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Philips HeartStart XL Plus 861290 Instructions For Use Manual

Defibrillator monitor.
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Philips
HeartStart XL
Plus Owners
Manual
Get an original copy of the Philips HeartStart XL Plus Owners
Manual for manufacturer information about service,
available accessories and how to use and maintain your
device.

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Table of Contents

   Summary of Contents for Philips HeartStart XL Plus 861290

  • Page 1 Philips HeartStart XL Plus Owners Manual Get an original copy of the Philips HeartStart XL Plus Owners Manual for manufacturer information about service, available accessories and how to use and maintain your device.
  • Page 2 English Instructions for Use HeartStart XL+ Model No. 861290...
  • Page 4 The information in this document applies to the HeartStart XL+ 71034 Böblingen versions indicated below. Germany Philips shall not be liable for errors contained herein or for Canada EMC: ICES-001 incidental or consequential damages in connection with the furnishing, performance, or use of this material.
  • Page 5: Conventions Used In This Manual

    Notice Conventions Used in This Manual This book contains the following conventions: WARNING: Warning statements alert you to a potential serious outcome, adverse event or safety hazard. Failure to observe a warning may result in death or serious injury to the user or patient. CAUTION: Caution statements alert you to where special care is necessary for the safe and effective use of the product.
  • Page 6: Table Of Contents

    Table of Content Chapter 1 Introduction Overview Intended Use Indications for Use Safety Considerations Getting Started Documentation and Training Chapter 2 Device Basics Introduction Basic Orientation Front of the Device Right (Therapy) Side Connecting the Therapy Cable Left (Monitor) Side Top Panel .
  • Page 7 Table of Contents Waveform and Display Soft Keys Area Adjusting Volumes Alarms Clinical Mode Alarm Notification Responding to Alarms Entering Patient Information Continued Use Passwords Safety Considerations Chapter 4 ECG Monitoring Overview Preparing to Monitor ECG Skin Preparation Monitoring ECG with Pads Monitoring ECG with Electrodes Monitor View Selecting the Waveform...
  • Page 8 Table of Contents Precautions for Manual Defibrillation . 74 Code View . 75 Preparing for Defibrillation . 76 Using Multifunction Electrode Pads . 76 Using External Paddles . 76 Using Infant Paddles . 77 Using Internal Paddles . 77 Defibrillation .
  • Page 9 Table of Contents Desat Alarm . 105 Changing SpO Alarm Limits . 105 Enabling/Disabling SpO Alarms . 105 Pulse Rate Alarms . 106 Changing Pulse Rate Alarm Limits . 106 Enabling/Disabling Pulse Rate Alarms . 106 Disabling SpO Monitoring . 107 Caring for Sensors .
  • Page 10 Table of Contents Exporting Settings Importing Settings Printing Settings Restoring Default Settings Configurable Parameters Chapter 14 Operational and Shift Checks Shift Check Weekly Shock Test Operational Check Performing an Operational Check Printing Operational Check Results Operational Check Summaries Auto Test Summaries Chapter 15 Maintenance Overview Automated Tests...
  • Page 11 Table of Contents Chapter 17 Supplies & Accessories Ordering Replacement Supplies and Accessories . 189 Chapter 18 Specifications Specifications . 195 General . 195 Defibrillator . 195 Manual Defibrillation Mode . 197 AED Mode . 198 ECG and Arrhythmia Monitoring .
  • Page 12: Chapter 1 Introduction

    Introduction Thank you for choosing the HeartStart XL+ defibrillator/monitor. Whether the HeartStart XL+ is your first Philips product or another in a long list of Philips devices, we welcome you to the Philips family of defibrillators. The HeartStart XL+ has been developed and designed around you to meet the advanced requirements of hospital code teams, nurses, physicians and biomedical engineers.
  • Page 13: Intended Use

    Trending. You can also transfer the data to a USB drive and download it to a compatible version of Philips’ data management solution – HeartStart Event Review Pro. The HeartStart XL+ is powered by a rechargeable Lithium Ion battery. Available battery power is determined by viewing the battery power indicators located on the front of the device, the icons on the display, or by checking the gauge on the battery itself.
  • Page 14: Safety Considerations

    Overview 1: Introduction Non-Invasive External Pacing The pacing option is indicated for treating patients with symptomatic bradycardia. Pulse Oximetry The SpO option is indicated for use when it is beneficial to assess the patient’s oxygen saturation level. Non-Invasive Blood Pressure Monitoring The NBP option is indicated for non-invasive measurement of a patient’s arterial blood pressure.
  • Page 15: Documentation And Training

    1: Introduction Overview Documentation and Training Philips Healthcare provides several additional options for HeartStart XL+ documentation and training, besides these Instructions for Use, including: • Quick Reference Card • Battery Application Note • ECG Quality Application Note • Algorithm Application Notes •...
  • Page 16: Device Basics

    HeartStart XL+ has been designed with the clinician in mind. Philips pioneered 1-2-3 defibrillation for you to defibrillate a patient and save a life quickly and easily. HeartStart XL+ controls, indicators, menus and icons were carefully designed and organized to facilitate ease of use.
  • Page 17: Basic Orientation

    2: Device Basics Basic Orientation Basic Orientation This section provides an overview of the HeartStart XL+, options and accessories. Front of the Device The front of the device contains operational controls and indicators as shown in Figure Figure 1 Front View Patient Category button Ready For Use (RFU) Indicator...
  • Page 18: Right (therapy) Side

    Basic Orientation 2: Device Basics Right (Therapy) Side The right side of the HeartStart XL+ is dedicated to administering therapy. It contains a therapy port for paddles (external or internal) or a therapy cable with multifunction electrode pads. Figure 2 Right (Therapy) Side View USB Data Port Cable Wrap Snap...
  • Page 19 Open the package and connect the pads connector to the end of the Therapy cable (see Figure NOTE: If you are using Philips’ HeartStart Preconnect Pads (989803166021), there is no need to open the pads package to connect the pads connector to the Therapy cable.
  • Page 20: Left (monitor) Side

    Basic Orientation 2: Device Basics Left (Monitor) Side The left side of the HeartStart XL+ is dedicated to monitoring key vital signs (see Figure 6). It has ports for ECG, SpO and NBP. Figure 6 Left (Monitor) Side View Cable Wrap Snap White ECG port Blue SpO port...
  • Page 21 2: Device Basics Basic Orientation Connecting the SpO Cable To connect the SpO cable: Hold the cable connector with the flat side and blue marking facing the front of the HeartStart XL+ (see Figure Insert the cable into the blue SpO port and push the blue portion of the connector into the device until it is no longer visible.
  • Page 22: Top Panel

    Basic Orientation 2: Device Basics Top Panel The top of the HeartStart XL+ has a handle for easy transport and also the USB data port. If optional external paddles are present, they reside in the paddle tray on the top of the device as shown in Figure Figure 10 Top View (with optional paddles installed)
  • Page 23 2: Device Basics Basic Orientation Accessing Infant Paddles To access the M3543A infant Figure 12 Infant Paddles paddles: Press down on the release buttons located on the front of the external paddles. Slide the adult electrode clip off and away from the paddle exposing the infant-sized Infant Paddles surface underneath.
  • Page 24: Back Panel

    AC power connection, the ECG Out jack to connect to an external monitor, and the LAN port. See Figure 14. For more information on ECG Out, see the ECG Out Cable Application Note which can be found on the Philips website at www.philips.com/ProductDocs. Figure 14...
  • Page 25 2: Device Basics Basic Orientation Removing the Battery To remove the HeartStart XL+ Lithium Ion battery: Push the Battery Latch to the left to eject the battery. Pull on the Battery Tab and battery to completely remove the battery. Figure 16 Removing the Battery Battery Fuel Gauge When you want to check the power remaining in your Lithium Ion battery when it is not installed in the...
  • Page 26 Basic Orientation 2: Device Basics Installing the Cable Wraps The HeartStart XL+ comes with cable wraps to assist in cable management. To attach the cable wraps to the HeartStart XL+: Snap the cable wrap into the Cable Management Connector snap on the back of the device. Loop your cable around the cable wrap and snap into place.
  • Page 27: Accessory Storage System

    2: Device Basics Basic Orientation Accessory Storage System The HeartStart XL+ can be ordered with an optional Accessory Storage System to assist in cable and accessory management. NOTE: You need a Phillips-head screwdriver to install the Accessory Storage System pouches. Attaching the Pouches To attach your HeartStart XL+ Accessory Storage System to your defibrillator: Insert the hook on the bottom of the storage system’s side pouch into the groove along the side of the...
  • Page 28 Basic Orientation 2: Device Basics Filling the Accessory Pouches The HeartStart XL+ Accessory Pouches are designed to hold your essential monitoring and defibrillation accessories. Recommended accessory placement includes: • Monitor side (see Figure 20): • Connect the NBP tubing to the NBP port. Coil the remaining tubing with the NBP cuff. Place them in the outside slot of the double-sided black bag.
  • Page 29: Installing Paper

    2: Device Basics Basic Orientation Installing Paper The HeartStart XL+ uses 50 mm graphed paper for printing. To install printer paper: Open the printer door by pushing on the printer door latch (see Figure 22). If there is an empty or almost empty paper roll in the printer, pull up on the roll to remove it. Examine the new roll of printer paper and remove any remaining adhesive residue from the outer layer of paper.
  • Page 30: Test Plug & Test Load

    Basic Orientation 2: Device Basics Test Plug & Test Load Your HeartStart XL+ comes with a defibrillator Test Plug to assist in performing a Weekly Shock Test. You can also use the M3725A Test Load, ordered seperately, to perform a Weekly Shock Test. To use either the Test Plug or Test Load during a Weekly Shock Test, insert the plug or load into the Therapy cable (see Figure...
  • Page 31 NOTES...
  • Page 32: Working With The Heartstart Xl

