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ZOLL X Series Operator's Manual

Portable defibrillator, includes real cpr help and see-thru cpr.
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X Series
Operator's Guide
®
®
®
Includes Real CPR Help
and See-Thru CPR
9650-001355-01 Rev. M

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   Summary of Contents for ZOLL X Series

  • Page 1

    X Series Operator’s Guide ® ® ® Includes Real CPR Help and See-Thru CPR 9650-001355-01 Rev. M...

  • Page 2

    The issue date for the X Series Operator's Guide (REF 9650-001355-01 Rev. M) is January, 2016. Copyright © 2016 ZOLL Medical Corporation. All rights reserved. CPR-D-padz, Pedi-padz, OneStep, Real CPR Help, Rectilinear Biphasic, RescueNet, See-Thru CPR, Stat-padz, SurePower, Perfusion Performance Indicator, X Series, and ZOLL are trademarks or registered trademarks of ZOLL Medical Corporation in the United States and/or other countries.

  • Page 3: Table Of Contents

    Operator’s Guide Updates ....................1-3 Unpacking........................... 1-4 Symbols Used on the Equipment ..................1-4 Conventions ........................1-7 X Series Indications for Use ....................1-8 Manual Defibrillation ....................1-8 Semiautomatic Operation (AED) ................1-9 ECG Monitoring ......................1-9 CPR Monitoring ......................1-9 External Transcutaneous Pacing ................

  • Page 4: Table Of Contents

    Display Brightness ....................2-19 Common Tasks ......................... 2-20 Setting the Date and Time ..................2-20 Changing the Display Brightness ................2-21 Replacing a Battery Pack on the X Series ..............2-22 Using Treatment Buttons ..................2-22 Chapter 3 Monitoring Overview X Series Monitoring Functions ....................

  • Page 5: Table Of Contents

    Preparing the Patient for Electrode Application ............6-3 Applying Electrodes to the Patient ................6-4 Connecting the ECG Cable To the X Series Unit ............6-6 Selecting ECG Waveforms for Display ............... 6-6 Selecting the Waveform Trace Size ................6-8 ECG Monitoring and Pacemakers ..................

  • Page 6: Table Of Contents

    Selecting the SpO2 Sensor ....................10-6 Applying the SpO2 Sensor ....................10-6 Applying a Two-Piece Single-Use Sensor/Cable ............10-7 Applying a Reusable Sensor/Cable ................10-9 Cleaning and Reuse of Sensors ................10-9 Connecting the SpO2 Sensor ..................10-10 www.zoll.com 9650-001355-01 Rev. M...

  • Page 7: Table Of Contents

    Enabling/Disabling Temperature Alarms and Setting Alarm Limits ........12-3 Setting Upper and Lower Temperature Alarm Limits ............12-3 Setting Upper and Lower Temperature Alarm Limits ............12-4 Selecting the Temperature Label ..................12-5 Temperature System Messages ..................12-6 9650-001355-01 Rev. M X Series Operator’s Guide...

  • Page 8: Table Of Contents

    Determine the Patient’s Condition Following Local Medical Protocols ..... 15-6 Begin CPR Following Medical Protocols ..............15-6 Prepare Patient ......................15-6 Turn On Unit ......................15-7 1 Select Energy Level ....................15-7 2 Charge Defibrillator ....................15-8 www.zoll.com 9650-001355-01 Rev. M...

  • Page 9: Table Of Contents

    2 Apply ECG Electrodes/Hands-Free Therapy Electrodes ........18-3 3 Press PACER button ..................... 18-3 4 Set Mode ....................... 18-4 5 Set Pacer Rate ...................... 18-4 6 Turn On Pacer ....................... 18-4 7 Set Pacer Output ....................18-4 9650-001355-01 Rev. M X Series Operator’s Guide...

  • Page 10: Table Of Contents

    Capturing a Data Snapshot ....................21-2 Reviewing and printing snapshots ................21-3 Treatment Summary Report ..................... 21-3 Printing Treatment Summary Report ................ 21-3 Transferring Data to a USB Device................... 21-4 Clearing the Log ....................... 21-5 viii www.zoll.com 9650-001355-01 Rev. M...

  • Page 11: Table Of Contents

    Annually ........................24-6 Guidelines for Maintaining Peak Battery Performance ............. 24-6 Cleaning instructions ......................24-7 Cleaning the X Series unit ..................24-7 Cleaning the NIBP Blood Pressure Cuff ..............24-7 Cleaning SpO2 Sensors ................... 24-7 Cleaning Cables and Accessories ................24-8 Loading Recorder Paper ...................

  • Page 12: Table Of Contents

    Electromagnetic Immunity: Non Life-Supporting Functions ........A-33 ECG Analysis Algorithm Accuracy ..................A-36 Clinical Performance Results ..................A-36 Wireless Output Guidance and Manufacturer’s Declaration..........A-37 RF Transmission Emitted (IEC 60601-1-2) ...............A-37 FCC Notice .......................A-37 Canada, Industry Canada (IC) Notices ..............A-37 Appendix B Accessories www.zoll.com 9650-001355-01 Rev. M...

  • Page 13: Product Description

    The X Series is a rugged, compact and lightweight unit that is designed for all resuscitation situations and is ideal for transport. The X Series is powered by auxiliary power as well as an easily replaceable battery pack that quickly recharges when the X Series is connected to auxiliary power.

  • Page 14

    The X Series has a patient data review and collection system that allows you to view, store, and transfer patient data. The X Series unit contains a printer and USB port, which you can use to print the data and transfer it to a PC.

  • Page 15: X Series Optional Features

    How to Use This Manual The X Series Operator's Guide provides information operators need for the safe and effective use and care of the X Series product. It is important that all persons using this device read and understand all the information contained within.

  • Page 16: Unpacking

    U.S.A. customers should call ZOLL Medical Corporation (1-800-348-9011). Customers outside of the U.S.A. should contact the nearest ZOLL authorized representative. If the shipping container is damaged, also notify the carrier.

  • Page 17

    Defibrillator-proof type CF patient connection. Fusible link. Equipotentiality. Alternating current (ac). Direct current (dc). Auxiliary power adapter operation. Caution, high voltage. Earth (ground). Negative input terminal. Positive input terminal. Power On/Off Protective earth (ground). 9650-001355-01 Rev. M X Series Operator’s Guide...

  • Page 18

    Return to a collection site intended for waste electrical and electronic equipment (WEEE). Do not dispose of in unsorted trash. Date of manufacture. Use by. Latex-free. Do not reuse. Do not fold. Not sterile. Manufacturer. Authorized representative in the European Community. www.zoll.com 9650-001355-01 Rev. M...

  • Page 19: Conventions

    Warning statements alert you to conditions or actions that can result in personal injury or death. Caution Caution statements alert you to conditions or actions that can result in damage to the unit. 9650-001355-01 Rev. M X Series Operator’s Guide...

  • Page 20: X Series Indications For Use

    X Series. The X Series is also intended for use by (or on the order of) physicians at the scene of an emergency or in a hospital emergency room, intensive care unit, cardiac care unit, or other similar areas of a hospital.

  • Page 21: Semiautomatic Operation (aed)

    ECG Monitoring The X Series is intended for use to monitor and/or record 3-, 5-, or 12-lead ECG waveform and heart rate, and to alarm when heart rate is above or below limits set by the operator. The patient population will range from newborn (neonate) to adult, with and without heart dysfunction.

  • Page 22: Non-invasive Blood Pressure Monitoring

    Respiration Monitoring The X Series is intended for use to continuously monitor respiration rate and to alarm if the rate falls outside of the range set by the operator. Because the measurement method actually measures respiratory effort, apnea episodes with continued respiratory effort (such as obstructive apnea) may not be detected.

  • Page 23: Lead Analysis

    X Series Product Functions Defibrillator Function The X Series 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. The unit uses paddles or disposable, pregelled electrodes for defibrillation.

  • Page 24: Ecg Monitoring

    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 OneStep Pediatric defibrillation electrodes. Do not delay therapy to determine the patient’s exact age or weight.

  • Page 25: Batteries

    X Series Product Functions Batteries X Series models use an easily replaced rechargeable lithium-ion battery pack (the SurePower II Battery Pack). A new, fully charged battery pack typically delivers more than 6 hours of ECG monitoring. Use of other functions (such as the defibrillator, printer, or pacemaker) reduces this time.

  • Page 26: Ready For Use (rfu) Indicator

    Chapter 1 General Information Ready For Use (RFU) Indicator The X Series has an RFU indicator on the front panel that indicates if the device is ready for use. The RFU indicator has three states which are described in the following table.

  • Page 27: Safety Considerations

    Change the selected energy. • Press the power switch to turn the unit off. • For safety, the X Series automatically disarms if left charged for more than 60 seconds if the SHOCK button ( ) is not pressed. Warnings General Federal (U.S.A.) law restricts this defibrillator to sale by or on the order of a physician.

  • Page 28

    Avoid using the X Series adjacent to, or stacked on, other equipment. If unavoidable, verify • that the unit operates normally in this configuration before clinical use. The X Series unit should be installed and put into service according to the EMC information • in Appendix A of this manual.

  • Page 29

    Do not place electrodes directly over an implanted pacemaker. • The X Series unit detects ECG electrical signals only. It does not detect a pulse (effective • circulatory perfusion). Always verify pulse and heart rate by physical assessment of the patient.

  • Page 30: Defibrillation

    If the X Series unit is in a shock-ready state, and you have to change the patient mode, wait • until the unit disarms itself. Pressing the SHOCK button immediately after changing the patient mode may result in the delivery of energy that is incorrect for the newly selected patient type.

  • Page 31: Pacing

    Do not leave the patient unattended when administering external pacing therapy. Warning! This device can only be used for external pacing of patients and cannot be used for internal pacing. Do not connect internal pacing lead wires to the X Series defibrillator. 9650-001355-01 Rev. M X Series Operator’s Guide...

  • Page 32: Pulse Oximeter

    Blood pressure measurement results may be affected by the position of the patient, his or her • physiological condition and other factors. Substitution of a component different from that supplied by ZOLL (e.g., cuff, hoses, etc.) • may result in measurement error. Use only ZOLL-approved cuffs and hoses. To avoid the risk of intravenous line misconnection and possible introduction of air into a patient’s blood,...

  • Page 33: Respiration

    • ambient environmental conditions, and certain patient conditions. Respiration Do not operate the X Series with any other monitor with respiration measurements on the • same patient. The two devices could affect the respiration accuracy. The device should not be used as an apnea monitor.

  • Page 34: Battery

    If the Low Battery indication occurs at any time during operation, immediately replace the • battery pack. If the LOW BATTERY icon appears, plug the X Series unit into a power source or install a • fully charged battery pack. When the warning low battery shutdown prompt appears, immediately replace the battery pack with a fully charged pack or plug the X Series unit into a power source, as unit shut down due to a low battery condition is imminent.

  • Page 35: Patient Safety

    To ensure patient safety, do not place the monitor in any position that might cause it to fall • on the patient. To ensure patient safety, connect the X Series only to equipment with circuits that are • electrically isolated.

  • Page 36: Cautions

    If the X Series unit is powered off for less than 2 minutes, all patient monitoring parameter settings will be retained. If the unit has been powered off for at least two minutes, it will be considered a New Patient and all of the patient-specific parameters (alarm limits, defibrillator energy, etc.) will be reset to their default values.

  • Page 37: 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 38: Software License

    1. Grant of License: In consideration of payment of the software license fee which is part of the price paid for this product ZOLL Medical Corporation grants the Purchaser a non- exclusive license, without right to sublicense, to use the system software in object-code form only.

  • Page 39

    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 40: The Zoll Serial Number

    “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 41: Defibrillator Controls And Indicators

    Chapter 2 Product Overview Defibrillator Controls and Indicators SHOCK 9650-001355-01 Rev.M X Series Operator’s Guide...

  • Page 42: The Front Panel

    For connecting the device to a docking station. The Front Panel The front panel of the X Series device includes the display screen, quick access keys, battery and auxiliary power indicators, Ready For Use (RFU) indicator, and the defibrillation front panel buttons: PACER, ANALYZE, ENERGY SELECT, CHARGE, and SHOCK ( See Figure 2-1.

  • Page 43

    Defibrillator Controls and Indicators Table 2: X 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 quick access key labels. Quick access keys Seven buttons control different functions of the unit. Labels for the quick access keys appear on the monitor display to the right of each key.

