-01 Label, Pacer Overlay, BLS Printer and Battery Well 0163-0416 Scr. #6-32, MCH, 7/16", PNH, PHL, STL, Ext. 1009-0903-01 Assembly, Battery Well Module...
Page 113 MOUNT, ADHESIVE, COLOR INVERTER, PCB, R SERIES 0163-0427 CLIP.RIGID PVC.PSA BACKED.BLK.SUITABLE FOR 1/2" WIRE BUNDLE 9320-0762 DISPLAY, RETENTION PLATE, R SERIES 9161-0033 GASKET, FRONT PANEL TO PRINTER FLEX, R SERIES 9330-0766 DISPLAY SUPPORT, .31 THICK, R SERIES 9650-0903-01 Rev. L...
Page 114 R Series Service Manual Part Number Description Item number 9330-0748 DISPLAY, SUPPORT, R SERIES 9500-0312 ASSY, CABLE, CONNECTOR, INVERTER, COLOR LCD 9230-0272 EDGE GROMMET, R SERIES 0163-1228 SCR.PHH/PNH.#6.0.250".ST.ZINC.HI/LO 9500-0777 CABLE, ASSY, FLAT, 51 CONDUCTOR 4-10 9650-0903-01 Rev. L...
Page 115: Diagrams
R Series Service Manual Diagrams 9650-0903-01 Rev. L 4-11...
Page 116 R Series Service Manual 4-12 9650-0903-01 Rev. L...
Page 117 R Series Service Manual 9650-0903-01 Rev. L 4-13...
Page 118 R Series Service Manual 4-14 9650-0903-01 Rev. L...
Page 119 R Series Service Manual 9650-0903-01 Rev. L 4-15...
Page 120 R Series Service Manual 4-16 9650-0903-01 Rev. L...
Page 121 R Series Service Manual 9650-0903-01 Rev. L 4-17...
Page 122 R Series Service Manual 4-18 9650-0903-01 Rev. L...
Page 123 R Series Service Manual 9650-0903-01 Rev. L 4-19...
Page 124 R Series Service Manual 4-20 9650-0903-01 Rev. L...
Page 125 R Series Service Manual 9650-0903-01 Rev. L 4-21...
Page 126 R Series Service Manual 4-22 9650-0903-01 Rev. L...
Page 127 R Series Service Manual 9650-0903-01 Rev. L 4-23...
Page 128 R Series Service Manual 4-24 9650-0903-01 Rev. L...
Page 129 R Series Service Manual 9650-0903-01 Rev. L 4-25...
Page 130 R Series Service Manual 4-26 9650-0903-01 Rev. L...
Page 131 R Series Service Manual 9650-0903-01 Rev. L 4-27...
Page 132 R Series Service Manual 4-28 9650-0903-01 Rev. L...
Page 133 R Series Service Manual 9650-0903-01 Rev. L 4-29...
Page 134 R Series Service Manual 4-30 9650-0903-01 Rev. L...
Page 135 R Series Service Manual 9650-0903-01 Rev. L 4-31...
Page 136 R Series Service Manual 4-32 9650-0903-01 Rev. L...
Page 137 R Series Service Manual 9650-0903-01 Rev. L 4-33...
Page 138 R Series Service Manual 4-34 9650-0903-01 Rev. L...
Page 139 R Series Service Manual 9650-0903-01 Rev. L 4-35...
Page 140 R Series Service Manual 4-36 9650-0903-01 Rev. L...
Page 141 R Series Service Manual 9650-0903-01 Rev. L 4-37...
Page 142 R Series Service Manual 4-38 9650-0903-01 Rev. L...
Page 143 R Series Service Manual 9650-0903-01 Rev. L 4-39...
Page 144 R Series Service Manual 4-40 9650-0903-01 Rev. L...
Page 145: Disassembling The System Brick Assembly
R Series Service Manual Disassembling the System Brick Assembly Refer to the diagrams beginning on page 4-43 for details. System Brick Replacement Parts Diagram number Part Number Description Torque 1009-0910-02 Assembly, Shielded Analog System Board, 3/5 Lead 9310-0883 Isolator, PD Engine to Analog PCB...
Page 146 R Series Service Manual Diagram number Part Number Description Torque 9301-0537-01 Assembly, PCB, Parameter PS (SpO only) 0163-0151 Scr. #4-40 X 1/4" 6 inch-lbs 9310-0979 Isolator, IPS, EtCO /NIBP 9330-0762 Adhesive, SpO , PCB 9301-0510-01 Assembly, PCB, Parameter Power Supply...
Page 147 R Series Service Manual Diagrams Single use only Single use only 9650-0903-01 Rev. L 4-43...
Page 148 R Series Service Manual 4-44 9650-0903-01 Rev. L...
Page 149 R Series Service Manual 9650-0903-01 Rev. L 4-45...
Page 150 R Series Service Manual 4-46 9650-0903-01 Rev. L...
Page 151 R Series Service Manual Bracket shown (Item 16) and Pad (Item 17) used in SpO only 9650-0903-01 Rev. L 4-47...
Page 152 R Series Service Manual Bracket shown (Item 18) used in SpO with EtCO /NIBP 4-48 9650-0903-01 Rev. L...
Page 153 R Series Service Manual Parameter Power Supply shown used for SpO with EtCO /NIBP. 9650-0903-01 Rev. L 4-49...
Page 154 R Series Service Manual Parameter Power Supply shown used for SpO only. 4-50 9650-0903-01 Rev. L...
Page 155 R Series Service Manual Parameter Power Supply shown used for SpO Parameter Power Supply shown used for SpO only. with EtCO /NIBP 9650-0903-01 Rev. L 4-51...
Page 156 R Series Service Manual 4-52 9650-0903-01 Rev. L...
Page 157 R Series Service Manual 9650-0903-01 Rev. L 4-53...
Page 158 R Series Service Manual 4-54 9650-0903-01 Rev. L...
Page 159: Ac Charger
AC Charger The AC charger converts AC power to DC for battery charging and R Series operation. The input voltage range is universal, accommodating either 100 to 120 VAC nominal or 200 to 240 VAC nominal. The charger can provide up to 100 watts output for 18 seconds and 45 watts steady state indefinitely.
Page 160: Digital System Board
In addition, a hardware R wave trigger is routed from the digital system board to the NIBP module. Digital System Board The R Series Digital System Board is the main control unit of the R Series defibrillator. The digital system includes these major blocks: System Processor: SH3-DSP SH7229 •...
Page 161: Analog System Board
Analog support functions In addition to the core ECG circuitry described above, the R Series Analog System Board contains DC power supplies, power management, and analog support functions for the R Series defibrillator. The major functional blocks are listed below and details can be found in 9301-0506-TO.
Page 162: Pace/Defib Core Engine
Pace/Defib Core Engine The R Series P/D Core Engine is an independent module with its own controller. It generates pace and defib therapeutic energies when supplied with appropriate high power (10 - 15A @ 10V min - 18V max), low power (+12, +5, +3.3, -5), serial communication commands, and digital signals. Direct digital signals are provided to reduce timing delays on critical signals - an example is the SYNC signal used to synchronize the defibrillator pulse.
Page 163: Accessories
R Series operating conditions in monitor mode with no printer. If the system shuts down due a slowly depleting battery, the R Series system requires user-intervention to turn back on. This could be due to battery drop- in or the front panel switch.
Page 164: Wifi
The software attempts to establish a P/D setting that reflects an estimate of the battery ESR. This is to avoid shutdown due to loading of the DC bus. Tables have been prepared on the basis of nominal R Series operating conditions without the printer operating. We will rely on the defib module throttling to handle additional load conditions (such as printer).
Page 165 The table listing Delivered Energy at Every Defibrillator Setting into a Range of Loads • Sync Connector Diagrams • The ZOLL R Series Maintenance Tests Checklist. Photocopy the checklist and use the copy to record the results of the maintenance tests performed on • the R Series equipment. 9650-0903-01 Rev. L...
Page 166: Interconnect Diagram For The R Series Biphasic Unit
R Series Service Manual Interconnect Diagram for the R Series Biphasic Unit 9650-0903-01 Rev. L...
Page 167: Delivered Energy At Every Defibrillator Setting Into A Range Of Loads
R Series Service Manual Delivered Energy at Every Defibrillator Setting into a Range of Loads Load Selected Energy 25 50 75 100 125 150 175 Accuracy* ±15% ±15% ±15% ±15% ±15% ±15% ±15% 10 J ±15% 10 J 11 J...
Page 168: Sync Connector Diagrams
R Series Service Manual SYNC Connectors Diagram There are 2 styles of Sync Connectors. Below are the pinouts for each style. This connector was introduced in manufacturing in January 2014. Note: 9650-0903-01 Rev. L...
Page 169: Maintenance Test Checklist
ZOLL R Series Serial No. Location Maintenance Test Checklist Tester Signature Date Use this checklist to 1.0 Physical Inspection 2.0 Front Panel Button 4.0 Power Supply Test 7.0 Heart Rate Display 10.0 Heart Rate Alarm Test Test Test record the results of the...
Page 170 ZOLL R Series Serial No. Location Maintenance Test Checklist Tester Signature Date 11.0 Defibrillator 14.0 Shock Test 16.0 Advisory Message 18.0 SpO Monitor Test 21.0 CO Accuracy Test Self Test Test Pass Fail Pass Fail Pass Fail Pass Fail Pass Fail 14.2...
Page 171 R Series R Series PLUS ® ® Operator’s Guide 9650-0904-01 Rev. N...
Page 172 The issue date for the R Series Operator’s Guide BLS/Plus (REF 9650-0904-01 Rev. N) is March, 2016. Copyright © 2016 ZOLL Medical Corporation. All rights reserved. R Series, M Series, pedi-padz, pro-padz, stat-padz, CodeNet, Real CPR Help, RescueNet, See-Thru CPR,...
Page 173 Table of Contents Chapter 1 General Information Product Description ......................1-1 R Series Model Features ....................1-3 How to Use This Manual..................... 1-4 Operator’s Guide Updates ....................1-4 Unpacking........................... 1-4 Symbols Used on the Equipment ..................1-4 Conventions ........................1-7 Defibrillator Function ......................
Page 174 Determine the Patient’s Condition Following Local Medical Protocols ....... 4-6 Begin CPR Following Medical Protocols ..............4-6 Prepare Patient ......................4-6 1 Select ON ........................ 4-8 2 Charge Defibrillator ....................4-9 3 Deliver Shock ......................4-10 Autoclavable Electrodes ....................4-10 www.zoll.com 9650-0904-01 Rev. N...
Page 175 Chapter 7 Real CPR Help Real CPR Help Field......................7-2 Perfusion Performance Indicator (R Series Plus/Adult Only) ........7-2 CPR Idle Time Display ....................7-2 CPR Rate and Depth Display ..................7-2 Compression Release Bar (R Series Plus/Adult only) ..........7-3 CPR Metronome ......................
Page 176 Implanted Pacemakers ..................... 10-5 5-Lead Monitoring......................10-7 Simultaneous 3-Lead Printing ................... 10-7 See-Thru CPR Filter (R Series Plus Only) ..............10-7 Adding Traces to Be Displayed ................10-8 Printing the ECG on a Stripchart ..................10-8 Diagnostic Bandwidth ....................10-8 Alarms..........................
Page 177 Transferring Files Through the USB Port (R Series Plus Only) ........12-4 Transferring Full Disclosure Files Through Wi-Fi (R Series Plus Only) ......12-5 Transferring Device Check and Activity Log Files Through Wi-Fi (R Series Plus Only) ... 12-6 Related Wi-Fi Messages ................... 12-7...
Page 178 Electromagnetic Emissions Declaration ..............A-8 Electromagnetic Immunity Declaration (EID) ..............A-9 EID for Life-Support Functions .................A-10 Recommended Separation Distances from RF Equipment for the R Series Life-Support Functions ...................A-11 EID for Non–Life-Support Functions .................A-12 Recommended Separation Distances from RF Equipment for the R Series Non–Life-Support Functions ...................A-13...
Page 179 The features that only apply to the Plus model are documented as R Series Plus Only within the manual, and optional features are documented as Optional. Refer to the table on page 1-3 for a listing of features that are available in the R Series defibrillator models.
Page 180 The R Series performs code readiness testing when the unit is OFF but connected to AC power, when the defibrillator is initially turned on, and periodically during operation.
Page 181 R Series Model Features R Series Model Features The following features are available in the R Series Plus and R Series BLS models. Pacing and SpO2 monitoring are additional options that may be purchased separately. Feature BLS Model Plus Model ...
Page 182 How to Use This Manual The R Series Operator's Guide provides information operators need for the safe and effective use and care of the R Series products. It is important that all persons using this device read and understand all the information contained within.
Page 183 Defibrillator-proof type BF patient connection. Defibrillator-proof type CF patient connection. Fusible link. Equipotentiality. Alternating current (AC). Direct current (DC). Contains lithium. Recycle or dispose of properly. R E C Y C L E 9650-0904-01 Rev. N ZOLL R Series Operator’s Guide 1–5...
Page 184 (WEEE). Do not dispose of in unsorted trash. Date of manufacture. Use by. Latex-free. Do not reuse. Do not fold. Not sterile. Nonionizing electromagnetic radiation from Wi-Fi during data transfer. Manufacturer. Authorized representative in the European Community. Serial Number. 1–6 www.zoll.com 9650-0904-01 Rev. N...
Page 185 Caution statements alert you to conditions or actions that can result in damage to the unit. Defibrillator Function The R Series product contains a direct current (DC) defibrillator capable of delivering up to 200 joules. It may be used in synchronized mode to perform synchronized cardioversion using the patient’s R-wave as a timing reference.
Page 186 HAPTER ENERAL NFORMATION Intended Use — Manual Operation Use of the R Series products in the manual mode for defibrillation is indicated on victims of cardiac arrest where there is apparent lack of circulation as indicated by: Unconsciousness. • Absence of breathing.
Page 187 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.
Page 188 The unique design of the R Series products allow clear viewing and interpretation of the electrocardiogram on the display without offset or distortion during external pacing.
Page 189 Do not connect internal pacing lead wires to the ZOLL defibrillator. Pediatric Pacing Pacing can be performed on pediatric patients weighing 55 lb. (25 kg) or less using ZOLL pediatric hands-free therapy electrodes. Prolonged pacing (in excess of 30 minutes), particularly in neonates, can cause burns.
Page 190 Desflurane in the exhaled breath beyond normal values (5%) may positively bias measured carbon dioxide values by up to an additional 3 mmHg. The R Series EtCO option is intended for use only with the ZOLL/Respironics Novametrix CAPNOSTAT 5 Mainstream CO Sensor.
Page 191 The R Series NIBP option is designed to measure blood pressure for adult patients (21 years of age and older) and for pediatric patients, as described in the following table:...
Page 192 Use appropriate precautions when disposing of contaminated electrodes. When the patient is less than 8 years old or weighs less than 55 lb. (25 kg), use ZOLL pediatric defibrillation electrodes. Do not delay therapy to determine the patient’s exact age or weight.
Page 193 • defibrillator energy. For safety, in Manual mode, the R Series unit automatically disarms if left charged for more than either 60 or 120 seconds (user configurable) if the SHOCK button is not pressed; in AED mode, the R Series unit automatically disarms if left charged for more than 30 seconds.
Page 194 Do not use the defibrillator until it has been inspected by appropriate personnel. The R Series unit might not perform to specifications when stored at the upper or lower extreme limits of storage temperature and then immediately put into use.
Page 195 When the warning REPLACE BATTERY appears, immediately replace the battery pack with a fully charged pack or plug the R Series unit into a power source, as unit shut down due to a low battery condition is imminent.
Page 196 When the R Series is performing a Code Readiness test, as indicated on the display, do not touch the connected paddles, electrodes, or OneStep cable connector.
