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Instructions For Use
HeartStart MRx
M3535A/M3536A

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   Summary of Contents for Philips HeartStart MRxM3536A

  • Page 1 English Instructions For Use HeartStart MRx M3535A/M3536A...
  • Page 3 Medical Device Directive 93/42/EEC and carries the http://www.philips.com/ProductDocs and search for mark accordingly. 0123 resuscitation. Philips shall not be liable for errors contained herein or for incidental or consequential damages in connection Manufacturer with the furnishing, performance, or use of this material. Philips Medical Systems...
  • Page 4 Notice Any changes or modifications to this equipment not expressly approved by Philips Medical Systems may cause harmful radio frequency interference and void your authority to operate this equipment. China: After Sales Service: Beijing MEHECO-PHILIPS Medical Equipment Service Center. After Sales Service Address: No. 208, 2nd District, Wang Jing Li Ze Zhong Yuan, Chao Yang District, Beijing.
  • Page 5 These Instructions for Use contain the following conventions: Warning statements describe conditions or actions that can result in personal injury or loss of life. WARNING CAUTION Caution statements describe conditions or actions that can result in damage to the equipment or loss of data.
  • Page 7: Table Of Contents

    Table of Contents 1 Introduction Overview Intended Use Indications for Use AED Therapy Manual Defibrillation Noninvasive External Pacing Therapy Pulse Oximetry Noninvasive Blood Pressure Monitoring End-tidal CO 12-Lead ECG Q-CPR Invasive Pressures Temperature ACI-TIPI Safety Considerations Documentation and Training 2 Getting Acquainted Basic Orientation Front Panel Side Panels...
  • Page 8 Controls Therapy Knob General Function Buttons Defibrillation Controls Soft Keys Indicators Audio Recording Reviewing Recorded Audio Alarms Responding to Alarms Printing on Alarms Identifying Your Device Entering Patient Information Continued Use Printing Waveforms Return to Owner 3 Setting Up Attaching the Carrying Case and Accessory Pouches Storing Accessories Connecting the ECG Cable Connecting the SpO...
  • Page 9 Aberrantly-Conducted Beats Intermittent Bundle Branch Block Heart Rate and Arrhythmia Alarms Arrhythmia Alarm Latching INOP Messages Setting Alarms Changing Heart Rate or VTACH Alarm Limits Enabling/Disabling Heart Rate and Arrhythmia Alarms Responding to HR and Arrhythmia Alarms Displaying an Annotated ECG Arrhythmia Learning/Relearning Troubleshooting 5 AED Mode...
  • Page 10 Pacing View Demand Mode Versus Fixed Mode Preparing for Pacing Demand Mode Pacing Fixed Mode Pacing Defibrillating During Pacing Troubleshooting 8 Pulse Oximetry Overview Understanding Pulse Oximetry Selecting a Sensor Applying the Sensor Monitoring SpO Pleth Wave Alarms Changing the SpO Alarm Limits Desat Alarm Enabling/Disabling the SpO...
  • Page 11 Enabling/Disabling the EtCO Alarms Changing the AwRR Alarm Limits Changing the Apnea Time Alarm Limit Enabling/Disabling AwRR Alarms Disabling the EtCO Monitoring Function Troubleshooting 11 Invasive Pressures Overview Setting up for a Pressure Measurement Selecting a Pressure to Monitor Pressure Waves Zeroing the Pressure Transducer Zeroing Using the Menu Select Button Zeroing Using a Soft Key in Monitor Mode...
  • Page 12 Caring For Your Temperature Cables and Probes Troubleshooting 13 12-Lead ECG Overview Preparation Preview Screen Acquiring a 12-Lead ECG Acquiring a 12-lead ECG with ACI-TIPI and/or TPI Analysis Critical Values Culprit Artery 12-Lead Report Accessing Stored Reports Improving Signal Quality Adjusting Wave Size 12-Lead Filters Troubleshooting...
  • Page 13 Feedback Prompts Adjusting CPR Feedback Volume After Each Use Q-CPR Data Capture Q-CPR Feedback Setting Data and Events Recorded Research Storage Setting Reviewing Q-CPR Data Troubleshooting 16 Networking IntelliVue Networking Display Connecting to the Network Physical Connections Wired Connection Wireless Connection Combined Connection Configuring to Work on the Network Using the Device Location Option...
  • Page 14 Configurable Parameters 18 Working with Data Overview Initiating an Event Summary Entering Data Management Mode Copying from Internal Memory Viewing and Erasing the External Data Card Printing During a Patient Event Event Summaries Vital Signs Trending Reports 12-Lead ECG Reports Printing Individual Events Printing from Data Management Mode Events Stored in Event Summary...
  • Page 15 20 Maintenance Overview Automated Tests Automated Test Summary Ready For Use Indicator Shift Checklist Weekly Shock Test HeartStart MRx Shift Checklist Operational Check Performing the Operational Check Operational Check Report Operational Check Summary Battery Maintenance Battery Life Charging Batteries Battery Calibration Storing Batteries Discarding Batteries Cleaning Instructions...
  • Page 16 ECG and Arrhythmia Monitoring Display Battery Thermal Array Printer Noninvasive Pacing SpO2 Pulse Oximetry Invasive Pressures Temperature EtCO2 AwRR Calibration Gas for CO Measurement System CPR Meter Patient Adhesive Pads 12-Lead ECG Networking Patient Data Storage Environmental (M3535A) Environmental (M3536A) Bluetooth Symbol Definitions Units and Abbreviations...
  • Page 17 Index...
  • Page 19: Introduction

    Introduction Thank you for choosing the HeartStart MRx monitor/defibrillator. Philips Healthcare welcomes you to its family of resuscitation devices. The HeartStart MRx is designed to meet your monitoring and resuscitation needs by providing advanced, multi-parameter monitoring functions, a full range of defibrillation therapies, industry- leading algorithms and a suite of data transmission options.
  • Page 20: Intended Use

    Reports and Vital Signs Trending, in its internal memory. The HeartStart MRx also enables you to store data and event information on an optional data card for downloading to Philips’ data management solution, HeartStart Event Review Pro, or you can send the data electronically via several methods to your destination point.
  • Page 21: Indications For Use

    Indications for Use 1 Introduction Indications for Use The HeartStart MRx is for use for the termination of ventricular tachycardia and ventricular fibrillation. The device is for use by qualified medical personnel trained in the operation of the device and qualified by training in basic life support, advanced cardiac support, or defibrillation.
  • Page 22: Q-cpr

    1 Introduction Indications for Use Q-CPR The Q-CPR option provides feedback designed to encourage rescuers to perform resuscitation in accordance with AHA/ERC guidelines for chest compression rate, depth, and duty cycle and ventilation rate, volume and flow rate (inflation time). The Q-CPR option is contraindicated as follows: •...
  • Page 23: Safety Considerations

    Enter training access password: meetMRx.) • HeartStart MRx User Training Videotape and DVD • To purchase additional copies of the Instructions for Use or Quick Cards, visit the Philips Healthcare eStore at: www.philips.com/healthcarestore. • Other Application Notes can be found on the Philips website at: www.medical.philips.com/goto/...
  • Page 25: Getting Acquainted

    Getting Acquainted The HeartStart MRx is designed with your needs in mind. Controls, indicators, and menus are carefully organized to facilitate easy use. Display information is tailored to the current task. This chapter acquaints you with the HeartStart MRx operational modes, display views, controls, and indicators.
  • Page 26: Basic Orientation

    2 Getting Acquainted Basic Orientation Basic Orientation HeartStart MRx controls, indicators, and connections are carefully organized. Front Panel The front panel contains operational controls and indicators, as shown below. Figure 1 Basic Orientation (Front) External Power Indicator Synchronized Location of Networking icon Cardioversion (Sync) (if device is network enabled) Ready For Use...
  • Page 27: Side Panels

    Basic Orientation 2 Getting Acquainted Side Panels The left side of the HeartStart MRx has ports for monitoring cables, including ECG, pulse oximetry (SpO ), noninvasive blood pressure (NBP), invasive pressure (2), temperature and carbon dioxide ). The ECG port may be used to connect a 3-, 5-, or 10-lead patient cable. The ECG Out jack may be used to connect to an external monitor.
  • Page 28: Top Panel

    2 Getting Acquainted Basic Orientation Top Panel The top of the HeartStart MRx has a handle and basic operating instructions. If optional external paddles are present, they reside on the top panel as shown. Figure 3 Basic Orientation (Top - with Optional Paddles)
  • Page 29: Back Panel

    Basic Orientation 2 Getting Acquainted Back Panel The back panel of the HeartStart MRx has two compartments for lithium ion batteries. Compartment B may also be used to connect an AC power module. Between the battery compartments is a DC Power Input port.
  • Page 30: M3538a Lithium Ion Battery

    2 Getting Acquainted M3538A Lithium Ion Battery M3538A Lithium Ion Battery The HeartStart MRx uses the M3538A Lithium Ion Battery. The battery has a fuel gauge with 5 LED indicators, each representing a charge of at least 20% of capacity. Press the fuel gauge button to illuminate the fuel gauge.
  • Page 31: Password Security

    Display Views 2 Getting Acquainted Password Security Access to Manual Defib Mode and Pacer Mode may be configured to be password protected. If the modes are password protected, you are prompted to enter the password upon moving the Therapy Knob to either the Pacer position or an energy selection. The password is entered by using the Navigation buttons to select the password numbers and then selecting Done to complete the entry.
  • Page 32: General Status

    2 Getting Acquainted Display Views General Status The general status area of the display contains: • Mark Event button label • Date and time • Audio recording icon. If the option is enabled, one of the audio recording icons is displayed to the left of the battery icons in all clinical modes to indicate the status of audio recording.
  • Page 33: Wave Sectors

    Display Views 2 Getting Acquainted Wave Sectors The HeartStart MRx is configured to populate each wave sector with a predetermined waveform, when powered on in Monitor, Manual Defib, or Pacer Mode. Figure 7 shows the default Waves configuration choices for a device containing all monitor options. See “Configuration” on page 199 for more information.
  • Page 34: Parameter Blocks

    2 Getting Acquainted Display Views Wave Sectors 2-4 Wave Sectors 2 through 4 are automatically populated when parameter sources (cables/tubing) are connected to the HeartStart MRx. If the parameter source is the configured choice of a particular wave sector, it is displayed in that wave sector. If you connect a parameter source that is not configured to be displayed, it is displayed in the first empty wave sector.
  • Page 35: Menus

    Display Views 2 Getting Acquainted Menus Menus with controls and options specific to each function of the HeartStart MRx are easily accessible using the Menu Select and Navigation buttons located on the front panel. Menus are used to adjust volume, select waveforms for display, select waves for printed strips, set alarms, schedule measurements, enter patient information, perform the Operational Check, generate reports, and a variety of other tasks.
  • Page 36: Message Windows

    2 Getting Acquainted High Contrast Display Message Windows Periodically, message windows appear on the display to provide additional status information, alert you to an error or a potential problem, or direct you to take action. Remain alert to these messages. If a response is required, use the Navigation buttons and Menu Select buttons to highlight and select the appropriate action.
  • Page 37: Controls

    Controls 2 Getting Acquainted Controls The Therapy Knob is used to turn the HeartStart MRx on in the desired mode of operation. Operating controls are organized by function, with general function buttons located along the left and bottom sides of the display, defibrillation controls to the right of the display, and soft keys immediately below the display.
  • Page 38: General Function Buttons

    2 Getting Acquainted Controls General Function Buttons The general function buttons control monitoring or non-critical resuscitation activities. They include: Mark Event button - allows you to insert a time-stamped annotation in the Event Summary Report to note events as they occur, including the administration of certain drugs. A Mark Event button label appears at the top left corner of the display.
  • Page 39: Defibrillation Controls

    Controls 2 Getting Acquainted Defibrillation Controls The defibrillation controls are shown in Figure 12. They include: Therapy Knob - Enables AED or selects an energy for Manual Defib Mode defibrillation or cardioversion. Charge Button - Charges the defibrillator to the selected Manual Defib energy setting. Used only in Manual Defib Mode.
  • Page 40: Indicators

    2 Getting Acquainted Controls Indicators The HeartStart MRx indicators provide a visual display of device status. Ready For Use Indicator The Ready For Use (RFU) indicator is located on the upper, right corner of the device. It indicates the status of the therapy delivery functions of the monitor/defibrillator using the following definitions: •...
  • Page 41: Audio Recording

    To review recorded audio, transmit your Event Summary from the HeartStart MRx to a receiving personal computer running Event Review Pro software. For more information about Event Review Pro, go to www.medical.philips.com and search for data management. For more information on HeartStart MRx transmission options see “Data Transmission” on page 239.
  • Page 42: Alarms

    2 Getting Acquainted Alarms Alarms The HeartStart MRx provides various alarm types indicating changes in patient condition or device/ cable conditions which may require attention. Table 3 details different alarm types. Table 3 HeartStart MRx Alarm Types Type of Alarm Condition High priority.
  • Page 43 Alarms 2 Getting Acquainted the audio for all active alarms while you are attending to the patient. INOPs do not reannunciate after pressing audio off. Figure 14 Audio Pause Label Audio Pause Then: Address the alarm condition on the HeartStart MRx. The menu shown in Figure 15 appears. Figure 15 Sample Alarm Response Menu SpO2 Alarm Alarms Off...
  • Page 44: Printing On Alarms

    2 Getting Acquainted Identifying Your Device Printing on Alarms You can configure your HeartStart MRx to automatically print on certain alarms and not on others. See “Printing Settings” on page 220 for more information. Identifying Your Device There are multiple ways to identify your HeartStart MRx and the data transmitted from it. In Configuration Mode you can set up an Institution Name and/or Device ID.
  • Page 45: Entering Patient Information

    Entering Patient Information 2 Getting Acquainted Entering Patient Information Patient information may be entered for the following: • Name • ID • Patient Category • Age (Date of Birth if the IntelliVue Networking option is installed) • Sex • Chest Pain (if the ACI-TIPI and TPI option is installed) •...
  • Page 46: Printing Waveforms

    2 Getting Acquainted Printing Waveforms Printing Waveforms By using the Print Button on the front of the HeartStart MRx, you can obtain a continuous printout of the primary ECG and one additional waveform if you have the 50mm printer installed; two additional waveforms if you have the 75mm printer installed.
  • Page 47: Return To Owner

    Return to Owner 2 Getting Acquainted Return to Owner The Return to Owner feature allows the owner of the HeartStart MRx to enable a specified loan period. When the time period is up, the borrower of the HeartStart MRx will be reminded to return the device to its owner as identified on the display.
  • Page 49: Setting Up

    Setting Up This chapter provides the basic set-up information you need to prepare your HeartStart MRx for operation and to connect the optional monitoring accessories. If your HeartStart MRx does not have some of the optional functionality or accessory pouches listed in N O T E this chapter, disregard these features and related information.
  • Page 50 3 Setting Up Attaching the Carrying Case and Accessory Pouches Fold the two sleeve flaps over the top of the device, positioning them so that the screw holes are exposed. Replace the paddle tray (and 4 T-15 screws) or cap plate, as appropriate, so that the molded openings fit over the sleeve flaps.
  • Page 51: Storing Accessories

    Storing Accessories 3 Setting Up Storing Accessories Suggested parameter cabling and accessories storage is shown below. Figure 17 Storing Accessories...
  • Page 52 3 Setting Up Storing Accessories Attach the Therapy cable and route it through cable fastener loop, securing the cable just below the strain relief. Attach the rear pouch using the buckles provided. N O T E Depressions are provided on the inside of the rear pouch should you wish to make a cut-out to accommodate external power.
  • Page 53: Connecting The Ecg Cable

    Connecting the ECG Cable 3 Setting Up Connecting the ECG Cable To connect a 3-, 5- or 10-lead cable: Align the ECG cable with the white ECG port, as shown in Figure 19. The white key marker on the ECG cable faces the top of the device. Push the ECG cable firmly into the ECG port, until the white portion of the cable connector is no longer visible.
  • Page 54: Connecting The Spo 2 Cable