  • Page 44: Spo2 Monitoring

    See Chapter 10, "Pulse CO-Oximetry (SpO2)" for information on Sp02 monitoring. Microphone (optional) Records audio activity in the vicinity of the X Series unit. Charge Indicator Light Located on the APEX paddle, this light turns on when the defibrillator (not shown) is charged and ready.

  • Page 45: Display Screen

    NIBP (96) ºF 98.6 Heart rate NIBP data data Current temp Respiration rate Color coding To differentiate information for various parameters, the unit displays each type of information in a specific user-configurable color. 9650-001355-01 Rev.M X Series Operator’s Guide...

  • Page 46: Battery Status And Auxiliary Power Indicators

    Note: Upon powering up the X Series unit, the battery capacity will be displayed within approximately 15 seconds under normal conditions. Under some circumstances, such as activating the defibrillator immediately after the unit is turned on, the battery icon may display less than one hour battery capacity for up to two minutes after exiting the defibrillation mode.

  • Page 47: Patient Cables And Connectors

    Temp For connecting temperature probe(s). Multifunction Cable (MFC) For connecting paddles or ZOLL hands-free therapy and pacing electrodes. For connecting the X Series defibrillator to a USB device. For connecting IBP cable(s). 9650-001355-01 Rev.M X Series Operator’s Guide...

  • Page 48

    The unit ships with an MFC that is used to defibrillate the patient. Any other cables that ship with your unit depend on the options you have purchased. See “ZOLL Cables and Compatible Accessories” on page 2-10 for a list of compatible accessories.

  • Page 49

    OneStep Cable (optional) The OneStep™ cable is used with OneStep electrodes for ECG monitoring and for use with Real CPR Help. See “ZOLL Cables and Compatible Accessories” on page 2-10 for a list of compatible accessories. When connecting a OneStep electrode to the OneStep cable, push the two connectors together until the latch clicks, as shown.

  • Page 50

    Chapter 2 Product Overview MFC with CPRD Connector (optional) The X Series MFC with CPRD connector is used for ECG monitoring and for use with Real CPR Help. See the table below for a list of compatible accessories. ZOLL Cables and Compatible Accessories...

  • Page 51: External Paddles

    You cannot use paddles for external transcutaneous pacing. Attaching the MFC cable Attach the MFC from the X Series unit to the connector at the base of the APEX paddle. 2. Insert MFC into APEX handle 1. Align MFC as shown...

  • Page 52

    When disconnecting the OneStep electrode and OneStep cable, press down the latch with your thumb as shown. Latch When attaching the OneStep cables to paddles, attach the OneStep cable from the X Series unit to the connector at the base of the apex paddle. 1. Align OneStep cable as shown.

  • Page 53

    Slide the Adult plate onto the paddle until it locks into place. Note: The X Series defibrillator also supports ZOLL autoclavable internal handles for use during open chest defibrillation procedures. 9650-001355-01 Rev.M X Series Operator’s Guide...

  • Page 54: Ac Auxiliary Power Adapter

    AC Auxiliary Power Adapter The AC auxiliary power adapter is used as backup power to operate the X Series unit. When it is connected to the unit, it powers the unit and charges the battery that is installed inside it.

  • Page 55: Dc Auxiliary Power Supply (optional)

    DC Auxiliary Power Supply (optional) The DC auxiliary power supply is used as backup power to operate the X Series unit. When it is connected to the unit, it powers the unit and charges the battery that is installed inside it. When...

  • Page 56: Connecting Ac Auxiliary Power Adapter Or Dc Auxiliary Power Supply

    Navigating the Display Screen You can access the X Series functions using the quick access keys that are located on the left side of the display screen, and the navigation keys that are located on the right side of the front panel.

  • Page 57

    Navigating the Display Screen Table 3: X Series Quick Access Keys Quick access key Description Lead Selects the ECG input source for the first waveform trace. I, II, III... 12 lead Displays the 12-lead monitoring screen. Turns CO on and off.

  • Page 58

    Chapter 2 Product Overview Table 3: X Series Quick Access Keys Quick access key Description Print Trends Prints the trends that are displayed in the Trend Summary window. Print Trends Trend Settings Displays settings for trend display format, trend on interval, and trend on alarm.

  • Page 59: Navigation Keys

    Navigating the Display Screen Table 3: X Series Quick Access Keys Quick access key Description Limits Displays the current alarm settings. Limits Disarm Safely discharges the defibrillator internally. No energy is delivered to the patient. Disarm Disarm Disarm IBP Setup Brings up the IBP Control Panel for the corresponding channel (P1, P2, or P3).

  • Page 60: Common Tasks

    • Setting the Date and Time The X Series Set Date and Time screen allows you to set the date the X Series will use and its internal real time clock. To set the X Series unit’s date and time: 1.

  • Page 61: Changing The Display Brightness

    For systems with the Clock Synchronization feature enabled, the Set Date and Time screen indicates the date and time of the X Series last synchronization to an external time source and allows you to adjust the clock for Daylight Saving Time. You can choose whether to enable Daylight Saving Time or not by selecting the Enable/Disable DST field as appropriate.

  • Page 62: Replacing A Battery Pack On The X Series

    Chapter 2 Product Overview Replacing a Battery Pack on the X Series This section describes how to replace a battery pack on the X Series. Replacing a Battery Pack on the X Series To remove a battery pack, use your fingers to grasp and raise the latch and pull the battery pack out of the compartment.

  • Page 63

    You can also customize up to 9 treatment buttons by pressing the Setup quick access key ( and then selecting Supervisor>Log>Treatment Options. Highlight Define Custom Labels, and then can customize up to 9 buttons. 9650-001355-01 Rev.M X Series Operator’s Guide 2-23...

  • Page 64

    Chapter 2 Product Overview 2-24 www.zoll.com 9650-001355-01 Rev.M...

  • Page 65: X Series Monitoring Functions

    If the X Series unit is powered off for less than 2 minutes, all patient monitoring parameter settings are retained. If the X Series unit is powered off for 2 minutes or longer, the unit operates as if there is a New Patient and all patient-specific parameters (alarm limits, defibrillator energy, etc.) are reset to their default values.

  • Page 66: Heart Rate

    ECG source, such as Pads, ECG Leads , or and so on, in this area. You can configure the X Series unit to display up to four ECG waveform traces. In addition to being able to specify the ECG source for each waveform trace, you can adjust the display scale of those traces to make them easier to view.

  • Page 67

    If the optional features SpCO (carboxhemoglobin saturation) and SpMet (methemoglobin saturation) or SpHb (total hemoglobin), SpOC (oxygen content), PVI (pleth variability index) and PI (perfusion index) are installed, the X Series unit also monitors these parameters.

  • Page 68: Monitoring Display Options

    Chapter 3 Monitoring Overview Monitoring Display Options The X Series unit gives you great flexibility in how you display a patient’s vital signs information. By pressing the Display/Home button ( ) on the front panel, you can successively display the patient’s vital signs information in these three windows: Waveform Display window, which initially displays an ECG waveform trace and numeric •...

  • Page 69

    (96) Press the Home/Display button to redisplay the Primary Display window. Note: When the X Series unit is displaying the Defibrillation or Pacing Control panels, the unit will not allow the display the Large Numerics Display window. 9650-001355-01 Rev. M...

  • Page 70: Configuring The Waveform Display

    If configured, the unit can display four ECG traces on startup, when no other monitoring devices are attached. The X Series unit can also cascade a trace onto the adjoining trace area to double the duration of the trace display.

  • Page 71

    EtCO2 (a capnogram). Notice that when the third trace is inserted, the numeric displays move to the right side of the window to allow more room for the waveform traces. 9650-001355-01 Rev. M X Series Operator’s Guide...

  • Page 72

    I, II, Source 1 cm/mV Pads III... Insert Cascade SYNC mmHg mmHg SpO2 NIBP (96) ºF 98.6 06/06/2011 12:34:56 Adult 00:17:43 I, II, 1 cm/mV III... NIBP mmHg (96) EtCO2 mmHg SYNC 1 cm/mV SpO2 ºF 98.6 www.zoll.com 9650-001355-01 Rev. M...

  • Page 73

    SYNC 1 cm/mV Insert Cascade SpO2 Remove ºF 98.6 06/06/2011 12:34:56 Adult 00:17:43 I, II, 1 cm/mV III... NIBP mmHg (96) 1 cm/mV EtCO2 mmHg SYNC 0 to 60 mmHg SpO2 ºF 98.6 9650-001355-01 Rev. M X Series Operator’s Guide...

  • Page 74

    Chapter 3 Monitoring Overview 3-10 www.zoll.com 9650-001355-01 Rev. M...

  • Page 75

    A patient alarm occurs and the Trend on Alarm option is on • The X Series unit can store at least 24 hours of trend information when logged at a 1 minute trend interval. You can view, print, or save to external memory all logged trend information.

  • Page 76: Displaying The Trends Status Window

    Chapter 4 Trends Displaying the Trends Status Window The X Series unit displays the logged trend information in the Trends status window. Press the Display/Home button ( ) to display the Trends window, the primary ECG trace, and the small numeric displays for each monitoring function:...

  • Page 77: Printing Trend Information

    Use the navigation keys to select the case or cases you want to print and press Select. A check mark displays next to the selected case(s). Highlight the Print Trend Summary field and press Select. The trend data for all the selected cases begins printing. 9650-001355-01 Rev. M X Series Operator’s Guide...

  • Page 78: Changing The Trends Status Window Display

    HR, SpO2, SpCO, SpMet SpHb HR, SpO2, SpHb, SpOC, PVI NIBP HR, SpO2, NIBP, RR IBP1 HR, SpO2, IBP1, RR IBP2 HR, SpO2, IBP2 RR IBP3 HR, SpO2, IBP3, RR Temp  HR, SpO2, T1, T2, www.zoll.com 9650-001355-01 Rev. M...

  • Page 79: Continuous Waveform Recording

    • Impedance The actual information that is stored depends on usage. Also, the specific combination of stored continuous waveform data depends on how the waveform recording settings are configured in the Supervisor menu. 9650-001355-01 Rev. M X Series Operator’s Guide...

  • Page 80

    Chapter 4 Trends www.zoll.com 9650-001355-01 Rev. M...

  • Page 81

    Chapter 5 Alarms The X Series unit supports the detection and indication of patient alarms and technical alerts. A patient alarm is any alarm condition that is caused by a monitored patient-related variable, such as a measured vital sign that falls outside of a configured alarm limit. You can configure patient alarm limits for each of the physiologic monitoring functions.

  • Page 82: Visual Alarm Indicators

    Chapter 5 Alarms Visual Alarm Indicators In addition to status messages that appear on the display, the X Series unit lights the red or yellow LED on the front panel to indicate the priority level of the highest-priority active alarm.

  • Page 83: Patient Alarm Display

    When a patient’s vital signs measurements trigger an alarm, in addition to sounding the patient alarm, the X Series unit displays an alarm message, and changes the display characteristics of the monitoring function’s numeric display (the alarming parameter appears in red against a white background).

  • Page 84: Life Threatening Rhythm Alarms

    LTA monitoring is not available in AED mode. Equipment Alert Display When a problem with the X Series unit or an attached sensor triggers an alert, in addition to sounding an equipment alert, the X Series unit displays an alert message (yellow background, black text).

  • Page 85: Responding To Active Alarms

    1. Check the patient and provide appropriate care. Press the Alarm Pause/Reset ( ) button on the X Series unit’s front panel to acknowledge the alarm and briefly pause (silence) the alarm (90 seconds). After caring for the patient, check that the appropriate alarms are set (for more information about setting alarms, see appropriate monitoring chapters later in this manual).

  • Page 86: Pausing (suspending) Alarms

    When audible alarms are disabled, make sure that the patient is closely observed. Alarm Reminders Your X Series unit may be configured to sound a Reminder Alarm at specified intervals. When the Reminder Alarm is enabled an alarm will sound every 5 (default), 10 or 15 minutes (depending on configuration) if an Audio Off condition persists.

  • Page 87: Alarm Options

    Alarm Options Alarm Options The X Series unit provides alarm options that you can specify through the Supervisor parameter control panel (access to Supervisor is passcode-controlled). Press the More quick access key ( ), press the Setup quick access key (...