    Working with the HeartStart XL+ The HeartStart XL+ was designed and built with clinical use in mind. Philips’ designers and engineers, building on our experience as a market leader, worked with clinicians around the globe to confirm the HeartStart XL+ meets clinicians’ needs.
  • Page 33: Controls

    3: Working with the HeartStart XL+ Controls Controls Operating controls are organized by function with the defibrillation controls to the right of the display, soft keys under the display, general function buttons under the soft keys and to the left and right of the display.
  • Page 34: General Function Buttons

    Controls 3: Working with the HeartStart XL+ General Function Buttons The General Function buttons control monitoring or non-critical resuscitation activity. See “Basic Orientation” on page 6 for the location of the buttons and below for their definitions. Lead Select Changes the ECG lead in Wave Sector 1. Pressing this button cycles through the available ECG waves, changing the displayed wave and label.
  • Page 35: Ready For Use Indicator

    3: Working with the HeartStart XL+ Ready For Use Indicator Ready For Use Indicator The Ready For Use (RFU) Indicator is located on the right side base of the device handle. It indicates the status of the therapy delivery functions using the following conventions: Blinking Hourglass Indicates the shock, pacing and ECG functions of the device are ready for use.
  • Page 36: Lithium Ion Battery

    Power 3: Working with the HeartStart XL+ Lithium Ion Battery The HeartStart XL+ uses a Lithium Ion battery for power. Battery Life Battery life depends on the frequency and duration of use. When properly cared for and used in its intended environment, the HeartStart XL+ Lithium Ion battery has a useful life of approximately 3 years.
  • Page 37: Turning The Heartstart Xl+ On

    3: Working with the HeartStart XL+ Power Figure 25 Power Indicators Battery Charge AC Power Indicator Indicator Turning the HeartStart XL+ On To turn the HeartStart XL+ on, turn the Therapy knob to the desired mode of operation. Turning the HeartStart XL+ Off To turn the HeartStart XL+ off, turn the Therapy knob to the position.
  • Page 38: The Display

    The Display 3: Working with the HeartStart XL+ The Display The HeartStart XL+’s display layout is easily configurable. There are four basic segments of the display. Figure Figure 27 General Display Layout 02:27 Adult 25 Jan 2011 10:25 AM Non-Paced Status Jones, Tony >= 25 Kg...
  • Page 39: Parameter Area

    3: Working with the HeartStart XL+ The Display Device information includes: • Clinical Alarm Indicator - Indicates the state of global alarms. If alarms are on, the indicator is Alarms Off blank. If they are off, the indicator says and uses the Alarms Off icon •...
  • Page 40: Message Area

    The Display 3: Working with the HeartStart XL+ Message Area The message area displays key messages during an event. The type of message shown varies according to the current mode. Figure 31 Message Area Check Pads Connection from Patient to Device Waveform and Display Soft Keys Area The HeartStart XL+ is configured to populate each of its three wave sectors with a preconfigured waveform when powered on in Monitor, Manual Defibrillation, Pacing Mode (two wave sectors only)
  • Page 41 3: Working with the HeartStart XL+ The Display NOTES: In synchronized cardioversion mode, the R-Wave arrows indicate which R-Waves would trigger a shock if the shock button is pressed. In Demand Mode Pacing, the time until the next delivered external pace pulse is from the previous pace pulse or the R-Wave arrow, whichever is the most recent.
  • Page 42 The Display 3: Working with the HeartStart XL+ Menus Menus with controls and options specific to each HeartStart XL+ function are easily accessible using the Menu Select and Navigation buttons located on the front panel. Menus are used to adjust volume, select waveforms, select waves for printing, set alarms, enter patient information, generate reports and complete a variety of other tasks.
  • Page 43: Adjusting Volumes

    3: Working with the HeartStart XL+ The Display Adjusting Numeric Values Using the HeartStart XL+ Navigation buttons, you can enter numeric values for several parameters, including high and low alarm limits. See Figure 35. The value initially displayed is the default value. Some values are adjustable in increments greater than 1.
  • Page 44: Alarms

    Alarms 3: Working with the HeartStart XL+ Alarms The HeartStart XL+ provides various types of alarms indicating changes in patient condition or device/cable conditions that may require attention. Alarms conditions are based on comparisons against preset limits and algorithm results. The HeartStart XL+ breaks alarms into two categories: Physiological Alarm: An alarm, detected while in a clinical mode, resulting from a patient-related parameter being monitored.
  • Page 45: Clinical Mode Alarm Notification

    3: Working with the HeartStart XL+ Alarms Clinical Mode Alarm Notification When in a Clinical Mode, the HeartStart XL+ can be configured to react differently when an alarm condition occurs. See Table Table 3 Alarm Notification Types Notification Indication on Display Indication Status Alarms On None...
  • Page 46 Alarms 3: Working with the HeartStart XL+ Alarm Notification Display Locations Depending on the alarm type, the HeartStart XL+ displays notifications in various locations. See Figure Figure 36 Alarm Notification Locations Battery-related alarms Technical are displayed here. alarms are 02:27 displayed here.
  • Page 47 Imminent shutdown. The device will shut down in one Alternating alternating pitch minute. between 1000 and 2100 Hz Philips’ high priority alarm tone 960 Hz Tone lasting 0.5 second, IEC’s high priority alarm tone Meets IEC repeated every second 60601-1-8 Philips’...
  • Page 48: Responding To Alarms

    Alarms 3: Working with the HeartStart XL+ Responding to Alarms Alarm limits are displayed with each parameter, if alarms for the parameter are on. When an alarm condition occurs there are several ways to respond. Initially: Attend to the patient. Identify the alarm(s) indicated.
  • Page 49: Entering Patient Information

    3: Working with the HeartStart XL+ Entering Patient Information Entering Patient Information Patient information can be entered (except when in AED Mode) for the following categories: • Name • ID • Sex • Paced Status To enter patient information on the HeartStart XL+: Press the Menu Select button to activate the Main Menu.
  • Page 50: Continued Use

    Continued Use 3: Working with the HeartStart XL+ Continued Use Once in a clinical mode, the Continued Use feature is activated. This feature facilitates continued treatment of the same patient by retaining the current settings and patient record when the HeartStart XL+ is turned off for less than 10 seconds.
  • Page 51: Safety Considerations

    3: Working with the HeartStart XL+ Safety Considerations Safety Considerations The following general warnings and cautions apply to the use of the HeartStart XL+. Additional warnings and cautions specific to a particular feature are provided in the appropriate sections. WARNINGS: The HeartStart XL+ is not intended to be deployed in settings or situations that promote use by untrained personnel.
  • Page 52 IEC Standard 60601-1-1. If in doubt, contact your local Philips Customer Care Center or local Philips representative. This device is suitable for use in the presence of high-frequency surgical equipment. Following electrosurgery interference, the equipment returns to the previous operating mode within 10 seconds without loss of stored data.
  • Page 53 NOTES...
  • Page 54: Ecg Monitoring

    ECG Monitoring Overview This chapter describes the HeartStart XL+’s basic ECG and arrhythmia monitoring functions. The device uses Philips’ ST/AR Algorithm for ECG analysis. You can use the HeartStart XL+ to monitor your patient’s ECG through: • multifunction electrode pads.
  • Page 55: Preparing To Monitor Ecg

    4: ECG Monitoring Preparing to Monitor ECG Preparing to Monitor ECG You can monitor ECG through multifunction electrode pads or ECG electrodes and do a quick look with external paddles. NOTE: If monitoring for an extended period of time, monitoring electrodes and multifunction electrode pads may need to be changed periodically.
  • Page 56: Monitoring Ecg With Electrodes

    Preparing to Monitor ECG 4: ECG Monitoring Monitoring ECG with Electrodes To monitor ECG through electrodes: Prepare the skin. Attach the snaps or grabbers to the electrodes before placing them on the patient. Apply electrodes by peeling them, one at a time, from the protective backing and sticking them firmly to the patient’s skin.
  • Page 57 4: ECG Monitoring Preparing to Monitor ECG Figure 40 shows the typical electrode placement for a 5-lead ECG set. Figure 40 5-Lead Placement RA/R (white/red) LA/L (black/yellow) placement: directly placement: directly below the clavicle and – – below the clavicle and near the right shoulder –...
  • Page 58 Preparing to Monitor ECG 4: ECG Monitoring For accurate V/C lead placement and measurement, it is important to locate the fourth intercostal space. To locate the fourth intercostal space: Locate the second intercostal space by first palpitating the Angle of Lewis (small bony protuberance where the body of the sternum joins the manubrium).
  • Page 59 4: ECG Monitoring Preparing to Monitor ECG CAUTIONS: Beware of patient cables, including ECG monitoring equipment when used with high frequency surgical equipment. Conductive parts of electrodes and associated connectors for applied parts, including the neutral electrode, should not contact other conductive parts including earth. NOTES: Signals from TENS or ESU units can cause artifact.
  • Page 60: Monitor View

    Monitor View 4: ECG Monitoring Monitor View You primarily monitor your patient’s ECG waveform in Monitor View by turning the Therapy knob to Monitor In Monitor View, you can review three waves simultaneously while monitoring all current vital sign parameters. See Figure Figure 42 Monitor View Layout...
  • Page 61 4: ECG Monitoring Monitor View If needed, select the appropriate ECG wave size and press the Menu Select button. NOTE: When you select the ECG wave size for a certain lead, all instances of that lead adjust to the selected size. For example, if you have Lead II selected for both Wave Sectors 1 and 2, and you change the size in Wave Sector 1, Wave Sector 2’s size changes automatically.
  • Page 62: Displaying An Annotated Ecg