Page 197 Neonatal and pediatric defibrillation energy level settings should be based on site-specific clinical protocols. To ensure patient safety, connect the R Series only to equipment with galvanically isolated circuits. Use only high-quality ECG electrodes. ECG electrodes are for rhythm acquisition only; you cannot use ECG electrodes for defibrillation or pacing.
Page 198 Restarting the Defibrillator Certain events require the R Series products to be restarted after they shut off or become inoperative (for example, when the battery runs down and the unit shuts off). In such a case, always try to restore defibrillator operation as follows: 1.
Page 199 Notification of Adverse Events As a health care provider, you may have responsibilities under the Safe Medical Devices Act (SMDA), for reporting to ZOLL Medical Corporation, and possibly to the FDA, the occurrence of certain events. These events, described in 21 CFR Part 803, include device-related death and serious injury or illness.
Page 200 Returning a unit for service Before sending a unit to the ZOLL Technical Service Department for repair, obtain a service request (SR) number from the service representative. Remove the battery pack from the unit. Pack the unit with its cables and battery in the original containers (if available) or equivalent packaging.
Page 201 “A” for January, “B” for February, “C” for March, and so on through “L” for December. The product serial number is a unique set of alphanumeric characters that ZOLL assigns to each individual unit.
Page 203: Chapter 2 Product Overview
Chapter 2 Product Overview Defibrillator Controls and Indicators Front Right Left Rear SpO2 13 14 9650-0904-01 Rev. N ZOLL R Series Operator’s Guide 2–1...
Page 204 (Reserved for future use — do not connect to any equipment.) (Optional) USB device connector For connecting the R Series defibrillator to a USB device. For details, refer to “Event Records and Reports” on page 11-1. Data card slot Holds a compact flash card for copying data stored in the device’s internal memory.
Page 205: The Front Panel
Defibrillator Controls and Indicators The Front Panel The front panel of the R Series device includes the display screen, softkeys, battery indicator, AC power indicator, Code Readiness indicator, SHOCK button, and control panel. The control panel configuration varies slightly depending on the model and whether the unit is in AED mode or Manual mode.
Page 206 RATE RATE Pacer door is open NIBP Button (optional) Six softkeys Figure 2-2. R Series Front Panel (Manual Mode) Table 2-2. R Series Controls and Indicators Control or Indicator Description Display screen Shows therapeutic settings, physiological waveforms, and other information for each monitored parameter, messages, time, and softkey labels.
Page 207 OneStep cable. Lead II or P3 (OneStep Pacing) is automatically selected when the R Series is powered up in PACER mode. Pads or Paddles monitoring is not available in PACER mode. SIZE Button Displays in Manual mode only.
Page 208: Display Screen
Dioxide (EtCO ), part number 9650-0915-01). Messages and prompts. • Labels above the softkeys (appropriate to the context). • Perfusion Performance Indicator and Release Bar (R Series Plus Only). • CPR Rate and Depth. • Remaining CPR Timer. • Figure 2-3 shows the layout of parameter values, waveforms, system data, and softkey labels.
Page 209 Data On/Off Figure 2-3. with optional SpO , NIBP and R Series Display Screen (shown in manual mode monitoring) Color coding To differentiate information for various parameters, the unit displays each type of information in a specific user-configurable color. Messages During operation, a fault or error message is displayed when a fault is detected.
Page 210: Patient Cables And Connectors
(Optional) For connecting pulse oximeter cable. OneStep Cables The R Series ships with either a OneStep, or OneStep Pacing cable. The OneStep Pacing cable has an additional connector that plugs into the rear panel ECG connector. This cable is used with OneStep Pacing electrodes or OneStep Complete electrodes for external pacing and ECG monitoring.
Page 211 As an option, the OneStep Cable Manager is available to store and organize cables. OneStep Cable Manager Cable Caddy Figure 2-6. The R Series with the Optional OneStep Cable Manager (Side View) 9650-0904-01 Rev. N ZOLL R Series Operator’s Guide 2–9...
Page 212: External Paddles (Manual Mode Only)
VERVIEW Power Cord The AC power cord is used to operate the R Series unit when battery power is not being used. An additional extension cord is available for use when the cable organizer accessory is attached to the unit. The extension cord plugs into the main AC power cord as shown below.
Page 213 Defibrillator Controls and Indicators Attach the OneStep cable from the R Series unit to the connector at the base of the apex paddle. 1. Align OneStep cable as shown. 2. Insert OneStep cable into APEX paddle. Figure 2-8. Attaching the OneStep Cable to the APEX Paddle...
Page 214: Working With Menus (Manual Mode Only)
Figure 2-11. Pediatric Plate Note: The R Series defibrillator also supports ZOLL autoclavable internal handles for use during open chest defibrillation procedures. Working with Menus (Manual Mode Only) For some functions, the screen shows a menu of options with related softkeys for navigating through the menus and making selections and entries.
Page 215: Common Tasks
To remove a battery pack, press the tab on the end of the battery pack inward, and lift the battery pack out of the compartment. Figure 2-13. Removing a Battery Pack 9650-0904-01 Rev. N ZOLL R Series Operator’s Guide 2–13...
Page 216: Adjusting Display Brightness (Manual Mode Only)
You can supplement an event summary by manually adding code markers which itemize drugs or treatments administered to the patient. Up to six Code Markers can be displayed on the screen at one time. Intubate LIDO Narcan MORE Figure 2-15. Code Markers 2–14 www.zoll.com 9650-0904-01 Rev. N...
Page 217 (For information on configuring these code marker lists, refer to the R Series Configuration Guide.) The code markers are removed from the display after 10 seconds. If no Code Marker softkey has been pressed during that time, a “default”...
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Page 219: Chapter 3 Automated External Defibrillator (Aed) Operation
Defibrillators. If your local protocol requires a different procedure, follow that protocol. (See the R Series Configuration Guide for instructions on how to configure the R Series to operate with other treatment protocols.) This chapter also describes how to switch the AED unit to Manual mode (see “Switching to Manual Mode Operation”...
Page 220: Determine Patient Condition Following Medical Protocols
EFIBRILLATOR PERATION The R Series defibrillator is capable of analyzing a patient’s ECG rhythm in two different ways. The first mode of analyzing is automatic; the other mode of analyzing is user activated analysis and is initiated by pressing the ANALYZE softkey.
Page 221 Therapy Electrode Application WARNING! Poor adherence and/or air under the therapy electrodes can lead to the possibility of arcing and skin burns. 1. Apply one edge of the pad securely to the patient. 9650-0904-01 Rev. N ZOLL R Series Operator’s Guide 3–3...
Page 222: Select On
ON mode selector light up on the front panel. If no hands-free therapy electrodes have been attached to the patient and connected to the R Series, the ATTACH PADS message and voice prompt will be issued. ATTACH PADS...
Page 223: Analyze
PADS or CHECK PADS message is displayed and analysis will be inhibited. Note: If the R Series has been configured to perform extra CPR, it displays a CHECK PULSE voice prompt and the message appears for 10 seconds. Then it displays an IF NO PULSE, PERFORM CPR message along with a voice prompt for the configured duration before analysis begins.
Page 224: Press Shock
A severe shock can result. Do not allow exposed portions of the patient’s body to come in contact with metal objects, such as a bed frame, as unwanted pathways for defibrillation current may result. 3–6 www.zoll.com 9650-0904-01 Rev. N...
Page 225 Rhythm analysis does not continue after the defibrillator is charged and ready once a decision to shock has been made. The R Series unit will not automatically disarm the defibrillator if the patient’s rhythm reverts to a non-shockable rhythm before the shock has been delivered.
Page 226: Operating Messages
ECG analysis is still in progress and a potentially shockable rhythm has been detected. The current charge level is displayed. SHOCK ADVISED A shockable rhythm has been detected and defibrillation is advised. The selected energy level has not yet been reached. The current energy level is displayed. 3–8 www.zoll.com 9650-0904-01 Rev. N...
Page 227 This message is announced when the chest compressions applied during CPR are forceful enough. CHECK PADS This message is displayed and announced when the therapy pads have been disconnected from the patient. 9650-0904-01 Rev. N ZOLL R Series Operator’s Guide 3–9...
Page 228: Switching To Manual Mode Operation
10 seconds, the unit will revert back to AED operation. Note: If the unit has been configured not to confirm the transition from AED mode to Manual mode, the unit will immediately enter Manual mode. CONFIRM MANUAL MODE 120J SEL. 00:01 Confirm 3–10 www.zoll.com 9650-0904-01 Rev. N...
Page 229 When changing from AED mode to Manual mode, the current selected energy level is maintained. Note: To transfer back to AED mode from Manual mode, power down the unit for more than 10 seconds and then power it back up. 9650-0904-01 Rev. N ZOLL R Series Operator’s Guide 3–11...
Page 230 (AED) O HAPTER UTOMATED XTERNAL EFIBRILLATOR PERATION 3–12 www.zoll.com 9650-0904-01 Rev. N...
Page 231: Chapter 4 Manual Defibrillation
No portion of the hands should be near the paddle plates. Determine the Patient’s Condition Following Local Medical Protocols Verify: Unconsciousness. • Absence of breathing. • Absence of pulse. • 9650-0904-01 Rev. N ZOLL R Series Operator’s Guide 4–1...
Page 232: Begin Cpr Following Local Medical Protocols
Look at the Display and verify the energy is appropriate. Unless internal handles are connected to the OneStep cable, the default energy selections for adult patients are: Shock 1 - 120 joules • Shock 2 - 150 joules • Shock 3 - 200 joules • 4–2 www.zoll.com 9650-0904-01 Rev. N...
Page 233 Alarms On/Off If you have configured Shocks 1, 2, and 3 to escalating energy levels (see the R Series Configuration Guide for instructions), the R Series automatically sets the energy to the preconfigured Energy Level: Shock 1, 2, 3 setting at power-up and after each of the first two shocks.
Page 234: Charge Defibrillator
Caution Changing the selected energy while the unit is charging or charged causes the defibrillator to disarm itself. Press the CHARGE button again to charge the unit to the newly selected energy level. 4–4 www.zoll.com 9650-0904-01 Rev. N...
Page 235: Deliver Shock
DEFIB XXXJ SEL. Press the CHARGE button to recharge the unit. Autoclavable External Paddles ZOLL Autoclavable External Paddles are available for use with manually operated ZOLL defibrillators when sterile conditions must be maintained during defibrillation. 9650-0904-01 Rev. N ZOLL R Series Operator’s Guide...
Page 236: Emergency Defibrillation Procedure With Hands-Free Therapy Electrodes
HAPTER ANUAL EFIBRILLATION Emergency Defibrillation Procedure with Hands-Free Therapy Electrodes ZOLL hands-free therapy electrodes are a defibrillation-protected Type BF patient connection. ECG leads are a defibrillation-protected Type CF patient connection. Determine the Patient’s Condition Following Local Medical Protocols Verify: Unconsciousness.
Page 237 WARNING! Application of adult electrodes to a pediatric patient will result in the automatic selection of adult energy levels. If needed, manually adjust the energy settings based on site-specific protocols. 9650-0904-01 Rev. N ZOLL R Series Operator’s Guide 4–7...
Page 238: Select On
When used with other pediatric defibrillation electrodes, defibrillator energies must be set manually based on site-specific institutional protocols for pediatric defibrillation. After the third shock, all subsequent shocks are delivered at the same energy as the third shock in both Adult and Pediatric modes. 4–8 www.zoll.com 9650-0904-01 Rev. N...
Page 239: Charge Defibrillator
Alarms On/Off If you have configured Shocks 1, 2, and 3 to escalating energy levels (see the R Series Configuration Guide for instructions), the R Series automatically sets the energy to the preconfigured Energy Level: Shock 1, 2, 3 setting at power-up and after each of the first two shocks.
Page 240: Deliver Shock
DEFIB XXXJ SEL. message remains to indicate the selected energy level. Autoclavable Electrodes ZOLL Autoclavable Internal Handles are designed for use with a manually operated ZOLL defibrillator to defibrillate the heart during open chest procedures. Two types of Autoclavable Internal Handles are available: 4–10...
Page 241 Autoclavable Internal Handles with removable internal defibrillation electrodes • When these internal handles are used, the R Series defibrillator can operate only in Manual mode even if the unit supports Advisory mode. When an internal handle set is connected to the R Series, it automatically limits energy output to a maximum of 50 joules.
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Page 243: Chapter 5 Advisory Defibrillation
When the Mode Selector is turned to ON, the unit is in Manual mode, and hands-free therapy electrodes are used, the R Series can identify shockable rhythms using its built in ECG analysis capability. You must read the advisory messages, charge the defibrillator to the preconfigured or user-selected energy level (if automatic charge is disabled), and deliver treatment to the patient when required by protocol and patient condition.
Page 244: Advisory Defibrillation Procedure
The message CONFIRM MANUAL MODE and the Confirm softkey will be displayed. Press the Confirm softkey to enter the Manual mode of operation. If the Confirm softkey is not pressed within 10 seconds, the unit will revert back to AED operation. 5–2 www.zoll.com 9650-0904-01 Rev. N...
Page 245 SHOCK 1, 2, 3 sequence and deliver a shock, it disables the automatic energy escalation. See the Energy Level: Shock 1, 2, 3 section of the R Series Configuration Guide for more details. 9650-0904-01 Rev. N ZOLL R Series Operator’s Guide...
Page 246: Press Analyze Button
Alarms On/Off Data When a nonshockable rhythm is detected, the unit displays a NO SHOCK ADV. message. Follow the local protocols to continue CPR or other life support, and re-analyze the ECG at appropriate intervals. 5–4 www.zoll.com 9650-0904-01 Rev. N...
Page 247 Advisory Defibrillation Procedure Note: When a nonshockable rhythm is detected, the R Series does not prevent the user from manually defibrillating the patient. When a shockable rhythm is detected (ventricular fibrillation or wide-complex tachycardia with heart rate > 150), one of the following occur: Units with the automatic charge option enabled automatically charge to the preconfigured or •...
Page 248: Press Shock
Rhythm analysis does not continue after the defibrillator is charged and ready once a decision to shock has been made. The R Series unit will not automatically disarm the defibrillator if the patient’s rhythm reverts to a non-shockable rhythm before the shock has been delivered.
