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Instructor Guide
HeartStart MRx
M3535A/M3536A

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Table of Contents

   Summary of Contents for Philips HeartStart MRx

  • Page 1 Instructor Guide HeartStart MRx M3535A/M3536A...
  • Page 3 This information is subject to change without Medical Device Directive notice. The HeartStart MRx complies with the requirements of Philips shall not be liable for errors contained herein or the Medical Device Directive 93/42/EEC and carries the for incidental or consequential damages in connection mark accordingly.
  • Page 4 Registration number: SFDA(I)20083211481. Product Standard number: YZB/USA 1863-2008. For the Declaration of Conformity Statement, please see the Philips Medical web site at http:// incenter.medical.philips.com/PMSPublic. Scroll over the Quality and Regulatory Tab located in the upper left corner of the window. Click to select Regulatory by Modality.
  • Page 5 This Instructor Guide contain the following conventions: “Voice” represents voice prompt messages represents messages that appear on the display Text Text represents bolded directions to the instructor that appear in the guide and options that appear on MRx menus [Soft key] represents soft key labels that appear on the display above the button to which they correspond.
  • Page 7: Table Of Contents

    Table of Contents 1 Introduction 2 Getting Acquainted Lesson Introduction ..... . . Objectives ......Time .
  • Page 8 Objectives ......41 Time ......41 Accessories Recommended .
  • Page 9 Overview ......74 Q-CPR Preparation ..... . 75 Q-CPR in Manual Defib Mode .
  • Page 10 Overview ......106 Preparing to Measure NBP ....107 Measuring NBP .
  • Page 11 Monitoring Temperature ....137 Alarms ......138 Disabling the Temperature Function .
  • Page 12 Connecting to the Network ....161 Patient Admit, Discharge, and Transfer ....164 Sharing Information on the Network .
  • Page 13 Time ......203 Accessories Recommended ....203 Maintenance Resources .
  • Page 15: Introduction

    Instructor Guide Introduction This instructor guide is designed to assist you in the delivery of end-user training on the HeartStart MRx. It provides directions and suggestions for teaching the safe and proper operation of the device, and is intended only for ACLS personnel thoroughly trained in the use of the device. Instruction Time It is estimated that this course will require 2-5 hours to complete, depending on class size, location, number of devices available for training, optional device parameters purchased, and student knowledge...
  • Page 16 They can be found on the User Documentation CD-ROM, as well as: – www.medical.philips.com/goto/productdocumentation • If possible, try to have one set of the latest version of the HeartStart MRx Quick Reference Cards available with each MRx used during the training.
  • Page 17: Safety Considerations

    • Provide a brief overview of the course structure and what is covered in each lesson. • Advise students to read the HeartStart MRx Instructions For Use for details on device features and information not covered in the classroom: –...
  • Page 18 – Operational Check • HeartStart MRx Web-based User Training - provides a comprehensive self-paced training on the same content found in the instructor guide. It is located on Philips Medical Systems’ web site at: www.medical.philips.com/goto/mrxtraining. Students need to enter the training access password meetMRx to get started.
  • Page 19 – DXL ECG Algorithm – Philips ACI-TIPI – Philips TPI – Vital Signs Trending – Improving ECG Quality – ECG Out Cable – Philips 12-Lead Algorithm Physician’s Guide, available from IntelliVue Information Center - User Materials under Patient Monitoring at http://www3.medical.philips.com/en-us/doc_downloads/ docdownload.asp...
  • Page 20 1 Introduction...
  • Page 21: Getting Acquainted

    Introduce the lesson, including the learning objectives, estimated time to complete, and applicable resources. This lesson provides an overview of the HeartStart MRx controls, indicators, operational modes, and display views. It also provides general information on use of the device.
  • Page 22: Lesson Presentation

    2 Getting Acquainted Lesson Presentation Lesson Presentation Overview Describe the high-level features of the MRx. • It is designed for a variety of needs. • It has controls, indicators, and menus organized to facilitate ease of use. • It displays information specific to the current task. Basic Orientation Introduce the physical features, controls, and indicators on the front, left, right, top, and back panels of the MRx.
  • Page 23 Lesson Presentation 2 Getting Acquainted • Lead Select - changes the ECG lead in Wave Sector 1; cycles through the available ECG waves, changing the displayed wave and label. The list of available ECG waves is based on the current lead set and device configuration, and includes pads or paddles if the corresponding cable is connected to the MRx.
  • Page 24 2 Getting Acquainted Lesson Presentation • A blinking red “X” and a periodic audio chirp indicate: – No battery is present or a low battery condition. – The device can be used in a low battery condition, but its operation time is limited. If the device is running only on external power, it takes longer to charge.
  • Page 25: Back Panel