    3 Setting Up Connecting the SpO Cable Connecting the SpO Cable To connect the SpO cable: Hold the cable connector with the flat side facing front, as shown in Figure 20. Insert the cable into the blue SpO port on the HeartStart MRx and push until the blue portion of the cable connector is no longer visible.
  • Page 55: Connecting The Nbp Interconnect Tubing

    Connecting the NBP Interconnect Tubing 3 Setting Up Connecting the NBP Interconnect Tubing To connect the NBP Interconnect Tubing: Insert the NBP Interconnect Tubing into the red NBP port as shown in Figure 21. Attach the NBP Interconnect Tubing fitting to the NBP cuff. Figure 21 Connecting NBP Interconnect Tubing / NBP Cuff...
  • Page 56: Connecting The Invasive Pressures Cable

    3 Setting Up Connecting the Invasive Pressures Cable Connecting the Invasive Pressures Cable To connect the invasive pressure cable: Insert the invasive pressure cable into either of the invasive pressure ports as shown in Figure 22. Attach the invasive pressure cable to your transducer/tubing. Assign a label to the connection on the HeartStart MRx.
  • Page 57: Connecting The Temperature Cable

    Connecting the Temperature Cable 3 Setting Up Connecting the Temperature Cable To connect the temperature cable: Insert the temperature cable into the temperature port as shown in Figure 23. If needed, attach the cable to your probe. Figure 23 Connecting the Temperature Cable...
  • Page 58: Connecting The Co 2 Filterline

    3 Setting Up Connecting the CO FilterLine Connecting the CO FilterLine ® To connect the CO FilterLine Using the end of the FilterLine fitting, slide the CO compartment door down. Insert the fitting into the CO Inlet port as shown in Figure 24. Turn the fitting clockwise into place.
  • Page 59: Connecting The Therapy Or Pads/cpr Cables

    Connecting the Therapy or Pads/CPR cables 3 Setting Up Connecting the Therapy or Pads/CPR cables To connect the Therapy or Pads/CPR cable: Align the white pointer on the cable with the white arrow on the green Therapy port as shown in Figure 25.
  • Page 60: Installing Paper

    3 Setting Up Installing Paper Installing Paper 50 mm paper To install printer paper: Open the printer door by pushing on the latch as shown in Figure 26. If there is an empty or low paper roll in the printer, pull up on the roll to remove it. Examine a new roll of printer paper and remove any remaining adhesive residue from the outer layer of paper.
  • Page 61: 75mm Printer (optional)

    Installing Paper 3 Setting Up 75mm Printer (optional) To install printer paper: Open the printer door by pushing on the latch as shown in Figure 27. If there is an empty or low paper roll in the printer, pull up on the tab holding the paper roll to remove it.
  • Page 62: Installing Batteries

    3 Setting Up Installing Batteries Installing Batteries To install the batteries: Align the M3538A Lithium Ion battery in a battery compartment. Insert the battery, and press until you hear it click into place. Ensure that the latches located on both sides of the battery are engaged fully. Figure 28 Installing Batteries Charging Batteries Charge batteries fully upon receipt and prior to use.
  • Page 63: Installing The Ac Power Module

    Installing the AC Power Module 3 Setting Up Installing the AC Power Module If not presently installed in your device, insert the M3539A AC power module as follows: Align the M3539A AC power module in Compartment B. Insert the AC power module, and press until you hear it click into place. Ensure that the latched located on both sides of the AC power module are engaged fully.
  • Page 64: Installing The Data Card

    3 Setting Up Installing the Data Card Installing the Data Card If not presently installed in your device, install the data card as follows: Insert the data card in the data card tray, sliding it under the tray clip. Confirm that the connector is facing away from the pull tab.
  • Page 65: Ecg And Arrhythmia Monitoring

    ECG and Arrhythmia Monitoring This chapter describes the basic ECG and arrhythmia monitoring functions of the HeartStart MRx monitor/defibrillator. For specific information related to taking a 12-Lead ECG, refer to Chapter 13 “12-Lead ECG” on page 135. Overview The HeartStart MRx can be used for ECG and arrhythmia monitoring, allowing you to monitor through: •...
  • Page 66: Monitoring View

    4 ECG and Arrhythmia Monitoring Monitoring View Monitoring View Monitoring View appears on the display when the Therapy Knob is in the Monitor position. Figure 31 shows the information displayed in Monitoring View. Figure 31 Monitoring View 10 Feb 2006 11:20 Mark Event Patient Name I nops A rea...
  • Page 67: Preparing To Monitor Ecg

    Preparing to Monitor ECG 4 ECG and Arrhythmia Monitoring There are two separate sources of ECG: the ECG leads connection and the Pads/Paddles connection. Leads/pads are displayed according to your device’s configuration. Lead II is configured as the primary ECG lead source and is displayed in Wave Sector 1. You may change this during use with the Lead Select button.
  • Page 68 4 ECG and Arrhythmia Monitoring Preparing to Monitor ECG If not preconnected, connect the ECG patient cable. – Align the keyed patient cable connector with the ECG port on the Measurement module, as shown in Figure 32. – Push the patient cable firmly into the ECG port until the white portion is no longer visible. Figure 32 ECG Cable Connection If monitoring via multifunction electrode pads: If not preconnected, connect the pads cable to the HeartStart MRx.
  • Page 69: Electrode Placement

    Electrode Placement 4 ECG and Arrhythmia Monitoring Electrode Placement Figure 33 shows the typical electrode placement for a 3-lead ECG set. Figure 33 3-lead Placement RA/R placement: directly below the clavicle and RA/R LA/L (White/Red) near the right shoulder (Black/ –...
  • Page 70 4 ECG and Arrhythmia Monitoring Electrode Placement The V/C lead may be placed in any of the precordial electrode positions as shown in Figure 35 (V1/C1 through V6/C6). Figure 35 V/C Electrode Placement V1/C1 placement: fourth intercostal space at right sternal margin. V2/C2 placement: fourth intercostal space at left sternal margin.
  • Page 71: Lead Selection

    Lead Selection 4 ECG and Arrhythmia Monitoring Lead Selection It is important to select a suitable lead for monitoring so that a QRS complex can be accurately detected. The guidelines for lead selection are as follows: For non-paced patients: • QRS complex should be tall and narrow (recommended amplitude > 0.5mV). •...
  • Page 72: Selecting The Lead

    4 ECG and Arrhythmia Monitoring Arrhythmia Monitoring Selecting the Lead The ECG lead for Wave Sector 1 is selected through the Lead Select button or through the Displayed Waves menu. The ECG lead for Wave Sectors 2-4 is selected through the Displayed Waves menu, as follows: Press the Menu Select button.
  • Page 73: Aberrantly-conducted Beats

    R-wave that is as narrow as possible to minimize incorrect classifications. For more information on arrhythmia analysis, refer to the Application Note, “Arrhythmia Monitoring N O T E Algorithm” available on the web at www.medical.philips.com/goto/productdocumentation.
  • Page 74: Heart Rate And Arrhythmia Alarms

    4 ECG and Arrhythmia Monitoring Heart Rate and Arrhythmia Alarms Heart Rate and Arrhythmia Alarms The HeartStart MRx detects arrhythmia alarm conditions by comparing ECG data to a set of pre- defined criteria. An alarm can be triggered by a rate exceeding a threshold (for example HR > XX), an abnormal rhythm (for example, Ventricular Tachycardia), or an ectopic event (for example, PVC >...
  • Page 75 Heart Rate and Arrhythmia Alarms 4 ECG and Arrhythmia Monitoring Figure 38 Alarm Chain for Basic Arrhythmia Monitoring Red Alarms Asystole V-Fib/V-Tach V-Tach Extreme Brady Extreme Tachy Yellow Alarms Beat Detection Alarms Rate Alarms PVC Alarms High HR Low HR PNC* PNP* Frequent PVCs First level timeout period...
  • Page 76: Inop Messages

    4 ECG and Arrhythmia Monitoring Heart Rate and Arrhythmia Alarms INOP Messages INOP messages communicate conditions that prevent the device from monitoring or analyzing the ECG. INOP messages are displayed just above the HR/Arrhythmia alarm status area. If multiple INOP conditions exist, the associated INOP messages will cycle through, alternating every 2 seconds. Table 7 ECG INOPs Alarm Message Condition...
  • Page 77: Setting Alarms

    Setting Alarms 4 ECG and Arrhythmia Monitoring Setting Alarms Alarms are automatically enabled in Monitor and Pacer modes. In Manual Defib Mode alarms are automatically enabled if the Sync function is enabled. If the Sync function is not enabled, alarms are enabled in Manual Defib mode using the Alarm Pause button.
  • Page 78: Displaying An Annotated Ecg

    4 ECG and Arrhythmia Monitoring Displaying an Annotated ECG Displaying an Annotated ECG You may choose to display an annotated ECG with arrhythmia beat labels in Wave Sector 2. The same ECG source appearing in the Wave Sector 1 is displayed with a six second delay along with white arrhythmia beat labels.
  • Page 79: Arrhythmia Learning/relearning

    Arrhythmia Learning/Relearning 4 ECG and Arrhythmia Monitoring Arrhythmia Learning/Relearning When arrhythmia monitoring starts, a “learning” process is initiated. The goal is to learn the patient's normal complexes and/or paced complexes (if the patient with an internal/transvenous pacemaker is in paced rhythm). The learning process involves the first 15 valid (non-noisy) beats encountered during the learning phase.
  • Page 81: Aed Mode

    In patients with cardiac pacemakers, the HeartStart MRx may have reduced sensitivity and not detect all shockable rhythms. The Philips HeartStart MRx AED mode is not intended for children under 8 years of age. For children N O TE S 8 years of age and older, the American Heart Association recommends that standard operating procedures for AEDs be followed.
  • Page 82: Aed View

    5 AED Mode AED View AED View Once the Therapy Knob is moved to AED, AED View is displayed. Figure 40 AED View Display 10 Feb 2006 11:20 Mark Event Alarms Off 02:42 P ads S hocks : 0 Analyzing Do Not Touch Patient P ause MENU...
  • Page 83: Preparation

    Preparation 5 AED Mode Preparation Confirm that the patient is: • unresponsive • not breathing • pulseless Then: Remove clothing from the patient’s chest. Wipe moisture from the patient’s chest and, if necessary, clip or shave excessive chest hair. Make sure the multifunction electrode pads packaging is intact and within the expiration date shown.
  • Page 84: Using Aed Mode

    5 AED Mode Using AED Mode Do not use anterior-posterior pads placement (multifunction electrode pads placed on the patient’s WARNING chest and back). The AED algorithm used by the HeartStart MRx has not been validated using this placement. Do not let the multifunction electrode pads touch each other or other monitoring electrodes, lead WARNING wires, dressings, transdermal patches, etc.
  • Page 85: Step 1 - Turn The Therapy Knob To Aed

    Using AED Mode 5 AED Mode Step 1 - Turn the Therapy Knob to AED When the HeartStart MRx is turned on in AED Mode, it checks to see if the pads cable and multifunction electrode pads are properly connected. If the: •...
  • Page 86: Shock Advised

    5 AED Mode Using AED Mode Shock Advised If a shockable rhythm is detected, the HeartStart MRx automatically charges to 150J. Charging is accompanied by voice and screen prompts as shown in Figure 44. A steady high-pitched tone is sounded, and the orange Shock button flashes when the device is fully charged. Heart rhythm analysis continues while the HeartStart MRx charges.
  • Page 87: Step 3 - Press Shock Button, If Prompted

    Troubleshooting 5 AED Mode Step 3 - Press Shock Button, if Prompted Once charging is complete, the HeartStart MRx prompts you to "Deliver Shock Now; Press the Orange Button Now". Make sure no one is touching the patient or anything connected to the patient. Call out clearly and loudly, “Stay Clear.”...
  • Page 89: Manual Defibrillation And Cardioversion

    Manual Defibrillation and Cardioversion This chapter explains how to prepare for and perform asynchronous and synchronous (cardioversion) defibrillation using multifunction electrode pads, external paddles, and internal paddles. Defibrillation is always performed through paddles or pads. However, during defibrillation you may N O T E choose to monitor the ECG using an alternate ECG source (3-, 5-, or 10-lead monitoring electrodes).
  • Page 90: Precautions For Manual Defibrillation Therapy

    6 Manual Defibrillation and Cardioversion Overview Precautions for Manual Defibrillation Therapy Defibrillating asystole can inhibit the recovery of natural pacemakers in the heart and completely eliminate any chance of recovery. Asystole should not be routinely shocked. Synchronized Cardioversion Therapy The HeartStart MRx provides synchronized cardioversion therapy by delivering a brief biphasic pulse of electricity to the cardiac muscle immediately following an R-wave detected in the ECG measurement.
  • Page 91: Code View

    Code View 6 Manual Defibrillation and Cardioversion Code View In Manual Defib Mode, an energy is selected and the Code View is displayed. Code View is optimized to clearly communicate data associated with a resuscitation event. Notice the increased prominence of the Event Timer, as well as the enlarged ECG in Wave Sectors 1 and 2 as shown in Figure 46.
  • Page 92: Preparing For Defibrillation

    6 Manual Defibrillation and Cardioversion Preparing for Defibrillation Preparing for Defibrillation In preparation for defibrillation: Connect the appropriate Therapy cable. Apply the paddles or pads as described below. Using Multifunction Electrode Pads To prepare for defibrillation using multifunction electrode pads: If not pre-connected, connect the pads cable to the HeartStart MRx by aligning the white pointer on the pads cable connector with the white arrow on the green Therapy port.
  • Page 93: Using External Paddles

    Preparing for Defibrillation 6 Manual Defibrillation and Cardioversion Using External Paddles To defibrillate using external paddles: If not pre-connected, connect the paddles cable to the HeartStart MRx by aligning the white pointer on the paddles cable connector with the white arrow on the green Therapy port. Then push until you hear it click into place.
  • Page 94: Using Pediatric Paddles

    6 Manual Defibrillation and Cardioversion Preparing for Defibrillation Using Pediatric Paddles The HeartStart MRx’s external paddle set comes with pediatric paddles included. The American Heart Association recommends using pediatric paddles on children weighing < 10 Kg (larger paddles may be used as long as contact between the paddles is avoided).
  • Page 95: Defibrillating (asynchronously)

    Defibrillating (asynchronously) 6 Manual Defibrillation and Cardioversion Defibrillating (asynchronously) Once you have performed the necessary preparation for defibrillation, perform the following steps: Select Energy - To select the energy setting, rotate the Therapy Knob to the desired energy level as shown in Figure 51.
  • Page 96 6 Manual Defibrillation and Cardioversion Defibrillating (asynchronously) harge Charge - Press the Charge button on the front panel. If using external paddles, the charge button on the paddles may be used instead. As the defibrillator charges, the energy selection shown in the Shock Status area changes to show the current charge energy.
  • Page 97: Performing Synchronized Cardioversion

    When using paddles, you should monitor the ECG through monitoring electrodes connected to a 3-, 5- or 10-lead ECG cable or a Philips bedside monitor. You may choose to monitor through an alternate source when using pads, as well. Cardioversion is still delivered through either pads or paddles.
  • Page 98: Delivering A Synchronized Shock

    6 Manual Defibrillation and Cardioversion Performing Synchronized Cardioversion Delivering a Synchronized Shock To perform synchronized cardioversion: With the Therapy Knob in the Monitor position, press the Sync button located beside the Therapy Knob (see Figure 51) to activate the Sync function. A Sync message appears in the upper right corner of Wave Sector 1.
  • Page 99: Delivering Additional Synchronized Shocks

    Troubleshooting 6 Manual Defibrillation and Cardioversion Delivering Additional Synchronized Shocks If additional synchronized shocks are indicated, perform the following steps: Make sure the Sync function is still enabled, as indicated by the presence of the Sync message in the upper right corner of the Wave Sector 1. Repeat Steps 4-6 under “Delivering a Synchronized Shock”.
  • Page 101: Noninvasive Pacing