Page 249: Advisory Function Messages
Check that the therapy electrodes are making good contact with the patient’s skin and that all cables are securely connected. This voice prompt will not sound if the therapy electrodes were not previously connected to the patient. 9650-0904-01 Rev. N ZOLL R Series Operator’s Guide 5–7...
Page 250 HAPTER DVISORY EFIBRILLATION (This page intentionally left blank.) 5–8 www.zoll.com 9650-0904-01 Rev. N...
Page 251: Chapter 6 Synchronized Cardioversion
T-wave segment of the cardiac cycle. When in the Sync mode, the unit displays markers (  ) above the ECG trace to indicate the points in the cardiac cycle (R waves) where discharge can occur. 9650-0904-01 Rev. N ZOLL R Series Operator’s Guide 6–1...
Page 252: Synchronized Cardioversion Procedure
Sync marker pattern. The Sync On/Off softkey may be highlighted for clearer visibility, if desired. This is off by default. Refer to the R Series Configuration Guide for instructions on how to turn on the highlighting.
Page 253: Select On
(or sternum paddle if using paddles). Press the Sync On/Off softkey Your system will be in Sync mode once you press the Sync On/Off softkey if your R Series is not configured to support Remote Sync. However, if your R Series is configured to support 9650-0904-01 Rev.
Page 254: Charge Defibrillator
Sync mode. Note that the unit can be configured to stay in Sync mode after defibrillation, if desired. Refer to the R Series Configuration Guide for instructions. 2 Charge Defibrillator Press the CHARGE button on the front panel or on the apex paddle handle.
Page 255: Deliver Shock
ECG monitoring device. See the R Series Configuration Manual. Be sure that the remote device is connected to the Sync In/Marker Out connector on the R Series unit. The remote device must have a Sync out connector and a cable must be provided to connect the two devices.
Page 256: Determine The Patient's Condition And Provide Care Following Local Medical Protocols
The words “REMOTE SYNC” are displayed in place of the ECG trace, and a REMOTE SYNC XXXJ SEL. message appears on the display. The ECG heartbeat indicator will flash with each synchronization pulse received from the remote monitoring device. 6–6 www.zoll.com 9650-0904-01 Rev. N...
Page 257: Charge Defibrillator
Warn all persons in attendance of the patient to STAND CLEAR prior to defibrillator discharge. Verify that no one is in contact with the patient, monitoring cable or leads, bed rails, or any other potential current pathways. 9650-0904-01 Rev. N ZOLL R Series Operator’s Guide 6–7...
Page 258 If the ANALYZE button is pressed while the unit is in Remote Sync mode, the unit displays the REMOVE SYNC message and disallows ECG rhythm analysis until the unit is taken out of Sync mode. 6–8 www.zoll.com 9650-0904-01 Rev. N...
Page 259: Chapter 7 Real Cpr Help
This sensor monitors the rate and depth of chest compressions and sends this information to the R Series unit for processing and display. The R Series defibrillator uses this information to provide feedback to the rescuer in one or more of the following forms: Perfusion Performance Indicator (R Series Plus Only) •...
Page 260: Real Cpr Help Field
This field includes the indicators described in the next sections. Perfusion Performance Indicator (R Series Plus/Adult Only) This feature is only available in R Series Plus models.This diamond shaped figure provides a quick, overall indicator of how well the rescuer's combined rate and depth of chest compressions match the AHA/ERC recommendations for adult CPR.
Page 261: Compression Release Bar (R Series Plus/Adult Only)
Compression Release Bar CPR Metronome The R Series unit includes a CPR metronome feature that can be used to encourage rescuers to perform chest compressions at the AHA/ERC recommended rate of 100 compressions per minute. This feature can be configured.
Page 262: Fully Release Prompt
By default, the FULLY RELEASE text prompt is not enabled. CPR Voice Prompts (R Series Plus/Adult only) The R Series can be configured to issue voice prompts related to the depth of chest compressions as feedback to rescuers performing CPR. Two voice prompts are available for...
Page 263: Chapter 8 See-Thru Cpr (R Series Plus Only)
See-Thru CPR enables the rescuer to see a close approximation of the patient’s underlying ECG rhythm while performing CPR. See-Thru CPR is available if the R Series is monitoring CPR. Chest compressions introduce CPR artifact into the ECG signal. See-Thru CPR uses a filter...
Page 264: Using See-Thru Cpr (R Series Plus Only)
Trace 1 ECG waveform. If configured to display the CPR Dashboard, the R Series unit can also be configured to display the filtered ECG in Trace1. When the unit is configured to display the filtered ECG in Trace1, the softkey Disable Filt ECG appears, which you can press to disable display of the filtered ECG in Trace1 and replace it with the unfiltered ECG.
Page 265 Using See-Thru CPR (R Series Plus Only) The following figure shows a patient in Fine VF. It is difficult for a rescuer to discern this rhythm during CPR compressions. When the CPR filter turns on, the Fine VF rhythm becomes more obvious.
Page 266 0:12 CoarseVF Raw ECG Raw ECG • | Filter ON Filtered ECG Filtered ECG 0:12 0:24 CoarseVF Raw ECG Raw ECG • | Filter OFF Filtered ECG Filtered ECG 0:24 0:36 12.5 mm/sec, 5 mm/mV 8–4 www.zoll.com 9650-0904-01 Rev. N...
Page 267 Using See-Thru CPR (R Series Plus Only) The following figure shows a patient in PEA, which could easily be mistaken for Fine VF because enough of the compression artifact leaks through to distort this signal. When the CPR filter turns on, the PEA is still not obvious because of the left over ripples from the CPR signal.
Page 268 Raw ECG • • | Filter OFF | Filter ON Filtered ECG Filtered ECG 0:12 0:24 SinusRhythm Raw ECG Raw ECG • | Filter OFF Filtered ECG Filtered ECG 0:24 0:36 12.5 mm/sec, 5 mm/mV 8–6 www.zoll.com 9650-0904-01 Rev. N...
Page 269: Chapter 9 Noninvasive Temporary Pacing (Optional)
(Optional) Note: This is an optional feature and is only available in Manual mode. When ZOLL hands-free therapy electrodes are used, the patient connection is considered to be defibrillation-protected Type BF. ECG leads are a defibrillation-protected Type CF patient connection.
Page 270: Determine Patient Condition And Provide Care Following Local Medical Protocols
PTIONAL Noninvasive Temporary Pacing R Series defibrillators with the pacer option contain a VVI demand pacemaker – a safe and effective design for Noninvasive Temporary Pacemakers. Proper demand pacing requires a reliable, high quality surface ECG signal. For best results: Apply both standard ECG monitoring electrodes and hands-free pacing therapy electrodes •...
Page 271: Select On
The unit beeps 4 times to indicate that it has passed the power on self test, and the green AED label and the ON mode selector light up on the front panel. 9650-0904-01 Rev. N ZOLL R Series Operator’s Guide 9–3...
Page 272: Turn Mode Selector To Pacer
Set the PACER RATE to a value 10-20 ppm higher than the patient’s intrinsic heart rate. If no intrinsic rate exists, use 100 ppm. The pacer rate increments or decrements by a value of 2 ppm on the display when the knob is turned. PACER OUTPUT OUTPUT RATE RATE 9–4 www.zoll.com 9650-0904-01 Rev. N...
Page 273: Set Pacer Output
Determination of electrical capture should only be performed by viewing the ECG trace on the R Series display with its ECG connection directly attached to the patient. Use of other ECG monitoring devices might provide misleading information due to the presence of pacer artifacts.
Page 274: Determine Optimum Threshold
Typically the lowest threshold is obtained when the position of the electrodes provides the most direct current pathway through the heart while avoiding large chest muscles. Lower stimulation currents produce less skeletal muscle contraction and are better tolerated. 9–6 www.zoll.com 9650-0904-01 Rev. N...
Page 275 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ PACE 00:01 50 mA 70 PPM Clear Async Pace Pacing Alarm On/Off 9650-0904-01 Rev. N ZOLL R Series Operator’s Guide 9–7...
Page 276: Special Pacing Applications
ACING PTIONAL Special Pacing Applications Noninvasive Temporary Pacing can be performed in the Cardiac Catheterization Lab either for emergency pacing or standby pacing. For pacing in X-ray and fluoroscopic applications, ZOLL ® pro-padz radiolucent hands-free therapy electrodes may be used.
Page 277: Select On
Manual mode, the unit will immediately enter Manual mode. The control buttons for Manual mode light up on the front panel. 2 Turn Mode Selector to PACER RECORDER PACER The pacer door drops open and the knobs are displayed. 9650-0904-01 Rev. N ZOLL R Series Operator’s Guide 9–9...
Page 278: Press The Async Pacing On/Off Softkey
Continuous pacing of neonates can cause skin burns. If it is necessary to pace for more than 30 minutes, periodic inspection of the underlying skin is strongly advised. Carefully follow all instructions on electrode packaging. 9–10 www.zoll.com 9650-0904-01 Rev. N...
Page 279: Ecg Monitoring
This option is only available in Manual mode. ECG leads are a defibrillation-protected Type CF patient connection. The R Series products can be used for either short- or long-term ECG monitoring. R Series products have built-in circuitry to prevent damage to their ECG monitoring circuits during defibrillation.
Page 280: Preparations
Attach conventional ECG electrodes for diagnostic purposes. Note: Note: Under certain clinical circumstances, the R Series heart rate counting system may respond to narrow, high-amplitude spikes in the ECG signal (e.g., 10 msec duration, 1 mV peak-to-peak amplitude) leading to miscounting of the patient’s heart rate.
Page 281: Monitoring Electrodes Attachment
3-lead cables are available with and without Electro Surgical Unit noise suppression. If the R Series unit is being used in the presence of an ESU, ablation device, or any other high electromagnetic noise emitting source, ZOLL recommends using the R Series 3-Lead ECG Cable, ESU Filtered (REF 9500-000693) specifically designed to limit ESU artifact when monitoring heart rates.
Page 282: Monitoring The Patient's Ecg
The message CONFIRM MANUAL MODE and the Confirm softkey will be displayed. Press the Confirm softkey to enter the Manual mode of operation. If the Confirm softkey is not pressed within 10 seconds, the unit will revert back to semiautomatic operation. 10–4 www.zoll.com 9650-0904-01 Rev. N...
Page 283: Implanted Pacemakers
Implanted Pacemakers The R Series device can be configured to detect pacemaker signals from a patient with an implanted pacemaker and indicate their presence on the display. When pacer pulses are detected, the device displays a 5mm, vertical, solid line on the ECG trace.
Page 284 PADS Depth Rate NIBP mmHg Pacer Off icon mmHg MONITOR Code Report Test Options Param Marker Data Alarms To re-enable detection of pacemaker spikes: 1. Press the Param softkey. Press ECG. Press Enable Pacer Detect. 10–6 www.zoll.com 9650-0904-01 Rev. N...
Page 285: 5-Lead Monitoring
Simultaneous 3-Lead Printing The R Series unit can display and print three simultaneous ECG leads when using a 5 lead cable and an ECG lead is selected as the signal source (not PADS or PADDLES).
Page 286: Adding Traces To Be Displayed
You can then switch between filtered and unfiltered ECG using the Enable/Disable Filt ECG softkey. With the unfiltered ECG displayed in Trace1, the user of the R Series unit can also enable the display of the filtered ECG in Trace2 or Trace3.
Page 287: Alarms
Alarms Setting Alarm Limits Unless configured otherwise, heart rate alarms are preset at 30 bpm (bradycardia) and 150 bpm (tachycardia). Refer to the R Series Configuration Guide for details on setting power-up alarm limits. To set alarm parameters: 1. Press the Alarms softkey to view the Alarm Set screen and softkeys.
Page 288: Heart Rate Alarm Limits
(NIBP), or end-tidal carbon dioxide monitoring (EtCO ), if available. The R Series unit has three levels of alarms: High Priority — Reflects physiological parameters that are out of bounds. When these • alerts occur, the unit emits an audio tone at 2.86 KHz, highlights the alarming parameter, and flashes the associated alarm bell.
Page 289: Smart Alarms
Activating and Deactivating Alarm Processing To deactivate all alarms on the R Series unit, press and hold down the ALARM SUSPEND button for 3 seconds or longer. The bell icons for all alarms will have an “X” through them to indicate that the alarms are deactivated. Alarm parameter values display normally (no highlighting).
Page 290: Alarm Settings For Unattended Monitoring
Alarm limits should be intentionally set to levels appropriate for detecting relevant changes in the patient’s condition. Leaving alarm settings at their default levels or setting them to the extremes of their ranges may defeat the utility of the alarms even when they are activated. 10–12 www.zoll.com 9650-0904-01 Rev. N...
Page 291: Chapter 11 Event Records And Reports
Note: This option is only available in Manual mode. The R Series defibrillator records important event information during operation. You can retrieve this information in various forms: Summary Report — Summary report allows you to store and later retrieve important ECG •...
Page 292: Summary Report Formats
(The time interval is specified in the Set Report Restart Delay parameter; see the R Series Configuration Manual for more information). A new patient record is automatically created when the unit has been turned off for a configurable time period of 5 minutes to 72 hours.
Page 293 The date/time printed on the top of the strip corresponds to the ECG data occurring 6 seconds before the event. Figure 11-2. Defibrillation Event Format (Pre-Shock) Figure 11-3. Defibrillation Event Format (Post Shock) 9650-0904-01 Rev. N ZOLL R Series Operator’s Guide 11–3...
Page 294 If async pace is active, the annotation ASYNC PACE is also recorded and printed. The date/time printed on the top of the strip corresponds to the ECG data occurring 6 seconds before the event. Figure 11-5. Pacer Mode Selected Format (Asynchronous Pacing) 11–4 www.zoll.com 9650-0904-01 Rev. N...
Page 295 CHECK PATIENT. The date/time printed on the top of the strip corresponds to the ECG data occurring 6 seconds before the event. Figure 11-7. VF Alarm Activated Format 9650-0904-01 Rev. N ZOLL R Series Operator’s Guide 11–5...
Page 296 If two or more of the three 3-second ECG analyses do not detect a shockable rhythm, the unit alerts the operator that no shock is advised. 11–6 www.zoll.com 9650-0904-01 Rev. N...
Page 297: Printing The Entire Summary Report
If the recorder is out of paper when the Report Data softkey and a corresponding print softkey are pressed, a CHECK RECORDER message appears on the display. Load paper and press the Report Data softkey again to select the report to print. 9650-0904-01 Rev. N ZOLL R Series Operator’s Guide 11–7...
Page 298: Printing A Partial Summary Report
Full Disclosure Recording Along with event information captured in Summary Report, R Series also records the full disclosure CPR sensor and parameter waveforms. The full disclosure recording on the unit can accommodate at least 6 hours of data. Full disclosure recordings are erased at the same times as Summary Reports.
Page 299: Erasing Summary Report And Full Disclosure