    Monitor View 4: ECG Monitoring Displaying an Annotated ECG You may choose to display an annotated ECG with arrhythmia beat labels in Wave Sector 2. The same Delayed ECG source appearing in Wave Sector 1 is displayed in Wave Sector 2 with a six-second delay. appears near the waveform.
  • Page 63: Arrhythmia Monitoring

    4: ECG Monitoring Arrhythmia Monitoring Arrhythmia Monitoring The HeartStart XL+ uses the ST/AR Algorithm. Arrhythmia analysis provides information on your patient’s condition, including heart rate and arrhythmia alarms. The HeartStart XL+ uses the ECG lead appearing in Wave Sector 1 for single-lead arrhythmia analysis. During arrhythmia analysis, the monitoring function continuously: •...
  • Page 64 NOTES: It is important to set the patient’s correct paced status in order to optimize ECG analysis. For more information on arrhythmia analysis, refer to the Application Note “Arrhythmia Monitoring Algorithm for HeartStart XL+” available on the Philips website at www.philips.com/ProductDocs.
  • Page 65: Heart Rate And Arrhythmia Alarms

    4: ECG Monitoring Heart Rate and Arrhythmia Alarms Heart Rate and Arrhythmia Alarms The HeartStart XL+ detects HR and arrhythmia alarm conditions by comparing ECG data to a set of pre-defined criteria. An alarm can be triggered by a rate exceeding a threshold (e.g., HR > configured limit), an abnormal rhythm (e.g., Ventricular Tachycardia) or an ectopic event (e.g., PVC >...
  • Page 66 Heart Rate and Arrhythmia Alarms 4: ECG Monitoring Table 8 HR/Arrhythmia Technical Alarms Alarm Message Condition Type of Alarm Indication Lead/ The multifunction electrode Pads/ pad/paddles or leads used as the source for Wave Sector 1 during Paddles Off Synchronized Cardioversion may be disconnected or not attached securely.
  • Page 67: Setting Alarms

    4: ECG Monitoring Heart Rate and Arrhythmia Alarms Figure 45 Cardiotach Mode Arrhythmia Alarm Priority Chain For AED Mode Only RED ALARMS (High Priority) Asystole V-Fib/VTach Extreme Tachy Extreme Brady YELLOW ARRHYTHMIA ALARMS (Medium Priority) High/Low HR Setting Alarms Alarm settings for Heart Rate (HR), VTach and PVC Rate Limit for the current patient event can be changed via the Menu Select button during the event.
  • Page 68: Responding To Alarms

    Troubleshooting 4: ECG Monitoring Responding to Alarms When an alarm occurs, the audio pause label appears above the Navigation and Menu Select buttons. Press either button to silence the alarm audio while you attend to the patient. The alarm reannunciates if the condition continues to exist beyond the configured alarm pause period or another alarm condition occurs.
  • Page 69 NOTES...
  • Page 70: Aed Mode

    The HeartStart XL+ uses Philips’ SMART Analysis algorithm as the basis for making a shock decision in AED Mode. The SMART Analysis algorithm was designed to make aggressive shock decisions concerning ventricular fibrillation.
  • Page 71: Precautions For Aed Therapy

    5: AED Mode Precautions for AED Therapy Precautions for AED Therapy WARNINGS: The AED algorithm is not designed to handle erratic spiking problems caused by a properly or improperly functioning pacemaker. In patients with cardiac pacemakers, the HeartStart XL+ may have reduced sensitivity and not detect all shockable rhythms.
  • Page 72: Aed View

    AED View 5: AED Mode AED View When the Therapy knob is moved to , AED View is displayed (see Figure 47). AED Mode-related information includes: AED Message Area: Displays important messages for the user while in AED Mode. Shock Counter: Displays the number of shocks for the current event (including shocks delivered in Manual Defibrillation Mode) Configured Energy: Displays the configured energy for the current patient category.
  • Page 73: Aed Soft Keys

    5: AED Mode AED View AED Soft Keys AED Mode has four soft keys available (see Figure 47): • CPR - Pressing the soft key initiates the configured pause period to perform CPR. Resume Analyzing • Resume Analyzing - Pressing the soft key initiates the AED analysis algorithm to resume or restart analysis.
  • Page 74: Using Aed Mode To Defibrillate

    Apply the pads to the patient as directed on the pads packaging or according to your organization’s protocol. NOTE: If you are using Philips’ HeartStart Preconnect Pads (989803166021), the pads may already be connected to the end of the Therapy cable. Open the package to apply the pads to the patient.
  • Page 75 5: AED Mode Using AED Mode to Defibrillate Step 1 - Turn the Therapy Knob to AED When the HeartStart XL+ is turned to , it announces and displays the patient category. Confirm you have the correct category active for the patient. If not, use the Patient Category button to select the correct category.
  • Page 76 Using AED Mode to Defibrillate 5: AED Mode - Pause Time - Analysis is suspended for the specific period which is defined by the NSA Action configuration choice. You may attend to the patient and administer CPR if indicated. The Pause Status Bar is displayed (see “AED View Layout”...
  • Page 77 5: AED Mode Using AED Mode to Defibrillate AED Mode User Messages AED Mode guides you through the defibrillation process. Depending upon the given situation, voice prompts and display messages are presented to assist you in using the mode. See Tables 9-16. Table 9 AED Mode Connect Pads Messages This message may appear when the Therapy cable is not connected properly to the HeartStart XL+.
  • Page 78 Using AED Mode to Defibrillate 5: AED Mode Table 12 AED Mode Pads Off Messages These messages may appear when the multifunction electrode pads are not secured to the patient. Audio Message Display Text Condition User Action L = long prompts S = short prompts Not noted = Both L - “Insert connector firmly.
  • Page 79 5: AED Mode Using AED Mode to Defibrillate Table 13 AED Mode Marginal Impedance Messages These messages may appear when the HeartStart XL+ detects a higher pad impedance than expected in the average patient. The cause could be a hairy chest, you are using old pads or the pads may not be fully on the patient. Audio Message Display Text Condition...
  • Page 80 Using AED Mode to Defibrillate 5: AED Mode Table 15 AED Mode Shock Related Messages These messages may appear when a shock is advised or immediately after a shock is delivered in AED Mode. Audio Message Display Text Condition User Action Deliver Shock Now “Deliver shock now”...
  • Page 81: Using Aed Mode To Monitor

    5: AED Mode Using AED Mode to Monitor Table 16 AED Mode Forced Pause Related Messages These messages may appear during a forced pause time period when analysis is not taking place and you can attend to the patient. Audio Message Display Text Condition User Action...
  • Page 82: Configurable Resuscitation Protocols

    Configurable Resuscitation Protocols 5: AED Mode To monitor optional SpO and pulse in AED Mode and activate alarms: Once in AED Mode, attach an SpO sensor to the patient (see “Applying the Sensor” on page 101). If you have the device configured to monitor SpO in AED Mode, SpO monitoring begins once a pulsatile reading is obtained.
  • Page 83: Other Alarms In Aed Mode

    5: AED Mode Troubleshooting Other Alarms in AED Mode If ECG alarms are turned on in AED Mode, all Technical Alarms listed in “HR/Arrhythmia Technical Alarms” on page 55 and the following Physiological Alarms from “HR/Arrhythmia Physiological Alarms” on page 54 are generated when the condition exists: •...
  • Page 84: Chapter 6 Manual Defibrillation

    Manual Defibrillation This chapter explains how to prepare for and perform defibrillation or asynchronous cardioversion on the HeartStart XL+ using multifunction electrode pads, external paddles and internal paddles. Chapter 7 “Cardioversion” on page 81 for information on synchronized cardioversion. Overview Defibrillation therapy is the definitive method for termination of lethal arrhythmias.The HeartStart XL+ provides this therapy through the application of a biphasic pulse of current to the heart.
  • Page 85: Precautions For Manual Defibrillation

    6: Manual Defibrillation Precautions for Manual Defibrillation Precautions for Manual Defibrillation WARNINGS: Defibrillating asystole can inhibit the recovery of natural pacemakers in the heart and completely eliminate any chance of recovery. Asystole should not be routinely shocked. Begin CPR. Remain attentive to the patient during the delivery of therapy. Delay in delivering a shock may result in a rhythm that was identified as shockable converting spontaneously to non-shockable and could result in inappropriate shock delivery.
  • Page 86: Code View

    Code View 6: Manual Defibrillation Code View In Manual Defibrillation Mode, when an energy is selected, Code View is displayed. Code View is optimized to clearly communicate data associated with a resuscitation event (see Figure 49). Code-related information in Code View includes: Enlarged Wave Sector 1: The waveform in Wave Sector 1 is larger for easier viewing.
  • Page 87: Preparing For Defibrillation

    “Connecting Multifunctional Pads” on page 8). NOTE: If you are using Philips’ HeartStart Preconnect Pads (989803166021), the pads may already be connected to the end of the Therapy cable. Open the package to apply the pads to the patient. Apply the pads to the patient as directed on the pads packaging or according to your institution’s protocol.
  • Page 88: Using Infant Paddles

    Preparing for Defibrillation 6: Manual Defibrillation Quick Look You can use external paddles for a “Quick Look” to assess the patient’s ECG rhythm and then, if necessary deliver therapy. Use this process only when multifunction pads and monitoring electrodes are not immediately available.
  • Page 89: Defibrillation