  • Page 88: Selecting Default Alarm Limits

    Do not set alarm limits to such extreme values that render the alarm system useless. Setting Alarm Limits Relative to the Patient -- Stat Set Option The X Series unit also allows you to set all alarm limits relative to the patient’s current vital signs measurements by performing the following actions: 1.

  • Page 89

    Limit = Numeric + 5 (mmHg) Temp Entire range Limit = Numeric + 0.5 Limit = Numeric – 0.5 (°C) Temp Entire range Limit = Numeric + 0.9 Limit = Numeric – 0.9 (°F) 9650-001355-01 Rev. M X Series Operator’s Guide...

  • Page 90

    Chapter 5 Alarms 5-10 www.zoll.com 9650-001355-01 Rev. M...

  • Page 91

    This chapter describes how to use the X Series unit to monitor ECG. X Series units can perform ECG monitoring through 3-, 5-, or 12-lead ECG patient cables, Multi-Function Pads, or standard defibrillation paddles. The use of an ECG patient cable and electrodes is required, however, to monitor ECG during pacing.

  • Page 92

    • Check the operation and integrity of the X Series unit and ECG cable regularly by performing the Daily Operational Verification Test. • Implanted pacemakers may cause the heart rate meter to count the pacemaker rate during incidents of cardiac arrest or other arrhythmias.

  • Page 93: Ecg Monitoring Setup

    Apply the electrode pads to the patient. Connect each lead of the ECG cable to the appropriate electrode. Insert the patient cable plug into the ECG input connector on the X Series unit. Select the ECG waveforms to be displayed on the waveform trace display screen.

  • Page 94: Applying Electrodes To The Patient

    LA/Black Electrode L/Yellow Electrode Place near patient’s left mid-clavicular line, directly below clavicle. LL/Red Electrode F/Green Electrode Place between 6th and 7th intercostal space on patient’s left mid-clavicular line. Figure 6-1 3-Lead Electrode Placement www.zoll.com 9650-001355-01 Rev. M...

  • Page 95

    V4 -- 5th intercostal space at mid-clavicular line. V5 -- Same transverse level as V4 at left anterior-axillary line. V6 -- Same transverse level as V4 at left mid-axillary line. Figure 6-2 5-Lead Electrode Placement 9650-001355-01 Rev. M X Series Operator’s Guide...

  • Page 96: Connecting The Ecg Cable To The X Series Unit

    Figure 6-3 Connecting ECG Cable to X Series Unit Selecting ECG Waveforms for Display You can fit up to four waveforms on the X Series display. The first waveform at the top of the display is always an ECG waveform. (If...

  • Page 97

    The X Series unit then displays the available ECG waveform sources. The following example illustrates the waveform source list that the X Series unit displays when a 5-lead ECG cable is connected to it. The list of available ECG waveform sources includes Leads , and .

  • Page 98: Selecting The Waveform Trace Size

    Chapter 6 Monitoring ECG Selecting the Waveform Trace Size The X Series unit allows you to select the waveform trace size to adjust the size of displayed the ECG waveform. To select the waveform size, use the navigation keys to highlight and select the trace size that...

  • Page 99: Ecg Monitoring And Pacemakers

    • If the Pacer Indicator setting is , the X Series does not perform the following actions: detect the implantable pacemaker pulses • blank the pacemaker pulses from the waveform •...

  • Page 100: Ecg System Messages

    Chapter 6 Monitoring ECG ECG System Messages When monitoring ECG, the X Series unit may display the following messages: System Message Cause LEAD FAULT The current ECG source lead is defective (check lead and replace, if necessary). -- OR --...

  • Page 101

    The X Series unit displays Respiration ) and Heart Rate ( ) meters. The Respiration and (Resp Heart Rate meters display values that the X Series unit derives from measurements taken by other X Series monitoring functions. 06/06/2011 12:34:56 Adult...

  • Page 102: Respiration/breath Rate Meter

    Chapter 7 Monitoring Respiration (Resp) and Heart Rate (HR) Respiration/Breath Rate Meter If enabled, the X Series unit displays the patient’s respiration in the Respiration/Breath Rate Meter. The respiration meter displays the respiration rate that it derives, by default, from the unit’s monitoring function.

  • Page 103: Configuring Respiration (rr/br) Alarms And Settings

    ECG monitoring source for the Respiration rate. Enabling/Disabling RR/BR Alarms and Setting Alarm Limits When enabled, the X Series unit sounds alarms whenever the patient’s respiration rate is above or below the specified respiration rate alarm limits.

  • Page 104: Using The Resp Parameter Control Panel

    Select the Resp Monitoring prompt to enable or disable monitoring. When Resp Resp Monitoring is set to On (the default), the X Series unit displays the Respiration Rate Meter. When set to off, X Series removes the Respiration Rate meter from the display. Warning! When using impedance pneumography, the X Series unit automatically rejects cardiovascular artifact (CVA).

  • Page 105: Heart Rate Meter

    300 as three plus signs ( Configuring Heart Rate (HR) Meter Alarms The X Series unit allows you to enable and disable the Heart Rate (HR) alarm, to set alarm limits, and to select a Heart Rate tone. Enabling/Disabling HR Alarms and Setting Alarm Limits When enabled, the X Series unit sounds alarms whenever the patient’s heart rate is above or...

  • Page 106

    Upper: 32 to 300 BPM Pediatric Lower: 50 BPM Lower: 30 to 298 BPM Upper: 150 BPM Upper: 32 to 300 BPM Neonate Lower: 100 BPM Lower: 30 to 298 BPM Upper: 200 BPM Upper: 32 to 300 BPM www.zoll.com 9650-001355-01 Rev. M...

  • Page 107

    Configuring Heart Rate (HR) Meter Alarms Life Threatening Rhythm Alarms When LTA monitoring is enabled, the X Series unit will monitor for the following life threatening ECG rhythms: asystole, ventricular fibrillation, ventricular tachycardia, extreme bradycardia, and extreme tachycardia. These events are also displayed on Treatment Summary Reports, Alarm Snapshots, and Continuous Waveform printouts.

  • Page 108

    LTA alarms are latching, which means that the alarm indication will persist until both of the following conditions are met: 1. The alarm has been acknowledged by pressing the Alarm Pause (Silence)/Reset button ) on the front panel of the unit. The alarming condition no longer exists. www.zoll.com 9650-001355-01 Rev. M...

  • Page 109: Using The Heart Rate Parameter Control Panel

    HR/PR Alarm Settings menu, on which you HR/PR Alarm can enable/disable Heart Rate alarms and set alarm limits. RESP System Message When monitoring Respiration using impedance pneumography, the X Series unit may display the following message: System Message Cause...

  • Page 110

    Chapter 7 Monitoring Respiration (Resp) and Heart Rate (HR) 7-10 www.zoll.com 9650-001355-01 Rev. M...

  • Page 111

    The X Series unit must perform ECG monitoring when using Smartcuf. The SureBP monitoring software allows the X Series unit to take an NIBP measurement as the cuff is inflating, which saves time -- the measurement takes about 15 seconds -- and improves patient comfort.

  • Page 112

    • Never use the X Series to monitor NIBP on one patient while simultaneously monitoring ECG on another patient. • If a non-invasive blood pressure measurement is suspect, repeat the measurement. If you are still uncertain about the measurement, use another method.

  • Page 113: How Does Nibp Work?

    How does NIBP Work? The blood pressure cuff and hose connect to the X Series unit through the NIBP connector on the side panel of the unit. The NIBP button on the front panel of the unit allows you to initiate and terminate blood pressure measurements, which are displayed in the NIBP area of the monitor.

  • Page 114: The Nibp Numeric Display

    Chapter 8 Monitoring Non-Invasive Blood Pressure (NIBP) The NIBP Numeric Display When NIBP monitoring has been set up and the X Series unit has begun taking NIBP measurements, the systolic, diastolic, and mean blood pressure measurements appear on the NIBP numeric display as follows:...

  • Page 115: Selecting The Nibp Cuff

    Using a cuff that is too large results in measurements lower than the patient’s actual blood pressure. The X Series unit uses the same definitions of Neonates, Pediatrics, and Adults as defined in the AAMI SP10:2002 standard:...

  • Page 116: Connecting The Nibp Cuff

    Chapter 8 Monitoring Non-Invasive Blood Pressure (NIBP) Connecting the NIBP Cuff Connecting the NIBP cuff requires you to attach the inflation hose to the X Series unit and the NIBP cuff. To use the SureBP feature, which enables the X Series unit to measure blood pressure on cuff inflation, you must use the FlexiPort cuff and dual lumen (two-tube) adaptor and hose.

  • Page 117

    Connecting the NIBP Cuff Attach a single lumen hose as follows: Figure 8-2 Attaching Single Lumen Hose to the X Series Unit 9650-001355-01 Rev. M X Series Operator’s Guide...

  • Page 118

    Insert the plastic connectors on the NIBP hose into the cuff hose connector, and twist the connectors until they lock. The connectors are the same; you can insert either of the plastic connectors into either of the cuff hose connectors in any order. www.zoll.com 9650-001355-01 Rev. M...

  • Page 119: Applying The Cuff To The Patient

    The following illustrates one possible cuff placement for adult/pediatric patients and, to the right, possible cuff placements for neonates: Figure 8-3 Applying Cuff to the Patient 9650-001355-01 Rev. M X Series Operator’s Guide...

  • Page 120: Ensuring Correct Cuff Inflation Settings

    The maximum cuff inflation pressure for neonates is 153 mmHg. Warning! Before using the X Series unit to monitor a new patient, power down the unit for at least 2 minutes to reset all patient parameters and eliminate all adjustments made for the previous patient.

  • Page 121: Configuring Nibp Alarms And Settings

    (or disabled), that alarm limits are appropriate, and that the NIBP settings are correct. Enabling/Disabling NIBP Alarms and Setting Alarm Limits When enabled, the X Series unit sounds alarms whenever measurements are outside set limits for the following: High and Low Systolic Pressure •...

  • Page 122

    Lower: 25-230 mmHg Upper: 120 mmHG Upper: 23-228 mmHg Pediatric Lower: 50 mmHg Lower: 25-140 mmHg Upper: 110 mmHg Upper: 23-138 mmHg Neonate Lower: 35 mmHg Lower: 15-110 mmHg Upper: 80 mmHg Upper: 13-108 mmHg 8-12 www.zoll.com 9650-001355-01 Rev. M...

  • Page 123: Using The Nibp Parameter Control Panel

    Specify NIBP Mode You can specify that the X Series unit operate in either Manual or Automatic Mode. In Manual Mode, the X Series unit takes a single NIBP measurement when you press the NIBP button on the front panel( ).

  • Page 124

    R-wave of the patient’s ECG to eliminate noise created by patient motion or vibration. Note: The X Series unit must perform ECG monitoring when using Smartcuf. If artifact is severe, a special symbol appears on the display and printouts: Figure 8-5 High Artifact Symbol By default, Smartcuf is Enabled.

  • Page 125: Nibp System Messages

    NIBP System Messages NIBP System Messages When monitoring NIBP, the X Series unit may display the following messages: System Message Cause READING IN PROGRESS The unit is taking an NIBP measurement and functioning normally. READING STOPPED The unit has stopped an NIBP measurement, because the operator has pressed the NIBP button and cancelled the measurement.

  • Page 126

    Chapter 8 Monitoring Non-Invasive Blood Pressure (NIBP) 8-16 www.zoll.com 9650-001355-01 Rev. M...

  • Page 127: Overview

    Chapter 9 Monitoring CO This chapter describes how to use the X Series unit to monitor End Tidal Carbon Dioxide (EtCO ), breath rate, and Fractional Inspired Carbon Dioxide (FiCO ). These options use the same connector on the X Series unit and may be used interchangeably.

  • Page 128

    Apply the Filterline airway adaptor or Smart CapnoLine Nasal or Nasal/Oral cannula to the patient. Check that the X Series unit is set up for the correct patient type -- Adult, Pediatric, or Neonate. Configure alarms (if the current alarm settings are not appropriate) and other CO features.

  • Page 129: Co2 Monitoring Setup And Use

    • You can use the following Oridion Microstream accessories for sidestream CO monitoring with the X Series unit: Table 7-1. Oridion Microstream CO Sampling Lines for use with X Series units. Accessory Type Part Number 8300-0520-01 FilterLine Set (Adult/Pediatric), box of 25...