5 minutes to 72 hours. Formatting the Disk The R Series uses an internal flash memory disk that stores the data in files similar in structure to those on a personal computer hard drive. Like a personal computer, there may be rare occasions when the internal disk requires formatting.
Page 300: Related Messages
Do not remove power (both battery and AC) while the unit is erasing reports or formatting the disk. ERASING REPORT The unit is erasing the selected report data. FORMATTING DISK The internal flash memory disk is being formatted. 11–10 www.zoll.com 9650-0904-01 Rev. N...
Page 301: Chapter 12 File Transfer
Note: The USB and Wi-Fi capabilities that are included in this chapter are only available if you have the R Series Plus model. The file transfer option is only available when you are in Manual mode. While you are in Transfer Data mode, if you press any of the buttons on the right side of the front panel (SHOCK, ANALYZE, CHARGE, ENERGY SELECT), the following message is displayed: SELECT DEFIB MODE.
Page 302: Wi-Fi (Optional)
802.11 protocol (Wi-Fi). This includes a ZOLL R Series Data COMM Card or ZOLL R Series Data COMM II card, and a protective guard that must be installed on the unit. See R Series Data COMM Instructions for Use and Wi-Fi Guard Installation (Part number 9652-000395) or R Series Data COMM II Instructions for Use and Wi-Fi Guard Installation (Part number 9652-000405) for instructions on how to install the Wi-Fi Guard.
Page 303: Transferring A Full Disclosure File To A Compact Flash Card
Do not remove the CF card while files are transferring. Corruption may result on the data card. When all files are transferred, the message DATA TRANSFERRED is displayed. You can now remove the CF card from the R Series unit. To exit Data Transfer Mode, press the Exit Transfer softkey. 9650-0904-01 Rev. N ZOLL R Series Operator’s Guide...
Page 304: Transferring Device Check And Activity Log Files To A Compact Flash Card
Transferring Files Through the USB Port (R Series Plus Only) Before you begin, connect a USB cable from the Windows external device with USB host capability (for example, a Window PC), to the R Series defibrillator USB device port. USB Host Port...
Page 305: Transferring Full Disclosure Files Through Wi-Fi (R Series Plus Only)
Transferring Full Disclosure Files Through Wi-Fi (R Series Plus Only) Before you begin, ensure the Wi-Fi card is properly seated with the name R Series Data COMM or Data COMM II facing up in the compact flash slot. Make sure that the Wi-Fi guard has been attached.
Page 306: Transferring Device Check And Activity Log Files Through Wi-Fi (R Series Plus Only)
To send the report, press the Send Report softkey. The R Series is now in Wi-Fi Transfer Mode and a status text message box appears in the middle of the screen and describes the status of the file being sent.
Page 307: Related Wi-Fi Messages
Press the Defib History to Wi-Fi softkey. The R Series is now in Wi-Fi Transfer Mode and a status text message box appears in the middle of the screen and describes the status of the files being sent. When the files are transferred, the message TRANSFER COMPLETE are displayed.
Page 308 • User Identity • Private Key Password • Client Certificate N = 7: Missing required configuration data for Network Profile 2 with Enterprise Authentication selected (Data COMM II only) Action: Same as above. 12–8 www.zoll.com 9650-0904-01 Rev. N...
Page 309 Transferring Device Check and Activity Log Files Through Wi-Fi (R Series Plus Only) TRANSFER FAILED N = 8: The Defib Upload Server's Username / Invalid Wi-Fi configuration Password are blank within the Full Disclosure and Defib Error Number: N History server configuration items Data COMM II only)
Page 310 Contact Network Administrator 1) Make sure that the configuration values for the SSID names are correct. 2) Make sure that the R Series unit is within range of the wireless server. 3) Contact the Network Administrator for assistance. TRANSFER FAILED...
Page 311 Transferring Device Check and Activity Log Files Through Wi-Fi (R Series Plus Only) TRANSFER FAILED The server rejected the unit’s request. Server Rejection Action: Contact the Network Administrator for Contact Network Administrator assistance. TRANSFER FAILED The card installed in the CF slot is not an R Series Data Unsupported Wi-Fi Card COMM or Data COMM II card.
Page 312 12 F HAPTER RANSFER 12–12 www.zoll.com 9650-0904-01 Rev. N...
Page 313: Chapter 13 Maintenance
Once per week; daily if Code Readiness Test is configured Off. Testing When the R Series device ships from ZOLL, the Code Readiness indicator may show a red “X.” A manual readiness test should be performed (in addition to other site-specific tests such as HiPot and Leakage) prior to putting the device into service.
Page 314: Routine Procedures
AC mains power outlet. Code Readiness Status Look at the /x Code Readiness indicator on the R Series defibrillator. If the Code Readiness indicator displays a red “X” the unit is not ready for therapeutic use.
Page 315: Code Readiness Test
• After the successful completion of the readiness check, the Code Readiness indicator displays a green check, indicating that the unit is ready for therapeutic use. If configured, the R Series will print a test record following automatic test completion.
Page 316: Defibrillator Testing With Paddles
If a LOW BATTERY message appears during testing, the battery is close to depletion and should be replaced or recharged. Before you begin 1. Connect the R Series to AC mains. Do one of the following: Connect unopened OneStep electrodes to the OneStep cable, •...
Page 317: Defibrillator Testing With Hands-Free Therapy Electrodes
CHECK PADS, and issues the voice prompt. The ECG trace appears as a solid line while the OneStep cable is connected to either the Test Port or OneStep electrodes. Press the Manual Test softkey. The unit charges to 30 joules. 9650-0904-01 Rev. N ZOLL R Series Operator’s Guide 13–5...
Page 318: Pacer Testing
The unit displays the message 30J TEST OK and displays a shock count of 1. If the message 30J TEST FAILED appears, contact appropriate technical personnel or the ZOLL Technical Service Department. Pacer Testing 1. Turn the Mode Selector to ON.
Page 319: Code Readiness Log
The Code Readiness Log can be transferred to an external computing device (see “Transferring Files to an External Device” on page 12-1). If configured, the R Series prints a Code Readiness Test Report following the completion of each automatic defibrillator test.
Page 320 ECG: OK AC Power: Connected Print Print Prev Next Test Log Test Test Test Return Figure 13-1. Code Readiness Test Log Print Display Figure 13-2. Code Readiness Test Log Figure 13-3. Code Readiness Test Report 13–8 www.zoll.com 9650-0904-01 Rev. N...
Page 321: Setting Time And Date
Press the Enter and Return softkey to set all values and return to normal monitoring mode. Note: The R Series unit may be configured to synchronize the time automatically with a data server in the Wi-Fi Data Transfer configuration settings. See the R Series Configuration Guide for more information.
Page 322: Loading Stripchart Paper
13 M HAPTER AINTENANCE ZOLL recommends cleaning the device, paddles, and cables with a soft damp cloth using the approved cleaning agents. The external printer parts should be cleaned with a damp, soft cloth only. Do not immerse any part of the defibrillator (or its accessories) in water. Do not use ketones (such as acetone or MEK) on the defibrillator.
Page 323: Cleaning The Print Head
Gently wipe the printhead with a cotton swab moistened with isopropyl alcohol, and dry any residual alcohol with another dry cotton swab. Figure 13-7. Cleaning the Print Head Place the paper back into the unit and close the cover (see Figure 13-6). 9650-0904-01 Rev. N ZOLL R Series Operator’s Guide 13–11...
Page 324: Operator's Checklist For R Series Product
Operator’s Checklist for R Series Product Recommended checks and procedures to be performed Date ______________________________________________ daily or weekly, depending on Automatic Test Location ____________________________________________ configuration. Unit Serial Number ___________________________________ 1. Condition Remarks Unit clean, no spills, clear of objects on top, case intact 2.
Page 325: Chapter 14 Troubleshooting
This chapter answers many of the common problems or questions that may arise during operation. If trouble persists after consulting this guide, contact the appropriate technical personnel or ZOLL Technical Service Department. Refer to the R Series Plus/BLS Service Manual for more detailed troubleshooting information. Code-Ready...
Page 326: Monitor
3. SET CLOCK message • Set time and date information. • Verify that the internal lithium battery has been replaced within the last 5 years. Contact ZOLL Technical Service Department for assistance 4. ECG LEAD OFF message • Check that ECG cable or OneStep Pacing cable is connected to patient and instrument.
Page 327 Monitor Symptom Recommended Action 6. Noisy ECG, artifact, wandering • Consider 1 – 21Hz filter bandwidth (see R Series baseline Configuration Manual). • Prepare the patient’s skin prior to electrode attachment. • Check for proper adhesion of electrodes to patient.
Page 328: Recorder
• Check patient’s pulse. appears after stimulus marker on • Increase output current. ECG display. • Ensure therapy electrodes are making good contact with the patient. • Select different ECG Lead configuration. • Review therapy electrode placement. 14–4 www.zoll.com 9650-0904-01 Rev. N...
Page 329: Defibrillator
• Select different ECG Lead configuration. on ECG trace. 6. Bedside/Central Station/Telemetry None, the patient monitor ECG inputs are overloaded by ECG display becomes erratic pacer signals. ECG can only be monitored by the R Series when pacing. or pacing device while pacing. Defibrillator Symptom Recommended Action 1.
Page 330 • Perform defibrillator self-test. • Check for CHECK PADS and POOR PAD CONTACT messages alternating on the monitor. • If hands-free therapy electrodes are used, ensure proper placement and contact. • Review the discharge stripchart for Joules/current delivered. 14–6 www.zoll.com 9650-0904-01 Rev. N...
Page 331 200 joules. Only 200 joule shocks are counted. The device is still usable; if you are responding to a code, continue using the device. Contact ZOLL Technical Service Department when possible. 9650-0904-01 Rev. N ZOLL R Series Operator’s Guide...
Page 332: Ac Charger
CHECK CPR PUCK message is • No action is required. This is an informational message displayed. to indicate that default calibration values are being used for the CPR puck. The CPR values will be within the specification. 14–8 www.zoll.com 9650-0904-01 Rev. N...
Page 333 Appendix A Specifications This section describes the specifications for the R Series Defibrillator as well as the ECG rhythm analysis algorithm. “Defibrillator Specifications” on page A-2 • “Battery Pack Specifications” on page A-7 • “IEC 60601-1-2 Specifications” on page A-8 •...
Page 334: Defibrillator Specifications
13.6 lb (6.17 kg) with OneStep cable and battery pack 15.2 lb (6.89 kg) with paddles Power (for Battery: Rechargeable lithium ion battery pack R Series ALS, BLS and Plus models) AC Power Requirements: 100-120 Vrms, 50/60 Hz 220-240 Vrms, 50 Hz...
Page 335 (advisory mode) with a new, fully charged pack (depleted by up to fifteen 200 J discharges) and using AC power at 90% of rated mains voltage. Patient Impedance 15 - 300 ohms Range Energy display Screen shows selected and delivered energy. 9650-0904-01 Rev. N ZOLL R Series Operator’s Guide A–3...
Page 336 ±2 mV to ±700mV amplitude, 0.1ms to 2ms width, with a recharge constant Detected of 0 to 100ms. Note: The pacemaker pulse rejection capability for the R Series with pacemaker pulses alone includes pulses between +/-2mV and +/ -700mV amplitude, with widths between 0.1ms and 2ms and overshoot from 0 to 100ms.
Page 337 < 0.8 mV Rejection Heart Rate The R Series averages the interval between the last 6 detected beats. On Averaging startup, the R Series averages the rate between detected beats once two beats are detected, until a full 6 beats have been received. The rate is updated every beat.
Page 338 Compact flash card Sync in / Marker out / ECG out Sync In 0-5 V (TTL Level) pulse, active R Series Connector high, 5 to 15 msec in duration, Pinout no closer than 200 ms apart. Energy transfer begins within 25 ms of the leading edge of the external sync pulse.
Page 339: Battery Pack Specifications
1.7 lb (0.77 kg) Nominal voltage 10.6 V Recharge time 4 hours or less within R Series. Operating time For a new, fully charged battery at 20°C: • 100 defibrillator discharges at maximum energy (200 joules), or • 4 hours of continuous ECG monitoring, or •...
Page 340: Iec 60601-1-2 Specifications
Guidance and manufacturer’s declaration — electromagnetic emissions for the R Series. The R Series is intended for use in the electromagnetic environment specified below. The customer or user of the R Series should ensure that it is used in such an environment.
Page 341: Electromagnetic Immunity Declaration (Eid
Guidance and manufacturer’s declaration — electromagnetic immunity for the R Series. The R Series is intended for use in the electromagnetic environment specified below. The customer or user of the R Series should ensure that it is used in such an environment.
Page 342: Eid For Life-Support Functions
To assess the electromagnetic environment due to fixed RF transmitters, an electromagnetic site survey should be considered. If the measured field strength in the location in which the R Series is used exceeds the applicable RF compliance level above, the R Series should be observed to verify normal operation. If abnormal performance is observed, additional measures may be necessary, such as reorienting or relocating the R Series.
Page 343: Recommended Separation Distances From Rf Equipment For The R Series Life-Support Functions
The life-support functions on the R Series are defined to be any function associated with ECG monitoring, pacing, defibrillation, and shock analysis. Specifically, these functions include, but are not limited to, the ECG waveform monitoring from leads or pads, the pacing pulse output, QRS detection, defibrillation energy discharge, and shock advisory functions.
Page 344: Eid For Non-Life-Support Functions
The non–life-support functions on the R Series are defined to be any function not listed as a life-support function in the "EID for Life-Support Functions" table (Note a). Specifically, this function is SpO b.
Page 345: Recommended Separation Distances From Rf Equipment For The R Series Non-Life-Support Functions
The non–life-support functions on the R Series are defined to be any function not listed as a life-support function in the "EID for Life-Support Functions" table (Note a). Specifically, this function is SpO 9650-0904-01 Rev.
Page 346: R Series Rectilinear Biphasic Waveform Characteristics
R Series Rectilinear Biphasic Waveform Characteristics ® Table A-1 shows the characteristics of the R Series Rectilinear Biphasic waveform when discharged into 25 ohm, 50 ohm, 100 ohm, 125 ohm, 150 ohm and 175 ohm loads at the maximum energy setting of 200 joules.