    6: Manual Defibrillation Defibrillation Defibrillation After performing the necessary preparation, defibrillation with HeartStart XL+ is a simple 1-2-3 process. Select an energy. Charge the device. Administer the shock. See the following sections for more information. Step 1 - Select Energy Rotate the Therapy knob to the desired energy level.
  • Page 90: Step 3 - Shock

    Defibrillation 6: Manual Defibrillation [Cancel Charge] If you need to disarm the defibrillator, press the soft key. Also, the defibrillator disarms automatically when the Shock button has not been pressed within the time period specified in the Time to Auto Disarm configuration setting. Step 3 - Shock Confirm that a shock is still indicated and the defibrillator is charged to the selected energy level.
  • Page 91: Manual Defibrillation Alarms

    6: Manual Defibrillation Manual Defibrillation Alarms Manual Defibrillation Alarms Defibrillation alarms can be generated for the conditions shown in Table 18. There are both audio and visual alerts when activated by the Alarms button. When you switch patient categories, all parameter alarm limits change to the new patient category.
  • Page 92: Chapter 7 Cardioversion

    Multifunction electrode pads directly connected to the HeartStart XL+ and an ECG signal coming from a Philips bedside monitor into the HeartStart XL+. NOTE: The best quality source for cardioversion is a 3 or 5-Lead set connected to the HeartStart XL+.
  • Page 93: Precautions For Cardioversion

    7: Cardioversion Precautions for Cardioversion Precautions for Cardioversion WARNINGS: Cardioversion should only be delivered by trained healthcare professionals. When performing synchronized cardioversion through external paddles, you should not use paddles as your monitoring lead in Wave Sector 1. Artifact introduced by paddle movement may resemble an R-Wave arrow and trigger a defibrillation shock.
  • Page 94: Preparing For Synchronized Cardioversion

    “With External Paddles” on page 85. NOTES: When a patient is already connected to Philips bedside monitoring equipment, an external “Sync” cable can plug into the bedside’s ECG Output jack and into the HeartStart XL+’s ECG port. This connects the ECG signal from the monitor into the HeartStart XL+ where it is displayed and synchronization occurs.
  • Page 95: Code View And Cardioversion

    7: Cardioversion Code View and Cardioversion Code View and Cardioversion When Synchronized Cardioversion is active, Code View adds R-Wave arrows and a Sync notification to the display. The Sync button is also backlit. See Figure Figure 51 Code View With Sync Layout 04:48 Adult 25 Jan 2010 10:44 AM...
  • Page 96: Delivering A Synchronized Shock

    Delivering a Synchronized Shock 7: Cardioversion Delivering a Synchronized Shock To perform synchronized cardioversion: Turn the Therapy knob to the desired energy setting Press the Sync button (see Figure 1 on page 6). Confirm that the Sync button lights up, the Sync indicator is present and R-Wave arrows appear only with each R-Wave.
  • Page 97: Delivering Additional Shocks

    7: Cardioversion Delivering a Synchronized Shock To perform synchronized cardioversion using external paddles: Prepare your patient for synchronized cardioversion as stated above. Place paddles on the patient’s chest prior to charging the defibrillator. Look at the wave label appearing in Wave Sector 1. If the label is Paddles: •...
  • Page 98: Cardioversion Alarms

    Cardioversion Alarms 7: Cardioversion Cardioversion Alarms Alarms can be generated for the conditions shown in Table 19. There are both audio and visual alerts. When you switch patient categories, all parameter alarm limits change to the new patient category. These changes are retained when you switch modes.
  • Page 99 NOTES...
  • Page 100: Chapter 8 Pacing

    Pacing This chapter explains the noninvasive transcutaneous pacing option available with the HeartStart XL+ and describes how to perform pacing. Overview Noninvasive transcutaneous pacing therapy is used to deliver monophasic pace pulses to the heart. Pace pulses are delivered through multifunction electrode pads that are applied to the patient’s bare chest. Pacing with paddles is not supported.
  • Page 101: Pacing View

    8: Pacing Pacing View Pacing View Pacer Pacing View appears when the Therapy knob is turned to the position. Pacing View includes a status block which appears in Wave Sector 3 of the display (see Figure 52). Pacing-related information in Pacing View includes: •...
  • Page 102: Demand Mode Versus Fixed Mode

    Demand Mode Versus Fixed Mode 8: Pacing Demand Mode Versus Fixed Mode The HeartStart XL+ can deliver paced pulses in either Demand Mode or Fixed Mode. • In Demand Mode, the pacer only delivers synchronous paced pulses when the patient’s heart rate is lower than the selected pacing rate.
  • Page 103 8: Pacing Preparing for Pacing NOTES: Pacing Therapy should be administered while connected to AC power with a battery installed for backup so that pacing will not be interrupted in the event of either an AC power failure or the battery losing its charge.
  • Page 104: Demand Mode Pacing

    Demand Mode Pacing 8: Pacing Demand Mode Pacing To pace in Demand Mode: Pacer Turn the Therapy knob to the position. Pacing Paused The message appears in the Pacing Bar indicating the pacing function is enabled but pace pulses are not being delivered. Pacing is enabled in Demand Mode with the configured lead in Wave Sector 1 used for R-Wave detection.
  • Page 105 8: Pacing Demand Mode Pacing [Output] Press the soft key. Use the upper portion of the soft key to increase the output until cardiac capture occurs. Capture is indicated by the appearance of a QRS complex after each pacing marker. Use the lower portion of the soft key to decrease the output to the lowest level that still maintains capture.
  • Page 106: Fixed Mode Pacing

    Fixed Mode Pacing 8: Pacing Fixed Mode Pacing To pace in Fixed Mode: Pacer Turn the Therapy knob to the position. Pacing Paused The message appears in the Pacing Bar and indicates the pacing function is enabled but pace pulses are not being delivered. Demand pacing is the default pacer mode. Change to Fixed Mode pacing.
  • Page 107: Defibrillating During Pacing

    8: Pacing Defibrillating During Pacing To stop pacing: [Pause Pacing] • Press the soft key. A prompt message asks you to confirm your action. Using the Navigation buttons, select to pause pacing; select to continue pacing. Once paused, press the [Start Pacing] flashing soft key to resume pacing.
  • Page 108: Pacing Alarms

    Pacing Alarms 8: Pacing Pacing Alarms Pacing alarms can be generated for the conditions shown in Table 20. Once generated, they appear as alarm messages in the Pacer Bar. There are both audio and visual alerts. When you switch patient categories, all parameter alarm limits change to the new patient category.
  • Page 109: Troubleshooting

    8: Pacing Troubleshooting WARNING: Observe the patient closely while pacing. Heart rate displays and alarms function during pacing but can be unreliable. Do not rely on the indicated heart rate or heart rate alarms as a measure of the patient’s perfusion status.
  • Page 110: Chapter 9 Pulse Oximetry

    Pulse Oximetry Pulse Oximetry (SpO ) is one of the tools available to assist in assessing a patient’s cardiac and respiratory systems. This chapter explains how Pulse Oximetry works and how to use the HeartStart XL+ to monitor Overview Pulse oximetry is a non-invasive method of continuously measuring functional oxygen saturation (SpO in arterial blood.
  • Page 111: Understanding Pulse Oximetry

    9: Pulse Oximetry Understanding Pulse Oximetry Understanding Pulse Oximetry A pulse oximetry sensor sends light through patient tissue to a receiver on the other side of the sensor. Light-emitting diodes transmit red and infrared light through the peripheral areas of the body such as a finger.
  • Page 112: Selecting A Sensor

    Understanding Pulse Oximetry 9: Pulse Oximetry Selecting a Sensor The most important factor when selecting a sensor is the position of the light emitting diodes in relation to the photodetector. When the sensor is applied, the diodes and the photodetector must be opposite each other.
  • Page 113: Monitoring Spo 2

    9: Pulse Oximetry Monitoring SpO WARNINGS: Failure to apply the sensor properly may reduce the accuracy of the SpO measurement. Inspect the sensor application site at least every two hours for changes in skin quality, correct optical alignment and proper sensor application. If skin quality is compromised, change the sensor site. Change the application site at least every four hours.
  • Page 114: Spo 2 Alarms

    Alarms 9: Pulse Oximetry Figure 57 Pulse Rate Value Pulse SpO2 Pulse Alarm Limits - If pulse rate alarms are turned on, the alarm limits are displayed. If alarm limits are turned off, the alarms off symbol is displayed. Pulse alarms are off by default. Pleth Wave When the sensor is connected to the HeartStart XL+, the pleth wave is displayed in the configured Wave Sector.
  • Page 115 9: Pulse Oximetry Alarms Table 21 Physiological Alarms Alarm Message Condition Type of Alarm Indication Desat The SpO value has fallen below High Priority Red alarm message with the Desat low limit. Latching Alarm audio tone High The SpO value exceeds the high Medium alarm limit.
  • Page 116: Spo 2 Desat Alarm

    Alarms 9: Pulse Oximetry Desat Alarm The SpO Desat alarm provides an additional limit setting below the low limit setting to notify you of potentially life-threatening decreases in oxygen saturation. This additional limit is preset through Configuration Mode. NOTE: If the SpO Low Limit alarm value is set below the configured SpO Desat Limit, the Desat Limit is automatically adjusted to the SpO...
  • Page 117: Pulse Rate Alarms

    9: Pulse Oximetry Pulse Rate Alarms Pulse Rate Alarms You can turn on/off Pulse Rate alarms in all clinical modes where SpO is available. The configured alarm limits may be changed during use. Alarms are annunciated if measurements fall outside the configured limits for high or low pulse rate.
  • Page 118: Disabling Spo 2 Monitoring