  • Page 130

    Chapter 9 Monitoring CO2 Connecting the CO Sampling Lines To connect the FilterLine or Smart CapnoLine: 1. Slide open the X Series unit’s CO inlet port cover. Put the fitting at the end of the sidestream tubing over the CO inlet port connector.

  • Page 131: Applying A Filterline Set

    To prevent moisture from draining into the sample tubing, ensure that the sampling tube exits from the top of the airway adapter, not its bottom or sides. See the following figure. 9650-001355-01 Rev. M X Series Operator’s Guide...

  • Page 132: Applying A Smart Capnoline Nasal Or Nasal/oral Cannula

    Placing the Cannula onto the Patient Place the oral/nasal cannula onto the patient as follows: Caution Dispose of Microstream EtCO consumables according to standard operating procedures or local regulations for the disposal of contaminated medical waste. www.zoll.com 9650-001355-01 Rev. M...

  • Page 133: Measuring Co2

    Check that connections have been made correctly by verifying the display a proper capnogram (the waveform is inserted automatically on the waveform display window). 06/06/2011 12:34:56 Adult 00:17:43 I, II, 1 cm/mV III... 0 to 60 mmHg SYNC mmHg mmHg SpO2 NIBP (96) ºF 98.6 9650-001355-01 Rev. M X Series Operator’s Guide...

  • Page 134

    Chapter 9 Monitoring CO2 Setting CO and Respiration Rate Alarms The X Series unit sounds alarms whenever measurements are outside set limits for the following: High and Low EtCO • High and Low Respiration Rate (in Breaths/Minute) • High FiCO •...

  • Page 135: Setting Co2 And Respiration Rate Alarms

    In high-altitude environments, EtCO values may be lower than values observed at sea level, as described by Dalton’s law of partial pressures. When using the X Series unit in high-altitude environments, it is advisable to adjust EtCO alarm settings accordingly.

  • Page 136: Using The Co2 Parameter Control Panel

    X-axis scale of the capnogram. For patients with slower respiration rates, a slower sweep speed will make the capnogram easier to view. You can specify sweep speeds of 3.13, 6.25, and 12.5 mm/second. The default sweep speed is 6.25 mm/second. 9-10 www.zoll.com 9650-001355-01 Rev. M...

  • Page 137: Co2 System Messages

    CO2 System Messages System Messages When monitoring CO , the X Series unit may display the following messages: System Message Cause INITIALIZING The unit is initializing the CO monitoring function measurement, is functioning normally, and will display measurement after a brief delay.

  • Page 138: Patents

    Chapter 9 Monitoring CO2 Patents The capnography component of the X Series unit is covered by one or more of the following US patents: 6,428,483; 6,997,880;5,3000,859; 6,437,316; 7,488,229; and their foreign equivalents. Additional patent applications pending. NO IMPLIED LICENSE Possession or purchase of this device does not convey any express or implied license to the...

  • Page 139

    The X Series SpO input is Type CF defibrillator proof. This chapter describes how to use the X Series unit to monitor Pulse CO-Oximetry (SpO ), as well as the optional features: SpCO, and SpMet, and SpHb, SpOC PVI, and PI.

  • Page 140

    Chapter 10 Pulse CO-Oximetry (SpO2) The X Series pulse CO-oximetry option is intended for use only with ZOLL / Masimo Rainbow sensors. The CO-oximetry sensor contains light-emitting diodes (LEDs) that transmit various visible and infrared light through the body’s extremities. The transmitted light is then received by a photodetector, which converts it to an electronic signal.

  • Page 141: Warnings -- Spo2 General

    Intravascular dyes such as indocyanine green or methylene blue • Abnormal hemoglobin levels • Low arterial perfusion • Low arterial oxygen saturation levels including altitude induced hypoxemia • Elevated total bilirubin levels • Motion artifact • 9650-001355-01 Rev. M X Series Operator’s Guide 10-3...

  • Page 142

    The pulse co-oximeter may be used during electrocautery, but this may affect the accuracy • or availability of the parameters and measurements. The pulse co-oximeter should not be used for arrhythmia analysis • 10-4 www.zoll.com 9650-001355-01 Rev. M...

  • Page 143

    Do not submerge the pulse co-oximeter in any cleaning solution or attempt to sterilize by • autoclave, irradiation, steam, gas, ethylene oxide or any other method. This will seriously damage the pulse co-oximeter. 9650-001355-01 Rev. M X Series Operator’s Guide 10-5...

  • Page 144

    For more information, refer to the Accessories section of this chapter, which provides a list of ZOLL-approved reusable and single-use sensors for adult, pediatric, and neonate patients. Before applying the sensor, always familiarize yourself with the Directions for Use that the manufacturer provides with the sensor.

  • Page 145: Applying The Spo2 Sensor

    Lift the clear plastic protective cover from the female end of the extension cable, then plug the sensor cable’s male connector into the extension cable connector -- make sure that the plug is all the way into the connector: Sensor Cable Connector Connector 9650-001355-01 Rev. M X Series Operator’s Guide 10-7...

  • Page 146

    Lower the clear plastic cover over the connection to secure it: Clear Protective Cover Figure 10-2 Lower Plastic Cover Over Cable Connection See “Connecting the SpO2 Sensor” on page 10-10 to connect the cable to the unit. 10-8 www.zoll.com 9650-001355-01 Rev. M...

  • Page 147: Applying A Reusable Sensor/cable

    Disconnect the sensor from the patient cable, if appropriate. Wipe the entire sensor clean with a 70% isopropyl alcohol moistened pad. Allow the sensor to air dry before returning it to use. 9650-001355-01 Rev. M X Series Operator’s Guide 10-9...

  • Page 148: Displaying Measurements

    SpCO values when you use a SpHb sensor and does not display SpHb values when you use a SpCO sensor. If the message, SENSOR FAILURE, appears, the sensor is either incompatible with the X Series unit, or it is not working, and you will need to replace the sensor.

  • Page 149: Enabling/disabling Spo2 Alarms And Setting Alarm Limits

    Enabling/Disabling SpO2 Alarms and Setting Alarm Limits Enabling/Disabling SpO Alarms and Setting Alarm Limits When enabled, the X Series unit sounds alarms whenever measurements are outside set limits for the high and low SpO values (and, if installed and monitoring is on, SpCO and SpMet, and SpHb, SpOC, PVI and PI values).

  • Page 150: Setting Upper And Lower Spco And Spmet Alarm Limits

    Upper: 2 - 25 g/dL 11.0 mmol/L 2 - 15.5 mmol/L Lower: 7.0g/dL Lower: 0 - 24.9 g/dL 4.0 mmol/L 0 - 15.4 mmol/L Neonate Upper: 17.0 g/dL Upper: 2 - 25 g/dL 11.0 mmol/L 2 - 15.5 mmol/L 10-12 www.zoll.com 9650-001355-01 Rev. M...

  • Page 151: Setting Upper And Lower Spoc Alarm Limits

    The following table lists the default PI limits for adult, pediatric, and neonate patients, and gives the range in which you can set these limits Patient Type PI Limit Default PI Limit Range Lower: 0% Lower: 0 - 19.8% Adult Upper: 20% Upper: 0.2 - 20% 9650-001355-01 Rev. M X Series Operator’s Guide 10-13...

  • Page 152: Spco And Spmet, And Sphb, Spoc, Pvi And Pi Monitoring

    Averaging Time The Masimo SpO module in the X Series unit provides three different time periods over which values are averaged: 4 seconds, 8 seconds (default) and 16 seconds. The averaging period is rarely changed from the 8 second default setting. For high risk patients with rapidly changing conditions, use the 4 second setting.

  • Page 153: Using The Spo2 Parameter Control Panel

    Selecting SpHb Venous Mode If the SpHb option is installed, the X Series unit allows you to specify whether to use venous mode (On) as the blood sample source or not (Off). When Off (default) the X Series uses arterial as the blood sample source.

  • Page 154: Spo2 System Messages

    Chapter 10 Pulse CO-Oximetry (SpO2) SpO2 System Messages The X Series unit may display the following system messages when monitoring SpO System Message Cause INITIALIZING The SpO pulse oximeter is initializing. SEARCHING The unit is searching for a pulse. CHECK SENSOR...

  • Page 155: Functional Testers And Patient Simulators

    For a properly functioning monitor, this difference will be reproducible over time and from monitor to monitor within the performance specifications of the test device. Patents All patent information related to the SpO2 component of the X Series unit can be found at the following: www.masimo.com/patents.htm...

  • Page 156

    Chapter 10 Pulse CO-Oximetry (SpO2) 10-18 www.zoll.com 9650-001355-01 Rev. M...

  • Page 157: Invasive Pressure Transducers

    This chapter describes how to use the X Series unit to monitor invasive pressures (IBP). The X Series unit has three invasive pressure channels: P1, P2, and P3. You can use these channels to measure arterial, venous, or intracranial pressures using invasive transducers with 5uV/V/mmHg sensitivity.

  • Page 158: Ibp Setup

    • Before you use the X Series unit on a new patient, always turn it off for at least 2 minutes. This clears the previous patient’s trend values, alarm limit settings, and NIBP cuff inflation pressure.

  • Page 159: Attaching The Invasive Pressure Transducer

    Plug the transducer cable into one of the three six-pin IBP cable connectors on the side of the X Series unit. Figure 11-1 Plugging the Transducer into the X Series When you plug the transducer cable into the unit, the message ZERO PROBE appears in the numeric display window for that IBP channel.

  • Page 160: Zeroing The Transducer

    Check that the unit is open to atmospheric air and that it is properly connected to the unit, then try zeroing the transducer again. The X Series unit will not zero the transducer if it detects pulsation in the pressure channel, if there is too much noise in the signal, or if transducer’s offset is too great.

  • Page 161: Rezeroing A Transducer

    MEAN values in the IBP channel’s numeric display and, optionally (if enabled through the unit’s Waveform Select menu) the waveform for that IBP channel: The X Series unit allows you to specify a label that identifies the channel’s IBP measurement, and to select a display format for the numeric display.

  • Page 162: Enabling/disabling Ibp Alarms And Setting Alarm Limits

    Chapter 11 Monitoring Invasive Pressures (IBP) Enabling/Disabling IBP Alarms and Setting Alarm Limits When enabled, the X Series unit sounds alarms whenever IBP measurements are outside set limits for the following: High and Low Systolic Pressure • High and Low Diastolic Pressure •...

  • Page 163: Setting Upper And Lower Diastolic (dia) Alarm Limits

    Lower: 50 mmHg Lower: -30 to 298 mmHg Upper: 110 mmHg Upper: -28 to 300 mmHg Neonate Lower: 35 mmHg Lower: -30 to 298 mmHg Upper: 80 mmHg Upper: -28 to 300 mmHg 9650-001355-01 Rev. M X Series Operator’s Guide 11-7...

  • Page 164: Setting Ibp Source Label

    Central Venous Pressure Femoral Artery Pressure Intracranial Pressure Labial Artery Pressure Pulmonary Artery Pressure Radial Artery Pressure Umbilical Artery Pressure Umbilical Venous Pressure In the following example, source labels are specified for all three IBP channels: 11-8 www.zoll.com 9650-001355-01 Rev. M...

  • Page 165: Ibp System Messages

    IBP System Messages IBP System Messages The X Series unit may display the following messages when monitoring IBP: System Message Cause TRANSDUCER FAILURE The IBP probe is damaged and needs to be replaced. INCOMPATIBLE TRANSDUCER The IBP probe is not compatible. See the Appendix B, Accessories, for a list of ZOLL-approved IBP probes.

  • Page 166

    Chapter 11 Monitoring Invasive Pressures (IBP) 11-10 www.zoll.com 9650-001355-01 Rev. M...

  • Page 167: Temperature Monitoring Setup

    This chapter describes how to use the X Series unit to monitor temperature. The X Series unit provides two temperature channels. When both channels are in use, the unit displays each channel’s temperature successively, followed by the difference between the ...

  • Page 168: Selecting And Applying Temperature Probes

    Chapter 12 Monitoring Temperature Selecting and Applying Temperature Probes You should use only temperature probes that are approved for use with the X Series unit. See Appendix B, Accessories for a list of ZOLL-approved temperature probes. The use of other probes that do not match the performance specifications of the ZOLL-approved probes may produce incorrect temperature readings.