Page 347 R Series defibrillation waveforms are considered substantially equivalent. Figures A-1 through A-21 show the Rectilinear Biphasic waveforms that are produced when the R Series defibrillator is discharged into loads of 25, 50, 75, 100, 125, 150, and 175 ohms at each energy setting.
Page 348 175 Ohm 200 Ohm Figure A-2. Rectilinear Biphasic Waveform at 150 Joules 25 Ohm 50 Ohm 75 Ohm 100 Ohm 125 Ohm 150 Ohm 175 Ohm 200 Ohm Figure A-3. Rectilinear Biphasic Waveform at 120 Joules A–16 www.zoll.com 9650-0904-01 Rev. N...
Page 349 R Series Rectilinear Biphasic Waveform Characteristics 25 Ohm 50 Ohm 75 Ohm 100 Ohm 125 Ohm 150 Ohm 175 Ohm 200 Ohm Figure A-4. Rectilinear Biphasic Waveform at 100 Joules 25 Ohm 50 Ohm 75 Ohm 100 Ohm 125 Ohm...
Page 350 175 Ohm 200 Ohm Figure A-6. Rectilinear Biphasic Waveform at 75 Joules 25 Ohm 50 Ohm 75 Ohm 100 Ohm 125 Ohm 150 Ohm 175 Ohm 200 Ohm Figure A-7. Rectilinear Biphasic Waveform at 70 Joules A–18 www.zoll.com 9650-0904-01 Rev. N...
Page 351 R Series Rectilinear Biphasic Waveform Characteristics 25 Ohm 50 Ohm 75 Ohm 100 Ohm 125 Ohm 150 Ohm 175 Ohm 200 Ohm Figure A-8. Rectilinear Biphasic Waveform at 50 Joules 25 Ohm 50 Ohm 75 Ohm 100 Ohm 125 Ohm...
Page 352 175 Ohm 200 Ohm Figure A-10. Rectilinear Biphasic Waveform at 20 Joules 25 Ohm 50 Ohm 75 Ohm 100 Ohm 125 Ohm 150 Ohm 175 Ohm 200 Ohm Figure A-11. Rectilinear Biphasic Waveform at 15 Joules A–20 www.zoll.com 9650-0904-01 Rev. N...
Page 353 R Series Rectilinear Biphasic Waveform Characteristics 25 Ohm 50 Ohm 75 Ohm 100 Ohm 125 Ohm 150 Ohm 175 Ohm 200 Ohm Figure A-12. Rectilinear Biphasic Waveform at 10 Joules 25 Ohm 50 Ohm 75 Ohm 100 Ohm 125 Ohm...
Page 354 175 Ohm 200 Ohm Figure A-14. Rectilinear Biphasic Waveform at 8 Joules 25 Ohm 50 Ohm 75 Ohm 100 Ohm 125 Ohm 150 Ohm 175 Ohm 200 Ohm Figure A-15. Rectilinear Biphasic Waveform at 7 Joules A–22 www.zoll.com 9650-0904-01 Rev. N...
Page 355 R Series Rectilinear Biphasic Waveform Characteristics 25 Ohm 50 Ohm 75 Ohm 100 Ohm 125 Ohm 150 Ohm 175 Ohm 200 Ohm Figure A-16. Rectilinear Biphasic Waveform at 6 Joules 25 Ohm 50 Ohm 75 Ohm 100 Ohm 125 Ohm...
Page 356 175 Ohm 200 Ohm Figure A-18. Rectilinear Biphasic Waveform at 4 Joules 25 Ohm 50 Ohm 75 Ohm 100 Ohm 125 Ohm 150 Ohm 175 Ohm 200 Ohm Figure A-19. Rectilinear Biphasic Waveform at 3 Joules A–24 www.zoll.com 9650-0904-01 Rev. N...
Page 357 R Series Rectilinear Biphasic Waveform Characteristics 25 Ohm 50 Ohm 75 Ohm 100 Ohm 125 Ohm 150 Ohm 175 Ohm 200 Ohm Figure A-20. Rectilinear Biphasic Waveform at 2 Joules 25 Ohm 50 Ohm 75 Ohm 100 Ohm 125 Ohm 150 Ohm -0.5...
Page 358: Clinical Trial Results For The Biphasic Waveform
PECIFICATIONS Clinical Trial Results for the Biphasic Waveform The efficacy of the ZOLL Rectilinear Biphasic waveform has been clinically verified during a study of defibrillation of Ventricular Fibrillation (VF) and Ventricular Tachycardia (VT). A feasibility study was performed initially for defibrillation of VF/VT (n=20) on two separate groups of patients to ensure waveform safety and energy selection.
Page 359: Randomized Multi-Center Clinical Trial For Cardioversion Of Atrial Fibrillation (Af
A total of 173 patients entered the study. Seven (7) patients who did not satisfy all protocol criteria were excluded from the analysis. ZOLL disposable gel electrodes with surface areas of 78 cm (anterior) and 113 cm (posterior) were used exclusively for the study.
Page 360: Synchronized Cardioversion Of Atrial Fibrillation
Cardioversion of atrial fibrillation (AF) and overall clinical effectiveness is enhanced by proper pad placement. Clinical studies (refer to above) of the M Series Biphasic Defibrillator Waveform demonstrated that high conversion rates are achieved when defibrillation pads are placed as shown in the diagram below. A–28 www.zoll.com 9650-0904-01 Rev. N...
Page 361 Place the front (apex) pad on the third intercostal space, mid clavicular line on the right anterior chest. The back/posterior pad should be placed in the standard posterior position on the patient’s left as shown. 9650-0904-01 Rev. N ZOLL R Series Operator’s Guide A–29...
Page 362: Ecg Rhythm Analysis Algorithm Accuracy
ZOLL’s ECG rhythm database. Rhythm sources included data records from ZOLL devices and public domain databases recorded with electrode systems and ECG signal processing characteristics similar to the R Series. Data records were of appropriate length to allow for satisfactory analysis.
Page 363 Young KD, Lewis RJ. “What is confidence? Part 2: Detailed definition and determination of confidence intervals”. Ann Emerg Med. September 1997;30:311-318. Beyer WH. Percentage Points, F-Distribution Table. CRC Standard Mathematical Tables. ed. Boca Raton, Fla: CRC Press; 1981:573. 9650-0904-01 Rev. N ZOLL R Series Operator’s Guide A–31...
Page 364 PPENDIX PECIFICATIONS A–32 www.zoll.com 9650-0904-01 Rev. N...
Page 365: Appendix B R Series Accessories
Appendix B R Series Accessories The following accessories are compatible for use with R Series products. To order any of these items, contact your local ZOLL representative. SPU = Single Patient Use Electrodes/Pads, Paddles, and Connectors OneStep resuscitation electrodes OneStep Basic Pacing/defibrillation electrodes with Monitor while Pace (MwP)
Page 366 EtCO2 Sensors and Cables CAPNOSTAT 5 CO Sensor and Cable SPU Pediatric/Adult Airway Adapter SPU Neonatal/Pediatric Airway Adapter Reusable Adult Airway Adapter Reusable Neonatal/Pediatric Airway Adapter SPU Pediatric/Adult Airway Adapter with Mouthpiece CAPNO mask, Large Adult B–2 www.zoll.com 9650-0904-01 Rev. N...
Page 367 Air hose with pneumatic fittings 3 m (9.8 ft.) Air hose with pneumatic fittings 1.5 m (4.9 ft.) Miscellaneous Recorder Paper, 80mm Fan Fold (10 or 20 pkgs) R Series Data COMM Card R Series Data COMM II Card 9650-0904-01 Rev. N ZOLL R Series Operator’s Guide B–3...
Page 368 (This page intentionally left blank.) B–4 www.zoll.com 9650-0904-01 Rev. N...
Page 369: Appendix C Wi-Fi Radio Module Information
(of the radio function). Changes or modifications to Wi-Fi settings on R Series wireless communication accessories not expressly approved by the administrator responsible for compliance could void the user’s authority to operate the equipment.
Page 370 PPENDIX ADIO ODULE NFORMATION (This page intentionally left blank.) C–2 www.zoll.com 9650-0904-01 Rev. N...
Page 371 R Series Operator’s Guide ® 9650-0912-01 Rev. N...
Page 372 The issue date for the R Series Operator’s Guide ALS (REF 9650-0912-01 Rev. N) is March, 2016. Copyright © 2016 ZOLL Medical Corporation. All rights reserved. R Series, M Series, pedi-padz, pro-padz, stat-padz, CodeNet, Real CPR Help, RescueNet, See-Thru CPR,...
Page 373 Patient Safety ......................1-17 Cautions..........................1-18 Restarting the Defibrillator ....................1-18 FDA Tracking Requirements ..................... 1-19 Notification of Adverse Events .................. 1-19 Software License ......................1-20 Service..........................1-20 The ZOLL Serial Number....................1-21 9650-0912-01 Rev. N ZOLL R Series Operator’s Guide...
Page 374 2 Press ANALYZE Button ................... 4-3 3 Press SHOCK ......................4-5 Advisory Function Messages ....................4-7 Warning Messages ......................4-7 Chapter 5 Synchronized Cardioversion Synchronized Cardioversion Procedure ................5-2 Determine the Patient’s Condition and Provide Care Following Local Medical www.zoll.com 9650-0912-01 Rev. N...
Page 375 4 Set Pacer Output ..................... 8-4 5 Determine Capture ....................8-5 6 Determine Optimum Threshold ................8-6 Special Pacing Applications ....................8-7 Standby Pacing ......................8-7 Asynchronous Pacing ....................8-7 Pediatric Pacing ......................8-8 9650-0912-01 Rev. N ZOLL R Series Operator’s Guide...
Page 376 Transferring a Full Disclosure File to a Compact Flash Card ........... 11-3 Transferring Device Check and Activity Log Files to a Compact Flash Card....11-3 Transferring Files Through the USB Port (Optional) ............11-4 Transferring Full Disclosure Files Through Wi-Fi (Optional) ..........11-5 www.zoll.com 9650-0912-01 Rev. N...
Page 377 Electromagnetic Emissions Declaration ..............A-7 Electromagnetic Immunity Declaration (EID) ..............A-8 EID for Life-Support Functions ...................A-9 Recommended Separation Distances from RF Equipment for the R Series Life-Support Functions ...................A-10 EID for Non–Life-Support Functions .................A-11 Recommended Separation Distances from RF Equipment for the R Series Non–Life-Support Functions ...................A-12...
Page 378 ABLE OF ONTENTS Randomized Multi-Center Clinical trial for Cardioversion of Atrial Fibrillation (AF) ........................A-26 Synchronized Cardioversion of Atrial Fibrillation ............A-27 ECG Rhythm Analysis Algorithm Accuracy ...............A-29 Appendix B R Series Accessories Appendix C Wi-Fi Radio Module Information www.zoll.com 9650-0912-01 Rev. N...
Page 379: Chapter 1 General Information
The product is designed for use in the hospital. All of its ruggedized features add to its durability in hospital applications. There are multiple models of the R Series defibrillator that can contain a variety of functions. Your model may not contain all of the functions that are documented in this manual.
Page 380: How To Use This Manual
How to Use This Manual The R Series Operator’s Guide provides information operators need for the safe and effective use and care of the R Series products. It is important that all persons using this device read and understand all the information contained within.
Page 381: Operator's Guide Updates
Operator’s Guide Updates An issue or revision date for this manual is shown on the front cover. If more than three years have elapsed since this date, contact ZOLL Medical Corporation to determine if additional product information updates are available.
Page 382 R E C Y C L E Keep away from open flame and high heat. Do not open, disassemble, or intentionally damage. Do not crush. Do not discard in trash. Recycle or dispose of properly. 1–4 www.zoll.com 9650-0912-01 Rev. N...
Page 383 Do not reuse. Do not fold. Not sterile. Nonionizing electromagnetic radiation from Wi-Fi during data transfer. Manufacturer. Authorized representative in the European Community. Serial Number. Catalogue number. Consult instructions for use. Prescription only. 9650-0912-01 Rev. N ZOLL R Series Operator’s Guide 1–5...
Page 384: Conventions
R-wave as a timing reference. The unit uses paddles or disposable, pregelled electrodes for defibrillation. Intended Use — Manual Operation Use of the R Series products in the manual mode for defibrillation is indicated on victims of cardiac arrest where there is apparent lack of circulation as indicated by: Unconsciousness.
Page 385: Intended Use - Ecg Monitoring
ECG morphology. In ECG monitoring mode, the unit is intended to be used by personnel who are qualified by training in the use of the R Series defibrillator, basic life and/or advanced life support, or other physician-authorized emergency medical training.
Page 386: External Pacemaker (Optional)
The unique design of the R Series products allow clear viewing and interpretation of the electrocardiogram on the display without offset or distortion during external pacing.
Page 387: Pacemaker Complications
There are reports of transient inhibition of spontaneous respiration in unconscious patients with previously available units when the anterior electrode was placed too low on the abdomen. WARNING! This device must not be connected to internal pacemaker electrodes. 9650-0912-01 Rev. N ZOLL R Series Operator’s Guide 1–9...
Page 388: Pediatric Pacing
NFORMATION Pediatric Pacing Pacing can be performed on pediatric patients weighing 55 lb. (25 kg) or less using ZOLL pediatric hands-free therapy electrodes. Prolonged pacing (in excess of 30 minutes), particularly in neonates, can cause burns. Periodic inspection of the underlying skin is recommended.
Page 389: Intended Use - Nibp
The R Series NIBP option is designed to measure blood pressure for adult patients (21 years of age and older) and for pediatric patients, as described in the following table:...
Page 390: Recorder Function
OneStep cable and used as the ECG monitoring lead. The R Series can monitor the patient’s ECG while pacing without the need for a separate ECG cable and ECG electrodes. This also allows demand pacing when separate ECG electrodes are either not connected, or unavailable.
Page 391: Batteries
Batteries When the patient is less than 8 years old or weighs less than 55 lb. (25 kg), use ZOLL pediatric defibrillation electrodes. Do not delay therapy to determine the patient’s exact age or weight. Batteries R Series products use an easily replaced rechargeable lithium-ion battery pack (the ZOLL SurePower battery pack).
Page 392: Safety Considerations
Turn the Mode Selector to OFF, MONITOR, or PACER. • Change the selected defibrillator energy. • For safety, the R Series unit automatically disarms if left charged for more than either 60 or 120 seconds (user configurable) if the SHOCK button is not pressed. Warnings General Federal (U.S.A.) law restricts this defibrillator to use by or on the order of a physician.
Page 393: Warnings
Warnings The R Series should be installed and put into service according to the EMC information in Appendix A of this manual. Assess the Wi-Fi performance for the possibility of RFI in your environment of use. If multiple devices are transmitting simultaneously to the same access point, Wi-Fi data transfer will be slowed down.
Page 394: Operator Safety
When the warning REPLACE BATTERY appears, immediately replace the battery pack with a fully charged pack or plug the R Series unit into a power source, as unit shut down due to a low battery condition is imminent.
Page 395: Patient Safety
When the R Series is performing a Code Readiness test, as indicated on the display, do not touch the connected paddles, electrodes, or OneStep cable connector.
Page 396: Cautions
Restarting the Defibrillator Certain events require the R Series products to be restarted after they shut off or become inoperative (for example, when the battery runs down and the unit shuts off). In such a case, always try to restore defibrillator operation as follows: 1.
Page 397 If restarted after a shutdown period of 10 seconds or more, the unit restores all settings (such as ECG lead, ECG size, and alarm state and limits) to their power-up default values. After restoring device operation, you might need to reinstate previously selected, non-default settings. 9650-0912-01 Rev. N ZOLL R Series Operator’s Guide 1–19...
Page 398: Fda Tracking Requirements
• donated, resold, or otherwise distributed to a different organization • If any such event occurs, contact ZOLL Medical Corporation in writing with the following information: 1. Originator's organization – Company name, address, contact name, and contact phone number...
Page 399: Software License
Service The R Series does not require periodic recalibration or adjustment. Appropriately trained and qualified personnel should, however, perform periodic tests of the defibrillator to verify proper operation.
Page 400: The Zoll Serial Number