    Disabling SpO Monitoring 9: Pulse Oximetry Disabling SpO Monitoring To disable SpO monitoring: Unplugged - Turn Off Disconnect the sensor cable from the SpO port. The message appears. Select and press the Menu Select button. Unplugged - Turn Off SpO NOTE: If the sensor cable is disconnected accidentally, the message appears.
  • Page 119 NOTES...
  • Page 120: Chapter 10 Blood Pressure Monitoring

    WARNING: Do not perform NBP monitoring on patients whose upper arm circumference is less than 13cm. Doing so may result in inaccurate measurements. NOTE: For more information on NBP monitoring, refer to the Application Note “About Noninvasive Blood Pressure” available on the Philips website at www.philips.com/ProductDocs.
  • Page 121: Measuring Nbp

    10: Blood Pressure Monitoring Measuring NBP Measuring NBP The first time an NBP measurement is taken, the cuff ’s initial inflation pressure is 160 mmHg/21 kPa (adult) and 120 mmHg/16 kPa (infant/child). If the measurement is successful, the next inflation pressure is 30 mmHg/4 kPa above the systolic pressure measurement, with a minimum inflation pressure of 120 mmHg/16 kPa.
  • Page 122 Measuring NBP 10: Blood Pressure Monitoring Check that the edge of the cuff falls within the range identified by the <----> markings. If it does not, use a cuff that fits better. Place the limb used for taking the measurement at the same level as the patient’s heart. [Start NBP] Press the soft key.
  • Page 123 10: Blood Pressure Monitoring Measuring NBP NBP Schedule NBP measurements can be taken on a manual or predetermined automatic basis, depending on how the device is configured and the patient’s needs: Manual - There is no schedule for additional measurements. One measurement is taken each time you [Start NBP] [Start NBP] press the...
  • Page 124: Nbp Alarms

    NBP Alarms 10: Blood Pressure Monitoring NBP Alarms Alarms are annunciated when a measurement for the configured source (systolic, diastolic or mean) falls outside the configured high or low limits. NBP alarms are non-latching alarms, meaning they are automatically removed when their alarm condition no longer exists. Both the source of the alarm and the limits may be changed during an ongoing patient event.
  • Page 125: Changing Nbp Alarm And Source Limits

    10: Blood Pressure Monitoring Caring for Cuffs NOTE: NBP alarms are on unless you specifically turn them off or alarms for the entire device are off. Once disabled, alarms remain off until they are turned back on. Changing NBP Alarm and Source Limits To change the NBP alarm source and/or limits: Press the Menu Select button.
  • Page 126: Chapter 11 Trending

    Trending This chapter describes how to review patient data using HeartStart XL+ Trending. Overview In Monitor Mode your HeartStart XL+ provides the ability to view and print numeric vital signs trending data for the current incident. Trending data are automatically acquired if parameters are on. When viewing trending data, the Trending Report is displayed in the HeartStart XL+’s lower two wave sectors and takes over the soft key functions.
  • Page 127 11: Trending Overview About the Data Displayed • When trending is initially displayed, the most recent trending data appear in the far right column. • The display automatically updates as new data become available, with the newest data appearing in the far right column of the display and older data moving over to the left.
  • Page 128: Printing The Trends Report

    Overview 11: Trending Printing the Trends Report You can print a Trends Report with or without a Trending report on the HeartStart XL+’s display. To print a Trends Report from Monitor Mode: Press the Report button Trends Using the Navigation buttons, select and then the appropriate interval.
  • Page 129 NOTES...
  • Page 130: Chapter 12 Data Management

    Data Management This chapter describes the data management features of the HeartStart XL+, including Data Management Mode, Event Summary, printing functionality and Mark Events. Overview The HeartStart XL+ automatically generates an Event Summary for each patient event. Each Event Summary is assigned a unique event identification number, is date/time stamped and stored in the device’s internal memory.
  • Page 131: Event Summary

    12: Data Management Event Summary Event Summary A new Event Summary is initiated the first time one of the following occurs after the device is powered • The arrival of a valid ECG signal either through electrodes or pads/paddles. • The arrival of valid SpO data.
  • Page 132 Event Summary 12: Data Management Figure 63 Sample Printed Event Summary Report Event ID: (12232000K) 05:33:53 Device On (Patient Name) 05:33:53 Monitor Mode Alarm Identification: Patient ID: (CGP03061998) 05:34:10 Pads On High priority physiological Patient Sex: (M or F) alarms are preceded by First Event: (Date and Time) Medium priority physiological Last Event: (Date and Time)
  • Page 133 12: Data Management Event Summary Table 26 Event Information Logged Event Frequency Power-related events Device On Logged when device first turns on. Continued Use Logged when device is turned on after being turned off for less than 10 seconds. Device Off Logged when the Therapy knob is turned to the position.
  • Page 134 Event Summary 12: Data Management Table 26 Event Information (Continued) Logged Event Frequency Internal Paddles On Logged when internal paddles make contact with the patient. Internal Paddles On Internal Paddles Off Logged after if paddles lose contact with the patient. Leads On Logged when monitoring electrodes for primary ECG are attached to the patient.
  • Page 135 12: Data Management Event Summary Table 26 Event Information (Continued) Logged Event Frequency Equipment Disabled: Logged when the device detects a therapy equipment failure. Therapy On/Off Logged when SpO monitoring is connected and any subsequent disconnect/connect. High (value) > (limit) Logged when the patient’s SpO value is higher than the configured limit.
  • Page 136 Event Summary 12: Data Management Table 26 Event Information (Continued) Logged Event Frequency NBP Alarms Off/On Logged when NBP alarms are turned on or off and any subsequent change. NBP Limits Systolic (low Logged when the Systolic NBP alarm limit is changed. value, high value) NBP Limits Diastolic (low Logged when the Diastolic NBP alarm limit is changed.
  • Page 137 12: Data Management Event Summary Table 26 Event Information (Continued) Logged Event Frequency Disarm Auto (reason) Logged when the device disarms automatically. Reasons include: Pads Off: Logged when the automatic disarm is caused by a bad connection between the device and the patient. Shock Equipment Malfunction: Logged when the device is unable to reach the selected energy during charging.
  • Page 138 Event Summary 12: Data Management Table 26 Event Information (Continued) Logged Event Frequency Pacer Started (rate) ppm Logged when pacing starts. (current) mA (width) ms Pacing Stopped. Power Logged when power is restored if pacing is interrupted or stopped due to a power loss and Interrupted.
  • Page 139: Data Management Mode

    12: Data Management Data Management Mode Data Management Mode Data Management Mode is a non-clinical mode used to manage event data records. You can print or export an individual Event Summary or export all Event Summaries. You can also configure the HeartStart XL+ to remove patient information from Event Summaries prior to exporting them.
  • Page 140 Data Management Mode 12: Data Management The following information is listed on the display: • ID – Indicates if the event data record contains any patient information which could uniquely identify the individual. indicates there is; indicates there isn’t. • Date and Time –...
  • Page 141: Accessing Data On The Usb Drive

    12: Data Management Data Management Mode Removing All Patient Data In Data Management Mode, you can de-identify patient Event Summaries two ways. Patient-related data include name, medical record number, dates related to the individual, patient age if over 89 and any other information that could uniquely identify an individual.
  • Page 142 Data Management Mode 12: Data Management Deleting Event Summaries from the USB Drive To delete Event Summaries from the USB drive: Confirm you are in Data Management Mode. Press the Menu Select button. View USB Drive Using the Navigation buttons, select and press the Menu Select button.
  • Page 143: Printing Data

    12: Data Management Printing Data Printing Data The HeartStart XL+ can print multiple pieces of information in both clinical and non-clinical modes. The device can be configured to print automatically when certain events occur or you can initiate a print request at any time during an event.
  • Page 144: Printing While In Data Management Mode

    Printing Data 12: Data Management Printing While in Data Management Mode To print a Event Summary contained in Internal Memory: Select the Event Summary you wish to print. Print Press the Menu Select button and select Event Summary Press the Report button , select from the listing and press the Menu Select button to print.
  • Page 145: Mark Events

    12: Data Management Mark Events Mark Events The Mark Events button allows you to annotate the Event Summary and ECG strip when the button is pressed. If configured, pressing the Mark Event button prints a 10-second ECG strip leading up to the event, the event itself, and the 5 seconds after the event. To mark an event: Press the Mark Event button.
  • Page 146: Chapter 13 Configuration

    Configuration This chapter describes the configurable parameters of the HeartStart XL+ and procedures for modifying configuration. Overview Configuration settings allow you to customize the HeartStart XL+ to meet your needs. Configuration is viewed and changed through the Configuration Menu. A password is required to change your device’s configuration.
  • Page 147: Setting Date And Time

    13: Configuration Overview Setting Date and Time To modify the date and time from Configuration: Once in Configuration Mode, press the Menu Select button. Date/Time Select and press the Menu Select button. The Configuration Date/Time screen appears. Figure Figure 69 Configuring Date and Time Year 2011...
  • Page 148: Changing Settings

    Overview 13: Configuration Changing Settings To change default settings in Configuration Mode: [Change Config] Press the soft key. Enter the configuration password: Using the Navigation buttons, select the first number and press the Menu Select button. Use the Navigation and Menu Select buttons to enter the remaining numbers in the password. Done When finished, select and press the Menu Select button.
  • Page 149: Printing Settings

    13: Configuration Overview Printing Settings To print the configuration settings: In Configuration Mode, press the Menu Select button. Print Configuration Using the Navigation buttons, select Press the Menu Select button to print the report. See Figure NOTE: To stop printing, press the Print button. Figure 70 Sample Configuration Report Configuration Report...
  • Page 150: Configurable Parameters