  • Page 169: Enabling/disabling Temperature Alarms And Setting Alarm Limits

    Enabling/Disabling Temperature Alarms and Setting Alarm Limits Enabling/Disabling Temperature Alarms and Setting Alarm Limits When enabled, the X Series unit sounds alarms whenever temperature measurements are outside set limits. You can enable (or disable) temperature alarms and set the upper and lower alarm limits through the Alarms quick access key or the Temp Parameter Control Panel.

  • Page 170: Setting Upper And Lower Temperature Alarm Limits

    Upper: 0.2 - 90.0 F (-17.7 - 32.2° C) Neonate Lower: 0.0F (0.0° C) Lower: 0.0 - 89.8 F (0.0 - 32.1° C) Upper: 5.0F (-15° C) Upper: 0.2 - 90.0 F (-17.7 - 32.2° C) 12-4 www.zoll.com 9650-001355-01 Rev. M...

  • Page 171: Selecting The Temperature Label

    Skin temperature probe (surface application) Ventilator airway temperature probe NASO Nasopharynx or nasal/oral temperature probe If you don’t select a label, the Temperature channels appear with the default labels of T1 and 9650-001355-01 Rev. M X Series Operator’s Guide 12-5...

  • Page 172: Temperature System Messages

    Chapter 12 Monitoring Temperature Temperature System Messages The X Series unit may display the following messages when monitoring Temperature. Note: The temperature function performs a self test when initially powered on and also performs system tests automatically, every 10 seconds, while this function is active.

  • Page 173

    This chapter describes the recommended method of operation in AED Mode. The X Series unit is configured to operate in compliance with the American Heart Association and European...

  • Page 174: Aed Operation

    CPR interval and then halts and waits for the pads to be reattached. The X 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 button.

  • Page 175: Prepare Patient

    If it is not possible to place the “BACK” pad on the patient’s back, the pads should be placed in the standard apex-sternum positions. Effective defibrillation will result, but pacing will usually be less effective. 9650-001355-01 Rev. M X Series Operator’s Guide 13-3...

  • Page 176: Turn On Unit

    Shock 3 - 85 joules Note: Pediatric defibrillator energy levels should be selected based on site specific protocols. Note: If the X Series unit has been configured to begin CPR upon start up, it will automatically begin with the CPR interval. 13-4 www.zoll.com...

  • Page 177: Analyze

    Analyze to resume the analysis process. Note: If the X Series has been configured to perform extra CPR at startup, it displays a CHECK PULSE voice prompt and the message appears for 10 seconds. Then it displays a PERFORM CPR message along with a voice prompt for the configured duration before analysis begins.

  • Page 178

    A continuous tone sounds for 20 or 50 seconds (depending on configuration), followed by a higher pitch tone for 10 seconds.You must deliver the shock within this 30 or 60 second interval (depending on configuration), or the defibrillator will disarm itself. PRESS SHOCK 13-6 www.zoll.com 9650-001355-01 Rev. M...

  • Page 179: Press Shock

    Begin chest compressions and rescue breathing per local protocol as prompted by the unit. Note: If ZOLL OneStep CPR pads, OneStep Complete pads or CPR-D-padz are connected, the unit monitors the rate and depth of chest compressions and can display PUSH HARDER and GOOD COMPRESSIONS messages and voice prompts.

  • Page 180: Operating Messages

    It resets to 0 after the unit has been off for more than two minutes. NO SHOCK ADVISED When ECG analysis detects a nonshockable rhythm, this message is announced and displays for 10 seconds following completion of the analysis. 13-8 www.zoll.com 9650-001355-01 Rev. M...

  • Page 181

    This message is displayed and announced when the unit is paused and detects a shockable rhythm during continuous background ECG analysis. The prompt persists as long as a shockable rhythm is being detected. Press the ANALYZE button to resume ECG analysis. 9650-001355-01 Rev. M X Series Operator’s Guide 13-9...

  • Page 182: Switching To Manual Mode Operation

    30 seconds and less than two minutes, then power it back up. If you wait longer than two minutes, the unit will reset the settings to the defaults and treat the case as a new patient. 13-10 www.zoll.com 9650-001355-01 Rev. M...

  • Page 183

    The X Series 12-Lead input is Type CF defibrillator proof. This chapter describes how to use the X Series unit to monitor 12-Lead ECG for adult and pediatric patients, and how to display 12-Lead ECG Interpretive Analysis information for adult patients.

  • Page 184

    To assure protection against the effects of defibrillator discharge, use only 12-lead cables supplied by ZOLL Medical Corporation. • Check the operation and integrity of the X Series unit and 12-lead cable regularly by performing the Daily Operational Verification Test. •...

  • Page 185: Entering Patient Information

    Figure 14-1 Patient Info Control Panel The X Series unit uses the name that you enter in the Patient Info panel to label the 12-lead ECG monitoring snapshots that it saves.

  • Page 186: Entering Patient Age And Gender

    ECG analysis is obtained. If you do not enter the patient’s age or gender the X Series uses the default age (45 years) and default gender (male). See “12-Lead Interpretive Analysis” on page 14-8.

  • Page 187: Preparing The Patient For Electrode Application

    American Heart Association International Electrotechnical Commission Patients should be in a resting, supine position when performing 12-Lead ECG monitoring. ZOLL Medical Corporation recommends placing the limb electrodes anywhere along the ankles and wrists. Avoid placing electrodes over tendons and major muscle masses.

  • Page 188

    Move your finger down two more intercostal spaces to the fourth intercostal space which is the V1 position. Note: When placing electrodes on female patients, always place leads V3-V6 under the breast rather than on the breast. 14-6 www.zoll.com 9650-001355-01 Rev. M...

  • Page 189: Connecting The 12-lead Cable

    . The screen displays all twelve waveform traces, with the size displayed above the waveform traces: 06/06/2011 12:34:56 Adult 00:17:43 1 mV/cm NIBP mmHg (96) EtCO2 mmHg SpO2 Exit SpMet 20.0 ºF 98.6 9650-001355-01 Rev. M X Series Operator’s Guide 14-7...

  • Page 190: Lead Interpretive Analysis

    Inovise 12L Interpretive Algorithm. Entering the correct age and gender ensures that the highest degree of ECG analysis is obtained. If you do not enter the patient’s age or gender the X Series uses the default age (45 years) and default gender (male). See “Entering Patient Information” on page 14-3.

  • Page 191

    12-Lead Interpretive Analysis information: In the example above, the interpretive statement, ***STEMI***, indicates the occurrence of ST-Elevation Myocardial Infarction. The interpretive statements that the X Series unit displays are produced by the Audicor software of Inovise Medical, Inc. For more information on these interpretive statements, see the Inovise 12L Interpretive Algorithm Physician’s Guide.

  • Page 192

    Chapter 14 12-Lead ECG Interpretive Analysis To display Analysis Page 2, press the 12-Lead Review Next quick access key ( Analysis Page 2 displays the identifying information that has been entered for the patient and additional analysis statements: 14-10 www.zoll.com 9650-001355-01 Rev. M...

  • Page 193: Fault Conditions Affecting 12-lead Interpretive Analysis

    An invalid cable is in use. • If the X Series unit detects one of these fault conditions, Analysis Page 1 indicates that there is No data available for Interpretive Analysis and lists the fault condition; all measurements on Analysis Page 2 appear as N/A.

  • Page 194: Printing 12-lead Waveform Traces

    Chapter 14 12-Lead ECG Interpretive Analysis Printing 12-Lead Waveform Traces Once you have determined that the X Series unit is correctly setup for 12-Lead ECG monitoring, you can print the 12-Lead ECG traces for review and analysis. Press to collect 10 seconds of 12-Lead data for print.

  • Page 195

    3 x 4 Non -Staggered or 3 x 4 Cabrera Non-Staggered The X Series unit stores a minimum of 32 12-Lead snapshots in a separate log. Once 32 12-lead snapshots are stored, the oldest snapshot in the log is overwritten by subsequent snapshots.

  • Page 196: Lead Print And Display Options

    Specifying the Number of 12-Lead Print Copies This option allows you to specify that the X Series unit print up to five copies of the 12-lead waveform trace set after pressing . By default, the unit prints only one 12-lead snapshot.

  • Page 197: Specifying The 12-lead Frequency Response

    AC Mains filter setting. Enabling 12-Lead Analysis This option allows you to enable or disable 12 Lead Analysis. The default is enabled ( 9650-001355-01 Rev. M X Series Operator’s Guide 14-15...

  • Page 198

    Chapter 14 12-Lead ECG Interpretive Analysis 14-16 www.zoll.com 9650-001355-01 Rev. M...

  • Page 199: Emergency Defibrillation Procedure With Paddles

    No portion of the hands should be near the paddle plates. Be sure to use the proper paddles/electrodes based on the size of the patient (adult - large, pediatric - small). 9650-001355-01 Rev. M X Series Operator’s Guide 15-1...

  • Page 200: Determine The Patient's Condition Following Local Medical Protocols

    Shock 2 - 70 joules Shock 3 - 85 joules Note: Neonatal and pediatric defibrillator energy levels should be selected based on site- specific protocols. SHOCK The selected energy level is displayed at the bottom of the display screen. 15-2 www.zoll.com 9650-001355-01 Rev. M...

  • Page 201: Charge Defibrillator

    Ensure that the paddles are connected to the multi-function (MFC) or OneStep cable, and that the cable is connected to the X Series unit. Apply a liberal amount of electrolyte gel to the electrode surface of each paddle, and rub the electrode surfaces together to evenly distribute the applied gel.

  • Page 202

    APEX paddle lights up. 06/06/2011 12:34:56 Adult 00:17:43 I, II, 1 cm/mV III... Disarm SYNC Defibrillator Selected Energy CHARGED Biphasic Press to Shock 15-4 www.zoll.com 9650-001355-01 Rev. M...

  • Page 203: Deliver Shock

    If additional countershocks are needed, follow steps 1 through 3 of this procedure starting on page 15-2, to readjust the energy settings, charge the unit, and deliver the shock. 9650-001355-01 Rev. M X Series Operator’s Guide 15-5...

  • Page 204: Emergency Defibrillation Procedure With Hands-free Therapy Electrodes

    Chapter 15 Manual Defibrillation 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 205

    Shock 2 - 70 joules Shock 3 - 85 joules Note: Neonatal and pediatric defibrillator energy levels should be selected based on site- specific protocols. SHOCK The selected energy level is shown on the display. 9650-001355-01 Rev. M X Series Operator’s Guide 15-7...

  • Page 206

    When the unit is fully charged, the tone changes to a continuous charge ready tone, the highlighted energy bar graph includes the selected energy, and the SHOCK button lights up. Selected Energy 15-8 www.zoll.com 9650-001355-01 Rev. M...

  • Page 207

    15-7, to readjust the energy settings, charge the unit, and deliver shock. Internal Paddles ZOLL internal paddles are designed for use with the ZOLL X Series defibrillator to defibrillate the heart during open chest procedures. Two types of Autoclavable Internal Handles are...

  • Page 208: Verification Prior To Use

    APPLY PADDLES TO PATIENT. This message verifies that the Discharge button located on the right handle is operating correctly. Press the Energy Select arrows (located on the front panel of the X Series unit) up or down to select 30 Joules.

  • Page 209: Synchronized Cardioversion

    Verify that markers are clearly visible on the monitor and their location is appropriate and consistent from beat to beat. The synchronized cardioversion procedure for ZOLL hands-free therapy electrodes is identical to that for paddles with the exception of the SHOCK button location.

  • Page 210: Synchronized Cardioversion Procedure

    SYNC mode, press the Sync quick access key on the front panel again. Changing the selected energy levels does not cause the unit to leave SYNC mode. Note: The unit can be configured to stay in SYNC mode after defibrillation in Defib/Pacer default settings in the Setup>Supervisor menu. 15-12 www.zoll.com 9650-001355-01 Rev. M...

  • Page 211: Select Energy Level

    When the unit is fully charged, the tone changes to a continuous charge ready tone, the highlighted energy bar graph includes the selected energy, and the SHOCK button lights up. 9650-001355-01 Rev. M X Series Operator’s Guide 15-13...

  • Page 212

    Sync quick access key again and follow steps 1 through 3 of this procedure starting on page 15-13, to readjust the energy settings, charge the unit, and deliver shock. You can configure the setting through the Setup>Supervisor>Defib/ Sync after Cardioversion Pacer>Default Settings menu. 15-14 www.zoll.com 9650-001355-01 Rev. M...