Returning a unit for service Before sending a unit to the ZOLL Technical Service Department for repair, obtain a service request (SR) number from the service representative. Remove the battery pack from the unit. Pack the unit with its cables and battery in the original containers (if available) or equivalent packaging.
Page 401 “A” for January, “B” for February, “C” for March, and so on through “L” for December. The product serial number is a unique set of alphanumeric characters that ZOLL assigns to each individual unit.
Page 402 HAPTER ENERAL NFORMATION 1–24 www.zoll.com 9650-0912-01 Rev. N...
Page 403: Chapter 2 Product Overview
Chapter 2 Product Overview Defibrillator Controls and Indicators SHOCK LEAD ANALYZE CHARGE SIZE ALARM ENERGY SUSPEND SELECT RECORDER MONITOR DEFIB PACER OUTPUT RATE Front Right Left Rear SpO2 13 14 9650-0912-01 Rev. N ZOLL R Series Operator’s Guide 2–1...
Page 404 (Reserved for future use — do not connect to any equipment.) (Optional) USB device connector For connecting the R Series defibrillator to a USB device. For details, refer to “Event Records and Reports” on page 10-1. Data card slot Holds a compact flash card for copying data stored in the device’s internal memory.
Page 405: The Front Panel
Defibrillator Controls and Indicators The Front Panel The front panel of the R Series device includes the display screen, softkeys, battery indicator, AC power indicator, Code Readiness indicator, SHOCK button, and control panel. The control panel configuration varies slightly depending on the model. See Figure 2-1.
Page 406 DEFIB or MONITOR mode with either hands-free therapy electrodes or paddles attached to the OneStep cable. Lead II or P3 (OneStep Pacing) is automatically selected when the R Series is powered up in PACER mode. Pads or Paddles monitoring is not available in PACER mode.
Page 407: Display Screen
Defibrillator Controls and Indicators Table 2-2. R Series Controls and Indicators (continued) Control or Indicator Description 4:1 Button This button is used to determine a patient’s underlying ECG rhythm. (optional) While depressed, this button causes pacing stimuli to be delivered at ¼...
Page 408 Param Marker Data Alarms On/Off Figure 2-2. R Series Display Screen (shown with optional SpO , NIBP and CO monitoring) Color coding To differentiate information for various parameters, the unit displays each type of information in a specific user-configurable color.
Page 409: Patient Cables And Connectors
(Optional) For connecting pulse oximeter cable. OneStep Cables The R Series ships with either a OneStep, or OneStep Pacing cable. The OneStep Pacing cable has an additional connector that plugs into the rear panel ECG connector. This cable is used with OneStep Pacing electrodes or OneStep Complete electrodes for external pacing and ECG monitoring.
Page 410 OneStep Cable Manager (Optional) As an option, the OneStep Cable Manager is available to store and organize cables. OneStep Cable Manager Cable Caddy Figure 2-5. The R Series with the Optional OneStep Cable Manager (Side View) 2–8 www.zoll.com 9650-0912-01 Rev. N...
Page 411: External Paddles
Defibrillator Controls and Indicators Power Cord The AC power cord is used to operate the R Series unit when battery power is not being used. An additional extension cord is available for use when the cable organizer accessory is attached to the unit.
Page 412 HAPTER RODUCT VERVIEW Attach the OneStep cable from the R Series unit to the connector at the base of the apex paddle. 1. Align OneStep cable as shown. 2. Insert OneStep cable into APEX paddle. Figure 2-7. Attaching the OneStep Cable to the APEX Paddle...
Page 413: Working With Menus
Figure 2-10. Pediatric Plate Note: The R Series defibrillator also supports ZOLL autoclavable internal handles for use during open chest defibrillation procedures. Working with Menus For some functions, the screen shows a menu of options with related softkeys for navigating through the menus and making selections and entries.
Page 414: Defib Mentor Mode (Optional)
MONITOR. When in this mode, the device displays a brief description of each front panel control’s function when that control is activated. Note: Do not run the Defib Mentor mode with a patient connected to the R Series unit. To access Defib Mentor mode: 1. Turn the Mode Selector to MONITOR.
Page 415: Common Tasks
Lower the tabbed end of the battery pack into the compartment and press down on the tabbed end until it locks into place. Figure 2-13. Installing a Battery Pack Adjusting Display Brightness To adjust brightness: 1. Press the Options softkey. 9650-0912-01 Rev. N ZOLL R Series Operator’s Guide 2–13...
Page 416: Using Code Markers
(For information on configuring these code marker lists, refer to the R Series Configuration Guide.) The code markers are removed from the display after 10 seconds. If no Code Marker softkey has been pressed during that time, a “default”...
Page 417: Chapter 3 Manual Defibrillation
No portion of the hands should be near the paddle plates. Determine the Patient’s Condition Following Local Medical Protocols Verify: Unconsciousness. • Absence of breathing. • Absence of pulse. • 9650-0912-01 Rev. N ZOLL R Series Operator’s Guide 3–1...
Page 418: Begin Cpr Following Local Medical Protocols
One pair is located on the front panel of the unit; the other pair is located on the sternum paddle. SHOCK SHOCK ANALYZE ANALYZE CHARGE CHARGE ENERGY ENERGY SELECT SELECT Note: Neonatal and pediatric defibrillator energy levels should be selected based on site- specific protocols. 3–2 www.zoll.com 9650-0912-01 Rev. N...
Page 419 On/Off Data If you have configured Shocks 1, 2, and 3 to escalating energy levels (see the R Series Configuration Guide for instructions), the R Series automatically sets the energy to the preconfigured Energy Level: Shock 1, 2, 3 setting at power-up and after each of the first two shocks.
Page 420: Charge Defibrillator
After charging to the selected energy, the charge indicator on the apex paddle lights. A distinctive charge ready tone sounds, and the message DEFIB XXXJ READY is displayed. The defibrillator is now ready to discharge. 3–4 www.zoll.com 9650-0912-01 Rev. N...
Page 421: Deliver Shock
DEFIB XXXJ SEL. Press the CHARGE button to recharge the unit. Autoclavable External Paddles ZOLL Autoclavable External Paddles are available for use with manually operated ZOLL defibrillators when sterile conditions must be maintained during defibrillation. 9650-0912-01 Rev. N ZOLL R Series Operator’s Guide...
Page 422: Emergency Defibrillation Procedure With Hands-Free Therapy Electrodes
HAPTER ANUAL EFIBRILLATION Emergency Defibrillation Procedure with Hands-Free Therapy Electrodes ZOLL hands-free therapy electrodes are a defibrillation-protected Type BF patient connection. ECG leads are a defibrillation-protected Type CF patient connection. Determine the Patient’s Condition Following Local Medical Protocols Verify: Unconsciousness.
Page 423 WARNING! Application of adult electrodes to a pediatric patient will result in the automatic selection of adult energy levels. If needed, manually adjust the energy settings based on site-specific protocols. 9650-0912-01 Rev. N ZOLL R Series Operator’s Guide 3–7...
Page 424: Select Defib
Adult and Pediatric modes. If medical protocol allows, you may select a different energy level using the ENERGY SELECT buttons on the front panel. SHOCK SHOCK ANALYZE ANALYZE CHARGE CHARGE ENERGY ENERGY SELECT SELECT 3–8 www.zoll.com 9650-0912-01 Rev. N...
Page 425: Charge Defibrillator
On/Off Data If you have configured Shocks 1, 2, and 3 to escalating energy levels (see the R Series Configuration Guide for instructions), the R Series automatically sets the energy to the preconfigured Energy Level: Shock 1, 2, 3 setting at power-up and after each of the first two shocks.
Page 426: Deliver Shock
Autoclavable Internal Handles with removable internal defibrillation electrodes • When these internal handles are used, the R Series defibrillator can operate only in Manual mode even if the unit supports Advisory mode. When an internal handle set is connected to the R Series, it automatically limits energy output to a maximum of 50 joules.
Page 427: Chapter 4 Advisory Defibrillation
When the Mode Selector is turned to DEFIB and hands-free therapy electrodes are used, the R Series can identify shockable rhythms using its built in ECG analysis capability. You must read the advisory messages, charge the defibrillator to the preconfigured or user-selected energy level (if automatic charge is disabled), and deliver treatment to the patient when required by protocol and patient condition.
Page 428: Advisory Defibrillation Procedure
Turn the Mode Selector to DEFIB. The unit displays DEFIB 120J SEL on the monitor. RECORDER MONITOR DEFIB PACER Energy Select The default energy selections for adult patients are: Shock 1 - 120 joules • Shock 2 - 150 joules • Shock 3 - 200 joules • 4–2 www.zoll.com 9650-0912-01 Rev. N...
Page 429: Press Analyze Button
SHOCK 1, 2, 3 sequence and deliver a shock, it disables the automatic energy escalation. See the Energy Level: Shock 1, 2, 3 section of the R Series Configuration Guide for more details. 2 Press ANALYZE Button WARNING! Keep patient motionless during ECG analysis.
Page 430 Follow the local protocols to continue CPR or other life support, and re-analyze the ECG at appropriate intervals. Note: When a nonshockable rhythm is detected, the R Series does not prevent the user from manually defibrillating the patient. When a shockable rhythm is detected (ventricular fibrillation or wide-complex tachycardia with heart rate >...
Page 431 A severe shock can result. Do not allow exposed portions of the patient’s body to come in contact with metal objects, such as a bed frame, as unwanted pathways for defibrillation current may result. 9650-0912-01 Rev. N ZOLL R Series Operator’s Guide 4–5...
Page 432: Press Shock
Rhythm analysis does not continue after the defibrillator is charged and ready once a decision to shock has been made. The R Series unit will not automatically disarm the defibrillator if the patient’s rhythm reverts to a non-shockable rhythm before the shock has been delivered.
Page 433: Advisory Function Messages
Check that the therapy electrodes are making good contact with the patient’s skin and that all cables are securely connected. This voice prompt will not sound if the therapy electrodes were not previously connected to the patient. 9650-0912-01 Rev. N ZOLL R Series Operator’s Guide 4–7...
Page 434 HAPTER DVISORY EFIBRILLATION (This page intentionally left blank.) 4–8 www.zoll.com 9650-0912-01 Rev. N...
Page 435: Chapter 5 Synchronized Cardioversion
T-wave segment of the cardiac cycle. When in the Sync mode, the unit displays markers (  ) above the ECG trace to indicate the points in the cardiac cycle (R waves) where discharge can occur. 9650-0912-01 Rev. N ZOLL R Series Operator’s Guide 5–1...
Page 436: Synchronized Cardioversion Procedure
Sync marker pattern. The Sync On/Off softkey may be highlighted for clearer visibility, if desired. This is off by default. Refer to the R Series Configuration Guide for instructions on how to turn on the highlighting.
Page 437: Select Defib
DEFIB Press the Sync On/Off softkey Your system will be in Sync mode once you press the Sync On/Off softkey if your R Series is not configured to support Remote Sync. However, if your R Series is configured to support Remote Sync, pressing the Sync On/Off softkey will cause two other softkeys to be displayed: Remote Sync and Sync.
Page 438: Charge Defibrillator
Sync mode. Note that the unit can be configured to stay in Sync mode after defibrillation, if desired. Refer to the R Series Configuration Guide for instructions. 2 Charge Defibrillator Press the CHARGE button on the front panel or on the apex paddle handle.
Page 439: Deliver Shock
ECG monitoring device. See the R Series Configuration Manual. Be sure that the remote device is connected to the Sync In/Marker Out connector on the R Series unit. The remote device must have a Sync out connector and a cable must be provided to connect the two devices.
Page 440: Determine The Patient's Condition And Provide Care Following Local Medical Protocols
Changing the selected energy levels does not cause the unit to leave Remote Sync mode. View the ECG trace on the remote device’s display. Verify that Sync markers appear with each R-wave. The Sync markers will appear as described in the remote device’s user manual. 5–6 www.zoll.com 9650-0912-01 Rev. N...
Page 441: Charge Defibrillator
During the ten seconds prior to this internal disarm, the charge ready tone beeps intermittently. The charge ready tone then stops and the defibrillator remains in Remote Sync mode. 9650-0912-01 Rev. N ZOLL R Series Operator’s Guide 5–7...
Page 442 If the ANALYZE button is pressed while the unit is in Remote Sync mode, the unit displays the REMOVE SYNC message and disallows ECG rhythm analysis until the unit is taken out of Sync mode. 5–8 www.zoll.com 9650-0912-01 Rev. N...
Page 443: Chapter 6 Real Cpr Help
This sensor monitors the rate and depth of chest compressions and sends this information to the R Series unit for processing and display. The R Series defibrillator uses this information to provide feedback to the rescuer in one or more of the following forms: Perfusion Performance Indicator •...
Page 444: Real Cpr Help Field
When complete filling of the Perfusion Performance Indicator has not been achieved due to diminished compression rate or depth, and the CPR Dashboard is configured Off, the R Series will display the words RATE and/or DEPTH to assist the rescuer in determining whether chest compression rate or depth should be increased.
Page 445: Compression Release Bar (Adult Only)
Depth and Rate Indicators CPR Metronome The R Series unit includes a CPR metronome feature that can be used to encourage rescuers to perform chest compressions at the AHA/ERC recommended rate of 100 compressions per minute. This feature can be configured.
Page 446: Cpr Voice Prompts (Adult Only)
This feature is unavailable while using Pediatric CPR electrodes. CPR Voice Prompts (Adult only) The R Series unit can be configured to issue voice prompts related to the depth of chest compressions as feedback to rescuers performing CPR. Two voice prompts are available for...
Page 447: Chapter 7 See-Thru Cpr (Optional)
See-Thru CPR enables the rescuer to see a close approximation of the patient’s underlying ECG rhythm while performing CPR. See-Thru CPR is available if the R Series is monitoring CPR. Chest compressions introduce CPR artifact into the ECG signal. See-Thru CPR uses a filter...
Page 448: Using See-Thru Cpr
Trace 1 ECG waveform. If configured to display the CPR Dashboard, the R Series unit can also be configured to display the filtered ECG in Trace1. When the unit is configured to display the filtered ECG in Trace1, the softkey Disable Filt ECG appears, which you can press to disable display of the filtered ECG in Trace1 and replace it with the unfiltered ECG.
Page 449 | Filter OFF | Filter ON Filtered ECG Filtered ECG 0:12 0:24 FineVF Raw ECG Raw ECG • | Filter OFF Filtered ECG Filtered ECG 0:24 0:36 12.5 mm/sec, 5 mm/mV 9650-0912-01 Rev. N ZOLL R Series Operator’s Guide 7–3...
Page 450 0:12 CoarseVF Raw ECG Raw ECG • | Filter ON Filtered ECG Filtered ECG 0:12 0:24 CoarseVF Raw ECG Raw ECG • | Filter OFF Filtered ECG Filtered ECG 0:24 0:36 12.5 mm/sec, 5 mm/mV 7–4 www.zoll.com 9650-0912-01 Rev. N...