    Setting Choices Patient Category Selects the default patient category. Adult, Infant/Child Alarm Tone Defines either traditional Philips or IEC Philips, IEC standard alarm tones. Alarm Pause Time Defines the interval of time during which 1 min, 2 min, 3 min, 5 min, 10...
  • Page 151 13: Configuration Overview Table 29 General Settings (Continued) Parameter Description Setting Choices Minimum Alarm Defines the minimum audible alarm level Very Soft, Soft, Medium, Loud, Volume available within use. Very Loud Voice Volume Defines voice prompt levels. Very Soft, Soft, Medium, Loud, Very Loud QRS Volume Defines the volume level of audible beeps...
  • Page 152 Overview 13: Configuration Table 30 Heart Rate/ECG Settings (Continued) Parameter Description Setting Choices NOTE: If the ECG source is pads or paddles, 0.15-40 Hz is used regardless of the configuration settings. ECG Electrode Selects the electrode label format. AAMI: AAMI, IEC Labels RA, LA, LL, RL, V;...
  • Page 153 13: Configuration Overview Table 31 NBP Settings (Continued) Parameter Description Setting Choices Diastolic High Limit Selects the high limit alarm value when Adult: 25-200, 90 (mmHg); diastolic is the selected alarm source. 3-27, 12 (kPa) Infant/Child: 25-120, 70 (mmHg); 3-16, 9 (kPa) Diastolic Low Limit Selects the low limit alarm value when Adult: 20-195, 50 (mmHg);...
  • Page 154 Overview 13: Configuration Table 33 Wave Settings (Continued) Parameter Description Setting Choices NOTE: The default for Wave Sector 1 cannot be set to Paddles. Wave 2 Selects the waveform displayed in Wave Pads/Paddles, I, II, III, aVR, aVL, Sector 2. aVF, V, Cascade, Annotated ECG, Pleth, None Wave 3...
  • Page 155 13: Configuration Overview Table 34 Defib/Sync/AED Settings (Continued) Parameter Description Setting Choices All energy settings ≥ 100J, 150 Adult 1st Shock Defines the energy dose for the first shock Energy Dose in a series in AED Mode. All energy settings ≥ the first Adult 2nd Shock Defines the energy dose for the second Energy Dose...
  • Page 156 Overview 13: Configuration Table 37 Mark Event Settings (Continued) Parameter Description Setting Choices Mark Event 7 Defines the seventh mark event menu Aspirin choice. Mark Event 8 Defines the eighth mark event menu choice. Other NOTE: There is a 20 character limit when defining Mark Events. See “Mark Events”...
  • Page 157 NOTES...
  • Page 158: Chapter 14 Operational And Shift Checks

    Philips Healthcare supports the AHA checklist recommendations and has provided a Shift Checklist document with the device and published a copy in this book. See “HeartStart XL+ Shift Checklist”...
  • Page 159: Weekly Shock Test

    14: Operational and Shift Checks Shift Check Weekly Shock Test A Weekly Shock Test is performed using either a test plug, a test load or paddles. The Weekly Shock Test process and results differ depending which way you choose to perform the test. See chart below. To perform the Weekly Shock Test: If you are If you are using...
  • Page 160 Shift Check 14: Operational and Shift Checks HeartStart XL+ Shift Checklist Inspect the HeartStart XL+, accessories and supplies at the change of every shift per AHA Guidelines. Place a checkmark in the box as you check each item in the list below. Place a dash mark or other symbol if the entry is not applicable.
  • Page 161 14: Operational and Shift Checks Shift Check Shift Checklist (Page 2) HeartStart XL+ Weekly Shock Test Do one of the following checks at least once a week to verify the ability to deliver defibrillation therapy: Operational Check (See the HeartStart XL+ Instructions for Use for details.) Deliver a 150J shock into a test plug/load (if using multifunction electrode pads) or the paddle tray (if using paddles).
  • Page 162: Operational Check

    Operational Check 14: Operational and Shift Checks Operational Check Operational Checks supplement automated tests by verifying therapy cables, the ECG cable, paddles, audio, charge and shock buttons, and the ability to deliver defibrillation and pacing therapy. Operational Check also notifies you if the battery needs calibration, checks the SpO and NBP modules and printer.
  • Page 163: Performing An Operational Check

    14: Operational and Shift Checks Operational Check Performing an Operational Check Prior to performing an Operational Check: If you use external paddles: Make sure the paddles are connected to the device, paddles and the paddle tray are thoroughly clean and there is no debris or residue (including all conductive material) on the electrode surfaces of the paddles and tray.
  • Page 164 Operational Check 14: Operational and Shift Checks NOTE: Once you have pressed the Sync button, you can leave the HeartStart XL+ unattended as Operational Check completes its process. If you cancel the Operational Check before it completes all tasks, there is no record of the check in the Operational Check Summary.
  • Page 165 14: Operational and Shift Checks Operational Check Operational Check Results Each test that makes up the Operational Check either passes or fails (see Figure 73 for an example). Figure 73 Operational Check In Process Screen 25 Jan 2011 11:11pm Operational Check Reference Number: (Device Reference Number) Serial Number:...
  • Page 166 Operational Check 14: Operational and Shift Checks Table 39 Operational Check Tests and Results Device What to do if test doesn’t Test User Actions Results Prompts pass General System - None None Pass - All tested systems are Take the device out of use tests internal clock functioning properly.
  • Page 167 14: Operational and Shift Checks Operational Check Table 39 Operational Check Tests and Results (Continued) Device What to do if test doesn’t Test User Actions Results Prompts pass Shock button - Once charged, Press the Shock Pass - Shock button passed Repeat Operational Check tests the Shock the device...
  • Page 168 Operational Check 14: Operational and Shift Checks Table 39 Operational Check Tests and Results (Continued) Device What to do if test doesn’t Test User Actions Results Prompts pass Pads/Paddles ECG None None Pass/cable type - ECG If Operational Check fails - Checks ECG acquisition and the cable are with a cable connected,...
  • Page 169: Printing Operational Check Results

    14: Operational and Shift Checks Operational Check Printing Operational Check Results If configured to do so (see “Printing Settings” on page 145), the Operational Check Report (see “Sample Operational Check Report” on page 159) automatically prints out after an Operational Check is Print completed.
  • Page 170 Operational Check 14: Operational and Shift Checks Figure 74 Sample Operational Check Report Operational Check Report Current Test Results: General System Test: Pass Pads/Paddles ECG Test: Pass HeartStart XL+ Therapy Knob: Pass Battery Test: Pass S/N: (Device Serial Number) Charge Button: Pass SpO2 Test: Pass SW Rev: (Software revision) Shock Button: Pass...
  • Page 171: Operational Check Summaries

    14: Operational and Shift Checks Operational Check Operational Check Summaries Op Check Summary Selecting from the Operational Check menu (see Figure 71) displays a summary of Operational Checks currently stored in the HeartStart XL+ (see Figure 75). Using the Navigation buttons, select the Operational Check report you want.
  • Page 172: Auto Test Summaries

    Operational Check 14: Operational and Shift Checks Auto Test Summaries Auto Test Summary Selecting from the Operational Check menu (see Figure 71) displays a summary of automated test results currently stored in the HeartStart XL+. Using the Navigation buttons, select the summary you want and press the Menu Select button to print out or export the summary.
  • Page 173 NOTES...
  • Page 174: Chapter 15 Maintenance

    Maintenance This chapter describes how to care for your HeartStart XL+ and its accessories. Overview Proper maintenance of the HeartStart XL+ is a simple, yet important factor in dependability. Attending to routine maintenance is vital to keeping the HeartStart XL+ ready to respond in an emergency. Routine maintenance involves: •...
  • Page 175: Automated Tests

    15: Maintenance Automated Tests Automated Tests The HeartStart XL+ performs many maintenance activities including three tests that run automatically at regularly scheduled intervals when power is supplied and the device is off. The tests assess operational performance and alert you if a problem exists. Results of tests associated with critical device functionality are reported through the RFU indicator and the Automated Test Summary Report.
  • Page 176 Automated Tests 15: Maintenance Figure 78 Automated Test Summary 16Jan2011 1:10am Automated Test Summary Date and Time Period Result Date and Time Period Result 16Jan2011 12:11AM Hourly Pass 16Jan2011 01:11AM Daily Pass 15Jan2011 01:11AM Daily Pass 14Jan2011 01:11AM Daily Pass 13Jan2011 01:11AM Daily Pass 12Jan2011 01:11AM Daily...
  • Page 177: Battery Maintenance

    Battery maintenance begins when you first receive your device and continues throughout the life of the battery. Detailed information on battery care is available in the Lithium Ion Battery Application Note which was provided with your HeartStart XL+ and can also be found on the Philips website at www.philips.com/ProductDocs Table 42 lists battery maintenance activities and when they should be performed.
  • Page 178: Calibrating Batteries

    Battery Maintenance 15: Maintenance Charge Status You can check the current charge status of a HeartStart XL+ Lithium Ion battery by: • Pushing the fuel gauge button on the battery to illuminate the fuel gauge (see “Battery Fuel Gauge” on page 14). Each light represents approximately 20% of capacity. •...
  • Page 179: General Battery Safety

    15: Maintenance Battery Maintenance General Battery Safety The following general warnings and cautions apply to the HeartStart XL+ battery. Additional warnings and cautions specific to a particular battery feature are provided in the appropriate sections. WARNINGS: Built-in safety circuits cannot protect against handling abuse. Adhere to all warnings and cautions in handling and using Lithium Ion batteries.
  • Page 180: Power-related Alarms