  • Page 213

    When the X Series unit is configured for Advisory (or single analysis) defibrillation, the X Series unit 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 214: Advisory Defibrillation Procedure

    CHECK PADS and does not allow delivery of energy. Note: Since analysis is only done using Pads as a lead, even if an ECG cable is connected and Lead II is available, the unit still displays a CHECK PADS message. 16-2 www.zoll.com 9650-001355-01 Rev. M...

  • Page 215

    If Unit is in Manual Mode – No additional steps are necessary to proceed. If no hands-free therapy electrodes have been attached to the patient and connected to the X Series unit, the ATTACH PADS message and voice prompt will be issued. Energy Select...

  • Page 216: Press Analyze Button

    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 X Series does not prevent the user from manually defibrillating the patient. 16-4 www.zoll.com...

  • Page 217: Press Shock Button

    Press the ANALYZE button to restart an ECG analysis and determine if additional shocks are required. Note: Reanalysis of the ECG rhythm is inhibited for 3 seconds after each shock. Continue Patient Care Continue patient care according to medical protocols. 9650-001355-01 Rev. M X Series Operator’s Guide 16-5...

  • Page 218

    Chapter 16 Advisory Defibrillation 16-6 www.zoll.com 9650-001355-01 Rev. M...

  • Page 219

    ZOLL hands-free therapy electrodes are a defibrillation-protected Type BF patient connection. When the X Series unit is configured for Analysis/CPR Protocol defibrillation, the unit guides you through a cardiac event by performing ECG analysis, preparing the device for a shock (if needed), and leading you through a CPR interval.

  • Page 220: Analysis/cpr Protocol Defibrillation Procedure

    Ensure that the electrodes are making good contact with the patient’s skin and are not covering any part of the ECG electrodes. If therapy electrodes are not making good contact with the patient’s skin, the unit issues the message CHECK PADS and does not allow delivery of energy. 17-2 www.zoll.com 9650-001355-01 Rev. M...

  • Page 221

    If Unit is in Manual Mode – No additional steps are necessary to proceed. If no hands-free therapy electrodes have been attached to the patient and connected to the X Series unit, the ATTACH PADS message and voice prompt will be issued. Energy Select...

  • Page 222

    If the analysis does not detect a shockable rhythm, the unit alerts the operator that no shock is advised. WARNING! ECG rhythm analysis does not warn of patient asystole, which is not a shockable rhythm. 17-4 www.zoll.com 9650-001355-01 Rev. M...

  • Page 223

    CPR Protocol is active. You can press the Exit quick access key at any time to return to Manual mode. Note: When a nonshockable rhythm is detected, the X Series does not prevent the user from manually defibrillating the patient. Shockable Rhythm If the patient’s rhythm is shockable, the unit displays the SHOCK ADVISED and PRESS...

  • Page 224

    Chapter 17 Analysis/CPR Protocol Defibrillation 17-6 www.zoll.com 9650-001355-01 Rev. M...

  • Page 225

    Chapter 18 External Pacing 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! Pacing is intended for use on adult patients and on adolescent, child, and infant pediatric patients.

  • Page 226: External Pacing

    ECG monitoring electrodes and hands-free pacing therapy electrodes to the patient. Pacer Modes The X Series has two pacer mode settings: Demand and Fixed. The default factory mode setting is Demand. In Demand mode, pacing pulses are inhibited by the patient’s QRS complexes that occur during an interval that is dependent on the setting of the rate control.

  • Page 227: Apply Ecg Electrodes/hands-free Therapy Electrodes

    Pacing in Demand Mode 2 Apply ECG Electrodes/Hands-Free Therapy Electrodes Apply ECG electrodes, attach lead wires, and connect the ECG cable to the X Series side panel (see Chapter 6, "Monitoring ECG" for instructions on attaching ECG electrodes to the patient).

  • Page 228: Set Mode

    Select the lowest output current that achieves both electrical and mechanical capture. Note: If the Pacer Settings window disappears before you have set the output current, press the PACER button again to display the settings window. 18-4 www.zoll.com 9650-001355-01 Rev. M...

  • Page 229: Determine Capture

    Determination of electrical capture should only be performed by viewing the ECG trace on the X 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 230: Pacing In Fixed Mode

    SELF TEST PASSED. 2 Apply ECG Electrodes/Hands-Free Therapy Electrodes Apply ECG electrodes, attach lead wires, and connect the ECG cable to the X Series side panel (see Chapter 6 for instructions on attaching ECG electrodes to the patient). Attach hands-free therapy electrodes according to instructions on the electrode packaging.

  • Page 231: Press Pacer Button

    6 Turn On Pacer Use the arrow keys to navigate to Start Pacer, and press the Select button to select it. The Pacing window displays behind the Pacer Settings window. PACING Output Rate Mode Fixed 9650-001355-01 Rev. M X Series Operator’s Guide 18-7...

  • Page 232: Set Pacer Output

    Determination of electrical capture should only be performed by viewing the ECG trace on the X 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 233: Pediatric Pacing

    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. Pace Fault The X Series unit may display the following messages when pacing. System Message Description PAUSED The pacer has paused pacing the patient.

  • Page 234

    Chapter 18 External Pacing 18-10 www.zoll.com 9650-001355-01 Rev. M...

  • Page 235

    Do not use Adult CPR electrodes with patients under 8 years of age. When used with CPR-D-padz or OneStep CPR electrodes, the X Series unit can provide rescuers with feedback about the quality of CPR they are delivering to their patients. The way in which feedback is provided varies with respect to the operational mode and user configuration, but is derived from compression rate and depth measurements.

  • Page 236

    The CPR features that the X Series unit provides differ depending whether adult or pediatric CPR electrodes are attached to the unit. The X Series unit automatically senses which type of CPR electrode is attached, and provides the CPR features as follows:...

  • Page 237: Cpr Voice Prompts (adult Only)

    CPR Voice Prompts (Adult Only) CPR Voice Prompts (Adult Only) The X 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 238: Constant Metronome Disabled

    Never FULLY RELEASE Prompt The X Series unit can be configured to display the text prompt FULLY RELEASE, which instructs rescuers to lift (fully release) their hands from the patient’s chest after compressions to allow full recoil. This prompt occurs 45 seconds into the CPR interval.

  • Page 239: Cpr Dashboard

    CPR electrodes are attached. With Adult CPR Electrodes Attached -- By default, the X Series unit displays CPR rate and depth measurements in green when adult CPR electrodes are attached. If the unit detects that CPR performance is consistently below the AHA/ERC-recommended compression rate, the unit displays the rate measurement in yellow (needs improvement).

  • Page 240: Chest Compression Indicator (adult Only)

    The CPR Compression Indicator is only available when using Adult CPR electrodes. CPR Countdown Timer The X Series unit displays a CPR Countdown Timer to indicate the time (in minutes and seconds) left in the current CPR interval. It decrements the time until it reaches zero. The CPR dashboard disappears if the CPR electrodes are disconnected.

  • Page 241: Cpr Compression Bar Graph (adult Only)

    CPR Compression Bar Graph (Adult Only) CPR Compression Bar Graph (Adult Only) When Adult CPR electrodes are attached, the X Series unit can display a CPR compression bar graph next to the dashboard that is computed from the CPR sensor signals. This bar graph, representing depth of compression, is presented on a (AHA/ERC 2005: 0 - 2.1, AHA/ERC...

  • Page 242

    Chapter 19 Real CPR Help 19-8 www.zoll.com 9650-001355-01 Rev. M...

  • Page 243

    See-Thru CPR See-Thru CPR is an optional feature in the X Series. WARNING! The See-Thru CPR filter works only when the X Series defibrillator is monitoring CPR in Manual mode. The See-Thru CPR filter stops if: The unit is in pace mode.

  • Page 244: Using See-thru Cpr

    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 X Series is monitoring CPR. Chest compressions introduce CPR artifact into the ECG signal. See-Thru CPR uses a filter...

  • Page 245: Examples

    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. 9650-001355-01 Rev. M X Series Operator’s Guide 20-3...

  • Page 246

    The following figure shows a patient in VF, which, during compressions, is slightly more difficult to discern. When viewing this ECG, it is possible to view the underlying rhythm as the filter is able to reject all of the CPR artifact. 20-4 www.zoll.com 9650-001355-01 Rev. M...

  • Page 247

    About 14 seconds into this chart, the rhythm changes to asystole, which could easily be mistaken for coarse VF. When the CPR filter turns on, the CPR compression ripples are still obvious, making the rhythm look like Fine VF. 9650-001355-01 Rev. M X Series Operator’s Guide 20-5...

  • Page 248

    Chapter 20 See-Thru CPR The following figure shows a patient with an organized rhythm where See-Thru CPR effectively filters out artifact created by CPR. 20-6 www.zoll.com 9650-001355-01 Rev. M...

  • Page 249

    This chapter describes procedures for storing, viewing, and transferring patient data from the X Series to an external system, such as a personal computer or handheld device. Note: Before deleting log files from the X Series, view the files on a personal computer to verify that they have been successfully transferred. Note: Data transfers will not be successful if the USB flash storage device is full or does not have sufficient memory available.

  • Page 250: Storing Data

    When data storage reaches its capacity, the unit performs automatic log management by deleting the oldest full disclosure case. If the log is not cleared or transferred, the X Series unit continues to delete cases as needed to acquire storage capacity. For more information on clearing or transferring the log, see page 21-4.

  • Page 251: Reviewing And Printing Snapshots

    Use the navigation keys to highlight and select the treatment summary you want to print. Note: The Treatment Summary Report that you selected has a check mark next to it. Use the navigation keys to highlight and select Print Treatment Summary. 9650-001355-01 Rev. M X Series Operator’s Guide 21-3...

  • Page 252: Transferring Data To A Usb Device

    The green LED on the top of the device turns on while data is transferred to the USB device. Note: Wait for the log transfer to complete and for the green light on the top of the X Series to turn off before removing the USB drive.

  • Page 253: Clearing The Log

    An UNABLE TO READ LOG message indicates that the log contains no information. This message can occur if you clear the log and then immediately enter the Treatment screen or the Trend Summary screen. 9650-001355-01 Rev. M X Series Operator’s Guide 21-5...

  • Page 254

    Chapter 21 Patient Data 21-6 www.zoll.com 9650-001355-01 Rev. M...

  • Page 255

    ZOLL RescueNet or ePCR software or saved to a USB device. You can set up a Bluetooth pairing or temporary wireless access point on the X Series unit by selecting the wireless icon on the display screen. Supervisors can set up permanent communications configuration, including up to 255 Wi-Fi profiles and up to 3 Cellular providers in the Setup/Communications menu, which requires a password.Once you have set...

  • Page 256: The Wireless Icon

    Replaces the wireless icon when Ethernet is enabled. An adapter is connected, and the connection is operating. Ethernet Not Replaces the wireless icon when Ethernet is enabled.An Ethernet Connected adapter is connected, but the connection is not operating. No icon All wireless connectivity is disabled. 22-2 www.zoll.com 9650-001355-01 Rev. M...

  • Page 257

    View or update 12-Lead distribution lists • Set up a temporary WiFi access point • Set up a Bluetooth connection. • Use the navigation keys to select the wireless icon. Wireless icon 9650-001355-01 Rev. M X Series Operator’s Guide 22-3...

  • Page 258: The Wireless Menu

    The Wireless menu has the following options: WiFi Access Point, View/Configure Paired Devices, View Distribution List, and Update Distribution List. Use the navigation keys to navigate the menu items; press the back arrow ( ) to exit the wireless menu. 22-4 www.zoll.com 9650-001355-01 Rev. M...

  • Page 259: Selecting A Pre-configured Access Point Profile

    Navigate to and select a profile from the Configured Access Point Profiles list. A green check mark appears to show that the profile has been selected. Press the back arrow ( ) to return to the Wireless menu. 9650-001355-01 Rev. M X Series Operator’s Guide 22-5...

  • Page 260: Creating A Temporary Access Point Profile

    Use the navigation keys to highlight and select Temporary Profile. A green check mark appears to show that the profile has been selected. To edit the profile, use the navigation keys to highlight and select Edit. The unit displays the Edit AP Profile menu. 22-6 www.zoll.com 9650-001355-01 Rev. M...