Page 451 | Filter OFF | Filter ON Filtered ECG Filtered ECG 0:12 0:24 Asystole Raw ECG Raw ECG • | Filter OFF Filtered ECG Filtered ECG 0:24 0:36 12.5 mm/sec, 5 mm/mV 9650-0912-01 Rev. N ZOLL R Series Operator’s Guide 7–5...
Page 452 Raw ECG • • | Filter OFF | Filter ON Filtered ECG Filtered ECG 0:12 0:24 SinusRhythm Raw ECG Raw ECG • | Filter OFF Filtered ECG Filtered ECG 0:24 0:36 12.5 mm/sec, 5 mm/mV 7–6 www.zoll.com 9650-0912-01 Rev. N...
Page 453: Chapter 8 Noninvasive Temporary Pacing (Optional)
Chapter 8 Noninvasive Temporary Pacing (Optional) When ZOLL hands-free therapy electrodes are used, the patient connection is considered to be defibrillation-protected Type BF. ECG leads are a defibrillation-protected Type CF patient connection. WARNING! To avoid risk of electrical shock, do not touch the gelled area of the hands-free therapy electrodes while pacing.
Page 454: Determine Patient Condition And Provide Care Following Local Medical Protocols
PTIONAL Noninvasive Temporary Pacing R Series defibrillators with the pacer option contain a VVI demand pacemaker – a safe and effective design for Noninvasive Temporary Pacemakers. Proper demand pacing requires a reliable, high quality surface ECG signal. For best results: Apply both standard ECG monitoring electrodes and hands-free pacing therapy electrodes •...
Page 455: Turn Selector Switch To Pacer
If the unit has just been turned on, the PACER OUTPUT is automatically set to 0 mA. 3 Set Pacer Rate Set the PACER RATE to a value 10-20 ppm higher than the patient’s intrinsic heart rate. If no intrinsic rate exists, use 100 ppm. 9650-0912-01 Rev. N ZOLL R Series Operator’s Guide 8–3...
Page 456: Set Pacer Output
When the unit is switched out of PACER mode into DEFIB or MONITOR mode and then switched back to PACER mode, within 10 seconds the pacer settings remain unchanged. If the unit is turned off for more than 10 seconds, the pacer’s power up default settings are restored. 8–4 www.zoll.com 9650-0912-01 Rev. N...
Page 457: Determine Capture
Determination of electrical capture should only be performed by viewing the ECG trace on the R Series display with its ECG connection directly attached to the patient. Use of other ECG monitoring devices might provide misleading information due to the presence of pacer artifacts.
Page 458: Determine Optimum Threshold
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ PACE 00:01 50 mA 70 PPM Clear Async Pace Pacing Alarm On/Off 8–6 www.zoll.com 9650-0912-01 Rev. N...
Page 459: Special Pacing Applications
Special Pacing Applications Noninvasive Temporary Pacing can be performed in the Cardiac Catheterization Lab either for emergency pacing or standby pacing. For pacing in X-ray and fluoroscopic applications, ZOLL pro-padz® radiolucent hands-free therapy electrodes may be used. Noninvasive Temporary Pacing can be performed in the Operating Room using ZOLL pro-padz sterile hands-free therapy electrodes.
Page 460: Pediatric Pacing
55 lbs/25 kg. Continuous pacing of neonates can cause skin burns. If it is necessary to pace for more than 30 minutes, periodic inspection of the underlying skin is strongly advised. Carefully follow all instructions on electrode packaging. 8–8 www.zoll.com 9650-0912-01 Rev. N...
Page 461: Ecg Monitoring
ECG Monitoring ECG leads are a defibrillation-protected Type CF patient connection. The R Series products can be used for either short- or long-term ECG monitoring. R Series products have built-in circuitry to prevent damage to their ECG monitoring circuits during defibrillation. Monitoring electrodes, however, can become polarized during defibrillator discharge, causing the ECG trace to briefly disappear from the screen.
Page 462: Preparations
Attach conventional ECG electrodes for diagnostic purposes. Note: Under certain clinical circumstances, the R Series heart rate counting system may respond to narrow, high-amplitude spikes in the ECG signal (e.g., 10 msec duration, 1 mV peak-to-peak amplitude) leading to miscounting of the patient’s heart rate. Do not rely on heart rate meters if the ECG waveform contains narrow, high-amplitude spikes.
Page 463: Monitoring Electrodes Attachment
3-lead cables are available with and without Electro Surgical Unit noise suppression. If the R Series unit is being used in the presence of an ESU, ablation device, or any other high electromagnetic noise emitting source, ZOLL recommends using the R Series 3-Lead ECG Cable, ESU Filtered (PN: 9500-000693) specifically designed to limit ESU artifact when monitoring heart rates.
Page 464 Keep all patient monitoring cables away from earth ground, ESU knives, and ESU return • wires. Use electrosurgical grounding pads with the largest practical contact area. • Always assure proper application of the electrosurgical return electrode to the patient. 9–4 www.zoll.com 9650-0912-01 Rev. N...
Page 465: Monitoring The Patient's Ecg
Implanted Pacemakers The R Series device can be configured to detect pacemaker signals from a patient with an implanted pacemaker and indicate their presence on the display. When pacer pulses are detected, the device displays a 5mm, vertical, solid line on the ECG trace.
Page 466 PADS Depth Rate NIBP mmHg Pacer Off icon mmHg MONITOR Code Report Test Options Param Data Alarms Marker To re-enable detection of pacemaker spikes: 1. Press the Param softkey. Press ECG. Press Enable Pacer Detect. 9–6 www.zoll.com 9650-0912-01 Rev. N...
Page 467: 5-Lead Monitoring
Simultaneous 3-Lead Printing The R Series unit can display and print three simultaneous ECG leads when using a 5 lead cable and an ECG lead is selected as the signal source (not PADS or PADDLES).
Page 468: Adding Traces To Be Displayed
You can then switch between filtered and unfiltered ECG using the Enable/Disable Filt ECG softkey. With the unfiltered ECG displayed in Trace1, the user of the R Series unit can also enable the display of the filtered ECG in Trace2 or Trace3.
Page 469: Alarms
Alarms Setting Alarm Limits Unless configured otherwise, heart rate alarms are preset at 30 bpm (bradycardia) and 150 bpm (tachycardia). Refer to the R Series Configuration Guide for details on setting power-up alarm limits. To set alarm parameters: 1. Press the Alarms softkey to view the Alarm Set screen and softkeys.
Page 470: Heart Rate Alarm Limits
(NIBP), or end-tidal carbon dioxide monitoring (EtCO ), if available. The R Series unit has three levels of alarms: High Priority — Reflects physiological parameters that are out of bounds. When these • alerts occur, the unit emits an audio tone at 2.86 KHz, highlights the alarming parameter, and flashes the associated alarm bell.
Page 471: Smart Alarms
Activating and Deactivating Alarm Processing To deactivate all alarms on the R Series unit, press and hold down the ALARM SUSPEND button for 3 seconds or longer. The bell icons for all alarms will have an “X” through them to indicate that the alarms are deactivated. Alarm parameter values display normally (no highlighting).
Page 472: Alarm Settings For Unattended Monitoring
Alarm limits should be intentionally set to levels appropriate for detecting relevant changes in the patient’s condition. Leaving alarm settings at their default levels or setting them to the extremes of their ranges may defeat the utility of the alarms even when they are activated. 9–12 www.zoll.com 9650-0912-01 Rev. N...
Page 473: Chapter 10 Event Records And Reports
Chapter 10 Event Records and Reports The R Series defibrillator records important event information during operation. You can retrieve this information in various forms: Summary Report — Summary report allows you to store and later retrieve important ECG • and event information. You can print summary report information in various formats. For more information about Summary Report and how to print a report, refer to the Summary Report section below.
Page 474: Summary Report Formats
(The time interval is specified in the Set Report Restart Delay parameter; see the R Series Configuration Manual for more information). A new patient record is automatically created when the unit has been turned off for a configurable time period of 5 minutes to 72 hours.
Page 475 The date/time printed on the top of the strip corresponds to the ECG data occurring 6 seconds before the event. Figure 10-2. Defibrillation Event Format (Pre-Shock) Figure 10-3. Defibrillation Event Format (Post Shock) 9650-0912-01 Rev. N ZOLL R Series Operator’s Guide 10–3...
Page 476 If Async pace is active, the annotation ASYNC PACE is also recorded and printed. The date/time printed on the top of the strip corresponds to the ECG data occurring 6 seconds before the event. Figure 10-5. Pacer Mode Selected Format (Asynchronous Pacing) 10–4 www.zoll.com 9650-0912-01 Rev. N...
Page 477 CHECK PATIENT. The date/time printed on the top of the strip corresponds to the ECG data occurring 6 seconds before the event. Figure 10-7. VF Alarm Activated Format 9650-0912-01 Rev. N ZOLL R Series Operator’s Guide 10–5...
Page 478 If two or more of the three 3-second ECG analyses do not detect a shockable rhythm, the unit alerts the operator that no shock is advised. 10–6 www.zoll.com 9650-0912-01 Rev. N...
Page 479: Printing The Entire Summary Report
If the recorder is out of paper when the Report Data softkey and a corresponding print softkey are pressed, a CHECK RECORDER message appears on the display. Load paper and press the Report Data softkey again to select the report to print. 9650-0912-01 Rev. N ZOLL R Series Operator’s Guide 10–7...
Page 480: Printing A Partial Summary Report
Full Disclosure Recording Along with event information captured in Summary Report, R Series also records the full disclosure CPR sensor and parameter waveforms. The full disclosure recording on the unit can accommodate at least 6 hours of data.
Page 481: Erasing Summary Report And Full Disclosure
5 minutes to 72 hours. Formatting the Disk The R Series uses an internal flash memory disk that stores the data in files similar in structure to those on a personal computer hard drive. Like a personal computer, there may be rare occasions when the internal disk requires formatting.
Page 482 Do not remove power (both battery and AC) while the unit is erasing reports or formatting the disk. ERASING REPORT The unit is erasing the selected report data. FORMATTING DISK The internal flash memory disk is being formatted. 10–10 www.zoll.com 9650-0912-01 Rev. N...
Page 483: Chapter 11 File Transfer
It also explains how to remove, install and erase a Compact Flash card. Transferring Files to an External Device You can transfer the following files from the R Series defibrillator to an external device: Device check, activity log, and full disclosure waveforms •...
Page 484: Wi-Fi (Optional)
802.11 protocol (Wi-Fi). This includes a ZOLL R Series Data COMM Card or ZOLL R Series Data COMM II card, and a protective guard that must be installed on the unit. See R Series Data COMM Instructions for Use and Wi-Fi Guard Installation (Part number 9652-000395) or R Series Data COMM II Instructions for Use and Wi-Fi Guard Installation (Part number 9652-000405) for instructions on how to install the Wi-Fi Guard.
Page 485: Transferring A Full Disclosure File To A Compact Flash Card
When all files are transferred, the message DATA TRANSFERRED is displayed. You can now remove the CF card from the R Series unit. To exit Data Transfer mode, press the Exit Transfer softkey. Transferring Device Check and Activity Log Files to a Compact Flash Card Make sure that a compact flash card is installed in the slot on the left side of the device.
Page 486: Transferring Files Through The Usb Port (Optional)
Transferring Files Through the USB Port (Optional) Before you begin, connect a USB cable from the Windows external device with USB host capability (for example, a Window PC), to the R Series defibrillator USB device port. USB Host Port USB Device Port (Future Use) Figure 11-3.
Page 487: Transferring Full Disclosure Files Through Wi-Fi (Optional)
To send the report, press the Send Report softkey. The R Series is now in Wi-Fi Transfer Mode and a status text message box appears in the middle of the screen and describes the status of the file being sent.
Page 488: Transferring Device Check And Activity Log Files Through Wi-Fi (Optional)
Press the Defib History to Wi-Fi softkey. The R Series is now in Wi-Fi Transfer Mode and a status text message box appears in the middle of the screen and describes the status of the files being sent. When the files are transferred, the messages TRANSFER COMPLETE, Device Check Was Sent, and Activity Log Was Sent are displayed.
Page 489: Related Wi-Fi Messages
DNS IP Address is not 0.0.0.0. N = 5: SSID Action: Make sure that there is at least one valid SSID for each desired mode (infrastructure and data management server). 9650-0912-01 Rev. N ZOLL R Series Operator’s Guide 11–7...
Page 490 If Authentication Protocol set to TLS, make sure that a root certificate has been added (if not using the default ZOLL root certificate) and that the correct client certificate has been configured. N = 10: Missing required certificate file for Network...
Page 491 Contact Network Administrator Action: 1) Make sure that the configuration values for the SSID names are correct. 2) Make sure that the R Series unit is within range of the wireless server. 3) Contact the Network Administrator for assistance. TRANSFER FAILED...
Page 492 Action: Contact the Network Administrator for Contact Network Administrator assistance. TRANSFER FAILED The card installed in the CF slot is not an R Series Unsupported Wi-Fi Card Data COMM or Data COMM II card. Verify Installation of Wi-Fi Card Action: Make sure that the correct Wi-Fi card is properly installed in the unit.
Page 493: Chapter 12 Maintenance
Once per week; daily if Code Readiness Test is configured Off. Testing When the R Series device ships from ZOLL, the Code Readiness indicator may show a red “X.” A manual readiness test should be performed (in addition to other site-specific tests such as HiPot and Leakage) prior to putting the device into service.
Page 494: Routine Procedures
AC mains power outlet. Code Readiness Status Look at the /x Code Readiness indicator on the R Series defibrillator. If the Code Readiness indicator displays a red “X” the unit is not ready for therapeutic use.
Page 495: Code Readiness Test
• After the successful completion of the readiness check, the Code Readiness indicator displays a green check, indicating that the unit is ready for therapeutic use. If configured, the R Series will print a test record following automatic test completion.
Page 496: Defibrillator Testing With Paddles
If a LOW BATTERY message appears during testing, the battery is close to depletion and should be replaced or recharged. Before you begin 1. Connect the R Series to AC mains. Do one of the following: Connect unopened OneStep electrodes to the OneStep cable, •...
Page 497: Defibrillator Testing With Hands-Free Therapy Electrodes
There should be no CHECK PADS or POOR PAD CONTACT messages. Disconnect the OneStep cable from the test port or OneStep electrodes, and slowly turn the PACER OUTPUT control to 16 mA or more. 9650-0912-01 Rev. N ZOLL R Series Operator’s Guide 12–5...
Page 498: Recorder Check
The Code Readiness Log can be transferred to an external computing device (see “Transferring Files to an External Device” on page 11-1). If configured, the R Series prints a Code Readiness Test Report following the completion of each automatic defibrillator test.