    Noninvasive Pacing This chapter explains the noninvasive transcutaneous pacing option available with the HeartStart MRx and describes how to perform pacing. Overview Noninvasive transcutaneous pacing therapy is used to deliver pace pulses to the heart. Pace pulses are delivered through multifunction electrode pads that are applied to the patient’s bare chest. While in Pacer Mode, the ECG strip and Event Summary are easily annotated with event information using the Mark Event function button.
  • Page 102: Alarms

    7 Noninvasive Pacing Alarms Alarms Arrhythmia alarms for Pacer Not Pacing and Pacer Not Capture are associated with non- transcutaneous pacing (such as internal, transvenous or epicardial pacing), therefore, these alarms are off when the HeartStart MRx is in Pacer Mode. All other red and yellow alarms are active if enabled, and their limits may be changed while in Pacer Mode.
  • Page 103: Pacing View

    Pacing View 7 Noninvasive Pacing Pacing View Pacing View appears when the Therapy Knob is set to the Pacer position. Figure 52 shows information displayed in Pacing View. Figure 52 Pacing View 10 Feb 2006 11:20 10 Feb 2006 11:20 Mark Event Jones, Samuel 02:02:42...
  • Page 104: Demand Mode Versus Fixed Mode

    7 Noninvasive Pacing Demand Mode Versus Fixed Mode A white pacing marker appears on the ECG waveform in Wave Sector 1 each time a pacer pulse is delivered to the patient. If pacing in demand mode, white R-wave markers also appear on the ECG until capture occurs.
  • Page 105: Preparing For Pacing

    Preparing for Pacing 7 Noninvasive Pacing Preparing for Pacing To prepare for pacing: If not pre-connected, connect the pads cable to the HeartStart MRx by aligning the white pointer on the pads cable with the white arrow on the green Therapy port. Then push until you hear it click into place.
  • Page 106: Demand Mode Pacing

    7 Noninvasive Pacing Demand Mode Pacing If pacing in demand mode, apply monitoring electrodes (see “Electrode Placement” on page 51), and connect the ECG cable to the HeartStart MRx (see “Connecting the ECG Cable” on page 35). If pacing for long periods of time, new monitoring electrodes and multifunction electrode pads should N O T E be applied periodically.
  • Page 107: Fixed Mode Pacing

    Fixed Mode Pacing 7 Noninvasive Pacing Spontaneous beats may be present which are not associated with the delivery of pace pulses. N O T E Additionally, if the patient’s heart rate is above the pacer rate, pace pulses are not delivered and, therefore, pacing markers do not appear.
  • Page 108 7 Noninvasive Pacing Fixed Mode Pacing Use the Lead Select button to select the desired lead for viewing. If you want to see the ECG waveform and related parameters while pacing, you must have electrodes N O T E on the patient with pads. Using pads only will give you an incorrect heart rate and inappropriate alarms.
  • Page 109: Defibrillating During Pacing

    Defibrillating During Pacing 7 Noninvasive Pacing Defibrillating During Pacing Should it be necessary to defibrillate the patient during pacing, refer to the procedure for defibrillating in Manual Defib Mode in Chapter 6, or AED Mode in Chapter 5. Once the Therapy Knob is moved from the Pacer position to a Manual Defib Mode energy setting or AED, pacing is stopped.
  • Page 111: Pulse Oximetry

    The HeartStart MRx allows you to monitor SpO while in Monitor, Manual Defib, and Pacer modes. When using the Q-CPR option, SpO monitoring functionality is not available. For more information on SpO , refer to the Application Note, Philips Pulse Oximetry. N O T E...
  • Page 112: Understanding Pulse Oximetry

    8 Pulse Oximetry Understanding Pulse Oximetry Understanding Pulse Oximetry A pulse oximetry sensor sends light through patient tissue to a receiver on the other side of the sensor. As Figure 57 shows, light emitting diodes transmit red and infrared light through peripheral areas of the body, such as a finger.
  • Page 113: Selecting A Sensor

    Selecting a Sensor 8 Pulse Oximetry Selecting a Sensor See “SpO2 Sensors and Cables” on page 293 for a list of the SpO sensors that may be used with the HeartStart MRx. CAUTION • Do not use disposable sensors in high humidity environments or in the presence of fluids which may contaminate sensor and electrical connections, causing unreliable or intermittent measurements.
  • Page 114: Applying The Sensor

    8 Pulse Oximetry Applying the Sensor Applying the Sensor Follow the manufacturer’s directions for applying and using the sensor, making sure to observe any warnings or cautions. For the best results: • Make sure the sensor is dry. • If the patient is moving, secure the sensor cable loosely to the patient. •...
  • Page 115: Monitoring Spo

    Monitoring SpO 8 Pulse Oximetry Monitoring SpO To monitor SpO Connect the appropriate sensor cable to the to the HeartStart MRx as described in “Connecting the SpO2 Cable” on page 36. Apply the sensor to the patient. If the HeartStart MRx is not turned on, turn the Therapy Knob to Monitor. Check that the patient category is appropriate for the patient.
  • Page 116: Pleth Wave

    8 Pulse Oximetry Monitoring SpO Pleth Wave When the sensor is connected to the HeartStart MRx, the pleth wave is displayed in the configured Wave Sector or the first available empty Wave Sector. It is drawn at an approximate speed of 25 mm/ second.
  • Page 117: Spo 2 Alarms

    Alarms 8 Pulse Oximetry Alarms Alarms are annunciated if measurements fall outside the configured limits for high or low SpO , or if the measurement falls below the configured SpO Desat Limit. SpO alarms, except Desat, are all categorized as “non-latching” alarms, meaning they are automatically removed when their alarm condition no longer exists.
  • Page 118: Spo 2 Desat Alarm

    8 Pulse Oximetry Pulse Rate Alarms Desat Alarm The HeartStart MRx also provides an alarm for SpO Desat Limit. The SpO Desat alarm provides an additional limit setting below the low limit setting to notify you of potentially life threatening decreases in oxygen saturation.
  • Page 119: Enabling/disabling The Pulse Rate Alarms

    Disabling the SpO Monitoring Function 8 Pulse Oximetry Enabling/Disabling the Pulse Rate Alarms To enable/disable the Pulse Rate Alarms, perform the following steps: Press the Menu Select button. Using the Navigation buttons, select the Measurements/Alarms menu and press the Menu Select button.
  • Page 120: Caring For Sensors

    8 Pulse Oximetry Caring for Sensors Caring for Sensors Refer to the manufacturer’s instructions for care and cleaning of sensors. To get the best results from your reusable SpO sensors, always handle the sensor and cable with care and protect them from sharp objects.
  • Page 121: Noninvasive Blood Pressure

    Noninvasive Blood Pressure This chapter describes how to monitor noninvasive blood pressure (NBP) with the HeartStart MRx. Overview Your HeartStart MRx measures blood pressure for both adult and pediatric patients using the oscillometric method. Systolic, diastolic, and mean measurements are provided, and alarms are available to alert you to changes in the patient’s condition.
  • Page 122: Preparing To Measure Nbp

    9 Noninvasive Blood Pressure Preparing to Measure NBP The first time an NBP measurement is taken, the cuff’s initial inflation pressure is 160 mmHg (adult) or 120 mmHg (pediatric). If the measurement is successful, the next inflation pressure is 35-40 mmHg above the systolic measurement, with a minimum inflation pressure of 120 mmHg.
  • Page 123 Preparing to Measure NBP 9 Noninvasive Blood Pressure Apply the blood pressure cuff to the patient’s arm or leg as follows: a. Ensure that the cuff is completely deflated. b. The cuff should not be placed on the same extremity as an SpO sensor.
  • Page 124: Measuring Nbp

    9 Noninvasive Blood Pressure Measuring NBP Measuring NBP To measure NBP, press the [Start NBP] soft key. The cuff pressure is displayed as the cuff inflates and deflates. When the measurement is complete, the NBP values are displayed. Additional measurements are taken according to the configured NBP schedule. If the schedule is configured to: Manual - There is no schedule for additional measurements.
  • Page 125: Alarms

    Alarms 9 Noninvasive Blood Pressure Alarms An NBP alarm is annunciated when a measurement for the configured source (systolic, diastolic, or mean) falls outside the configured high or low limits. NBP alarms are all categorized as “non-latching” alarms, meaning they are automatically removed when their alarm condition no longer exists. Both the source of the alarm and the limits may be changed during use, for the current patient incident.
  • Page 126: Enabling/disabling Nbp Alarms

    9 Noninvasive Blood Pressure Troubleshooting Enabling/Disabling NBP Alarms To enable/disable NBP Alarms: Press the Menu Select button. Using the Navigation buttons, select the Measurements/Alarms menu and press the Menu Select button. Select NBP and press the Menu Select button. Select Alarms On/Off and press the Menu Select button. Troubleshooting If your HeartStart MRx does not operate as expected during NBP Monitoring, see Chapter 22, “Troubleshooting”...
  • Page 127: Monitoring Carbon Dioxide

    Monitoring Carbon Dioxide This chapter describes how to monitor carbon dioxide (CO ) and measure end-tidal carbon dioxide ® (EtCO ) and Airway Respiration Rate (AwRR) with the HeartStart MRx using the Microstream (sidestream) method. CO Monitoring is available in Monitor, Pacer, and Manual Defib modes. Overview The carbon dioxide monitoring function of the HeartStart MRx, together with the appropriate ®...
  • Page 128: Preparing To Measure Etco

    10 Monitoring Carbon Dioxide Preparing to Measure EtCO Preparing to Measure EtCO Selecting the Accessories There are some factors to consider when selecting accessories: • the type of patient, adult, pediatric, or neonate. • airway status of the patient, ventilated or not ventilated. •...
  • Page 129: Setting Up Microstream Etco 2 Measurements

    Setting Up Microstream EtCO Measurements 10 Monitoring Carbon Dioxide Setting Up Microstream EtCO Measurements • Danger - explosion hazard - sidestream measurement should not be used in the presence of WARNING flammable anesthetics such as: – flammable anesthetic mixture with air –...
  • Page 130: Measuring Etco

    10 Monitoring Carbon Dioxide Measuring EtCO When using the Microstream EtCO measurement on patients who are receiving or have recently WARNING received anesthetics, connect exhaust tubing from the CO Outlet port to a scavenging system or to the anesthesia machine/ventilator to prevent exposing medical staff to anesthetics. Use an exhaust tube to remove the sample gas to a scavenging system.
  • Page 131: Changing The Etco 2 Alarm Limits

    EtCO and AwRR Alarms 10 Monitoring Carbon Dioxide Changing the EtCO Alarm Limits To change the EtCO alarm limits: Press the Menu Select button. Using the Navigation buttons, select the Measurements/Alarms menu and press the Menu Select button. Select EtCO and press the Menu Select button.
  • Page 132: Changing The Apnea Time Alarm Limit

    10 Monitoring Carbon Dioxide Disabling the EtCO Monitoring Function Changing the Apnea Time Alarm Limit To change the apnea time alarm limit: Press the Menu Select button. Using the Navigation buttons, select the Measurements/Alarms menu and press the Menu Select button.
  • Page 133: Invasive Pressures

    Invasive Pressures This chapter describes how to monitor invasive pressures using the HeartStart MRx. Overview The Invasive Pressures option on your HeartStart MRx offers two channels of real-time continuous invasive pressure measurements and waveforms in Monitor, Manual Defib and Pacer modes. If the pressure signal is pulsatile, numeric values are displayed for systolic, diastolic and mean pressure.
  • Page 134 11 Invasive Pressures Setting up for a Pressure Measurement If you are using an infusion pressure cuff with the pressure line, attach the pressure cuff to the fluid to be infused. Inflate it according to your hospital’s standard procedure then begin the infusion. Position the transducer so that it is level with the heart, approximately at the level of the midaxillary line.
  • Page 135: Selecting A Pressure To Monitor

    Selecting a Pressure to Monitor 11 Invasive Pressures Selecting a Pressure to Monitor You need to assign a label to each pressure channel as it is connected. Channels are identified as Press 1 and Press 2. You can apply labels to each pressure channel by selecting the appropriate pressure label using the Menu Select button.
  • Page 136: Pressure Waves

    11 Invasive Pressures Pressure Waves Pressure Waves Each pressure label has a set of scales for the pressure wave. You can adapt the displayed wave to the offset and amplitude of the signal. The scale can be modified through the Displayed Waves menu. To select a pressure wave and the associated scale for the display or printed strip, perform the following steps: Press the Menu Select...
  • Page 137: Zeroing The Pressure Transducer

    Zeroing the Pressure Transducer 11 Invasive Pressures Zeroing the Pressure Transducer To avoid inaccurate pressure readings, the HeartStart MRx requires a valid zero be performed on the pressure channel. It should be zeroed according to your hospital policy - at least once per day. Also, you should rezero in the following circumstances: •...
  • Page 138 11 Invasive Pressures Zeroing the Pressure Transducer Invasive pressure alarms and pulse alarms (if they are derived from invasive pressure readings) are WARNING temporarily turned off while the transducer is zeroing. The alarms will turn back on 30 seconds after zeroing is complete.
  • Page 139: Calibration

    Calibration 11 Invasive Pressures Calibration The HeartStart MRx allows you to input the calibration factor (see documentation supplied by the transducer’s manufacturer) of a new transducer plugged into the pressure line. Known Calibration Factor To set a known calibration factor, perform the following: Zero the transducer (see previous section) Press the Menu Select button.
  • Page 140: Calibrating Reusable Transducer Cpj840j6

    11 Invasive Pressures Calibration Calibrating Reusable Transducer CPJ840J6 Perform a mercury calibration when you use a new reusable transducer and at regular intervals according to your hospital policy. You will need: • standard sphygmomanometer • sterile 10cc syringe with heparinized solution •...
  • Page 141: Calibration Confirmation

    Calibration 11 Invasive Pressures Raise the manometer pressure to approximately 200 mmHg or 27.0 kPa. Press the Menu Select button. Using the Navigation buttons, select Measurements/Alarms and press the Menu Select button. Select the pressure (channel: label) you wish to calibrate and press the Menu Select button. Select Calibration Pressure and press the Menu Select button.
  • Page 142: Last Zero/calibration

    11 Invasive Pressures Calibration Last Zero/Calibration You can view dates and times for a channel’s last zero or mercury calibration through the HeartStart MRx menu. To view a channel’s last zero and mercury calibration dates, perform the following steps: Press the Menu Select button.
  • Page 143: Alarms

    Alarms 11 Invasive Pressures Alarms Alarms are provided to alert you to a change in the patient’s condition. If alarms are enabled, alarm limits appear next to the pressure value. Invasive pressure alarms (except ABP, ART, Ao, PAP, P1 or P2 disconnect alarms) are all categorized as “non-latching”...
  • Page 144: Enabling/disabling Alarms

    11 Invasive Pressures Alarms Enabling/Disabling alarms To enable/disable alarms, perform the following steps: Press the Menu Select button. Using the Navigation buttons, select Measurements/Alarms and press the Menu Select button. Select the pressure label (channel: label) you wish to modify alarm status on and press the Menu Select button.
  • Page 145: Cpp Alarms

    Alarms 11 Invasive Pressures CPP Alarms With CPP and ICP, only one of the two parameters can have alarms enabled at one time. If CPP alarms are turned on then ICP alarms are turned off. Both alarms can be turned off at the same time. The parameter with alarms off will be displayed at the bottom of the ICP/CPP parameter area with the Alarms Off symbol.
  • Page 146: Pulse

    11 Invasive Pressures Pulse Pulse The HeartStart MRx can provide pulse readings from either the SpO or Invasive Pressures options. To understand how pulse works with SpO only, read Chapter 8, Pulse Oximetry. If your device has both options, read the following section. Pulse Sources When both SpO and Invasive Pressures options are present on the HeartStart MRx, pulse can be...
  • Page 147: Changing Pulse Source