  • Page 261

    Use the alphabetical keypad to enter the SSID name. Press SAVE to save changes and return to the Temporary Profile menu; press Cancel to return to the Temporary Profile menu without saving changes. 9650-001355-01 Rev. M X Series Operator’s Guide 22-7...

  • Page 262

    For WPA-PSK or WPA2-PSK, you are required to enter a security key (8-64 characters). Use the alphabetical keypad to enter the security key. Press SAVE to save changes and return to the Temporary Profile menu; press Cancel to return to the Temporary Profile menu without saving changes. 22-8 www.zoll.com 9650-001355-01 Rev. M...

  • Page 263

    Other options on the screen will be greyed out. Note: The X Series unit only supports PEAPv0/v1 + MSCHAPV2. TLS (Transport Layer Security): If TLS is selected, you must select a Client Certificate and enter the Private Key Password corresponding to the private key in the Certificate file. Other options on the screen will be greyed out.

  • Page 264: Bluetooth Device Pairing

    Select Pair Now to pair the device. On your Bluetooth device, accept the pairing request and enter the PIN, if prompted. The unit then returns to the list of paired devices. 22-10 www.zoll.com 9650-001355-01 Rev. M...

  • Page 265

    ZOLL Medical Corporation sales representative for a list of approved devices. Changing the PIN It may be necessary to change the PIN on the X Series unit; check your device’s documentation. To change the PIN, select Change Pin in the Bluetooth menu, then use the numerical keypad to enter the desired PIN.

  • Page 266: Sending A 12-lead Report

    Sending a 12-Lead Report When a 12-lead report has been acquired or a previously acquired 12-lead has been selected for review, the X Series unit prepares the report for transmission. When this is complete, the Transmit quick access key( ) displays.

  • Page 267: Sending Disclosure Logs

    Sending Disclosure Logs Sending Disclosure Logs For systems with a Disclosure log server configured, the X Series unit allows you to send patient disclosure logs for up to 15 cases at one time to a remote server through a wireless connection.

  • Page 268: Supervisor Communications Menu

    Press the Setup quick access key ( ). Use the navigation keys to scroll down to Supervisor. Press Enter the password. The Supervisor menu appears. Use the navigation keys to highlight and select Communications. The options for Communications are displayed. 22-14 www.zoll.com 9650-001355-01 Rev. M...

  • Page 269

    Disclosure Log The X Series unit allows you to send the Disclosure Logs and audio for up to 15 cases at one time to a remote server. Use the Disclosure Log menu to configure the server to which to send the log data (see “Configuring Disclosure Log Transmissions”...

  • Page 270: Wifi Access Point Profiles

    Power Management option is enabled by default. To add a new Access Point Profile: Use the navigation keys to highlight and select Add. You can enter the type of network setting, profile name, SSID, authentication, and security key. 22-16 www.zoll.com 9650-001355-01 Rev. M...

  • Page 271

    Use the navigation keys to select either DHCP or Static IP. If you select Static IP, use the numeric keypad to enter values for the IP Address, Subnet Mask, Default Gateway, Preferred DNS Server, and Alternate DNS Server. 9650-001355-01 Rev. M X Series Operator’s Guide 22-17...

  • Page 272

    Use the navigation keys to enable or disable non-broadcast or hidden SSIDs. This must be set to Enabled to allow the X-Series to connect to a WiFi network that is configured not to broadcast its SSID. 22-18 www.zoll.com 9650-001355-01 Rev. M...

  • Page 273

    Use the alphabetical keypad to enter the security key. Press SAVE to save changes and return to the Temporary Profile menu; press Cancel to return to the Temporary Profile menu without saving changes. 9650-001355-01 Rev. M X Series Operator’s Guide 22-19...

  • Page 274

    If the network requires it, you may enter an Anonymous Identity. The CA certificate is also optional. Other options on the screen will be greyed out. The X Series unit only supports PEAPv0/v1 + MSCHAPV2. Note: TLS (Transport Layer Security): If TLS is selected, you must select a Client Certificate and enter the Private Key Password corresponding to the private key in the Certificate file.

  • Page 275

    Filenames can only be 24 characters long. If the files on the USB device are more than 24 characters, then they will not appear on the X Series unit screen. The X Series unit only supports PFX format client certificates.

  • Page 276: Setting Up Cellular Communications

    Chapter 22 Communications Setting up Cellular Communications You can configure your USB cellular modem or Bluetooth device to work with the X Series unit. Under the Communications menu, select Cellular Configure. The Cellular menu appears. You can use the arrow keys to enable or disable all cellular functions, and configure your cell phone provider information.

  • Page 277

    Call number is an access number sometime referred to as a Dial String. Account Name and Password • Some providers require an account name and password. If your provider does not require these fields, leave them blank. 9650-001355-01 Rev. M X Series Operator’s Guide 22-23...

  • Page 278

    Select Pair Now to pair the device. On your Bluetooth device, accept the pairing request and enter the PIN, if prompted. 22-24 www.zoll.com 9650-001355-01 Rev. M...

  • Page 279

    ) to return to the list of paired devices. Use Bluetooth devices with DUN or PAN-NAP profiles only. Not all cellular phones Note: transmit reliably; contact your local ZOLL Medical Corporation sales representative for a list of approved devices. 9650-001355-01 Rev. M X Series Operator’s Guide...

  • Page 280

    Chapter 22 Communications Changing the PIN: It may be necessary to change the PIN on the X Series unit; check your device’s documentation. To change the PIN, select Change Pin in the Pair New Device menu, then use the numerical keypad to enter the desired PIN.

  • Page 281: Setting Up An Ethernet Connection

    Use the navigation keys to select either DHCP or Static IP. If you select Static IP, use the numeric keypad to enter values for the IP Address, Subnet Mask, Default Gateway, Preferred DNS Server, and Alternate DNS Server. 9650-001355-01 Rev. M X Series Operator’s Guide 22-27...

  • Page 282: Configuring 12-lead Report Transmissions

    Update Distribution List button to complete the download. The X-Series retains the current Distribution List until a new one is downloaded. If you modify the Distribution List entries using RescueNet, you should download a new copy to the X Series device.

  • Page 283: Configuring Disclosure Log Transmissions

    12-lead snapshots and analysis. • For systems with a Disclosure Log server configured, the X Series unit allows you to wirelessly transmit the full Disclosure case logs and audio for up to 15 cases to a remote server for subsequent retrieval. Use the Supervisor>Communications>Disclosure Log menu to configure the remote server to which to send the disclosure log case data.

  • Page 284: Configuring Clock Synchronization

    To ensure that the real time clock never changes during patient treatments, the X Series will make adjustments to its clock, if necessary, after the unit has been off for at least two minutes and prior to the start of a new case.

  • Page 285

    1. Under the Communications menu, select Clock Sync > Configure. The Clock Synchronization menu displays. In the Clock Sync field, specify whether or not to synchronize the X Series internal real time clock to an external time source. Select SNTP if you would like to synchronize the X Series clock to an external time —...

  • Page 286: Communications System Messages

    Chapter 22 Communications Communications System Messages The X Series unit may display one of the following status messages during the transmission: System Message Cause TRYING TO CONNECT TO The unit is connecting to the network. NETWORK TRANSMITTING The data transfer is in progress TRANSMISSION COMPLETE The data transfer is complete.

  • Page 287: Printing Patient Data

    • Note: A date that contains question marks (??/??/??) indicates that the X Series was not able to determine the date and time on power up. Power cycling the unit may correct the problem. If the problem persists, set the date and time by highlighting the Date and Time display field and pressing Select.

  • Page 288: Printer Setup

    Treatment Summary Snapshots • Printing Waveforms You can print waveforms by pressing . The X Series unit will print the displayed waveforms as configured in the Number of Traces option. The Print Number of Traces option can be set to , or .

  • Page 289: Printing Reports

    Use the navigation keys to highlight and select the treatment summary you want to print. Note: The Treatment Summary Report that you selected has a check mark next to it. Use the navigation keys to highlight and select Print Treatment Summary. 9650-001355-01 Rev. M X Series Operator’s Guide 23-3...

  • Page 290: Printing Trends

    Printed trends are useful for reviewing the patient’s vital signs over the last several minutes to the last five hours. The X Series unit enables you to print vital signs data at one selected time or a trend summary showing vital signs values acquired during the current case (up to the last 24 hours).

  • Page 291

    Maintenance Resuscitation equipment must be maintained to be ready for immediate use. To ensure the readiness and optimum working condition of the X Series unit, you should perform the following inspections and tests daily or at each shift change. In addition to the daily check, authorized personnel should complete performance and calibration testing at regularly scheduled intervals, which should not exceed one year.

  • Page 292: Daily/shift Check Procedure

    Ensure that the therapy and monitoring electrodes are sealed within the packages and within • the expiration dates printed on the packages. Open the recorder door on the left side of the X Series unit and verify that an adequate • supply of paper is available in the unit.

  • Page 293: Defibrillator/pacing Test With Hands-free Therapy Electrodes

    Connect the external AC adapter to a working Verify that the green Auxiliary Power LED AC outlet and to the X Series rear panel. illuminates on the X Series front panel. Insert a battery into the unit (if a battery is not Verify that the Battery Charge LED on the X already in the slot).

  • Page 294

    Press the Select Energy arrow (up or down) Verify that the defibrillator window shows to select 30 Joules on the X Series unit. 30 J as the selected energy. 10 Press the CHARGE button on the front panel. Verify that a periodic tone sounds while the defibrillator is charging.

  • Page 295: Defibrillator Testing With External Paddles

    Defibrillator Testing with External Paddles Defibrillator Testing with External Paddles Prior to testing external defibrillator paddles with the X Series unit, complete the testing described in “Defibrillator/Pacing Test with Hands-Free Therapy Electrodes” on page 24-3. Note: If a low battery message appears during any of this testing, the battery is close to depletion and should be replaced or recharged.

  • Page 296: Recommended Minimum Preventive Maintenance Schedule

    Caution DO NOT leave X Series battery packs in a depleted state. Damage to the battery packs can occur if they are left in a depleted state for more than 14 days. 24-6 www.zoll.com...

  • Page 297: Cleaning Instructions

    Cleaning instructions Cleaning the X Series unit To clean the X Series unit, use a nearly dry cloth containing one of the mild cleaning agents listed below. DO NOT allow cleaning agent or water to run into the crevices or connector openings at any time.

  • Page 298: Cleaning Cables And Accessories

    The unit displays the message PRINTER OUT OF PAPER when the printer is activated without recorder paper or if the supply runs out during printing. Use ZOLL recorder paper (part number 8000-000901). To load the recorder paper into the printer: 1.

  • Page 299: Cleaning The Print Head

    Gently wipe the print head with a cotton swab moistened with isopropyl alcohol, and dry any residual alcohol with another dry cotton swab. Figure 24-3. Cleaning the Print Head Place the paper back into the unit and close the cover (see Fig. 24-2). 9650-001355-01 Rev. M X Series Operator’s Guide 24-9...

  • Page 300

    Chapter 24 Maintenance X Series OPERATOR’S SHIFT CHECKLIST Date: ________________ Shift: _______________ Location: _______________ Mfr/Model No.: ____________________________ Serial No. or Facility ID No.: _________________ At the beginning of each shift, inspect the unit. Indicate whether all requirements have been met.

  • Page 301

    Appendix A Specifications This chapter provides specification information for the X Series Monitor/Defibrillator. “Defibrillator” on page A-2. • “Monitor/Display” on page A-14 • “Impedance Pneumography” on page A-15 • “Alarms” on page A-16 • “Recorder” on page A-17 • “Battery” on page A-17 •...

  • Page 302: Defibrillator

    R wave and the delivery of energy. Table A-1 shows the characteristics of the X 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 303

    Series defibrillation waveforms are considered substantially equivalent. Figures A-1 through A-20 show the Rectilinear Biphasic waveforms that are produced when the X Series defibrillator is discharged into loads of 25, 50, 75, 100, 125, 150, and 175 ohms at each energy setting.

  • Page 304

    175 Ohm 200 Ohm Figure A-1. Rectilinear Biphasic Waveform at 200 Joules 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 www.zoll.com 9650-001355-01 Rev. M...

  • Page 305

    200 Ohm Figure A-3. Rectilinear Biphasic Waveform at 120 Joules 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 9650-001355-01 Rev. M X Series Operator’s Guide...