    For post-event Batch LAN Data Transfer (or when the patient is not connected to the MRx), the MRx should only be connected to the facility network. • An RS-232 serial port for 12-Lead ECG transmission and Philips network connectivity. Note the following: The RS-232 serial port is intended for connection to the IntelliVue wireless backpack.
  • Page 26: Display View

    2 Getting Acquainted Lesson Presentation Additional points/notes: ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ Display View Introduce the display view characteristics of the MRx, starting with a brief look at the various operating modes. Attach a simulator (set to a normal sinus rhythm), 3-, 5-, or 10-Lead ECG set, and all available parameter accessories to the MRx.
  • Page 27 Lesson Presentation 2 Getting Acquainted Password Security Access to Manual Defib Mode and Pacer Mode may be password protected if configured. If the modes are password protected, you are prompted to enter the password when you move the Therapy Knob to either the Pacer position or an energy selection.
  • Page 28 • Provide measurements for displayed waveforms and monitored parameters. The position of most parameters are in fixed locations depending upon the options which were included in your HeartStart MRx. • Block 1 always contains heart rate and HR alarm settings; may display Pulse, Temp, and NBP...
  • Page 29 Lesson Presentation 2 Getting Acquainted • Block 2 may contain Invasive Pressures, SpO , EtCO , and Airway Respiration Rate (AwRR) measurements and related high/low alarm limit settings; “-?-” is displayed until a valid measurement is obtained; settings may contain the Alarms Off icon. Block 2 may also contain Q-CPR compression and ventilation values.
  • Page 30: Responding To Alarms

    2 Getting Acquainted Lesson Presentation • Display appears with a yellow background and all other screen elements appearing in black or shades of gray. • Select High Contrast On from the Main Menu to enable the feature. Note the following: The High Contrast view does not display the colors red or blue, therefore, be sure the MRx is configured correctly with the appropriate parameter color settings.
  • Page 31: Device Identification

    – Confirm the alarm limits are appropriate for the patient each time there is a new patient incident. – Do not set alarm limits to such extreme values that render the alarm system useless. Note the following if you are using the HeartStart MRx M3536A using R.03 software and later: You can configure the MRx to: •...
  • Page 32: Entering Patient Information

    2 Getting Acquainted Lesson Presentation Entering Patient Information Discuss the various patient information that can be entered on the MRx. • Name • ID • Patient Category • Age (Date of Birth if the IntelliVue Networking option is installed) • Sex •...
  • Page 33: Return To Owner

    Lesson Presentation 2 Getting Acquainted • Certain waveforms (including invasive pressures and CO ) include scale indications on the printout. • Printouts are generated either real-time or with a 10-second delay, depending on your configuration. To change wave forms for the second wave printed with a 50mm printer: 1.
  • Page 34: Audio Recording

    2 Getting Acquainted Lesson Presentation 5. Enter the password and press Menu Select. 6. Press the [Exit Return-To] soft key. Additional points/notes: ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ Audio Recording Discuss characteristics of the Audio Recording option. • Configured to “On” by default; can only be turned off in Configuration Mode •...
  • Page 35: Carrying Case And Accessory Pouch Assembly

    Lesson Presentation 2 Getting Acquainted Carrying Case and Accessory Pouch Assembly This topic should be covered for only customers who have carrying cases and accessory pouches, as appropriate. Discuss the following procedures for carrying case assembly and recommended accessory placement. 1.
  • Page 36 2 Getting Acquainted Lesson Presentation...
  • Page 37: Storing Accessories

    Lesson Presentation 2 Getting Acquainted Storing Accessories 1. Store parameter cabling and accessories as shown below. 2. Attach the Therapy cable and route it through the cable fastener loop, securing the cable just below the strain relief. (See below left.) 3.
  • Page 38 2 Getting Acquainted Lesson Presentation Here are recommended carry bag storage instructions for Q-CPR accessories for easy access. Option 1 Option 2 Suggestion: Have students set up the carrying case and accessory pouches during your instruction.
  • Page 39 Lesson Presentation 2 Getting Acquainted Additional points/notes: ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________...
  • Page 40: Review

    Review Have students answer the following questions individually or as a group. (Correct answers are in bold.) 1. Identify at least three controls or buttons on the MRx involved with defibrillation. (Therapy Knob, Charge button, Shock button, Sync button) 2. What does a solid red “X” and periodic audio chirp indicate on the RFU? a.
  • Page 41: Ecg And Arrhythmia Monitoring

    Lesson Introduction Introduce the lesson, including the learning objectives, estimated time to complete, and applicable resources. This lesson describes the basic ECG and arrhythmia monitoring functions of the HeartStart MRx. Objectives Upon completion of this lesson, students should be able to: 1.
  • Page 42: Lesson Presentation

    Suggestion: Ask students to point out characteristics instead of YOU stating them. Note the following for the HeartStart MRx M3536A using R.02 software and later, which features automatic lead switching behavior: In Monitor mode, you can configure the MRx to switch sources for the waveform in Wave Sector 1.
  • Page 43: Preparation