    Battery Maintenance 15: Maintenance Power-Related Alarms Power-related alarms are generated for the conditions shown in Table Figure 43. Once generated, they appear as alarm messages on the HeartStart XL+ display. There are both audio and visual alerts. For more information on alarms, see “Alarms”...
  • Page 181: Cleaning Instructions

    15: Maintenance Cleaning Instructions Cleaning Instructions Listed below are the recommended cleaning instructions for the HeartStart XL+ and its associated accessories. CAUTIONS: The HeartStart XL+, along with its accessories and supplies, may not be autoclaved, steam sterilized, ultrasonically cleaned or immersed unless otherwise indicated in the Instructions for Use that accompany the accessory or supply.
  • Page 182: Printer Printhead

    HeartStart XL+ Disposal 15: Maintenance Printer Printhead If the printout has light or varying print density, clean the printhead to remove any buildup of paper residue. To clean the printhead: Push the printer door latch to open the door. Remove the roll of paper. Clean the printhead surface (top, front of the compartment) with a cotton swap dipped in isopropyl alcohol.
  • Page 183 NOTES...
  • Page 184: Chapter 16 Troubleshooting

    Troubleshooting Overview If the HeartStart XL+ detects an error or potential problem during use, it displays a textual message to guide you. These messages are often accompanied by a voice prompt or audible beeping tone. This chapter describes these statements that you see, along with other symptoms, and provides suggestions for what to do and resources for you to contact for further information.
  • Page 185 16: Troubleshooting Resolving Issues Device Info Report While troubleshooting, it is often beneficial to know what versions of software and hardware your HeartStart XL+ contains. The Device Info Report provides that information. To print a Device Info Report: Press the Menu Select button. Other Using the Navigation buttons, select and press the Menu Select button.
  • Page 186: Symptoms

    Symptoms 16: Troubleshooting Symptoms The following tables list symptoms, statements and messages that you may encounter while using the HeartStart XL+. The tables also provide possible causes and potential solutions. Symptoms are categorized by functionality. NOTE: When troubleshooting issues related to connecting the patient to the HeartStart XL+, it is recommended that one single person follow the connection path from the patient to the device to assure a proper end-to-end connection.
  • Page 187 16: Troubleshooting Symptoms Table 44 General Problems (Continued) Symptom Possible Cause Possible Solution Non-critical Device Failure A non-critical device failure Review error and alarm messages on screen. Call for Detected. Service Required has been detected at startup or service. message on display. during RFU testing.
  • Page 188 Symptoms 16: Troubleshooting Table 44 General Problems (Continued) Symptom Possible Cause Possible Solution Trending data is not appearing You might not be in Monitor Make sure your device is in Monitor Mode before on the display. Mode. attempting to display trending information. Event Record You receive a You have reached the eight...
  • Page 189 16: Troubleshooting Symptoms Table 45 ECG Monitoring Problems Symptom Possible Cause Possible Solution The QRS volume is configured Configure the QRS beeper volume. or the setting is too low. QRS beeper inaudible or beeps The QRS volume was turned Adjust the volume through the Volume menu. do not occur with each QRS off or set too low through the complex.
  • Page 190 Symptoms 16: Troubleshooting Table 45 ECG Monitoring Problems (Continued) Symptom Possible Cause Possible Solution Device is in AED Mode. The Lead Select button is disabled in AED Mode. To select a lead, exit AED Mode and enter Monitor or Manual Defibrillation Mode. Pads/paddles cannot be used Exit pacing or choose Fixed Mode pacing.
  • Page 191 16: Troubleshooting Symptoms Table 45 ECG Monitoring Problems (Continued) Symptom Possible Cause Possible Solution Press “I,II..” Button to Select The waveform in Wave Sector Check that the monitoring electrodes/pads are Another ECG Lead message on 1 is no longer valid and properly applied.
  • Page 192 Symptoms 16: Troubleshooting Table 46 Defibrillation and Pacing Problems (Continued) Symptom Possible Cause Possible Solution A test load or defibrillator test Remove the test load or defibrillator test plug and plug is attached to the end of attach multifunction electrode pads. Check Pads Connection the Therapy Cable.
  • Page 193 16: Troubleshooting Symptoms Table 46 Defibrillation and Pacing Problems (Continued) Symptom Possible Cause Possible Solution Pacing Stopped. Pads Off Proper pads contact has been Check pads connection with patient. Confirm proper technical alarm. lost with the patient. skin prep. Replace pads if necessary. Resume pacing.
  • Page 194 Symptoms 16: Troubleshooting Table 47 Monitoring Problems (Continued) Symptom Possible Cause Possible Solution Non Pulsatile technical The patient’s pulse is absent or Check perfusion at the measurement site. alarm. too weak to be detected or the Check that the sensor is applied properly. sensor has come off.
  • Page 195 16: Troubleshooting Symptoms Table 47 Monitoring Problems (Continued) Symptom Possible Cause Possible Solution Extended Update An NBP measurement or an Wait until the NBP measurement is complete. technical alarm. excessively noisy signal is Try another sensor site. delaying display/update of the The SpO numeric value is Move sensor to a different limb than the NBP cuff.
  • Page 196 Symptoms 16: Troubleshooting Table 48 NBP Monitoring Problems (Continued) Symptom Possible Cause Possible Solution NBP Measurement Failed A measurement value could Check cuff size and placement. technical alarm. not be obtained. The NBP numeric value is replaced with a -?-. NBP Calibration Overdue The NBP module needs technical alarm.
  • Page 197 16: Troubleshooting Symptoms Table 49 Printing Problems (Continued) Symptom Possible Cause Possible Solution Printer Font Unavailable The required font is If printing is essential to patient care, take the device technical alarm. unavailable for the currently out of use and call for service. installed language.
  • Page 198: Calling For Service

    Calling For Service 16: Troubleshooting Calling For Service For telephone assistance, call the Response Center nearest to you or visit Philips’ website at www.healthcare.philips.com In the United States call: 1-800-722-9377. For other telephone numbers worldwide: Visit www.healthcare.philips.com Click on the appropriate region of the world where you are located.
  • Page 199 NOTES...
  • Page 200: Chapter 17 Supplies & Accessories

    • In the US, call 800-225-0230 for pads, electrodes, cables, paper, etc. • Outside the US, contact your local Philips Healthcare Sales Office or your authorized Philips Healthcare Dealer or Distributor. WARNINGS: Use only multifunction electrode pads, battery and accessories listed in this Instructions for Use.
  • Page 201 17: Supplies & Accessories Ordering Replacement Supplies and Accessories Table 51 Supplies and Accessories (Continued) Part Number Description Hands-Free Pads Therapy Cables M3507A Defibrillator Pads Hands-Free Cable, barrel style (2.2 m/7 ft.) M3508A Defibrillator Pads Hands-Free Cable, plug style (2.2 m/7 ft.) 05-10200 Pads Adapter (use with M3507A) External Paddles...
  • Page 202 Ordering Replacement Supplies and Accessories 17: Supplies & Accessories Table 51 Supplies and Accessories (Continued) Part Number Description 5-Lead ECG Cable Sets M1520A 5-lead ECG Trunk Cable (AAMI) M1530A 5-lead ECG Trunk Cable (IEC) M1625A 5-lead ECG set with snaps (AAMI) M1635A 5-lead ECG set with snaps (IEC) M1644A...
  • Page 203 17: Supplies & Accessories Ordering Replacement Supplies and Accessories Table 51 Supplies and Accessories (Continued) Part Number Description NBP Interconnect Tubing M1598B Adult Pressure Interconnect Cable (1.5m) M1599B Adult Pressure Interconnect Cable (3m) Reusable Blood Pressure Cuffs 40400A Reusable Cuff Kit, 3 sizes (Pediatric, Adult, Large Adult) 40400B Reusable Cuff Kit, 5 sizes (Infant, Pediatric, Adult, Large Adult, Thigh) 40401A...
  • Page 204 Ordering Replacement Supplies and Accessories 17: Supplies & Accessories Table 51 Supplies and Accessories (Continued) Part Number Description Disposable Blood Pressure Cuffs M1874A Disposable Cuff — Infant M1875A Disposable Cuff — Pediatric M1876A Disposable Cuff — Small Adult M1877A Disposable Cuff — Adult M1878A Disposable Cuff —...
  • Page 205 17: Supplies & Accessories Ordering Replacement Supplies and Accessories Table 51 Supplies and Accessories (Continued) Part Number Description M1941A Extension Cable (2m) M1943A Reusable SpO Sensor Adapter Cable (1m) — Use with M1903B/M1904B M1943AL Reusable SpO Sensor Adapter Cable Paper 40457C 50 mm Chemical Thermal Paper, gray grid (10 rolls) 40457D...
  • Page 206: Chapter 18 Specifications

    Specifications This chapter includes: • HeartStart XL+ specifications. See below. • Symbol and abbreviation definitions, see “Symbol Definition” on page 206 and “Abbreviation Definitions” on page 208. • Electromagnetic Compatibility, see “Electromagnetic Compatibility” on page 209. Specifications General Dimensions: 29.6 cm (W) x 23 cm (H) x 27.9 cm (D); 11.6 in (W) x 9 in (H) x 10.9 in (D) Weight: 14.7 lbs/6.6 kg (includes one battery, one new roll of paper, one Therapy cable).
  • Page 207 18: Specifications Specifications Table 52 Delivered Energy Accuracy Nominal Delivered Energy vs. Load Impedance Load Impedance (ohms) ±2% Selected Energy 10 J 15 J 20 J 30 J 50 J 70 J 100 J 120 J 150 J 170 J 200 J The delivered energy accuracy is ±10% or ±1J whichever is greater for all energy settings Charge time:...
  • Page 208: Manual Defibrillation Mode