  • Page 306

    175 Ohm 200 Ohm Figure A-5. Rectilinear Biphasic Waveform at 85 Joules 25 Ohm 50 Ohm 75 Ohm 100 Ohm 125 Ohm 150 Ohm 175 Ohm 200 Ohm Figure A-6. Rectilinear Biphasic Waveform at 70 Joules www.zoll.com 9650-001355-01 Rev. M...

  • Page 307

    200 Ohm Figure A-7. Rectilinear Biphasic Waveform at 50 Joules 25 Ohm 50 Ohm 75 Ohm 100 Ohm 125 Ohm 150 Ohm 175 Ohm 200 Ohm Figure A-8. Rectilinear Biphasic Waveform at 30 Joules 9650-001355-01 Rev. M X Series Operator’s Guide...

  • Page 308

    175 Ohm 200 Ohm Figure A-9. Rectilinear Biphasic Waveform at 20 Joules 25 Ohm 50 Ohm 75 Ohm 100 Ohm 125 Ohm 150 Ohm 175 Ohm 200 Ohm Figure A-10. Rectilinear Biphasic Waveform at 15 Joules www.zoll.com 9650-001355-01 Rev. M...

  • Page 309

    200 Ohm Figure A-11. Rectilinear Biphasic Waveform at 10 Joules 25 Ohm 50 Ohm 75 Ohm 100 Ohm 125 Ohm 150 Ohm 175 Ohm 200 Ohm Figure A-12. Rectilinear Biphasic Waveform at 9 Joules 9650-001355-01 Rev. M X Series Operator’s Guide...

  • Page 310

    175 Ohm 200 Ohm Figure A-13. Rectilinear Biphasic Waveform at 8 Joules 25 Ohm 50 Ohm 75 Ohm 100 Ohm 125 Ohm 150 Ohm 175 Ohm 200 Ohm Figure A-14. Rectilinear Biphasic Waveform at 7 Joules A-10 www.zoll.com 9650-001355-01 Rev. M...

  • Page 311

    Figure A-15. Rectilinear Biphasic Waveform at 6 Joules 25 Ohm 50 Ohm 75 Ohm 100 Ohm 125 Ohm 150 Ohm 175 Ohm 200 Ohm Figure A-16. Rectilinear Biphasic Waveform at 5 Joules 9650-001355-01 Rev. M X Series Operator’s Guide A-11...

  • Page 312

    175 Ohm 200 Ohm Figure A-17. Rectilinear Biphasic Waveform at 4 Joules 25 Ohm 50 Ohm 75 Ohm 100 Ohm 125 Ohm 150 Ohm 175 Ohm 200 Ohm Figure A-18. Rectilinear Biphasic Waveform at 3 Joules A-12 www.zoll.com 9650-001355-01 Rev. M...

  • Page 313

    Figure A-19. 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-20. Rectilinear Biphasic Waveform at 1 Joule 9650-001355-01 Rev. M X Series Operator’s Guide A-13...

  • Page 314: Monitor/display

    Responds to a 40 BPM step increase in heart rate within 4.5 seconds per AAMI EC-13-2002, section 4.1.2.1.f. Responds to a 40 BPM step decrease within 3.9 seconds per AAMI EC-13-2002, section 4.1.2.1.f. Response times include a 1.0-second display update interval. A-14 www.zoll.com 9650-001355-01 Rev. M...

  • Page 315: Impedance Pneumography

    • may trigger the pacemaker pulse detector. Electrosurgery Protection: The X Series is suitable for use in the presence of electrosurgery as specified in IEC 60601-2-27. Burn hazard protection via a 1K current limiting resistor contained in each ECG leadwire.

  • Page 316: Alarms

    IBP, 6 seconds • if source is NIBP, no hold off • , SpCO, and SpMet Saturation: 10 seconds EtCO : 7 seconds FiCO : 5 seconds IBP (Systolic, Diastolic, Mean): 3 seconds Temperature: 2 seconds A-16 www.zoll.com 9650-001355-01 Rev. M...

  • Page 317: Recorder

    Proper battery care is required to maintain maximum available capacity. Battery Indicators: 5 Battery capacity LED indicators, Fault indicator, Recalibration indicator Recharge Rate: 100% in 4 hours, when initiated at Low Battery indication. 9650-001355-01 Rev. M X Series Operator’s Guide A-17...

  • Page 318: General

    Transport and Storage: Temperature: -30 to 70°C Note: The X Series device may not perform to specifications when stored at the upper or lower extreme limits of storage temperature and immediately put into use. Humidity: 15 to 95% RH (non-condensing) Atmospheric pressure: 572 mbar to 1034 mbar Shock/vibration: MIL STD 810G, Method 514.6, 4.4.2, Procedure II...

  • Page 319: Pacer

    The accuracy specification is maintained to within 4% for the following gas mixtures (all values are in Vol.%). Anesthetic Agents 1.0 to 13 0 to 97.5 0 to 100 0 to 80 Dry to saturated According to EN 21647 9650-001355-01 Rev. M X Series Operator’s Guide A-19...

  • Page 320

    Resolution: : 1% SpCO: 1% SpMet: 0.1% for range up to 9.9%, 1% for range 10 - 99% SpHb: 0.1 g/dL SpOC: 0.1 ml/dL PVI: 1% PI: 0.1% Pulse rate: 1 bpm (beats per minute) A-20 www.zoll.com 9650-001355-01 Rev. M...

  • Page 321

    Rainbow Sensors at 100 mA pulsed: 25 mW  Bio-Compatibility: Patient contacting material meets requirements of ISO 10993-1, Biological Evaluation of Medical Device - Part I, for external devices, intact surfaces and short-term exposure 9650-001355-01 Rev. M X Series Operator’s Guide A-21...

  • Page 322

    • Dyes, or any substance containing dyes, that change usual blood pigmentation may cause • erroneous readings. Elevated levels of total bilirubin may lead to inaccurate SpO , SpMet, SpCO and SpHb • readings. A-22 www.zoll.com 9650-001355-01 Rev. M...

  • Page 323: Non-invasive Blood Pressure

    Measurements on the deflation: 30 to 45 seconds Measurements on the inflation (SureBP)*: 15 to 30 seconds * using dual lumen cuffs Maximum Determination Time - Measurement on the Inflation Adult: 150 seconds Pediatric:120 seconds Neonatal:80 seconds 9650-001355-01 Rev. M X Series Operator’s Guide A-23...

  • Page 324: Invasive Pressures

    American National Standards Institute (ANSI-AAMI SP10). To receive a copy of the report containing the AAMI SP10 results, contact the ZOLL Technical Service Department. NIBP Accuracy: NIBP accuracy has been verified utilizing clinical test methods which have been determined to meet the requirements of EN ISO 81060-2:2012.

  • Page 325: Temperature

     Display: T1, T2, Minimum Measurement Time: See the probe’s Instructions for Use to obtain minimum measurement times for accurate readings. The X Series does not add any clinically significant time to obtain accurate readings. 9650-001355-01 Rev. M X Series Operator’s Guide...

  • Page 326: Clinical Trial Results For The Biphasic Waveform

    Specifications 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 327: 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 328

    Conclusion: The data demonstrate the superior efficacy of low energy rectilinear biphasic shocks compared to high energy monophasic shocks for transthoracic cardioversion of atrial fibrillation. There were no unsafe outcomes or adverse events due to the use of Rectilinear Biphasic Waveform. A-28 www.zoll.com 9650-001355-01 Rev. M...

  • Page 329: Synchronized Cardioversion Of Atrial Fibrillation

    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. 9650-001355-01 Rev. M X Series Operator’s Guide A-29...

  • Page 330: Electromagnetic Compatibility Guidance And Manufacturer's Declaration

    Guidance and manufacturer’s declaration – electromagnetic emissions The X Series unit is intended for use in the electromagnetic environment specified below. The customer or the user of the X Series unit should assure that it is used in such an environment.

  • Page 331: Electromagnetic Immunity (iec 60601-1-2)

    Guidance and manufacturer’s declaration – electromagnetic immunity The X Series unit is intended for use in the electromagnetic environment specified below. The customer or the user of the X Series should assure that it is used in such an environment.

  • Page 332: Electromagnetic Immunity: Life-supporting 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 X Series is used exceeds the applicable RF compliance level above, the X Series should be observed to verify normal operation. If abnormal performance is observed, additional measures may be necessary, such as reorienting or relocating the X Series.

  • Page 333: Electromagnetic Immunity: Non Life-supporting Functions

    The non life-supporting functions of the X Series are intended for use in the electromagnetic environment specified below. The customer or user of the X Series should ensure that it is used in such an environment. Immunity test...

  • Page 334

    Recommended separation distances between portable and mobile RF communications equipment and the X Series The life-supporting functions of the X Series are intended for use in the electromagnetic environment in which radiated RF disturbances are controlled. The customer or user of the X Series can help prevent...

  • Page 335

    X Series The non life-supporting functions of the X Series are intended for use in the electromagnetic environment in which radiated RF disturbances are controlled. The customer or user of the X Series can help prevent...

  • Page 336: Ecg Analysis Algorithm Accuracy

    (as a percentage of the total number of non-shockable rhythms). The data in the following table summarizes the accuracy of the ECG analysis algorithm as tested against ZOLL’s ECG Rhythm Database. The algorithm sequence takes approximately 9 seconds and proceeds as follows: •...

  • Page 337: Wireless Output Guidance And Manufacturer's Declaration

    Wireless Output Guidance and Manufacturer’s Declaration Wireless Output Guidance and Manufacturer’s Declaration RF Transmission Emitted (IEC 60601-1-2) The X Series unit complies with IEC 60601-1-2 for medical electrical equipment and medical electrical systems that include RF transmitters as specified below. Standard...

  • Page 338

    Specifications A-38 www.zoll.com 9650-001355-01 Rev. M...

  • Page 339

    Appendix B Accessories The following accessories are compatible for use with the X Series unit. To order any of these items, contact your local ZOLL representative. ECG Accessories ECG, 3-Lead Cable, AAMI ECG, 3-Lead Cable, IEC ECG, 5-Lead Cable, AAMI ECG, 5-Lead Cable, IEC ECG, 12-Lead “Breakaway”...

  • Page 340

    Welch Allyn REUSE-11L-2MQ Cuff, Adult Long, 2-Tube, Twist lock connector Welch Allyn REUSE-12-2MQ Cuff, Lg Adult, 2-Tube, Twist lock connector Welch Allyn REUSE-12L-2MQ Cuff, Lg Adult Long, 2-Tube, Twist lock connector Welch Allyn REUSE-13-2MQ Cuff, Thigh, 2-Tube, Twist lock connector www.zoll.com 9650-001355-01 Rev. M...

  • Page 341

    M-LNCS™ Inf-3, Infant SpO2 adhesive sensor, 3 ft. cable, 3-20 kg. Single-patient use only Temperature Accessories YSI Reusable Adult, Skin Probe YSI Reusable Pediatric, Skin Probe YSI Reusable Adult, Esophageal/Rectal YSI Reusable Pediatric, Esophageal/Rectal 9650-001355-01 Rev. M X Series Operator’s Guide...

  • Page 342

    M Series External Paddles set with controls and built-in pediatric electrodes ZOLL Sterilizable Internal Handle (black), with Switch, 1.0" spoon, 10' cable (US only) or 7’ cable ZOLL Sterilizable Internal Handle (black), with Switch, 1.6" spoon, 10' cable (US only) or 7’ cable ZOLL Sterilizable Internal Handle (black), with Switch, 2.0"...

  • Page 343

    OneStep electrodes Power Accessories ZOLL SurePower II Rechargable Battery SurePower Charger Station SurePower II Battery Charger X Series Battery Adapter AC Auxiliary Power Adapter, 8300-0004 DC Auxiliary Power Adapter, 8300-000006 Replacement Power Cord – U.S. Replacement Power Cord – Japan 9650-001355-01 Rev.

  • Page 344

    Cable adapter, USB to Ethernet USB Cable Extension X Series Multi-Tech Cell Modem; GSM Version X Series Multi-Tech Cell Modem; CDMA Version X Series Multi-Tech Cell Modem External Antenna Kit, GSM Version X Series Pre-Grid Paper www.zoll.com 9650-001355-01 Rev. M...

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