    Lesson Presentation 3 ECG and Arrhythmia Monitoring Preparation Discuss monitoring preparation using multifunction electrode pads or electrodes. Multifunction electrode pads 1. Prepare the patient’s chest (i.e., remove clothing, remove moisture from chest, and remove excessive hair). 2. Apply multifunction electrode pads to the patient according to the pads package directions or your organization’s protocol.
  • Page 44 3 ECG and Arrhythmia Monitoring Lesson Presentation Lead Choices Review the choice of leads available for 3-, 5-, and 10-Lead ECG sets if connected to the MRx. If you are using: These leads are available: The maximum number of leads displayed is: a 3-Lead ECG set I, II, III...
  • Page 45 Lesson Presentation 3 ECG and Arrhythmia Monitoring Practice Exercise 1 Have students attach a simulator and 3-, 5-, and 10-Lead ECG set to the MRx (5- or 10-Lead set preferred), set the simulator to a normal sinus rhythm, and complete a variety of lead selections for Wave Sectors 2, 3, and 4, as appropriate.
  • Page 46: Heart Rate And Arrhythmia Alarms

    (i.e., is announced first) and overrides lower priority alarms (e.g., extreme BRADY over low HR). • Because the ST/AR Basic Arrhythmia Algorithm is the HeartStart MRx’s cardiotach source and is needed to generate heart rate and heart rate alarms, the algorithm can never be disabled. However, if desired, arrhythmia and heart rate alarms can be turned off.
  • Page 47 Lesson Presentation 3 ECG and Arrhythmia Monitoring HR/Arrhythmia Yellow Alarms Alarm Message Condition Indication Latching/ Non-Latching HR High The HR exceeds the configured Yellow alarm Non-Latching HR high limit message, alarm tone HR Low The HR is below the configured Yellow alarm Non-Latching HR low limit...
  • Page 48 3 ECG and Arrhythmia Monitoring Lesson Presentation INOP Messages Review INOP messages. Produce only 1-2 messages for reference purposes. • Communicate conditions preventing ECG monitoring or analysis. • Displayed just above the HR/Arrhythmia alarm status area. • Multiple messages alternate every 2 seconds. Alarm Message Condition Indication...
  • Page 49 Lesson Presentation 3 ECG and Arrhythmia Monitoring Additional points/notes: ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ _______________________________________________________________ ________________________________________________________________ Setting Alarms Introduce 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 using the Alarm Pause button.
  • Page 50 3 ECG and Arrhythmia Monitoring Lesson Presentation Note the following: Disabling alarms prevent all alarms associated with HR measurements from being annunciated. If an alarm condition occurs, no alarm indication will be given. Responding to HR and Arrhythmia Alarms Discuss and demonstrate how to respond to alarms. •...
  • Page 51: Displaying An Annotated Ecg

    Lesson Presentation 3 ECG and Arrhythmia Monitoring Displaying an Annotated ECG Demonstrate how to display an annotated ECG. • Beat labels appear in Wave Sector 2 based on the ST/AR Algorithm analysis. • Beat labels appear in Wave Sector 1 after a six second delay. •...
  • Page 52: Arrhythmia Learning/relearning

    3 ECG and Arrhythmia Monitoring Lesson Presentation Arrhythmia Learning/Relearning Discuss and demonstrate how the MRx learns and relearns automatically and manually. • To ensure the ST/AR Algorithm can properly analyze the patient’s normal and/or paced complexes, MRx automatically performs arrhythmia learning/relearning: –...
  • Page 53: Review

    Review 3 ECG and Arrhythmia Monitoring Review Have students answer the following questions individually or as a group. (Correct answers are in bold. Consider having students correct FALSE statements to ensure comprehension.) 1. Identify the Monitoring View elements. (4 wave sectors, INOP area, ECG/HR alarms, HR values, alarm settings) 2.
  • Page 55: Semi-automated External Defibrillation

    Instructor Guide Semi-Automated External Defibrillation Lesson Introduction Introduce the lesson, including the learning objectives, estimated time to complete, and applicable resources. This lesson describes how to use AED Mode. It highlights the AED display view and explains the steps and associated prompts that guide users through the defibrillation process. Objectives Upon completion of this lesson, students should be able to: 1.
  • Page 56: Lesson Presentation

    4 Semi-Automated External Defibrillation Lesson Presentation Lesson Presentation Overview Introduce the Semi-Automated External Defibrillation (AED) Mode. • AED Mode guides users through standard treatment algorithms for cardiac arrest. • It includes voice and screen prompts for defibrillation preparation, ECG analysis, and shock delivery.
  • Page 57: Preparation