Page 499 AC Power: Connected Print Print Prev Next Test Log Test Test Test Return Figure 12-1. Code Readiness Test Log Print Display Figure 12-2. Code Readiness Test Log Figure 12-3. Code Readiness Test Report 9650-0912-01 Rev. N ZOLL R Series Operator’s Guide 12–7...
Page 500: Setting Time And Date
Press the Enter and Return softkey to set all values and return to normal monitoring mode. Note: The R Series unit may be configured to synchronize the time automatically with a data server in the Wi-Fi Data Transfer configuration settings. See the R Series Configuration Guide for more information.
Page 501: Loading Stripchart Paper
The unit displays the message CHECK RECORDER when the printer is activated without paper or if the supply runs out during printing. Use ZOLL stripchart paper (Part number 8000-0300). To load paper into the stripchart printer: 1. Press the release button and allow the printer door to open, then remove any paper.
Page 502: Cleaning The Print Head
Gently wipe the printhead with a cotton swab moistened with isopropyl alcohol, and dry any residual alcohol with another dry cotton swab. Figure 12-7. Cleaning the Print Head Place the paper back into the unit and close the cover (see Figure 12-6). 12–10 www.zoll.com 9650-0912-01 Rev. N...
Page 503: Operator's Checklist For R Series Product
Operator’s Checklist for R Series Product Recommended checks and procedures to be performed Date ______________________________________________ daily or weekly, depending on Automatic Test Location ____________________________________________ configuration. Unit Serial Number ___________________________________ 1. Condition Remarks Unit clean, no spills, clear of objects on top, case intact 2.
Page 504 12 M HAPTER AINTENANCE (This page intentionally left blank.) 12–12 www.zoll.com 9650-0912-01 Rev. N...
Page 505: Chapter 13 Troubleshooting
This chapter answers many of the common problems or questions that may arise during operation. If trouble persists after consulting this guide, contact the appropriate technical personnel or ZOLL Technical Service Department. Refer to the R Series Service Manual for more detailed troubleshooting information. Code-Ready...
Page 506: Monitor
3. SET CLOCK message • Set time and date information. • Verify that the internal lithium battery has been replaced within the last 5 years. Contact ZOLL Technical Service Department for assistance 4. ECG LEAD OFF message • Check that ECG cable or OneStep Pacing cable is connected to patient and instrument.
Page 507: Recorder
Recorder Symptom Recommended Action 6. Noisy ECG, artifact, wandering • Consider 1 – 21Hz filter bandwidth (see R Series baseline Configuration Manual). • Prepare the patient’s skin prior to electrode attachment. • Check for proper adhesion of electrodes to patient.
Page 508: Pacer
• Select different ECG Lead configuration. on ECG trace. 6. Bedside/Central Station/Telemetry None, the patient monitor ECG inputs are overloaded by ECG display becomes erratic pacer signals. ECG can only be monitored by the R Series when pacing. or pacing device while pacing. 13–4 www.zoll.com...
Page 509: Defibrillator
• Check for Sync markers (arrow above R wave). If not present, change lead selection, or electrode placement. • Press and hold SHOCK button(s) until energy is delivered to the patient. • Alter ECG electrode placement. 9650-0912-01 Rev. N ZOLL R Series Operator’s Guide 13–5...
Page 510 10. NOISY ECG • Check for proper application and adhesion of hands- RETRY ANALYSIS message free therapy electrodes. • Check to make sure that nobody is touching the patient and that the patient is motionless. 13–6 www.zoll.com 9650-0912-01 Rev. N...
Page 511: Ac Charger
Test Port. • If testing with paddles, make sure to press the paddles firmly into the paddle wells while discharging. 12. DEFIB MAINT. REQ. message • Contact ZOLL Technical Service Department. AC Charger Symptom Recommended Action 1.
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Page 513: Appendix A Specifications
Appendix A Specifications This section describes the specifications for the R Series Defibrillator as well as the ECG rhythm analysis algorithm. “Defibrillator Specifications” on page A-2 • “Battery Pack Specifications” on page A-6 • “IEC 60601-1-2 Specifications” on page A-7 •...
Page 514: Defibrillator Specifications
20.8 cm • 26.7 cm • 31.7 cm with handle or 25.4 cm without handle Weight 13.6 lb (6.17 kg) with OneStep cable and battery pack 15.2 lb (6.89 kg) with paddles Power (for R Series Battery: Rechargeable lithium ion battery pack ALS, BLS and Plus models)
Page 515 Standard apex/sternum paddles. Adult plate slides off to expose smaller plate for pediatric patients. Automatic Verifies defibrillator charging and discharging without removing paddles Defibrillator Test from storage wells or with OneStep cable connected to the Test Port or OneStep electrodes. 9650-0912-01 Rev. N ZOLL R Series Operator’s Guide A–3...
Page 516 ±2 mV to ±700mV amplitude, 0.1ms to 2ms width, with a recharge constant Detected of 0 to 100ms. Note: The pacemaker pulse rejection capability for the R Series with pacemaker pulses alone includes pulses between +/-2mV and +/ -700mV amplitude, with widths between 0.1ms and 2ms and overshoot from 0 to 100ms.
Page 517 Defibrillator Specifications Heart Rate The R Series averages the interval between the last 6 detected beats. On Averaging startup, the R Series averages the rate between detected beats once two beats are detected, until a full 6 beats have been received. The rate is updated every beat.
Page 518: Battery Pack Specifications
1.7 lb (0.77 kg) Nominal voltage 10.6 V Recharge time 4 hours or less within R Series. Operating time For a new, fully charged battery at 20°C: • 100 defibrillator discharges at maximum energy (200 joules), or • 4 hours of continuous ECG monitoring, or •...
Page 519: Electromagnetic Emissions Declaration
Guidance and manufacturer’s declaration — electromagnetic emissions for the R Series. The R Series is intended for use in the electromagnetic environment specified below. The customer or user of the R Series should ensure that it is used in such an environment.
Page 520: Electromagnetic Immunity Declaration (Eid
Guidance and manufacturer’s declaration — electromagnetic immunity for the R Series. The R Series is intended for use in the electromagnetic environment specified below. The customer or user of the R Series should ensure that it is used in such an environment.
Page 521: Eid For Life-Support Functions
To assess the electromagnetic environment due to fixed RF transmitters, an electromagnetic site survey should be considered. If the measured field strength in the location in which the R Series is used exceeds the applicable RF compliance level above, the R Series should be observed to verify normal operation. If abnormal performance is observed, additional measures may be necessary, such as reorienting or relocating the R Series.
Page 522: Recommended Separation Distances From Rf Equipment For The R Series Life-Support Functions
The life-support functions on the R Series are defined to be any function associated with ECG monitoring, pacing, defibrillation, and shock analysis. Specifically, these functions include, but are not limited to, the ECG waveform monitoring from leads or pads, the pacing pulse output, QRS detection, defibrillation energy discharge, and shock advisory functions.
Page 523: Eid For Non-Life-Support Functions
The non–life-support functions on the R Series are defined to be any function not listed as a life-support function in the "EID for Life-Support Functions" table (Note a). Specifically, this function is SpO b.
Page 524: Recommended Separation Distances From Rf Equipment For The R Series Non-Life-Support Functions
The non–life-support functions on the R Series are defined to be any function not listed as a life-support function in the "EID for Life-Support Functions" table (Note a). Specifically, this function is SpO A–12...
Page 525: R Series Rectilinear Biphasic Waveform Characteristics
R Series Rectilinear Biphasic Waveform Characteristics Table A-1 shows the characteristics of the R Series Rectilinear Biphasic™ waveform when discharged into 25 ohm, 50 ohm, 100 ohm, 125 ohm, 150 ohm and 175 ohm loads at the maximum energy setting of 200 joules.
Page 526 R Series defibrillation waveforms are considered substantially equivalent. Figures A-1 through A-21 show the Rectilinear Biphasic waveforms that are produced when the R Series defibrillator is discharged into loads of 25, 50, 75, 100, 125, 150, and 175 ohms at each energy setting.
Page 527 R Series Rectilinear Biphasic Waveform Characteristics 25 Ohm 50 Ohm 75 Ohm 100 Ohm 125 Ohm 150 Ohm 175 Ohm 200 Ohm Figure A-2. Rectilinear Biphasic Waveform at 150 Joules 25 Ohm 50 Ohm 75 Ohm 100 Ohm 125 Ohm...
Page 528 175 Ohm 200 Ohm Figure A-4. Rectilinear Biphasic Waveform at 100 Joules 25 Ohm 50 Ohm 75 Ohm 100 Ohm 125 Ohm 150 Ohm 175 Ohm 200 Ohm Figure A-5. Rectilinear Biphasic Waveform at 85 Joules A–16 www.zoll.com 9650-0912-01 Rev. N...
Page 529 R Series Rectilinear Biphasic Waveform Characteristics 25 Ohm 50 Ohm 75 Ohm 100 Ohm 125 Ohm 150 Ohm 175 Ohm 200 Ohm Figure A-6. Rectilinear Biphasic Waveform at 75 Joules 25 Ohm 50 Ohm 75 Ohm 100 Ohm 125 Ohm...
Page 530 175 Ohm 200 Ohm Figure A-8. Rectilinear Biphasic Waveform at 50 Joules 25 Ohm 50 Ohm 75 Ohm 100 Ohm 125 Ohm 150 Ohm 175 Ohm 200 Ohm Figure A-9. Rectilinear Biphasic Waveform at 30 Joules A–18 www.zoll.com 9650-0912-01 Rev. N...
Page 531 R Series Rectilinear Biphasic Waveform Characteristics 25 Ohm 50 Ohm 75 Ohm 100 Ohm 125 Ohm 150 Ohm 175 Ohm 200 Ohm Figure A-10. Rectilinear Biphasic Waveform at 20 Joules 25 Ohm 50 Ohm 75 Ohm 100 Ohm 125 Ohm...
Page 532 175 Ohm 200 Ohm Figure A-12. Rectilinear Biphasic Waveform at 10 Joules 25 Ohm 50 Ohm 75 Ohm 100 Ohm 125 Ohm 150 Ohm 175 Ohm 200 Ohm Figure A-13. Rectilinear Biphasic Waveform at 9 Joules A–20 www.zoll.com 9650-0912-01 Rev. N...
Page 533 R Series Rectilinear Biphasic Waveform Characteristics 25 Ohm 50 Ohm 75 Ohm 100 Ohm 125 Ohm 150 Ohm 175 Ohm 200 Ohm Figure A-14. Rectilinear Biphasic Waveform at 8 Joules 25 Ohm 50 Ohm 75 Ohm 100 Ohm 125 Ohm...
Page 534 175 Ohm 200 Ohm Figure A-16. Rectilinear Biphasic Waveform at 6 Joules 25 Ohm 50 Ohm 75 Ohm 100 Ohm 125 Ohm 150 Ohm 175 Ohm 200 Ohm Figure A-17. Rectilinear Biphasic Waveform at 5 Joules A–22 www.zoll.com 9650-0912-01 Rev. N...
Page 535 R Series Rectilinear Biphasic Waveform Characteristics 25 Ohm 50 Ohm 75 Ohm 100 Ohm 125 Ohm 150 Ohm 175 Ohm 200 Ohm Figure A-18. Rectilinear Biphasic Waveform at 4 Joules 25 Ohm 50 Ohm 75 Ohm 100 Ohm 125 Ohm...
Page 536 Figure A-20. Rectilinear Biphasic Waveform at 2 Joules 25 Ohm 50 Ohm 75 Ohm 100 Ohm 125 Ohm 150 Ohm -0.5 175 Ohm 200 Ohm -1.5 -2.5 Figure A-21. Rectilinear Biphasic Waveform at 1 Joule A–24 www.zoll.com 9650-0912-01 Rev. N...
Page 537: Clinical Trial Results For The Biphasic Waveform
Clinical Trial Results for the Biphasic Waveform Clinical Trial Results for the Biphasic Waveform The efficacy of the ZOLL Rectilinear Biphasic waveform has been clinically verified during a study of defibrillation of Ventricular Fibrillation (VF) and Ventricular Tachycardia (VT). A feasibility study was performed initially for defibrillation of VF/VT (n=20) on two separate groups of patients to ensure waveform safety and energy selection.
Page 538: Randomized Multi-Center Clinical Trial For Cardioversion Of Atrial Fibrillation (Af
A total of 173 patients entered the study. Seven (7) patients who did not satisfy all protocol criteria were excluded from the analysis. ZOLL disposable gel electrodes with surface areas of 78 cm (anterior) and 113 cm (posterior) were used exclusively for the study.
Page 539: Synchronized Cardioversion Of Atrial Fibrillation
Clinical studies (refer to above) of the M Series Biphasic Defibrillator Waveform demonstrated that high conversion rates are achieved when defibrillation pads are placed as shown in the diagram below. 9650-0912-01 Rev. N ZOLL R Series Operator’s Guide A–27...
Page 540 Place the front (apex) pad on the third intercostal space, mid clavicular line on the right anterior chest. The back/posterior pad should be placed in the standard posterior position on the patient’s left as shown. A–28 www.zoll.com 9650-0912-01 Rev. N...
Page 541: Ecg Rhythm Analysis Algorithm Accuracy
ZOLL’s ECG rhythm database. Rhythm sources included data records from ZOLL devices and public domain databases recorded with electrode systems and ECG signal processing characteristics similar to the R Series. Data records were of appropriate length to allow for satisfactory analysis.
Page 542 Young KD, Lewis RJ. “What is confidence? Part 2: Detailed definition and determination of confidence intervals”. Ann Emerg Med. September 1997;30:311-318. Beyer WH. Percentage Points, F-Distribution Table. CRC Standard Mathematical Tables. ed. Boca Raton, Fla: CRC Press; 1981:573. A–30 www.zoll.com 9650-0912-01 Rev. N...
Page 543: Appendix B R Series Accessories
Appendix B R Series Accessories The following accessories are compatible for use with R Series products. To order any of these items, contact your local ZOLL representative. SPU = Single Patient Use Electrodes/Pads, Paddles, and Connectors OneStep resuscitation electrodes OneStep Basic Pacing/defibrillation electrodes with Monitor while Pace (MwP)
Page 544 LNCS-to-LNOP Adapter Cable, LNCS Sensor to LNOP Patient Cable LNOP DC-12 LNOP Adult Reusable Direct Connect 12’ Cable EtCO Sensors and Cables CAPNOSTAT 5 CO Sensor and Cable SPU Pediatric/Adult Airway Adapter SPU Neonatal/Pediatric Airway Adapter B–2 www.zoll.com 9650-0912-01 Rev. N...
Page 545 Air hose with pneumatic fittings 3 m (9.8 ft.) Air hose with pneumatic fittings 1.5 m (4.9 ft.) Miscellaneous Recorder Paper, 80mm Fan Fold (10 or 20 pkgs) R Series Data COMM Card R Series Data COMM II Card 9650-0912-01 Rev. N ZOLL R Series Operator’s Guide B–3...
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Page 547: Appendix C Wi-Fi Radio Module Information
(of the radio function). Changes or modifications to Wi-Fi settings on R Series wireless communication accessories not expressly approved by the administrator responsible for compliance could void the user’s authority to operate the equipment.
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ZOLL R Series Service Manual

Table of Contents

Product Overview

Chapter 2 Product Overview

Chapter 3 Automated External Defibrillator (AED) Operation

Chapter 4 Manual Defibrillation

Chapter 5 Advisory Defibrillation

Chapter 6 Synchronized Cardioversion

Chapter 7 Real CPR Help

Chapter 8 See-Thru CPR (R Series Plus Only)

Chapter 9 Noninvasive Temporary Pacing (Optional)

Chapter 11 Event Records and Reports

Chapter 12 File Transfer

Chapter 13 Maintenance

Chapter 14 Troubleshooting

Appendix A Specifications

Appendix B R Series Accessories

Appendix C Wi-Fi Radio Module Information

General Information

Chapter 1 General Information

Chapter 10 Event Records and Reports

Appendix A Specifications

Appendix B R Series Accessories

Appendix C Wi-Fi Radio Module Information

Quick Links

Chapters

Troubleshooting

Related Manuals for ZOLL R Series

Summary of Contents for ZOLL R Series