    Pulse 11 Invasive Pressures Changing Pulse Source To change pulse source for the current incident, perform the following steps: Press the Menu Select button. Using the Navigation buttons, select Measurements/Alarms and press the Menu Select button. Select Pulse and press the Menu Select button. Select Pulse Source and press the Menu Select button.
  • Page 148: Pulse Alarm Limits

    11 Invasive Pressures Caring For Your Transducers and Probes Pulse Alarm Limits Pulse alarm limits can be changed for the current incident. To change alarm limits, perform the following steps: Press the Menu Select button. Using the Navigation buttons, select Measurements/Alarms and press the Menu Select button. Select Pulse and press the Menu Select button.
  • Page 149: Temperature

    Temperature This chapter describes how to monitor temperature using the HeartStart MRx. Overview The HeartStart MRx offers one channel of real-time continuous temperature monitoring. The device can monitor nasopharyngeal, esophageal, rectal, skin, arterial, venous, core and urinary bladder temperatures. Measurements, which can be displayed in either Fahrenheit or Celsius, may be taken while in Monitor, Pacer or Manual Defib modes.
  • Page 150: Monitoring Temperature

    12 Temperature Monitoring Temperature Monitoring Temperature To monitor temperature, perform the following: Connect the temperature cable to the HeartStart MRx. Select the correct temperature label for your measurement. Check that the current device settings (including alarm settings) are appropriate for the patient. Apply the temperature probe to the patient.
  • Page 151: Changing Temperature Alarm Limits

    Changing Degree Units 12 Temperature Changing Temperature Alarm Limits To change the temperature alarm limits for the current incident, perform the following: Press the Menu Select button. Using the Navigation buttons, select Measurements/Alarms and press the Menu Select button. Select the temperature label option currently assigned to your measurement and press the Menu Select button.
  • Page 152: Disabling The Temperature Function

    12 Temperature Caring For Your Temperature Cables and Probes Disabling the Temperature Function To turn off the Temperature function, disconnect the temperature cable from the HeartStart MRx port. The message Temp (or the label currently activated) unplugged. Turn off Temp? appears. Select Yes and press the Menu Select button.
  • Page 153: 12-lead Ecg

    This chapter describes how to use the diagnostic 12-lead ECG function of the HeartStart MRx. Overview The optional 12-lead ECG function, using Philips’ DXL Algorithm, is available in Monitor Mode and allows you to preview, acquire, print, copy, and store a 12-lead ECG. In addition, the 12-lead function provides computerized ECG analysis using the DXL Algorithm.
  • Page 154: Preparation

    Preparation N O TE S The Philips DXL Algorithm is capable of interpreting up to 16 leads, however the HeartStart MRx uses the 12-lead functionality only. ACI-TIPI and TPI are to be used as part of a suite of diagnostic tools and used in an advisory basis.
  • Page 155: Preview Screen

    Preview Screen 13 12-Lead ECG Preview Screen The 12-lead function’s Preview Screen allows you to see real-time 12-lead ECG data and verify signal quality before acquiring the ECG. As shown in Figure 66, it displays patient information and approximately 2.5 seconds of each of the 12 leads acquired. Waveforms are presented at a rate of 25mm/sec and the configured wave size.
  • Page 156: Acquiring A 12-lead Ecg

    13 12-Lead ECG Acquiring a 12-Lead ECG Acquiring a 12-Lead ECG Once preparation is complete, to acquire a 12-lead ECG in Monitor Mode: Press the [12-Lead] soft key. The Preview Screen is displayed, as shown in Figure 66. Check the signal quality on each lead and, if necessary, make adjustments as described in “Improving Signal Quality”...
  • Page 157: Acquiring A 12-lead Ecg With Aci-tipi And/or Tpi Analysis

    Acquiring a 12-Lead ECG 13 12-Lead ECG Acquiring a 12-lead ECG with ACI-TIPI and/or TPI Analysis If configured to do so, the HeartStart MRx runs the ACI-TIPI and TPI predictive instrument algorithms after a 12-lead ECG has been acquired. You can configure your device to: •...
  • Page 158 13 12-Lead ECG Acquiring a 12-Lead ECG Figure 67 TPI Inputs Candidate for Thrombolysis Time Since Onset of Ischemic Symptoms Unknown Blood Pressure Unknown History of Hypertension unknown Unknown History of Diabetes Unknown Patient Weight Unknown Contraindications for Thrombolytic Therapy After entering TPI inputs, the HeartStart MRx prompts you to indicate the presence of thrombolytic therapy contraindications from a pre-configured list.
  • Page 159 Acquiring a 12-Lead ECG 13 12-Lead ECG To change a contraindication: When the list of contraindications appears on the HeartStart MRx display (see Figure 68), use the Navigation buttons to highlight one of the contraindications and press the Menu Select button. Use the Navigation buttons to select a new value for the contraindication and press the Menu Select button.
  • Page 160 However, ventricular conduction abnormalities and ventricular hypertrophy cause secondary ST and T wave changes that, if misinterpreted as primary could cause erroneously high ACI-TIPI scores. Philips’ algorithm attempts to sort out the primary from the secondary ST and T changes when conduction abnormalities are present.
  • Page 161: Critical Values

    Acquiring a 12-Lead ECG 13 12-Lead ECG Critical Values Certain interpretive results generate Critical Value statements which alert you to a condition which may need immediate attention. The Critical Value statements appear on the bottom of the HeartStart MRx 12-Lead display in white text on a red background with directional arrows (>>> <<<) on each side of the statement text.
  • Page 162 13 12-Lead ECG Acquiring a 12-Lead ECG Table 21 Acute MI Statements (Continued) Interpretive Statement Criteria Lateral infarct, acute (LAD) ST >.10 mV, V5 V6 I aVL Posterior infarct, acute ST<-.01 V1-V3 or ST>.05 V7-V9 Probable posterior infarct, acute ST<-.05 V1-V3 or >.05 V7-V9 Posterior infarct, acute (LCX) ST<-.01 V1-V3 or ST>.05 V7-V9 Acute Ischemia...
  • Page 163: Culprit Artery

    Acquiring a 12-Lead ECG 13 12-Lead ECG Culprit Artery If your 12-Lead interpretive statement contains an acronym in parenthesis (see Table 25), it is an indication the analysis is identifying the probable anatomical site of a coronary artery occlusion responsible for ischemia. Table 25 Culprit Arteries Acronym Probable Anatomical Site...
  • Page 164: 12-lead Report

    Interpretive statements - Measurements and patient information are used by the Philips 12-Lead DXL Algorithm to generate statements describing the patient’s cardiac rhythm and waveform morphology.
  • Page 165 Inferior injury, probable early acute infarct Statements Ant-sept injurt, probable early acute infarct QTc 360 Lateral leads are also involved --Axis-- Severity Unconfirmed diagnosis -ABNORMAL ECG- Philips Predicted Probability of Acute Ischemia Predicted Probability Acute MI >>> <<< of Acute Ischemia Start...
  • Page 166: Accessing Stored Reports

    13 12-Lead ECG 12-Lead Report Accessing Stored Reports You may access stored reports to print additional copies or delete the report from internal storage. You may also copy the report to a data card. The list of stored reports for the current patient event may be accessed while a report is displayed or from either the 12-Lead Acquire Screen or the 12-Lead Preview Screen.
  • Page 167: Improving Signal Quality

    Improving Signal Quality 13 12-Lead ECG Improving Signal Quality Signal quality can impact ECG analysis. Refer to Table 26 for possible solutions to common ECG quality problems. Table 26 ECG Signal Problems Problem Possible Causes Possible Solutions Tremor or muscle artifact •...
  • Page 168: 12-lead Filters

    13 12-Lead ECG 12-Lead Filters 12-Lead Filters ECG bandwidth filters of 0.15 - 40 Hz, 0.05 - 40 Hz, or 0.05 - 150 Hz may be selected in Configuration to apply to 12-lead ECG waveforms shown on the display. Additionally, the 12-Lead Report may be configured to apply either the same filter choice used for the display, or a 0.05 - 150 Hz filter.
  • Page 169: Vital Signs Trending

    Vital Signs Trending This chapter describes how to review patient data using HeartStart MRx Vital Signs Trending. Overview In Monitor Mode, your HeartStart MRx provides the ability to view and print numeric vital sign trending for the current incident. Trending data are automatically acquired if parameters are on. When viewing trending, the Vital Sign Trending Report is displayed in the HeartStart MRx’s lower two wave sectors and takes over the soft key functions.
  • Page 170: About The Data Displayed

    14 Vital Signs Trending Reviewing Trending Data Figure 70 Vital Signs Trending Report Time intervals - Vital Sign trends are displayed at the selected time interval. See Date of report - The earliest time displayed “Vital Signs Trending Report Intervals” on in the table determines the date of the report.
  • Page 171: Vital Signs Trending Report Parameter List Order

    Reviewing Trending Data 14 Vital Signs Trending When the time interval in the Vital Signs Trending Report is one minute, data from continuous N O T E measurements represents the average reading for that one-minute period. For all other time intervals, the measurement shown is the one-minute average from the most recent minute in the time interval.
  • Page 172: Printing The Vital Signs Trending Report

    14 Vital Signs Trending Reviewing Trending Data Printing the Vital Signs Trending Report You can print the Vital Signs Trending Report two ways: Press the soft key under the Print Trends label. A report for the displayed period and interval is printed.
  • Page 173: Exiting Vital Signs Trending Report

    Troubleshooting 14 Vital Signs Trending Exiting Vital Signs Trending Report To exit the Vital Signs Trending Report and return to a waveform display, press the soft key under the [Close Trends] label in the Vital Signs Trending Report display. You will be returned to Monitor Mode.
  • Page 175: Cpr And Data Capture

    Compressions are measured by the CPR meter connected to the HeartStart MRx using a Pads/CPR meter cable. Ventilation data is acquired through Philips multifunction defib electrode pads applied to the patient and connected to the HeartStart MRx using the same Pads/CPR cable.
  • Page 176 15 Q-CPR and Data Capture Overview The Q-CPR option is not intended for use in a moving environment, such as an ambulance. WARNING Additional movement introduced during patient transport may reduce the accuracy of the compression and ventilation measurements. If Q-CPR must be used in a moving environment, do not rely on the Q-CPR feedback during such conditions.
  • Page 177: Preparing To Use Q-cpr

    Preparing to Use Q-CPR 15 Q-CPR and Data Capture Preparing to Use Q-CPR A Pads/CPR cable connects the CPR meter to the HeartStart MRx. To set up the Q-CPR option on the HeartStart MRx and prepare the patient for use, follow the steps described on the following pages. Connecting the Pads/CPR Cable To connect the Pads/CPR cable: Align the white pointer on the cable with the white arrow on the green Therapy port as shown in...
  • Page 178: Connecting The Cpr Meter To The Pads/cpr Cable

    Apply the pads to the patient in the anterior/anterior position as shown on the pads package. WARNING Anterior-posterior pad placement should not be used with the Q-CPR option. CAUTION Philips multifunction defib electrode pads are required to measure ventilation activity, as well as acquire an ECG signal and deliver a shock, as appropriate.
  • Page 179: Cpr Meter

    Mount Area 3.9 - 10 V Compression max 170mA 453564145481 Area Manuf actured for PHILIPS MEDICAL SYSTEMS Andover, MA 01810, USA by LAERDAL MED ICAL AS, N orway Vent membrane* CPR meter Placement Guide * The vent membrane allows internal and external pressures to equalize.
  • Page 180: Attaching The Cpr Meter Adhesive Pad

    15 Q-CPR and Data Capture Preparing to Use Q-CPR Attaching the CPR Meter Adhesive Pad You need to attach an adhesive pad to the back of the CPR meter before using. To attach the CPR meter Adhesive Pad to the CPR meter: Open the package of CPR meter Adhesive Pads and peel one from the liner strip to expose the adhesive surface on the underside.
  • Page 181: Placing The Cpr Meter On The Patient

    Preparing to Use Q-CPR 15 Q-CPR and Data Capture Placing the CPR Meter on the Patient To place the CPR meter on the patient: Ensure the patient’s skin is clean and dry. If necessary, clip or shave the hair from the sternum area. Peel off the green liner from the CPR meter Adhesive Pad to expose the adhesive surface.
  • Page 182: Starting Cpr With The Cpr Meter

    15 Q-CPR and Data Capture Preparing to Use Q-CPR Starting CPR with the CPR Meter Using standard CPR technique, place the heel of one hand directly over the compression area of the attached CPR meter. Place your other hand on top of the first, interlocking your fingers. You should be able to see the display area of the CPR meter to look for feedback (see Figure 79).
  • Page 183: Cpr Meter Display

    Preparing to Use Q-CPR 15 Q-CPR and Data Capture CPR Meter Display The CPR meter provides real-time graphical feedback as a coaching tool once CPR compressions begin. See Figure 81. Figure 81 CPR Meter Indicators Compression Compression Rate Target Release Target Compression Compression Rate Indicator...
  • Page 184 15 Q-CPR and Data Capture Preparing to Use Q-CPR Compression Rate The CPR meter also provides feedback on your rate of compressions and uses a speedometer to tell you to speed up or slow down your compression rate. See Figure 83. Figure 83 Compression Rate Indicator If the CPR meter detects the rate of compression is within the target area, the speedometer needle on the...
  • Page 185: Q-cpr Feedback On The Heartstart Mrx

    Q-CPR Feedback on the HeartStart MRx 15 Q-CPR and Data Capture Q-CPR Feedback on the HeartStart MRx Depending upon how you configure your HeartStart MRx, you can receive a variety of information on the HeartStart MRx display. Feedback is also displayed on the CPR meter. On the HeartStart MRx display, Advanced View can be displayed in both Manual Defibrillation Mode and in AED Mode while Basic View is available in AED Mode only.
  • Page 186 15 Q-CPR and Data Capture Q-CPR Feedback on the HeartStart MRx Figure 84 Advanced Q-CPR View 11 Feb 2006 22:32 Mark Event Alarms Off Adult Non- Paced 14:02 Shocks: 0 Selected Energy: 150 Joules Compression CPR Timer CPR: 02:30 Compressions: Counter Comp Comp...
  • Page 187 Q-CPR Feedback on the HeartStart MRx 15 Q-CPR and Data Capture If your device does not have invasive pressure active, the ventilation detection icon is displayed in Parameter Block 2 and depicts the level of ventilation volume. A set of lungs graphically shows the three states of volume: full, empty and questionable (if ventilation cannot be measured, lungs marked with a “- ? -”...
  • Page 188: Basic View

    15 Q-CPR and Data Capture Q-CPR Feedback on the HeartStart MRx Basic View When selecting Basic View, the HeartStart MRx displays the following parameters, depending upon your configuration (See Figure 86): • CPR Timer • AED and Q-CPR prompt commands. See “Feedback Prompts” on page 172. Figure 86 Basic Q-CPR View 11 Feb 2006 22:25 Mark Event...
  • Page 189: Using Q-cpr In Manual Defib Mode

    Using Q-CPR in Manual Defib Mode 15 Q-CPR and Data Capture Using Q-CPR in Manual Defib Mode When the Therapy Knob is moved to the 150J Manual Defib setting, the Advanced CPR View is automatically displayed only if the Sync function is disabled, patient category is Adult, and patient age is equal to or greater than 8 years old.
  • Page 190: Feedback Prompts

    15 Q-CPR and Data Capture Using Q-CPR in AED Mode Feedback Prompts Table 28 lists the feedback prompts that may be issued during the use of Q-CPR. Table 28 CPR Feedback Prompts CPR Component Problem HeartStart MRx Accompanying HeartStart MRx Voice Prompt Text Prompt (Basic View only) Compression Depth...
  • Page 191: Adjusting Cpr Feedback Volume

    Using Q-CPR in AED Mode 15 Q-CPR and Data Capture Adjusting CPR Feedback Volume To adjust the volume of CPR feedback voice prompts: Press the Menu Select button. Using the Navigation buttons, select Volume from the menu and press the Menu Select button. Select Voice and press the Menu Select button.
  • Page 192: After Each Use