    Lesson Presentation 4 Semi-Automated External Defibrillation Preparation Discuss the AED defibrillation preparation. 1. Confirm the patient’s condition (i.e., unresponsive, not breathing, and/or pulseless). 2. Prepare the patient’s chest. Wipe moisture away and, if necessary, clip or shave excessive chest hair. 3.
  • Page 58: Aed Mode

    4 Semi-Automated External Defibrillation Lesson Presentation AED Mode Demonstrate the AED defibrillation steps with the simulator set to VF (V-Fib). 1. Turn the Therapy Knob to AED. 2. Follow the voice and screen prompts. 3. Press the orange Shock button, if prompted. Mention the following AED Mode characteristics during the demonstration.
  • Page 59 Lesson Presentation 4 Semi-Automated External Defibrillation Turn the Therapy Knob to AED When the MRx is turned to AED, it checks for proper pads cable and pads connection, as follows. If the: you are prompted to: pads cable is not properly Connect Pads Cable attached - pads are not connected...
  • Page 60: Shock Advised

    4 Semi-Automated External Defibrillation Lesson Presentation Follow the Screen and Voice Prompts Next, connect the pads and pads cable, set the simulator to a shockable rhythm (e.g., VF), and complete the defibrillation process (steps 2 and 3). Note the following: •...
  • Page 61 Lesson Presentation 4 Semi-Automated External Defibrillation Additional points/notes: ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ Press the Orange Shock Button, if Prompted Now complete the Shock step. Note the following: • MRx prompts Deliver Shock Now; Press the Orange Button Now once charging is complete.
  • Page 62 4 Semi-Automated External Defibrillation Lesson Presentation Additional points/notes: ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ No Shock Advised (NSA) Finally, set the simulator to a normal sinus rhythm (NSR). Tell users how their MRx is configured for NSA (Monitor or a pause time setting). Mention that if a shockable rhythm is not detected, MRx: •...
  • Page 63: Review

    Review 4 Semi-Automated External Defibrillation Review Have students answer the following questions individually or as a group. (Correct answers are in bold.) 1. Identify the AED View elements. (Event timer, enlarged ECG, shock counter, message window) 2. Apply multifunction electrode pads using anterior-posterior placement for AED. (F - anterior- anterior) 3.
  • Page 65: Manual Defibrillation And Cardioversion

    Instructor Guide Manual Defibrillation and Cardioversion Lesson Introduction Introduce the lesson, including the learning objectives, estimated time to complete, and applicable resources. This lesson explains how to prepare for and perform manual asynchronous and synchronous (cardioversion) defibrillation using multifunction electrode pads and external/internal paddles. Objectives Upon completion of this lesson, students should be able to: 1.
  • Page 66: Lesson Presentation

    5 Manual Defibrillation and Cardioversion Lesson Presentation Lesson Presentation Manual Mode Introduce the Manual Defib Mode. • The entire defibrillation process is under your control (i.e., you assess the ECG, decide if defibrillation or cardioversion is indicated, select the appropriate energy setting, charge the device, and deliver the shock).
  • Page 67: Manual Defibrillation Preparation

    Lesson Presentation 5 Manual Defibrillation and Cardioversion Additional points/notes: ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ Manual Defibrillation Preparation Discuss defibrillation preparation using multifunction electrode pads, external paddles, and/or internal paddles. Multifunction electrode pads 1. Confirm the patient’s condition (i.e., unresponsive, not breathing, and/or pulseless). 2.
  • Page 68: Manual Defibrillation

    5 Manual Defibrillation and Cardioversion Lesson Presentation • Impedance is the resistance between the defibrillator’s pads or paddles that the defibrillator must overcome to deliver an effective discharge of energy. The degree of impedance differs from patient to patient and is affected by several factors, including the presence of chest hair, moisture, and lotions or powders on the skin.
  • Page 69 Lesson Presentation 5 Manual Defibrillation and Cardioversion • The energy selection in the Shock Status area changes and a continuous, low-pitch charging tone sounds as the defibrillator charges. • The current energy displays and a continuous, high-pitch ‘charge done’ tone sounds at the end of the charge.
  • Page 70: Synchronized Cardioversion

    5 Manual Defibrillation and Cardioversion Lesson Presentation Synchronized Cardioversion Introduce synchronized cardioversion. • Synch cardioversion allows synchronized shock delivery with the ECG R-wave monitored in Wave Sector 1. • It can be performed through either multifunction electrode pads or external paddles. •...
  • Page 71: Synchronized Shock Delivery

    Lesson Presentation 5 Manual Defibrillation and Cardioversion Synchronized Shock Delivery Demonstrate synchronized cardioversion with a simulator set to AFib. 1. Turn the Therapy Knob to Monitor and press the Sync button. 2. Confirm that the Sync marker appears with each R-wave. If the marker does not appear, select another lead.
  • Page 72 5 Manual Defibrillation and Cardioversion Lesson Presentation Practice Exercise 2 Have students attach a simulator and pads to the MRx, set the simulator to a shockable rhythm (e.g., VF), and complete synchronized cardioversion. Pose the following questions: 1. What do you see when you press the Sync button? 2.
  • Page 73: Review