    Patient Impedance Range: Minimum: 25 ohm (external defibrillation); 15 ohm (internal defibrillation); Maximum: 250 ohm. Actual functional range may exceed these values. Figure 79 Smart Biphasic Waveform Philips Smart Biphasic Waveform at 200J into 25-175 Ohms 2500 2000 1500 1000...
  • Page 209: Aed Mode

    18: Specifications Specifications AED Mode AED Energy Profile: 150 Joules for Adult/50 J for Infant/Child (factory default) nominal into a 50 ohm test load. AED Controls: On/Off, shock. Text and Voice Prompts: Extensive text/audible messages guide user through a user-configured protocol. Indicators: Monitor display messages and prompts, voice prompts, battery status, RFU, external power.
  • Page 210 Specifications 18: Specifications Frequency Response: • ECG AC Line Filter - 50 Hz or 60 Hz. • ECG for Display - 0.15-40 Hz, 0.05-40 Hz • ECG for Printer - 0.05-150 Hz Diagnostic, 0.15-40 Hz, 0.05-40 Hz Heart rate accuracy and response to irregular rhythm: Meets AAMI standard for ventricular bigeminy (HR=80 bpm);...
  • Page 211: Display

    18: Specifications Specifications Display Size: Approximately 6.5 in (16.5 cm) diagonal viewing area. Type: Color TFT LCD. Resolution: 640 x 480 pixels (VGA) with 32 brightness levels per color. Sweep Speed: 20 mm/s nominal (stationary trace; sweeping erase bar) for ECG and SpO Wave Viewing Time: 5.2 sec Battery Type: Rechargeable, Lithium Ion;...
  • Page 212: Thermal Array Printer

    Specifications 18: Specifications Thermal Array Printer Continuous ECG Strip: The Print key starts and stops the strip. The printer can be configured to be run real time or with a 10-second delay. The strip prints the primary ECG lead and a second wave with event annotations and measurements.
  • Page 213: Spo 2 Pulse Oximetry

    M1904B ±3% NOTES: Accuracy outside the range specified for each sensor is not indicated. The above referenced sensors were validated for use with the HeartStart XL+ using the Philips picoSAT II SpO module with Fourier Artifact Suppression Technology (FAST). While the SpO module is able to report values below 70% and alarm limits can be set below 70%, the accuracy of measurements less than 70% has not been validated.
  • Page 214: Nbp

    Specifications 18: Specifications and Pulse Averaging Time: 10 sec Emitted Light Energy: ≤15 mW Wavelength Range: 500-1000 nm (Information about wavelength range can be useful to clinicians, especially those performing photodynamic therapy.) Desat Alarm Signal Generation Delay: 20 sec Pulse Rate Measurement Range: 30-300 bpm Pulse Rate Resolution: 5 bpm Pulse Rate Accuracy: 2% or 1 bpm whichever is greater Pulse Response Time (90 to 120 bpm): average 18.0 seconds, standard deviation 0.86 seconds...
  • Page 215: Patient Data Storage

    18: Specifications Specifications Auto Mode Repetition Time: 1, 2.5, 5, 10, 15, 30, 60 or 120 min Maximum Measurement Time: 120 sec Interconnect Tube Length: M1598B Connect tubing 1.5 m (4.92 ft.) M1599B Connect tubing 3.0 m (9.24 ft.) Recommended Frequency of Pressure Transducer Calibration: Yearly Patient Data Storage Internal Event Summary: The HeartStart XL+ can store up to 8 hours of 2 continuous ECG waves, 1 pleth wave, research waves (AED Mode only) events and trending data per Event Summary.
  • Page 216: Usb Device

    Specifications 18: Specifications Water/Solids Ingress Resistance: Meets Ingress Protection level IP21. EMC: Complies with the requirements of standard EN 60601-1-2:2002. Safety: Meets UL 60601-1 (1st edition), EN 60601-2-4:2003, EN 60601-1:1990. Other considerations: • The HeartStart XL+ is not suitable for use in the presence of concentrated oxygen or a flammable anesthetic mixture with air, oxygen or nitrous oxide.
  • Page 217: Symbol Definition

    18: Specifications Symbol Definition Symbol Definition Table 54 lists the meaning of each symbol appearing on the HeartStart XL+ and the Lithium Ion battery. Table 54 HeartStart XL+ Symbol Definitions Symbol Definition Symbol Definition Dangerous voltage Input Meets IEC type CF leakage current This product has passed relevant safety requirements and is defibrillator tests by the CSA, a nationally recognized...
  • Page 218: Shipper Carton Symbol Definitions

    Shipper Carton Symbol Definitions 18: Specifications Shipper Carton Symbol Definitions Table 55 lists the meaning of each symbol appearing on the HeartStart XL+ shipping carton. Table 55 Carton Symbol Definitions Symbol Definition Symbol Definition Fragile Temperature Range Do not get wet Atmospheric pressure range Stack only three high Relative humidity range...
  • Page 219: Abbreviation Definitions

    18: Specifications Abbreviation Definitions Abbreviation Definitions Table 56 lists various abbreviations used with the HeartStart XL+ and in these Instructions for Use. Table 56 Abbreviations Abbreviation Definition Abbreviation Definition percent µs microseconds °C degrees Celsius µV microVolt °F degrees Fahrenheit milliAmpere alternating current milliVolt...
  • Page 220: Electromagnetic Compatibility

    Electromagnetic Compatibility 18: Specifications Electromagnetic Compatibility When using the HeartStart XL+, electromagnetic compatibility with surrounding devices should be assessed. A medical device can either generate or receive electromagnetic disturbances. Testing for electromagnetic compatibility EMC with the appropriate accessories has been performed according to the international standard for EMC for medical devices (IEC 60601-1-2).
  • Page 221 WARNING: The use of accessories, transducers and cables other than those specified might result in increased emissions or decreased immunity of the HeartStart XL+. The list of cables, transducers, and other accessories with which Philips claims compliance with the emissions and immunity requirements of IEC standard 60601-1-2 are listed in “Supplies & Accessories”...
  • Page 222 Electromagnetic Compatibility 18: Specifications Table 58 Electromagnetic Immunity - General Immunity Test IEC 60601 Compliance Electromagnetic Environment - Test Level Level Guidance Electrostatic discharge ± 6 kV contact ± 6 kV contact Floors should be wood, concrete, or ceramic (ESD) tile.
  • Page 223 18: Specifications Electromagnetic Compatibility Table 59 Electromagnetic Immunity - Life-Supporting Systems Immunity Test IEC 60601 Test Level Compliance Electromagnetic Environment - Guidance Level Portable and mobile RF communications equipment should be used no closer to any part of the HeartStart XL+ including cables, than the recommended separation distance calculated from the equation applicable to the frequency of the transmitter.
  • Page 224: Recommended Separation Distances

    Electromagnetic Compatibility 18: Specifications Recommended Separation Distances The HeartStart XL+ is intended for use in an electromagnetic environment in which radiated RF disturbances are controlled. The customer or the user of the HeartStart XL+ can help prevent electromagnetic interference by maintaining a minimum distance between portable and mobile RF communications equipment (transmitters) and the HeartStart XL+ as recommended below, according to the maximum output power of the communications equipment.
  • Page 225 NOTES...
  • Page 226 Index menus medium priority message area multiple alerts indicator Abbreviations mode messages multiple conditions Aberrantly-conducted beats monitoring parameters AC Connection monitoring pulse NBP limits multifunction electrode pads non-latching AC Line Filter no shock advised notification Accessing USB drive pads connect messages pacing Accessories pads off messages...
  • Page 227 Automatic NBP measurements Calibration bar Basic orientation Shift Check Calling for service Shock button Cannot analyze ECG soft keys Cascading leads port Basic orientation symbols defined adjusting numeric values Changing configuration settings Sync button adjusting volume Changing leads with Lead Select button therapy knob AED View Changing NBP schedule...
  • Page 228 Connecting Desat limit ECG cable monitor view Device Info report multifunction electrode pads monitoring electrode accessories Diastolic NBP NBP cable monitoring with electrodes Discarding the Battery NBP cuff monitoring with pads SpO2 cable normal complex Disinfecting therapy cable paced status Display USB flash drive parameter limits...
  • Page 229 Event Summary Indications for use Maintenance pacing cleaning SpO sensors stored events discarding battery leads rerun Exiting Configuration Mode Infant paddles NBP calibration release button Exporting Operational Check using configuration settings power alarms data Initial NBP cuff pressure External Paddles Initiating an Event Summary Shift Check manual defibrillation...
  • Page 230 Mean NBP Pacing manual measurements adjusting numeric values Measuring NBP mean alarms Menu Select button measuring Alarms button location message area changing modes Menus Operational Check results charge button grayed out options parameter area configuration options patient category connecting multifunction electrode Mercury port pads...
  • Page 231 Patient category Print R-Wave adult saved event summary aberrantly conducted beats button Trends report arrows button location troubleshooting pacing configuration options user checks synchronized cardioversion infant/child Printer, location location on display Printing a strip weight range on display configuration settings Safety Patient Contact Indicators installing paper...
  • Page 232 Specifications Synchronized cardioversion Troubleshooting events stored in Event Summary alarms layout external paddles battery lead select flat line charge time Mark Event button Lead Select button data storage message area manual defibrillation defibrillator message area display non-paddles lead multiple alerts indicator paced status environmental Patient Category button...
  • Page 233 NOTES...
  • Page 235 By e-mail written consent of the copyright holder. healthcare@philips.com Philips Healthcare reserves the right By postal service to make changes in specifications or Philips Healthcare to discontinue any product at any 3000 Minuteman Road...

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