    15 Q-CPR and Data Capture After Each Use After Each Use The CPR meter, vent membrane and horizontal groove on the rear of the meter should be inspected after each use and cleaned if necessary. Remove the CPR meter Adhesive Pad from the CPR meter and follow the cleaning directions listed in the Maintenance chapter section entitled “CPR meter”...
  • Page 193: Data And Events Recorded

    Troubleshooting 15 Q-CPR and Data Capture Data and Events Recorded With the Data Capture option, the HeartStart MRx records CPR data in all clinical modes when data recording is active. It will start recording when a CPR meter is detected and stop when the CPR meter is removed from the HeartStart MRx or the HeartStart MRx leaves a clinical mode.
  • Page 195: Networking

    The IntelliVue Networking Option allows the HeartStart MRx monitor/defibrillator to connect and communicate with the Philips IntelliVue M3185 Clinical Network (System J or later) via a wired network connection or wirelessly. When on the network, the HeartStart MRx performs in a fashion...
  • Page 196: Intellivue Networking Display

    16 Networking IntelliVue Networking Display IntelliVue Networking Display When in a clinical mode, the status area of the HeartStart MRx with IntelliVue Networking Option provides network-related data (see Figure 88) including: Network Connectivity Icon An icon indicating a wired or wireless Local Area Network (LAN) connection is displayed.
  • Page 197: Connecting To The Network

    HeartStart MRx. See "Wired Connection" on page 180. “Wireless.” Philips’ Instrument Telemetry 1.4 GHz radio and A/C module (radio/AC power module backpack) is mounted on the HeartStart MRx and plugged into the RS-232 connector. See "Wireless Connection"...
  • Page 198: Wired Connection

    16 Networking Connecting to the Network Wired Connection To connect your HeartStart MRx to the network using a wired connection, plug an active IntelliVue Network cable into the LAN port on the back of the device. See Figure 89. Figure 89 Wired Connection Physical Setup On the display: The wired icon appears on your display in...
  • Page 199: Combined Connection

    Connecting to the Network 16 Networking Combined Connection In instances when you have both wired and wireless connections available (See Figure 91), the wired connection takes priority. If you lose the wired connection, the device automatically attempts to connect to the network via the N O T E wireless radio/AC module.
  • Page 200: Using The Device Location Option

    16 Networking Connecting to the Network Using the Device Location Option A HeartStart MRx that is powered on and has an active wireless connection to the IntelliVue Clinical Network can be located by using the Information Center’s Device Location option. The Device Location option allows you to identify the general location of your HeartStart MRx by associating the device with network access points installed in the healthcare facility.
  • Page 201: Network Settings

    Connecting to the Network 16 Networking Network Settings You can view your current network settings in Monitor, Pacer and Manual Defib modes. To view current network settings, perform the following: Press the Menu Select button. ), select Other and press the Menu Select button. Using the Navigation buttons ( Select Network Settings and press the Menu Select button.
  • Page 202: Admit, Discharge, Transfer Of Patients

    16 Networking Admit, Discharge, Transfer of Patients Admit, Discharge, Transfer of Patients A HeartStart MRx with the IntelliVue Networking Option synchronizes and maintains common patient demographic data with the Information Center. The HeartStart MRx can admit, discharge and transfer (ADT) patients to or from the Information Center and update or modify patient information. The HeartStart MRx will also accept certain patient admission data entered at the Information Center including name, medical record number (patient ID), patient type (category), date of birth, gender (sex) and paced status.
  • Page 203: Discharge

    Admit, Discharge, Transfer of Patients 16 Networking Patient Type and Paced status will always have a value, regardless if the patient is admitted or not. If WARNING you do not specify settings for these two fields, the HeartStart MRx uses the default settings, which may not be correct for your patient.
  • Page 204 16 Networking Admit, Discharge, Transfer of Patients Table 33 Discharge Patient Messages Network Status Discharge Patient Message The patient demographics and all patient data will be closed in the Connected to network MRx and erased in Central and settings reset to defaults. Not connected to network All trends, events and patient identification of the current patient will be closed and settings reset to defaults.
  • Page 205: Transfer

    Admit, Discharge, Transfer of Patients 16 Networking If a patient discharge is confirmed: The current patient incident is closed. The HeartStart MRx sends the discharge command to the Information Center (if connected) then automatically shuts down and restarts. While shutting down, the display will go black. You can turn the device off at this point.
  • Page 206: Transfer Mode

    16 Networking Admit, Discharge, Transfer of Patients Transfer Mode Transfer Mode is used to hand off patient data from one monitoring location to another. While in Transfer Mode patient information can’t be modified. The HeartStart MRx continues to send data to the Information Center without an associated patient name.
  • Page 207 Admit, Discharge, Transfer of Patients 16 Networking Clear Transfer Clear Transfer exits the HeartStart MRx’s Transfer Mode after losing connection to the network. Demographic or patient data remain in the Information Center’s transfer list and are maintained at the HeartStart MRx. To select Clear Transfer perform the following steps: While in Transfer Mode, press the Menu Select button.
  • Page 208: Sharing Information On The Network

    16 Networking Sharing Information on the Network Sharing Information on the Network Once connected to the IntelliVue Network, the HeartStart MRx shares information and data with the Information Center. You can also silence and reset most alarms remotely from the Information Center. Patient Information Updates After the HeartStart MRx makes a network connection with the Information Center, all patient...
  • Page 209 Sharing Information on the Network 16 Networking Date and Time In instances where the HeartStart MRx’s date and time are not in agreement with the Information Center, the HeartStart MRx automatically synchronizes its date and time to match the Information Center’s.
  • Page 210: Conflict Handling

    16 Networking Sharing Information on the Network Conflict Handling Conflicting patient information between the Information Center and the HeartStart MRx is automatically resolved (using the Information Center’s “Same Patient” Conflict Resolution) when the HeartStart MRx associates with the Information Center. If patient information on the HeartStart MRx has changed as a result of the resolution, the message “Patient information from the MRx and Central has been merged”...
  • Page 211: Viewing Patient Incident Data

    Sharing Information on the Network 16 Networking Viewing Patient Incident Data While at the Information Center, you can view patient incident data sent from the HeartStart MRx. Refer to the IntelliVue Clinical Information Center Instructions for Use for details. Up to 30 single- valued and/or tripled-valued parameters, up to four waveforms (except for Q-CPR) and seven alarms are viewable at the Information Center.
  • Page 212: Leaving A Clinical Mode

    16 Networking Sharing Information on the Network Leaving a Clinical Mode If a networked HeartStart MRx is changed to a non-clinical mode (i.e. Data Management, Operational Check, Battery Calibration, Configuration or Service modes) a “No data from bed” INOP statement appears on the Information Center display.
  • Page 213: Events Logged

    Sharing Information on the Network 16 Networking Events Logged The HeartStart MRx automatically creates an Event Summary for each patient incident. Each Event Summary is assigned a unique event identification number and is date/time stamped. Table 34 lists IntelliVue Networking-related events and information stored in the Event Summary. Refer to the "Working with Data"...
  • Page 214 16 Networking Sharing Information on the Network Table 35 HeartStart MRx Messages at the Information Center HeartStart MRx Information Center Defibrillation/Pacing Alarm/INOP Type Alarm/INOP Type Charge Button Failure Hard INOP Defib Malf Hard INOP Shock Button Failure Hard INOP Defib Malf Hard INOP Shock Equip Malfunction Hard INOP...
  • Page 215: Troubleshooting

    Troubleshooting 16 Networking Troubleshooting If your HeartStart MRx does not operate as expected while trying to communicate with the IntelliVue Network, see “” on page 314 and “Network Connection Rejection Messages” on page 317.
  • Page 217: Configuration

    Configuration This chapter describes the configurable parameters of the HeartStart MRx and the procedures for modifying configuration. Overview Configuration settings allow you to customize the HeartStart MRx to best meet your needs. Configuration is performed through the Configuration menu of the device and may be saved to a data card for replication on multiple devices.
  • Page 218: Setting The Date And Time

    17 Configuration Setting the Date and Time Setting the Date and Time To modify the date and time setting from the Configuration menu: Press the Menu Select button. Using the Navigation buttons, select Date and Time. Then press the Menu Select button. Using the Navigation buttons, adjust the value for the year.
  • Page 219: Saving Configuration Settings To A Data Card

    Saving Configuration Settings to a Data Card 17 Configuration Saving Configuration Settings to a Data Card To save configuration settings to a data card: Make sure a data card is in the HeartStart MRx. Press the [Export] soft key. The HeartStart MRx copies the configuration settings to the data card. Loading Configuration Settings from a Data Card To load configuration settings from a data card: Insert the data card with the saved configuration in the HeartStart MRx.
  • Page 220: Configurable Parameters

    17 Configuration Configurable Parameters Configurable Parameters The following tables list configurable parameters for each of the sub-menus on the Configuration Main menu. A description of each parameter is provided, along with the possible choices for settings. Default settings are in bold type. Table 36 General Settings Parameter Description...
  • Page 221 Configurable Parameters 17 Configuration Table 37 Heart Rate and ECG Settings Parameter Description Setting Choices Auto Gain Determines whether ECG size is automatically On, Off adjusted to the standard maximum wave size without clipping the wave sector. If auto-gain is off, the gain is set to 1 (10mm/mV).
  • Page 222 17 Configuration Configurable Parameters Table 38 Invasive Pressure Settings - Default Labels Parameter Description Values / Default Unit and Default Selects measurement units for all invasive mmHg, kPa Labels pressures Press 1 Label Selects default label for pressure channel 1 P1, ABP, ART, Ao, CVP, ICP, LAP, PAP, RAP Press 2 Label Selects default label for pressure channel 2...
  • Page 223 Configurable Parameters 17 Configuration Table 40 Invasive Pressure Settings - P2 All setting options are exactly the same as P1 in Table 39 except for: Parameter Description Value/Defaults Color Selects the P2 color. Red, Yellow, Blue, Green, Cyan, Magenta, White Table 41 Invasive Pressure Settings - ABP, ART, Ao All setting options are exactly the same as P1 in Table 39 Table 42 Invasive Pressure Settings - CVP, RAP, LAP...
  • Page 224 17 Configuration Configurable Parameters Table 43 Invasive Pressure Settings - PAP Parameter Description Values / Default Alarm Source Selects the type of alarm source. Systolic, Diastolic, Mean Systolic High Limit Selects the systolic high limit value. Adult: -39 - 360, 35 (mmHg) Ped: -39 - 360, 60 Adjusted in increments of 1 mmHg or 0.1 kPa...
  • Page 225 Configurable Parameters 17 Configuration Table 44 Invasive Pressure Settings - ICP Parameter Description Values / Default Alarm Source Source is always Mean and not configurable. High Limit Selects the high limit value. Adult: -39 - 360, 10 (mmHg) Ped: -39 - 360, 4 Adjusted in increments of 1 mmHg or 0.1 kPa Low Limit...
  • Page 226 17 Configuration Configurable Parameters Table 46 Noninvasive Blood Pressure Settings Parameter Description Setting Choices NBP Schedule Selects the schedule for NBP measurements, Manual, q1, q2.5, q5, q10, q15, q30, q60, manual, or automatic at the selected frequency. q120 NBP Alarm Source Selects the alarm source.
  • Page 227 Configurable Parameters 17 Configuration Table 47 End-Tidal Carbon Dioxide Settings Parameter Description Setting Choices Unit Selects the unit of measure mmHg, kPa EtCO High Limit Selects the high limit alarm value. Adult: 20-95, 50 (mmHg) Pediatric: 20-95, 50 adjusted in increments of 1mmHg or 0.1 kPa EtCO Low Limit Selects the low limit alarm value.
  • Page 228 17 Configuration Configurable Parameters Table 48 SpO Settings Parameter Description Setting Choices High Limit Selects high limit alarm value. Adult: 51-100, 100 (%) Pediatric: 51-100, 100 adjusted in increments of 1 Low Limit Selects low limit alarm value. Adult: 50-99, 90 (%) Pediatric: 50-99, 90 adjusted in increments of 1 Desat Limit...
  • Page 229 Table 52 Alarm Settings Parameter Description Setting Choices Alarm Tone Selects either traditional Philips or IEC Standard Philips, IEC alarm tones. Alarm Pause Time Selects the interval of time during which alarms 1, 2, 3, 5, 10, indefinite...
  • Page 230 17 Configuration Configurable Parameters Table 53 12-Lead Settings Parameter Description Setting Choices Institution Name Enters your organization’s name in the 12-Lead 32 characters, blank ECG Report. (If you are sending data to the TraceMasterVue database then this field must match a valid entry in the TraceMasterVue database.) Facility ID Enters the Facility ID in the 12-Lead ECG...
  • Page 231 Configurable Parameters 17 Configuration Parameter Description Setting Choices ECG Report Specifies how the 12-lead ECG segments are Sequential, Simultaneous displayed for the 12-Lead Report. The segments are displayed in three rows, four columns for each row. • Sequential reports: Each column represents a sequential 2.5-second period of time for a total of 10 seconds.
  • Page 232 17 Configuration Configurable Parameters Table 54 Data Transmission - Serial Phone Profile Settings Parameter Description Setting Choices Profile Name Name of the profile. (This field is fixed) Serial Phone Profile Configuration String Available from your cell phone service provider. 45 characters, blank Dial String Available from your cell phone service provider.
  • Page 233 Configurable Parameters 17 Configuration Table 55 Data Transmission - Phone/Modem Settings Parameter Description Setting Choices Profile Name Name of the profile. Serial Phone Profile Configuration String Available from your cell phone service provider. 45 characters, blank Landline Set to Yes if you are using a modem. Yes, No Dial Prefix Only configurable if Landline is set to Yes.
  • Page 234 17 Configuration Configurable Parameters Table 56 Data Transmission - 12-Lead Settings (Hub) Parameter Description Setting Choices Server URL Hub server address. Available from your ISP. 40 characters, blank User Name http user name. Use your web server 30 characters, blank documentation to create user accounts on the hub.
  • Page 235 Configurable Parameters 17 Configuration Table 59 Reference ID Parameter Description Setting Choices Reference ID Defines a maximum of 20 preconfigured Up to 20 user-defined settings Reference IDs. Each Reference ID has a maximum of 16 characters limited to uppercase letters, numbers, spaces and hyphens. Table 60 Manual Therapy Settings Parameter Description...
  • Page 236 17 Configuration Configurable Parameters Table 61 AED Settings Parameter Description Setting Choices Shock Series Sets the number of shocks that must be delivered to activate an 1, 2, 3, 4 automatic CPR Pause. The length of the CPR pause is determined by the CPR Timer Setting.
  • Page 237 Configurable Parameters 17 Configuration Table 62 Network Settings Parameter Description Setting Choices Equipment Label A user-entered name that uniquely identifies the device; up to 16 Unicode characters, blank used to associate the HeartStart MRx with an Information Center monitoring sector. Controls whether the No Central Monitoring INOP Central Monitoring Mandatory, Optional...
  • Page 238 17 Configuration Configurable Parameters Table 63 Printing Settings Parameter Description Setting Choices Print on Alarm Prints a 15 second strip (10 seconds of pre-alarm Red/Yellow, Red, Red Arrhythmia data and 5 seconds of post alarm data) when selected alarm type occurs. Red Arrhythmia: An alarm recording strip is printed for Asystole, VFIB/VTACH, VTACH, Extreme Tachy, Extreme Brady.
  • Page 239 Configurable Parameters 17 Configuration Table 64 Mark Event Settings Parameter Description Setting Choices Mark Event 1 Defines menu choice #1 on the Mark Events 20 characters, ET Access menu. Mark Event 2 Defines menu choice #2 on the Mark Events 20 characters, IV Access menu.
  • Page 240 17 Configuration Configurable Parameters Table 65 CPR Settings Parameter Description Setting Choices Q-CPR In devices with the Q-CPR option, this On, Off setting defines whether Q-CPR is configured off or on. CPR Timer Sets the length of the pause interval that 30, 60, 90, 120, 150, 180, 240, 300 automatically starts when: •...
  • Page 241 Configurable Parameters 17 Configuration Table 66 Thrombolytic Therapy Contraindications Settings Parameter Description Setting Choices Prompt for Enables/disables the prompt for Yes, No Contraindications Thrombolytic Therapy Contraindications. Contraindication 1 Right vs. left arm sys. BP difference > 15 mmHg Contraindication 2 History of structural central nervous system disease Contraindication 3 Significant closed head/facial trauma within prev.
  • Page 243: Working With Data