    Review 5 Manual Defibrillation and Cardioversion Review Have students answer the following questions individually or as a group. (Correct answers are in bold.) 1. Identify the Code View elements. (Event timer, heart rate, enlarged ECG, shock status area) 2. What are the three basic steps for manual defibrillation using the MRx? a.
  • Page 75: Cpr® With Cpr Meter

    • Pads/CPR meter cable • CPR meter • CPR meter adhesive pads • Philips multifunction electrode pads • Ambu bag • Resusci Anne manikin (to perform compressions only) Note: To perform and measure both compressions and ventilations, the Resusci Anne SkillReporter manikin and Q-CPR Trainer are required.
  • Page 76: Lesson Presentation

    • There is a Q-CPR Data Capture option available that allows you to capture data on CPR quality from the HeartStart MRx using the Q-CPR option, as well as standard MRx defibrillation and monitoring events and ECG waveforms. Events related to Q-CPR are logged to the patient incident record but not included in the Event Summary report printed by the MRx;...
  • Page 77: Q-cpr Preparation

    • Pre-connect the Pads/CPR cable to the MRx (prior to a resuscitation event or rescue) to save on set- up time. • The Q-CPR option requires the Pads/CPR cable to be connected to the HeartStart MRx. CPR feedback is not available if the standard pads or paddles cable is connected.
  • Page 78 • Anterior-posterior pad placement should not be used with the Q-CPR option. • Philips multifunction pads are required to measure ventilation activity, as well as acquire an ECG signal and deliver a shock, as appropriate. Pads need to be applied securely and maintain good contact to ensure a good signal for ventilation measurement.
  • Page 79 Lesson Presentation 6 Q-CPR® with CPR meter Starting CPR with the CPR meter 1. 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.
  • Page 80 6 Q-CPR® with CPR meter Lesson Presentation • If the CPR meter detects the compression rate is faster than the target rate (120 compressions per minute), the needle on the compression rate indicator points to the right of the green target zone. If the compression rate is not corrected, the MRx provides corrective voice prompts (if configured).
  • Page 81: Q-cpr In Manual Defib Mode

    Lesson Presentation 6 Q-CPR® with CPR meter Q-CPR in Manual Defib Mode Demonstrate Q-CPR in manual defibrillation mode with a simulator set to VF (VFib). 1. Turn the Therapy Knob to Manual Defib and select the 150J energy setting to automatically display the Advanced CPR View.
  • Page 82 The No Flow Time value is reset when a compression occurs or when the Shock button on the HeartStart MRx is pressed. If the No Flow Time value exceeds 1 minute, it is assumed that CPR compression activity has stopped intentionally and the value is cleared (two dashes).
  • Page 83 Lesson Presentation 6 Q-CPR® with CPR meter Note the following: • SpO monitoring functionality is not available during Q-CPR use. • Compression and ventilation measurement values are printed in the annotation area of the ECG printed strip. Suggestion: Print a strip to exhibit the values. Soft Keys Toggle between the soft keys in manual defibrillation mode and discuss the following characteristics.
  • Page 84: Q-cpr In Aed Mode

    6 Q-CPR® with CPR meter Lesson Presentation Additional points/notes: ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ Q-CPR in AED Mode Demonstrate Q-CPR in AED Mode in Basic and/or Advanced CPR View. (Configure the Advanced View prior to class, as needed.) Turn the Therapy Knob to AED, press the Pause for CPR soft key, and mention the following AED Q-CPR view characteristics while performing CPR.
  • Page 85 Lesson Presentation 6 Q-CPR® with CPR meter Additional points/notes: ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ CPR Feedback Volume Adjustment Turn the MRx Therapy Knob to a Manual Defib setting (e.g., 150J) and demonstrate the volume adjustment. Press the Start CPR soft key and mute the voice prompts. To mute the CPR feedback voice prompts (once you start CPR): 1.
  • Page 86: Review

    Review Have students answer the following questions individually or as a group. (Correct answers are in bold.) 1. True or false? Q-CPR can be used on patients 8 years and older. (T) 2. True or false? The multifunction pads should be placed in an anterior/posterior position to measure ventilation activity.
  • Page 87: Cpr® With Compression Sensor

    ® This lesson describes how to set-up and use the Q-CPR option (with compression sensor) available on the HeartStart MRx. Objectives Upon completion of this lesson, students should be able to: 1. Identify intended use and preparation for use related to Q-CPR.
  • Page 88: Lesson Presentation

    CPR devices go with which HeartStart MRx units. • Q-CPR is intended for use with only the HeartStart MRx and available in Manual Defib Mode and AED Mode. Both modes provide audio prompts and visual indicators when CPR performance deviates outside of target ranges and in accordance with AHA/ERC guidelines.
  • Page 89: Q-cpr Preparation

    • Pre-connect the Pads/CPR cable to the MRx (prior to a resuscitation event or rescue) to save on set- up time. • The Q-CPR option requires the Pads/CPR cable to be connected to the HeartStart MRx. CPR feedback is not available if the standard pads or paddles cable is connected.
  • Page 90 7 Q-CPR® with Compression Sensor Lesson Presentation Multifunction Electrode Pads 1. Check the expiration date on the pads package and inspect the packaging for any damage. 2. Prepare the patient’s chest. 3. Apply the pads to the patient as directed on the pads package, using the anterior-anterior placement.
  • Page 91 Lesson Presentation 7 Q-CPR® with Compression Sensor Practice Exercise 1 Have students make all cable attachments and then detach a cable (e.g., Pads/CPR or Compression Sensor cable) to see what inop is produced. For example, the message Connect Pads/CPR Cable displays if not pre-connected.
  • Page 92: Q-cpr In Manual Defib Mode

    7 Q-CPR® with Compression Sensor Lesson Presentation Q-CPR in Manual Defib Mode Demonstrate Q-CPR in manual defibrillation mode with a simulator set to VF (VFib). 1. Turn the Therapy Knob to Manual Defib and select the 150J energy setting to automatically display the Q-CPR sub view.
  • Page 93 The No Flow Time value is reset when a compression occurs or when the Shock button on the HeartStart MRx is pressed. If the No Flow Time value exceeds 1 minute, it is assumed that CPR compression activity has stopped intentionally and the value is cleared.
  • Page 94 7 Q-CPR® with Compression Sensor Lesson Presentation Note the following: – When intubation is indicated, the Ventilate Less Forcefully and Ventilate a Little Less Forcefully audio feedback is suppressed. – The Q-CPR option should not be used to verify placement of airway adjuncts, such as endotracheal tubes and laryngeal masks.
  • Page 95: Q-cpr In Aed Mode

    Lesson Presentation 7 Q-CPR® with Compression Sensor Q-CPR in AED Mode Demonstrate Q-CPR in AED mode. Turn the Therapy Knob to AED, press the Pause for CPR soft key, and mention the following AED Q-CPR view characteristics while performing CPR. Consider enlisting two students to perform compressions and ventilations so that you can focus on discussion of Q-CPR characteristics.
  • Page 96 7 Q-CPR® with Compression Sensor Lesson Presentation CPR Feedback Volume Adjustment Turn the MRx Therapy Knob to a Manual Defib setting (e.g., 150J) and demonstrate the volume adjustment. Press the Start CPR soft key and mute the voice prompts. To mute the CPR feedback voice prompts (once you start CPR): 1.
  • Page 97: Review

    Review 7 Q-CPR® with Compression Sensor Review Have students answer the following questions individually or as a group. (Correct answers are in bold.) 1. True or false? Q-CPR can be used on patients 8 years and older. (T) 2. True or false? The multifunction pads should be placed in an anterior/posterior position to ensure the ventilation algorithm interprets ventilations properly.
  • Page 99: Noninvasive Pacing

    Lesson Introduction Introduce the lesson, including the learning objectives, estimated time to complete, and applicable resources. This lesson describes the noninvasive transcutaneous pacing option available with the HeartStart MRx and how to perform pacing. Objectives Upon completion of this lesson, students should be able to: 1.
  • Page 100: Lesson Presentation

    8 Noninvasive Pacing Lesson Presentation Lesson Presentation Pacer Mode Introduce the Pacer Mode. • Pacer Mode delivers pace pulses to the heart through multifunction electrode pads. • The ECG strip and Event Summary are easily annotated (using the Mark Event button) in Pacer Mode.
  • Page 101: Pacing View

    Lesson Presentation 8 Noninvasive Pacing Pacing View Turn the Therapy Knob to Pacer on the MRx and introduce the unique Pacing View characteristics. • A status block appears in Wave Sector 4. The first line communicates status (active or paused) or pacing by batteries (if configured) and the second line identifies the pacing mode (demand or fixed), pacing rate (ppm), and pacing output (mA).
  • Page 102: Demand Vs. Fixed Mode

    8 Noninvasive Pacing Lesson Presentation Demand vs. Fixed Mode Introduce demand and fixed mode pacing. Demand mode • Pace pulses are delivered when the patient’s heart rate is lower than the selected pacing rate. • Use this mode whenever possible. •...
  • Page 103: Preparation

    Lesson Presentation 8 Noninvasive Pacing Preparation Demonstrate preparation for pacing. 1. Prepare the patient’s chest. Wipe moisture away and, if necessary, clip or shave excessive chest hair. 2. Apply multifunction electrode pads to the patient as directed on the pads packaging or according to your organization’s protocol.
  • Page 104: Demand Mode Pacing