    Working with Data This chapter describes the data management features of the HeartStart MRx. See “Data Transmission” on page 239 for instructions on how to send data from the HeartStart MRx. Overview The two most common uses of data coming from the HeartStart MRx are: •...
  • Page 244: Initiating An Event Summary

    18 Working with Data Initiating an Event Summary Initiating an Event Summary New Event Summaries are initiated each time one of the following activities occurs: • The arrival of a valid ECG signal. • The arrival of valid SpO data. •...
  • Page 245: Copying From Internal Memory

    Copying from Internal Memory 18 Working with Data Copying from Internal Memory You can copy Event Summaries and 12-Lead ECG Reports stored in internal memory to a data card from Data Management Mode: Insert a data card, see “Installing the Data Card” on page 46. Enter Data Management Mode.
  • Page 246: Viewing And Erasing The External Data Card

    Use the Erase Card menu entry to delete the contents of the data card. CAUTION If you format a Philips data card in a PC card reader, you must use a FAT16 file system to format the data card. Using a FAT32 format makes the card incompatible with the HeartStart MRx.
  • Page 247: Printing During A Patient Event

    Printing During a Patient Event 18 Working with Data Printing During a Patient Event The HeartStart MRx allows you to print data reports during a patient event. The device also allows you to go back and print data reports after the fact from Data Management Mode, see “Printing from Data Management Mode”...
  • Page 248: Printing Individual Events

    18 Working with Data Printing During a Patient Event Printing Individual Events The HeartStart MRx can be configured to print automatically when certain events occur. Table 67 lists these events and the length of the strip printed, depending on whether the printer is configured to print real-time or with a 10-second delay.
  • Page 249: Printing From Data Management Mode

    Printing from Data Management Mode 18 Working with Data Printing from Data Management Mode To print a historical Event Summary, Vital Sign Trends Report or 12-Lead Report: Enter Data Management Mode. See “Entering Data Management Mode” on page 226. Use the soft keys labeled [Prev Item] and [Next Item] to select the Event Summary you want to print.
  • Page 250: Events Stored In Event Summary

    18 Working with Data Events Stored in Event Summary Events Stored in Event Summary Table 68 lists events and related information stored in an Event Summary, if they occur. Not all are possible based on your device options. Italicized text is replaced by an appropriate value. Table 68 Event Information Logged Event Frequency...
  • Page 251 Events Stored in Event Summary 18 Working with Data Table 68 Event Information (Continued) Logged Event Frequency Measurements PVC/min Limit Logged when device is turned on if ECG alarms are on, when settings are changed, or when ECG alarms are turned on. VTACH Limits HR value Run value ECG Alarms Off...
  • Page 252 18 Working with Data Events Stored in Event Summary Table 68 Event Information (Continued) Logged Event Frequency [Temperature] Label: Logged when a temperature label is set or changed. Temperature Label Alarms **yellow or***red alarm Logged when alarm condition occurs. Alarms Paused Logged when action occurs.
  • Page 253 Events Stored in Event Summary 18 Working with Data Table 68 Event Information (Continued) Logged Event Frequency INOPs See "Troubleshooting" chapter for information regarding INOP statements. Defibrillation Charging to xx J Logged when device starts charging to selected energy setting. Disarm [Manual, Auto] Logged when device disarmed by user or automatically after time-out period.
  • Page 254 18 Working with Data Events Stored in Event Summary Table 68 Event Information (Continued) Logged Event Frequency Print Print Strip Logged when Print button is pressed Periodic Clinical Data Transfer Start Data Transmit to Logged when the HeartStart MRx begins a periodic clinical data transfer session (site) End Data Transmit Logged when the HeartStart MRx ends a periodic clinical data transfer session...
  • Page 255: Marking Events

    Marking Events 18 Working with Data Marking Events The Mark Event button allows you to annotate the Event Summary and the ECG strip at the point in time the button is pressed. If configured, pressing the Mark Event button prints a 6-second ECG strip.
  • Page 257: Data Transmission

    Data Transmission This chapter provides instructions on how to transmit data from the HeartStart MRx to various external devices using the suite of data transmission options available in the monitor/defibrillator. Overview There are two applicable scenarios for transmitting HeartStart MRx data: •...
  • Page 258: Transmitting During A Critical Care Event

    1 – Patient Care Report (PCR) software must be able to deliver the file to the healthcare facility. The destination site set at the HeartStart MRx is contained in the file information transmitted. If you use a Philips product to deliver the file to the healthcare facility, it reads the destination site from the file sent. For more information on the set-up of your ePCR software, see the software’s Instructions for Use.
  • Page 259: Preparing For Transmission

    Preparing for Transmission 19 Data Transmission Preparing for Transmission Before transmitting data, the HeartStart MRx needs to be set up properly based on the type of transmission option selected. If you are using Bluetooth wireless technology, your wireless devices need to be set up as well.
  • Page 260: Setting Up Bluetooth Transmissions

    Menu Select button. Generally, phones and gateways are Dial-Up Networking and personal computers are File Transfer. If you are unsure of which service to select, contact your Philips installation manager for more information. If you selected dial-up networking, select the designated profile from the Phone/Modem Profiles menu.
  • Page 261 Preparing for Transmission 19 Data Transmission Once the Bluetooth device is paired with the HeartStart MRx and the profile selected, the HeartStart MRx performs a transmission test. After successfully connecting, the message Transmission Test Passed is displayed. Press the Menu Select button to acknowledge the message. Should the transmission test fail, the message Transmission Test Failed is displayed, along with additional information about where the failure occurred.
  • Page 262 19 Data Transmission Preparing for Transmission Changing Bluetooth Profiles Once you have added and paired a Bluetooth device, you can change its profile using the following steps: In 12-Lead Mode, press the Menu Select button. From the 12-Lead Main Menu, select Bluetooth Devices and press the Menu Select button. A list of paired Bluetooth devices is displayed.
  • Page 263: Setting Up Rosetta Transmissions

    Setting up Rosetta Transmissions 19 Data Transmission Setting up Rosetta Transmissions Using an easy cable connection, the HeartStart MRx enables you to transmit a 12-Lead Report to a Rosetta-Lt for two-way radio transmission to a healthcare facility running CAREpoint or Rosetta-Rx. See Figure 104.
  • Page 264: Connecting Rosetta-lt

    19 Data Transmission Setting up Rosetta Transmissions CAUTION A 12-Lead Report sent to the Rosetta-Lt will overwrite any 12-Lead Report which currently exists on the Rosetta-Lt. It is your responsibility to forward the 12-Lead Report from the Rosetta-Lt to its destination.
  • Page 265: Setting Up For Rs-232 Transmissions

    Setting Up for RS-232 Transmissions 19 Data Transmission Setting Up for RS-232 Transmissions 12-Lead ECG Transmission using RS-232 requires a 9-pin serial cable connected to the RS-232 Serial Port located on the back panel of the HeartStart MRx. Attach the cable to the device and secure the screws into place.
  • Page 266: Transmitting In 12-lead Mode

    PDAs, Philips TraceMaster ECG Management System or other servers running Philips data viewing server software. Reports are sent from the HeartStart MRx to the hub (a web server running Philips 12-Lead Transfer Station software). Using Bluetooth transmission, they are transmitted to the hub using configured wireless devices such as cell phones, handheld devices and other external devices like computers, laptops and other mobile devices.
  • Page 267: Transmitting To A Manually Entered Fax Number

    Transmitting in 12-Lead Mode 19 Data Transmission For further information concerning the setup and configuration of transmission devices and the N O T E S HeartStart MRx, refer to the Transmission Implementation Guide. For further information concerning the data viewing server, refer to the software’s instructions for use. Subsequent 12-Lead Reports can be placed in queue for transmittal while transmission is in progress, or the originally selected 12-Lead Report can be chosen for transmission to multiple sites.
  • Page 268: Periodic Clinical Data Transmission

    19 Data Transmission Periodic Clinical Data Transmission Periodic Clinical Data Transmission Periodic Clinical Data Transmission (PCDT) provides the ability to transmit clinical data from the point of care for a critical care patient to the receiving hospital to facilitate the next level of care. The PCDT option uses Bluetooth technology to automatically transmit periodic vitals and transmit 12- leads and waveform data upon a set of trigger events from a clinical mode to remote data viewing software.
  • Page 269 Periodic Clinical Data Transmission 19 Data Transmission Table 71 Data Transmitted During PCDT Event When What data is sent Vital signs updated every 1 to 5 minutes • Patient vital data for pulse, heart and AwRR rates, NBP, EtCO , Invasive Pressures and temperature for the parameters that (based on configuration) are turned on;...
  • Page 270: Starting A Periodic Clinical Data Transmission

    19 Data Transmission Periodic Clinical Data Transmission Configuring a receiving site Before sending a Periodic Clinical Data Transmission, you need to have a receiving site destination configured, unless you are sending to an electronic Patient Care Record (ePCR) application. See “Modifying Settings”...
  • Page 271: Ending A Periodic Clinical Values Transmission

    Periodic Clinical Data Transmission 19 Data Transmission Priorities For Sending Data In low bandwidth or poor signal quality areas, the HeartStart MRx has the ability to queue periodic data transmissions. See “Periodic Clinical Data Transmission” on page 250 for details on data transmitted.
  • Page 272: Transmitting Event Summaries Post Event

    19 Data Transmission Transmitting Event Summaries Post Event Transmitting Event Summaries Post Event The HeartStart MRx provides options (see Figure 110 and Table 72 ) to transmit data after an event for quality review, billing and archiving. You can: • Save data to the data card for personal transport to another device. See “Copying from Internal Memory”...
  • Page 273: Transmitting In Data Management Mode

    Transmitting in Data Management Mode 19 Data Transmission Transmitting in Data Management Mode The HeartStart MRx Event Summary, Bluetooth option uses Bluetooth wireless technology to send an Event Summary (complete or partial) or a 12-Lead Report to a receiving Bluetooth device from Data Management Mode.
  • Page 274 19 Data Transmission Transmitting in Data Management Mode Depending upon which option you selected in Step 4, you are presented with different menus. If you selected a 12-Lead Report: Select a destination for the 12-Lead Report from the Send To menu. Highlight the destination and press the Menu Select button.
  • Page 275: Tracking Data Transmission

    Transmitting in Data Management Mode 19 Data Transmission Tracking Data Transmission After initiating a data transmission from the HeartStart MRx, you can track transmission progress on the device display. For events, the Event ID along with the date and time of the event data being sent are displayed while for 12-Lead reports, the date and time of the report are displayed.
  • Page 276: Queuing Transmissions

    19 Data Transmission Transmitting in Data Management Mode Queuing Transmissions You can queue more than one HeartStart MRx 12-Lead Report or Event Summary for a non-BLDT transmission using the same transmission device (except the Rosetta-Lt). 12-Lead Reports can be queued to the same or different locations. If you are using the Rosetta-Lt, you must complete the transmission from the HeartStart MRx to the Rosetta-Lt AND from the Rosetta-Lt to its communication device before beginning another transmission.
  • Page 277: Batch Lan Data Transfer

    Batch LAN Data Transfer 19 Data Transmission Batch LAN Data Transfer By using Batch LAN Data Transfer (BLDT) you can download either a single Event Summary or all Event Summaries on the Internal Data Card to an external personal computer running Data Messenger software for further review and archiving.
  • Page 278: Transferring Files With Bldt

    19 Data Transmission Batch LAN Data Transfer Transferring Files with BLDT To transfer data using the BLDT option: Confirm the HeartStart MRx is in Data Management Mode, Data Messenger is running on the receiving personal computer and the LAN cable is securely connected. See “Setting Up for Batch LAN Data Transfer”...
  • Page 279: Troubleshooting

    Troubleshooting 19 Data Transmission Cancelling BLDT To cancel a BLDT currently being sent, press the Menu Select button, use the Navigation buttons to highlight Cancel Transmission and press the Menu Select button. The transfer stops and the HeartStart MRx is placed back in the Data Management screen. Troubleshooting If your HeartStart MRx does not operate as expected during transmission, see “Troubleshooting”...
  • Page 281: Maintenance

    Maintenance This chapter describes how to care for your HeartStart MRx and its accessories. Overview Proper maintenance of the HeartStart MRx is a very simple, yet important factor in dependability. It involves: • Providing power so automated tests can be run •...
  • Page 282: Automated Tests

    20 Maintenance Automated Tests Automated Tests The HeartStart MRx independently performs many maintenance activities, including three tests that run automatically at regularly scheduled intervals while the device is off to assess operational performance and alert you if a problem exists. Results of tests associated with critical functionality of the device are reported through the Ready For Use indicator and the Automated Test Summary report.
  • Page 283: Automated Test Summary

    20%. battery. Charging may be done in the HeartStart MRx or by connecting to AC/ DC power, or in a Philips-approved battery support system. Fail/D Hourglass A problem has been detected Turn the Therapy Knob to Monitor.
  • Page 284: Ready For Use Indicator

    Charging may be done in the is not being charged. No HeartStart MRx by connecting to AC/ chirping indicates the battery is DC power, or in a Philips-approved battery support system being charged. Solid red “X” and a A failure has been detected that Turn the Therapy Knob to Monitor.
  • Page 285: Shift Checklist

    Philips Healthcare supports the AHA checklist recommendations and has provided a Shift Checklist document with the device and published a copy in this book. See the “HeartStart MRx Shift Checklist”...
  • Page 286: Heartstart Mrx Shift Checklist

    20 Maintenance Shift Checklist HeartStart MRx Shift Checklist Inspect the MRx, accessories, and supplies at the change of every shift, per AHA guidelines. Place a check mark in the box as you check each item in the list below or place a dash (-) or N/A if not applicable.
  • Page 287 Shift Checklist 20 Maintenance Shift Checklist (page 2) HeartStart MRx Weekly Shock Test Do one of the following at least once a week to verify the ability to deliver defibrillation therapy: Operational check (See Instructions for Use for details) Signature:________________________________ Date: _________________ Deliver a 150J shock into a test load (See instructions below) Signature:________________________________ Date: _________________ Note: If the HeartStart MRx has Software Release B.05 or greater with the Pacing option, you cannot...
  • Page 288: Operational Check

    20 Maintenance Operational Check Operational Check Operational Checks should be performed at regular intervals to supplement the hourly, daily, and weekly Automated Tests executed by the HeartStart MRx. Automated Tests provide adequate assurance that the device is in a functional state of readiness. Operational Checks supplement the Automated Tests by verifying therapy cables, the ECG cable, paddles, audio, the Charge and Shock buttons, Therapy Knob, and CPR meter, along with replicating the Weekly test.
  • Page 289: Performing The Operational Check

    Operational Check 20 Maintenance Performing the Operational Check To perform the Operational Check: Insert a charged battery (capacity of 20% or greater). Turn the Therapy Knob to Monitor. Press the Menu Select button Using the Navigation buttons, select Other and press the Menu Select button. Select Operational Check and press the Menu Select button.
  • Page 290 20 Maintenance Operational Check Figure 119 Operational Check Setup Screen 02 Mar 2006 10:52 Operational Check Model Number: M3535A Serial Number: US00108360 Last Operational Check: 01 Mar 2006 9:35 Pass Setup 1. Connect pads/CPR cable, CPR meter and test load Connect pads cable and test load 2.
  • Page 291 Operational Check 20 Maintenance Figure 120 Operational Check Screen 02 Mar 2006 10:53 Operational Check Model Number: M3535A Serial Number: US00108360 Last Operational Check: 04 May 2005 9:35 Pass General System Test: Pass Therapy Knob: Pass Charge Button: Pass Shock Button: Pass Audio Test: Pass...
  • Page 292 20 Maintenance Operational Check Table 76 Operational Checks Test Test Description Prompts Action General System Tests internal clock battery, None. None. power supply, and internal memory card. Therapy Knob Tests if the Therapy Knob is set None. None. to 150J. Charge Button Tests the Charge button.
  • Page 293 Operational Check 20 Maintenance Table 76 Operational Checks Test (Continued) Test Description Prompts Action Did you hear Shock/No Shock Audio If a shock was delivered during Use the navigation buttons to Delivered? the Shock test, the voice respond Yes or No. Then press prompt, Shock Delivered is the Menu Select button.
  • Page 294 20 Maintenance Operational Check Table 76 Operational Checks Test (Continued) Test Description Prompts Action Pads/Paddles ECG Checks ECG acquisition None, if test passes. If test fails the If the Pads/Paddles test fails with through pad/paddles. following prompt is displayed at the cable and passes without the the end of all remaining tests: cable, the cable is bad.
  • Page 295: Operational Check Report

    Operational Check 20 Maintenance Operational Check Report The Operational Check takes only a short time to complete. When it is done, a report is printed, as shown in Figure 121. The first part of the report lists test results. The second part lists checks to be performed by the user.
  • Page 296 20 Maintenance Operational Check User Checks The guidelines for completing user checks are as follows: Defibrillator Inspection Make sure the HeartStart MRx is clean (including the surfaces of the paddles and paddle tray), clear of objects, and has no visible signs of damage. Cables/Connectors/Paddles/Pads/Monitoring Electrodes Make sure there are no cracks, broken wires, or other visible signs of damage.
  • Page 297 Operational Check 20 Maintenance Table 77 Operational Check Test Results Test Results Action if Test Does Not Pass General System • Pass - The clock battery, power supplies, and internal If the test fails with the AC/DC power memory are functioning. module present, remove the module and repeat the test.
  • Page 298 20 Maintenance Operational Check Table 77 Operational Check Test Results (Continued) Test Results Action if Test Does Not Pass Pads/Paddles ECG Pass/cable type - ECG acquisition and the cable are both If the test fails with a cable connected, remove functioning.
  • Page 299 Operational Check 20 Maintenance Table 77 Operational Check Test Results (Continued) Test Results Action if Test Does Not Pass Invasive Pressures • Pass - Invasive Pressures passed its self-test. If the test fails, call for service (to replace the Invasive Pressures/Temperature board.) If •...
  • Page 300: Operational Check Summary

    20 Maintenance Operational Check Operational Check Summary The Operational Check Summary lists the results from the last 60 Operational Checks. Test results are reported as described in Table 77. To view the Operational Check Summary: Turn the Therapy Knob to Monitor. Press the Menu Select button.
  • Page 301: Battery Maintenance

    Battery Maintenance 20 Maintenance Battery Maintenance Battery maintenance is essential to ensure that the battery’s state of charge is accurately reported, there is sufficient charge and capacity to operate your HeartStart MRx, and battery life is optimized. Remove faulty batteries from service immediately. Battery maintenance begins upon receipt of a new battery, and continues throughout the life of the battery.
  • Page 302: Charging Batteries

    Battery Maintenance Charging Batteries The M3538A Lithium Ion Battery should be charged in either the HeartStart MRx or in a Philips- approved battery support system. The two methods of charging in the HeartStart MRx are as follows: Using AC power - Insert the battery to be charged into Battery Compartment A. Insert the AC Power Module into Battery Compartment B and connect to an AC power source.
  • Page 303 Calibration takes approximately 11 hours to complete in the HeartStart MRx. Progress is shown on the display. It takes significantly less time to calibrate in a Philips-approved battery support system. Monitoring/therapy functions are not available during battery calibration in the MRx. If it is necessary to terminate calibration to resume clinical use, press the [Cancel] soft key.
  • Page 304: Storing Batteries

    20 Maintenance Battery Maintenance Storing Batteries Batteries should be rotated regularly to ensure even usage. When storing batteries, make sure that the battery terminals do not come in contact with metallic objects. If batteries are stored for an extended period of time, they should be stored in a cool place, with a partial charge of 20% (1 LED illuminated) to 40% (2 LED’s illuminated) capacity.
  • Page 305: Cleaning Instructions

    Cleaning Instructions 20 Maintenance Cleaning Instructions Listed below are recommendations for cleaning the HeartStart MRx and its associated accessories. CAUTION • The HeartStart MRx, along with its accessories and supplies, may not be autoclaved, steam sterilized, ultrasonically cleaned, or immersed unless otherwise indicated in the Instructions for Use that accompany the accessories and supplies.
  • Page 306: Paddles, Therapy Cable

    For information about cleaning and sterilizing internal and external sterilizable paddles, see the Sterilizable Defibrillator Paddles Instructions for Use. Philips’ disposable sterile internal defibrillation paddles, multifunction electrode pads and monitoring electrodes are single use items and do not require cleaning.
  • Page 307: Carrying Case

    Cleaning Instructions 20 Maintenance Carrying Case The carrying case may be cleaned by hand with mild soap and water. Fabric stain removers may be used to remove stubborn stains. Air dry the carrying case. Do not wash or dry by machine. NBP Cuff The cuff can be disinfected by immersion in a decontamination solution of 70-85% isopropyl alcohol, but remember to remove the rubber bag if you use this method.
  • Page 308: Heartstart Mrx Disposal

    20 Maintenance HeartStart MRx Disposal HeartStart MRx Disposal Prior to disposal, remove the batteries. Then dispose of the device and accessories in accordance with your country’s regulations for equipment containing electronic parts. WARNING Disposal of the device with the battery inserted presents a potential shock hazard. To avoid contaminating or infecting personnel, the environment, or other equipment, make sure you disinfect and decontaminate the monitor/defibrillator and any appropriate device accessories appropriately prior to disposal.
  • Page 309: Supplies & Accessories

    Approved supplies and accessories for your HeartStart MRx are listed in the following tables. To order: In the USA, call 1-800-225-0230 (pads, electrodes, cables, paper, etc.). Outside the USA, contact your local Philips Healthcare Sales Office, your authorized Philips Healthcare Dealer or Distributor, or visit our website at: http://philips.com/healthcarestore and follow the Medical Supplies link.
  • Page 310 21 Supplies & Accessories Overview Table 80 Supplies and Accessories (Continued) M4743A 4.5 cm Switched M4744A 2.8 cm Switched M4740A Internal Paddles Adapter Cable Multifunction Electrode Pads M3713A Adult Plus M3716A Adult Radiolucent M3717A Pediatric Plus M3718A Adult Radiotransparent/Reduced Skin M3719A Pediatric Radiotransparent/Reduced Skin M3501A...
  • Page 311 Overview 21 Supplies & Accessories Table 80 Supplies and Accessories (Continued) M1510A 3-lead ECG Trunk Cable (IEC) M1605A 3-lead ECG Lead Set with Snaps (AAMI) M1615A 3-lead ECG Lead Set with Snaps (IEC) M1669A 3-Lead Trunk Cable M1671A 3-Lead ICU Grabber (AAMI) M1672A 3-Lead ICU Grabber (IEC) M1673A...
  • Page 312 21 Supplies & Accessories Overview Table 80 Supplies and Accessories (Continued) M1192A Reusable SpO Sensor - Pediatric/Small Adult Finger M1192T Reusable Pediatric Sensor (Nellcor 9-pin D-sub connector) M1194A Reusable SpO Sensor - Adult/Pediatric Ear Clip M1195A Reusable SpO Sensor - Infant M1196A Reusable Clip Adult Sensor M1196T...
  • Page 313 Overview 21 Supplies & Accessories Table 80 Supplies and Accessories (Continued) EtCO Intubated Circuits M1920A FilterLine Set - Adult/Pediatric (25 sets/case) M1921A Filter H Set - Adult/Pediatric (25 sets/case) M1923A Filter H Set - Infant/Neonatal (yellow, 25 sets/case) Non-Intubated Dual Purpose Circuits (CO M2520A Smart CapnoLine - Pediatric M2522A...
  • Page 314 21 Supplies & Accessories Overview Table 80 Supplies and Accessories (Continued) Power M3538A Lithium Ion Battery M3539A AC Power Module M5529A DC Power Module M5528A DC Power Module Mounting Bracket 989803135301 2-Bay Battery Support System for Lithium Ion Batteries 989803135331 4-Bay Battery Support System for Lithium Ion Batteries 989803135341 4-Bay Battery Support System for Sealed Lead Acid and Lithium Ion Batteries...
  • Page 315: Troubleshooting

    Troubleshooting If the HeartStart MRx detects an error or potential problem during use, it displays an INOP statement or a message window with text to guide you. INOP statements and messages are often accompanied by a voice prompt or an audible beeping tone. This chapter describes the INOP statements and messages that you may see, along with other symptoms, and provides suggestions for what to do.
  • Page 316: Symptoms

    22 Troubleshooting Symptoms Symptoms The following tables list symptoms, INOP statements, and messages that you may encounter, along with possible causes of the problem, and potential solutions. Symptoms are characterized by functionality. Table 81 General Problems Symptom Possible Cause Possible Solution The HeartStart MRx does not There is no power.
  • Page 317 Symptoms 22 Troubleshooting Table 81 General Problems (Continued) Symptom Possible Cause Possible Solution Event Storage Full message. Event Summary data for the Copy or print Event Summary to retain data and then current patient case exceeds the begin a new patient case. storage capacity of internal memory Print the Event Summary Report.
  • Page 318 22 Troubleshooting Symptoms Table 82 ECG Monitoring Problems (Continued) Symptom Possible Cause Possible Solution The paddles/pads are not making Ensure proper skin preparation and correction proper contact with the patient. application. If necessary, apply new pads. The pads are outdated or dried- Check the date code on the pads.
  • Page 319 Symptoms 22 Troubleshooting Table 82 ECG Monitoring Problems (Continued) Symptom Possible Cause Possible Solution Pads ECG Cable Failure INOP. A short was detected between a Replace the pads cable and perform an Operational lead wire and ground. Check. ECG Cable Failure INOP. A short has been detected between Replace the ECG cable.
  • Page 320 22 Troubleshooting Symptoms Table 83 NBP Monitoring Problems Symptom Possible Cause Possible Solution NBP Cuff Not Deflated INOP. The NBP cuff pressure has been Remove cuff from patient. greater than 5mmHg (0.67kPa) for The NBP numeric value is Release pressure in the cuff (disconnect cuff from more than 3 minutes.
  • Page 321 Symptoms 22 Troubleshooting Table 84 SpO Monitoring Problems Symptom Possible Cause Possible Solution The sensor is not properly Check the sensor connection and cable. connected or the sensor cable is Try another sensor. damaged. The SpO waveform is not displayed. The SpO waveform is not Use the Displayed Waves menu to select a wave sector...
  • Page 322 22 Troubleshooting Symptoms Table 84 SpO Monitoring Problems (Continued) Symptom Possible Cause Possible Solution Sensor Malfunction The SpO sensor or cable is faulty. Try another sensor. INOP. If the problem persists, call for service of the SpO module. If SpO monitoring is essential to patient The SpO numeric value is...
  • Page 323 Symptoms 22 Troubleshooting Table 85 Transmission Problems (Bluetooth) (Continued) Symptom Possible Cause Possible Solution Bluetooth Connection Lost The Bluetooth device is not Move the Bluetooth device closer to the MRx, within the within range. transmitting range. (See the Transmission Implementation Guide message.
  • Page 324 22 Troubleshooting Symptoms Table 85 Transmission Problems (Bluetooth) (Continued) Symptom Possible Cause Possible Solution An error occurred during Check that the cellular signal strength is sufficient. transmission of one of the Move the Bluetooth device closer to the MRx, within the files.
  • Page 325 Symptoms 22 Troubleshooting Table 86 12-Lead Transmission Problems (RS-232) First, attempt to solve the problem by disconnecting the serial cable from the cell phone, reconnecting it, and resending the 12-Lead Report. Symptom Possible Cause Possible Solution Transmission Settings Have Hub information has not Modify the Hub configuration settings as needed.
  • Page 326 22 Troubleshooting Symptoms Table 86 12-Lead Transmission Problems (RS-232) (Continued) First, attempt to solve the problem by disconnecting the serial cable from the cell phone, reconnecting it, and resending the 12-Lead Report. Symptom Possible Cause Possible Solution Transmission Failed The connection with the Choose the destination site again and re-connect.
  • Page 327 Symptoms 22 Troubleshooting Table 90 CO Monitoring Problems Symptom Possible Cause Possible Solution The FilterLine is not properly Check the FilterLine connection. connected. Check tubing for knots, kinks or pinches. The CO waveform does not The CO waveform is not Use the Displayed Waves menu to select a wave sector appear on the display.
  • Page 328 22 Troubleshooting Symptoms Table 91 Defibrillation and Pacing Problems Symptom Possible Cause Possible Solution Excessive patient movement. Minimize patient movement. If the patient is being Analyzing Stopped , or transported, stop if necessary. Cannot Analyze ECG message Radio or electrical sources are Remove possible sources of interference from the area in AED Mode.
  • Page 329 Symptoms 22 Troubleshooting Table 91 Defibrillation and Pacing Problems (Continued) Symptom Possible Cause Possible Solution Shock Button Failure INOP During an Operational Check, Remove the device from use and call for service. when the Shock button was pressed, there was no response. Therapy Knob Failure INOP During an Operational Check, the Remove the device from use and call for service.
  • Page 330 22 Troubleshooting Symptoms Table 92 Printer Problems (Continued) Symptom Possible Cause Possible Solution Incompatible Printer message. The installed printer does not Install the 75 mm printer. support the fonts required. Asian fonts require the 75 mm printer. Check Printer message. The printer is out of paper or the Load/reload the printer paper.
  • Page 331 Symptoms 22 Troubleshooting Table 94 Invasive Pressure Monitoring Problems (Continued) Symptom Possible Cause Possible Solution Invasive Pressure Label Noisy This can only occur when pulse is Stop movement. Signal INOP determined from a pressure wave. Minimize possible electrical interference. The pulse rate is higher than 350 bpm.
  • Page 332 Malfunction in the meter. Remove the CPR meter from service and contact orange and the display is dark. Philips for technical support. If there is no other responder present to help, provide CPR using the meter even though it does not adhere to the patient.
  • Page 333 Symptoms 22 Troubleshooting Table 97 Q-CPR Problems (Continued) Symptom Possible Cause Possible Solution The CPR meter is unplugged. Check the CPR meter and cable connections. The device cannot communicate Confirm your HeartStart MRx is running with the CPR meter. Version F.01 software and you are using the CPR CPR meter Unplugged INOP.
  • Page 334 22 Troubleshooting Symptoms Table 98 IntelliVue Networking Problems (Continued) Symptom Possible Cause Possible Solution The device may not have a Print Device Info report and verify therapy hardware revision compatible therapy board. is at least 14. If not, call for service to upgrade therapy board. No network connection.
  • Page 335 Symptoms 22 Troubleshooting Table 99 Network Connection Rejection Messages When the Information Center rejects a connection attempt from the HeartStart MRx, a momentary message accompanied by an audio beep is displayed in the middle of the HeartStart MRx display. Messages, possible causes and possible solutions: Message Possible Cause Possible Solution...
  • Page 336: Audio Tones And Alarm Indications

    Continuous tone, alternating pitch. Device will shut down in one minute. Tone repeated once a second. Philips’ Red Alarm Tone: Red alarm indicator message for applicable HR/ Generated while at least one red alarm is occurring. arrhythmia, apnea, extreme desat and pressure disconnect alarms.
  • Page 337: Calling For Service

    Calling for Service 22 Troubleshooting Calling for Service For telephone assistance, call the Response Center nearest to you, or visit our website at: www.medical.philips.com/cms and click on “Support”. Table 101Response Center Phone Numbers North America Canada 800-323-2280 United States of America...
  • Page 339: Specifications And Safety