    • The ECG cable must be directly connected to the MRx when in demand mode. If a sync cable is used, connect the cable using the ECG Out port on the MRx and the ECG In port on the Philips bedside monitor.
  • Page 105 Lesson Presentation 8 Noninvasive Pacing • Pacing will not start if a pads connection or patient contact problem exists; pace pulses will not be delivered if a monitoring electrodes connection problem exists. An inop message alerts you to either connection problem. For the pads problem, you should check the pads cable is connected, the pads are properly applied, or apply new pads, as needed.
  • Page 106: Fixed Mode Pacing

    8 Noninvasive Pacing Lesson Presentation Fixed Mode Pacing Demonstrate how to pace in fixed mode. 1. Turn the Therapy Knob to Pacer. Note the following: The message Pacing Paused appears in the status block, indicating that the pacing function is enabled, though pace pulses are not being delivered. 2.
  • Page 107: Defibrillating During Pacing

    Lesson Presentation 8 Noninvasive Pacing Defibrillating During Pacing Discuss how switching to Manual or AED Mode affects pacing. • Once the Therapy Knob is moved from Pacer to Manual Defib or AED, pacing is stopped. • To resume pacing after defibrillation, repeat the pacing procedure. When pacing is resumed, pacing settings selected prior to defibrillation (mode, rate, and output) are retained.
  • Page 108: Review

    8 Noninvasive Pacing Review Review Have students answer the following questions individually or as a group. (Correct answers are in bold. Consider having students correct FALSE statements to ensure comprehension.) 1. Which of the following statement(s) are TRUE related to pacing with the MRx? a.
  • Page 109: Pulse Oximetry Monitoring

    Lesson Introduction Introduce the lesson, including the learning objectives, estimated time to complete, and applicable resources. This lesson describes how to use the HeartStart MRx to monitor Pulse Oximetry (SpO Objectives Upon completion of this lesson, students should be able to: 1.
  • Page 110: Lesson Presentation

    9 Pulse Oximetry Monitoring Lesson Presentation Lesson Presentation Overview Discuss pulse oximetry respective to its use with the MRx. • Pulse oximetry is a noninvasive method of continuously measuring oxygen saturation (SpO ) in arterial blood; SpO reading indicates percentage of hemoglobin molecules in the arterial blood saturated with oxygen.
  • Page 111: Applying The Sensor

    Lesson Presentation 9 Pulse Oximetry Monitoring • Reusable sensors may be reused on different patients after they have been cleaned and disinfected. (See the manufacturer’s instructions supplied with the sensor.) • Disposable sensors should be used only once and then discarded. They may be relocated to another sensor site on the patient if the first location does not give the desired results.
  • Page 112: Monitoring Spo

    9 Pulse Oximetry Monitoring Lesson Presentation Monitoring SpO Attach an SpO sensor cable to the MRx, the sensor to yourself, and demonstrate preparation for monitor SpO 1. Connect the appropriate sensor cable to the MRx. 2. Apply the sensor to the patient. If a finger sensor is used, the cable should come down the back of the hand.
  • Page 113: Pleth Wave

    Lesson Presentation 9 Pulse Oximetry Monitoring Pleth Wave Mention the following characteristics associated with the pleth wave. • The wave displays in the configured Wave Sector, if available; otherwise, the wave fills the first available empty Wave Sector. • The wave is drawn at an approximate speed of 25 mm/second. •...
  • Page 114: Setting Spo 2 Alarms

    9 Pulse Oximetry Monitoring Lesson Presentation Setting SpO Alarms Mention the following SpO alarm characteristics. • Alarms sound if measurements fall outside the configured high or low SpO limits or 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 115 Lesson Presentation 9 Pulse Oximetry Monitoring Practice Exercise 1 Have students change SpO limits, and enable/disable and respond to related alarms. Pose the following questions: 1. What happens when you change a limit? Disable an alarm? Respond to an alarm? Additional points/notes: ________________________________________________________________ ________________________________________________________________...
  • Page 116: Setting Pulse Rate Alarms

    9 Pulse Oximetry Monitoring Lesson Presentation Setting Pulse Rate Alarms Mention the following pulse rate alarm characteristics. • Alarms sound if measurements fall outside the configured high and low pulse rate limits. • Pulse rate alarms are all categorized as “non-latching” alarms, meaning they are automatically removed when their alarm condition no longer exists.
  • Page 117 Lesson Presentation 9 Pulse Oximetry Monitoring Additional points/notes: ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________...
  • Page 118: Review

    9 Pulse Oximetry Monitoring Review Review Have students answer the following questions individually or as a group. (Correct answers are in bold.) 1. True or false? You can monitor SpO in all MRx modes (Monitor, Manual Defib, AED or Pacer). (F - Not AED) 2.
  • Page 119: Noninvasive Blood Pressure Monitoring