    Specifications and Safety This chapter describes the specifications and safety features of the HeartStart MRx monitor/ defibrillator. Specifications General Dimensions with pads: 31.5 cm (W) x 21.0 cm (D) x 29.5 cm (H); (12.4 in. x 8.3 in. x 11.7 in.) Dimensions with paddles: 34.0 cm (W) x 21.0 cm (D) x 34.5 cm (H);...
  • Page 340 23 Specifications and Safety Specifications Delivered Energy Accuracy Selected Nominal Delivered Energy vs. Patient Impedance Accuracy Energy Load Impedance (ohms) 100 125 150 175 ±2J ±2J ±2J ±2J ±2J ±2J ±2J ±2J ±2J ±2J ±15% ±15% ±15% ±15% ±15% 100J 100 101 103 104 104 101 ±15% 120J 110 120 121 123 125 125 121 ±15%...
  • Page 341 Specifications 23 Specifications and Safety • Less than 40 seconds from initial power on (AED Mode) with a new, fully charged Lithium Ion battery pack at 25 C, depleted by up to 15 200 Joule discharges. • Less than 40 seconds from initial power on (AED Mode) when operating without a battery, using the 3539A AC power module alone at 90-100% rated mains voltage.
  • Page 342: Ecg And Arrhythmia Monitoring

    (specificity > 95%) for adult defibrillation rhythms a. From Philips Medical Systems ECG rhythm databases. b. American Heart Association (AHA) AED Task Force, Subcommittee on AED Safety & Efficacy. Automatic External Defibrillators for Public Access Use: Recommendations for Specifying and Reporting Arrhythmia Analysis Algorithm Performance, Incorporation of New Waveforms, and Enhancing Safety.
  • Page 343 Specifications 23 Specifications and Safety Frequency Response: • AC Line Filter - 60 Hz or 50 Hz • Pads ECG for Display: Monitor - (.15-40 Hz) or EMS (1-30 Hz) • Pads ECG for Printer - Monitor (.15-40 Hz) or EMS (1-30 Hz) •...
  • Page 344: Display

    23 Specifications and Safety Specifications Display Size: 128 mm x 171 mm Type: TFT Color LCD Resolution: 640 x 480 pixels (VGA) Sweep Speed: 25mm/s nominal (stationary trace; sweeping erase bar) for ECG, Invasive Pressure and ; 6.25 mm/sec for CO Wave Viewing Time: 5 seconds (ECG) Battery Type: Rechargeable, Lithium Ion;...
  • Page 345: Thermal Array Printer

    Specifications 23 Specifications and Safety Thermal Array Printer Continuous ECG Strip: The Print key starts and stops the strip. The printer can be configured to run real time or with a 10-second delay. The strip prints the primary ECG lead and a second or third wave (75mm printer only) with event annotations and measurements.
  • Page 346: Spo2 Pulse Oximetry

    Accuracy outside the range indicated for each sensor is not specified. The above referenced sensors were N O T E validated for use with the HeartStart MRx using the Philips picoSAT II SpO module with Fourier Artifact Suppression Technology (FAST). This module is not available as a stand-alone device.
  • Page 347: Nbp

    Specifications 23 Specifications and Safety Wavelength Range: 500-1000nm (Information about wavelength range can be useful to clinicians, especially those performing photodynamic therapy.) average 18.9 seconds; standard deviation 0.88 seconds Desat Alarm Signal Generation Delay: 20 seconds Pulse Rate Measurement Range 30-300 bpm Pulse Rate Resolution 1bpm Pulse Rate Accuracy: 2% or 1 bpm (whichever is greater) over the measurement range Pulse Alarm Range:...
  • Page 348: Invasive Pressures

    23 Specifications and Safety Specifications Maximum Measurement Time: 120 sec. Interconnect Tube Length: • M1598B Connect tubing 1.5 m • M1599B Connect tubing 3.0 m Recommended frequency of pressure transducer calibration: yearly Invasive Pressures Transducer Sensitivity: 5uV/V mmHg (37.5uV/V/kPa) Sensitivity Adjustment Range: +10% Transducer Load Resistance: 195 to 2200 Ohms Transducer Output Resistance: 0 to 3000 Ohms Frequency Response: 0-12Hz or 0-40Hz...
  • Page 349: Temperature

    Specifications 23 Specifications and Safety Pulse Rate Resolution: 1 bpm Temperature Measurement Range: 0 - 45 C (32 - 113 Measurement Resolution: 0.1 C (0.2 Measurement Accuracy (excluding any adapter cable): +0.1 C from 25 C to 45 C; +0.3 C from C to 24.9 C (temperature probe adds an additional +0.1...
  • Page 350: Awrr

    23 Specifications and Safety Specifications Microstream CO Humidity Correction Factor: BTPS (Body Temperature and Pressure, Saturated - 37 C, 750mmHg, 100% humidity or 47mmHg) is the humidity correction factor for the Microstream CO readings. Correction calculation formula: = FCO x (Pb-47) BTPS ~ FCO x 0.94...
  • Page 351: Cpr Meter

    Specifications 23 Specifications and Safety CPR Meter Dimensions: 154mm x 64mm x 28mm with a .91m integrated cable. Weight: 6 oz. (170 g) Input voltage: 4.0-6.0V at 170mA. The CPR meter is electrically and galvanically isolated from the defibrillator power and communication sources. Temperature: Storage: -20 C to 60 C (-4...
  • Page 352: Patient Data Storage

    23 Specifications and Safety Specifications Patient Data Storage Internal Event Summary: The internal Event Summary stores up to 12 hours of 2 continuous ECG waves, 1 CO and 2 invasive pressure waves, events and trending per Event Summary. There is a maximum capacity of 55 Event Summaries or 240 megabytes (62 megabytes for those devices with a 64 megabyte card) of patient data, whichever comes first.
  • Page 353: Environmental (m3536a)

    Specifications 23 Specifications and Safety Other Considerations: • The HeartStart MRx is not suitable for use in the presence of concentrated oxygen or a flammable anesthetic mixture with air, oxygen, or nitrous oxide. • Hazards arising from software errors were minimized by the product’s compliance with the software requirements contained in EN 60601-1-4:1996.
  • Page 354: Bluetooth

    23 Specifications and Safety Specifications • Non-Operating: - IEC 68-2-6 Vibration (sinusoidal) (10-57 Hz+ 0.15mm; 58-150 Hz, 2g; 20 sweeps x 3 axes) - IEC 68-2-64 Vibration, broad-band random (10-20 Hz, 0.05 g /Hz; 20-150 Hz, -3 dB/octave; 150 Hz, 0.0065 g /Hz;...
  • Page 355: Symbol Definitions

    Specifications 23 Specifications and Safety Symbol Definitions Table 103 lists the meaning of each symbol shown on the HeartStart MRx and the M3538A battery. Table 103 Monitor/Defibrillator, Battery and CPR Meter Symbols Symbol Definition Dangerous voltage Dispose of in accordance to your country’s requirements.
  • Page 356 23 Specifications and Safety Specifications Table 103 Monitor/Defibrillator, Battery and CPR Meter Symbols (Continued) Symbol Definition Device is Network-enabled. Reference order number Non-Ionizing Radiation. Device The CPR meter meets IEC 60529 class contains a radio frequency transmitter. IP55 Device complies with the requirements Expiration date of Medical Device Directive 93/42/EEC This product has passed relevant safety...
  • Page 357 Specifications 23 Specifications and Safety Table 104 lists the meaning of the symbols that may appear on the shipping carton. Table 104 HeartStart MRx Shipping Carton Symbols Symbol Definition Symbol Definition Atmospheric pressure range. Recyclable paper product. Temperature range Fragile. Relative humidity range.
  • Page 358: Units And Abbreviations

    23 Specifications and Safety Units and Abbreviations Units and Abbreviations Table 105 lists units and abbreviations used with the HeartStart MRx. Table 105 Abbreviations Unit Definition Unit Definition beats per minute compressions per minute degrees Celsius seconds degrees Fahrenheit minutes mmHg millimeters of mercury mm/mV millimeter per millivolt...
  • Page 359: Clinical Performance Summary - Defibrillation

    Clinical Performance Summary - Defibrillation 23 Specifications and Safety Clinical Performance Summary - Defibrillation An international, multicenter, prospective, randomized, clinical study was conducted to assess the effectiveness of the SMART Biphasic waveform in out-of-hospital sudden cardiac arrests (SCAs), as compared to monophasic waveforms. The primary objective of the study was to compare the percent of patients with ventricular fibrillation (VF) as the initial monitored rhythm that were defibrillated in the first series of three shocks or less.
  • Page 360: Clinical Performance Summary - Cardioversion

    23 Specifications and Safety Clinical Performance Summary - Cardioversion Clinical Performance Summary - Cardioversion An international, multicenter, prospective, double-blinded, randomized, clinical trial was conducted to assess the effectiveness of the SMART Biphasic waveform in treatment of atrial fibrillation (AF), as compared to monophasic waveforms.
  • Page 361: Conclusion

    Clinical Performance Summary - Cardioversion 23 Specifications and Safety Table 107 Clinical Summary - Cardioversion Biphasic Patients Monophasic Patients P Value Number (%) Number (%) Cumulative Cardioversion Efficacy - Single shock only 58/96 (60%) 24/107 (22%) <0.0001 - <2 shocks 74/96 (77%) 47/107 (44%) <0.0001...
  • Page 362: Clinical Performance Summary - Internal Defibrillation

    23 Specifications and Safety Clinical Performance Summary - Internal Defibrillation Clinical Performance Summary - Internal Defibrillation Overview A study was conducted during the first half of 2002 to assess the effectiveness of the HeartStart MRx (biphasic) for use in intra-thoracic application, as compared to a control biphasic waveform. This appendix summarizes the methods and results of the study.
  • Page 363: Safety Considerations

    Safety Considerations 23 Specifications and Safety Safety Considerations The following general warnings and cautions apply to use of the HeartStart MRx. Additional warning and cautions specific to a particular feature are provided in the appropriate section. General WARNING The HeartStart MRx is not intended to be deployed in settings or situations that promote use by untrained personnel.
  • Page 364 23 Specifications and Safety Safety Considerations Electric shock hazards exist internally. Do not remove assembly screws except as described in the carry WARNING bag assembly procedure. Refer servicing to qualified personnel. WARNING Operating the HeartStart MRx or its accessories in conditions outside the environmental specifications can result in device or accessory malfunction.
  • Page 365 Safety Considerations 23 Specifications and Safety CAUTION Be aware of patient cables, including ECG monitoring equipment when used with high frequency surgical equipment. NOT E This device and its accessories are not intended for home use. The HeartStart MRx can be operated with only AC/DC power, only 14V M3538A Lithium Ion NOT E Battery, or AC/DC power and M3538A battery simultaneously.
  • Page 366: Defibrillation

    23 Specifications and Safety Safety Considerations Defibrillation WARNING Keep hands and feet clear of paddle electrode edges. Use your thumbs to depress the shock buttons on the paddle handle. Do not allow multifunction electrode pads to touch each other or to touch other ECG monitoring WARNING electrodes, lead wires, dressings, etc.
  • Page 367: Battery

    Safety Considerations 23 Specifications and Safety Battery Properly dispose of or recycle depleted batteries according to local regulations. Do not puncture, WARNING disassemble, or incinerate batteries. WARNING Built in safety circuits can not protect against handling abuse. Adhere to all warnings and cautions in handing and using lithium ion batteries.
  • Page 368: Supplies And Accessories

    23 Specifications and Safety Electromagnetic Compatibility Supplies and Accessories Use only the multifunction electrode pads, battery, and accessories as listed in this guide. Substitutions WARNING may cause the HeartStart MRx to function improperly. WARNING Use multifunction electrode pads prior to their expiration date. Discard pads after use. Do not reuse pads.
  • Page 369: Restrictions For Use

    WARNING emissions or decreased immunity of the HeartStart MRx. The list of cables, transducers, and other accessories with which Philips claims compliance with the emissions and immunity requirements of IEC standard 60601-1-2 are listed in “Supplies & Accessories” on page 291.
  • Page 370 23 Specifications and Safety Electromagnetic Compatibility Table 109 Electromagnetic Emissions Emissions Test Compliance Electromagnetic Environment - Guidance RF emissions Group 1 The HeartStart MRx uses RF energy only for its internal function. Therefore, its RF emissions are CISPR 11 very low and not likely to cause interference in nearby electronic equipment.
  • Page 371 Electromagnetic Compatibility 23 Specifications and Safety Table 110 Electromagnetic Immunity - General Immunity Test IEC 60601 Compliance Electromagnetic Environment - Test Level Level Guidance Electrostatic + 6 kV contact + 6 kV contact Floors should be wood, concrete, or discharge (ESD) ceramic tile.
  • Page 372 23 Specifications and Safety Electromagnetic Compatibility Table 111Electromagnetic Immunity - Life Supporting Functions Immunity Test IEC 60601 Compliance Electromagnetic Environment - Guidance Test Level Level Portable and mobile RF communications equipment should be used no closer to any part of the HeartStart MRx, including cables, than the recommended separation distance calculated from the equation applicable to the frequency of the transmitter.
  • Page 373 Electromagnetic Compatibility 23 Specifications and Safety Table 111Electromagnetic Immunity - Life Supporting Functions (Continued) Immunity Test IEC 60601 Compliance Electromagnetic Environment - Guidance Test Level Level Radiated RF 10 V/m 10 V/m 80 MHz to 800 MHz IEC 61000-4-3 80 MHz to 2.5 GHz 800 MHz to 2.5 GHz where P is the maximum output power rating of the transmitter in watts (W) according to...
  • Page 374 23 Specifications and Safety Electromagnetic Compatibility Table 112Electromagnetic Immunity - Nonlife Supporting Functions Immunity Test IEC 60601 Compliance Electromagnetic Environment - Guidance Test Level Level Portable and mobile RF communications equipment should be used no closer to any part of the HeartStart MRx, including cables, than the recommended separation distance calculated from the equation applicable to the frequency of the transmitter.
  • Page 375: Recommended Separation Distances

    Electromagnetic Compatibility 23 Specifications and Safety Recommended Separation Distances The HeartStart MRx is intended for use in an electromagnetic environment in which radiated RF disturbances are controlled. The customer or the user of the HeartStart MRx can help prevent electromagnetic interference by maintaining a minimum distance between portable and mobile RF communications equipment (transmitters) and the HeartStart MRx as recommended below, according to the maximum output power of the communications equipment.
  • Page 377 Index Index configurable parameters changing limits ECG analysis enabling/disabling 12-Lead ECG impedance types ACI-TIPI indications annotated ECG acquiring no shock advised Apnea Time Alarm adjusting wave sizes patient status arrhythmia algorithm prepping the patient alarms chain configurable parameters set up learning/relearning Critical Values specifications...
  • Page 378 Index life expectancy printing configuration settings data sent low battery warning restoring default settings icons M3538A Lithium Ion Battery saving configuration to a data card transmission intervals maintenance setting date/time transmit interval process troubleshooting continued use specifications Rosetta and pacing storage connecting devices controls...
  • Page 379 Index radio/AC power module re-admitting a patient ECG and arrhythmia monitoring – HeartStart MRx specifications AED Mode set up transfer patient confirmation bundle branch calling for service transferring a patient configurable parameters identifying your device troubleshooting ECG wave size indications for use turning device off electrode placement intended use...
  • Page 380 Index configurable parameters test results adjusting volume indications tests CPR meter specifications User Checks adhesive pad after each use Mark Event back configurable parameters Basic View details menu Pacing compression depth indicator patient info see Noninvasive Pacing feedback monitoring view paddles compression depth indicator using internal...
  • Page 381 Index SMART Biphasic using an external monitor impedance Vital Signs Trending soft key labels adjusting interval specifications Temperature data 12-Lead ECG alarms exiting report AED Mode changing printing report batteries enabling/disabling report format Bluetooth changing degree units reviewing data CPR meter configurable parameters scrolling adhesive pads...
  • Page 382 989803160421 Edition 1 Philips Medical Systems Printed in the U.S.A. April 2009 *989803160421*...

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