    Lesson Introduction Introduce the lesson, including the learning objectives, estimated time to complete, and applicable resources. This lesson describes how to monitor noninvasive blood pressure (NBP) with the HeartStart MRx. Objectives Upon completion of this lesson, students should be able to: 1.
  • Page 120: Lesson Presentation

    10 Noninvasive Blood Pressure Monitoring Lesson Presentation Lesson Presentation Overview Review NBP characteristics respective to its use with the MRx. • MRx measures blood pressure (for adults/pediatrics) using the oscillometric method. • NBP may be measured in Monitor, Pacer, or Manual Defib Modes. •...
  • Page 121: Preparing To Measure Nbp

    Lesson Presentation 10 Noninvasive Blood Pressure Monitoring Preparing to Measure NBP Demonstrate NBP measurement preparation using the NBP cuff. 1. Select the appropriately sized cuff for the patient. 2. Attach the cuff to the NBP tubing. 3. Insert the NBP tubing into the NBP port on the MRx. 4.
  • Page 122: Measuring Nbp

    10 Noninvasive Blood Pressure Monitoring Lesson Presentation Measuring NBP Demonstrate the steps to measure NBP. 1. Press the [Start NBP] soft key. Note the following: • NBP values display when the measurement is complete. • You need to press [Start NBP] for every manual measurement. •...
  • Page 123 Lesson Presentation 10 Noninvasive Blood Pressure Monitoring Practice Exercise 1 Have students complete manual and automatic NBP measurements, including changing the NBP schedule. Pose the following questions: 1. What displays when you start a measurement? Stop a measurement? 2. How does the display differ between a manual and automatic measurement? Additional points/notes: ________________________________________________________________ ________________________________________________________________...
  • Page 124: Alarms

    10 Noninvasive Blood Pressure Monitoring Lesson Presentation Alarms Mention the following NBP alarm characteristics. • An alarm sounds when a measurement (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.
  • Page 125 Lesson Presentation 10 Noninvasive Blood Pressure Monitoring Practice Exercise 2 Have students change NBP alarm limits, and enable/disable and respond to related alarms. Pose the following questions: 1. What happens when you change a limit? Disable an alarm? Respond to an alarm? Additional points/notes: ________________________________________________________________ ________________________________________________________________...
  • Page 126: Review

    10 Noninvasive Blood Pressure Monitoring Review Review Have students answer the following questions individually or as a group. (Correct answers are in bold.) 1. Which of the following items can display when monitoring NBP? a. Systolic and diastolic pressure b. Alarm limits c.
  • Page 127: Carbon Dioxide Monitoring

    This lesson 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. Objectives Upon completion of this lesson, students should be able to: 1.
  • Page 128: Lesson Presentation

    11 Carbon Dioxide Monitoring Lesson Presentation Lesson Presentation Overview Briefly review the CO monitoring function. • It measures the partial pressure of CO in a sample of the patient’s exhaled breath (with the appropriate FilterLine and, if necessary, airway adapter). •...
  • Page 129: Preparing To Measure Etco

    Lesson Presentation 11 Carbon Dioxide Monitoring Preparing to Measure EtCO Demonstrate the following preparation to measure EtCO 1. Select the appropriate Microstream accessories based on the type and airway status of the patient. 2. Set up the Microstream accessories. 3. Attach the FilterLine tubing to the CO Inlet port.
  • Page 130: Measuring Etco

    11 Carbon Dioxide Monitoring Lesson Presentation Measuring EtCO Cover the following display characteristics related to EtCO measurement. • The measurement is automatically turned on when the FilterLine is connected to the CO Inlet port. • The CO waveform displays in the configured Wave Sector, if available; otherwise, the wave fills the first available empty Wave Sector.
  • Page 131 Lesson Presentation 11 Carbon Dioxide Monitoring Changing AwRR Alarm Limits Demonstrate how to change the AwRR alarm limits. 1. Press Menu Select. 2. Using the Navigation buttons, select Measurements/Alarms and press Menu Select. 3. Select AwRR and press Menu Select. 4.
  • Page 132: Disabling Etco 2 Monitoring

    11 Carbon Dioxide Monitoring Lesson Presentation Disabling EtCO Monitoring Demonstrate how to disable EtCO monitoring. • Disconnect the FilterLine from the CO inlet port. The message CO2 Unplugged. Turn off EtCO2? appears. Select Yes and press Menu Select. • Should the FilterLine be disconnected accidentally, select No in response to the message and press Menu Select.
  • Page 133: Review

    Review 11 Carbon Dioxide Monitoring Review Have students answer the following questions individually or as a group. (Correct answers are in bold.) 1. True or false? EtCO values may be significantly low if a patient is breathing through their mouth when using a nasal FilterLine.
  • Page 135: Invasive Pressures Monitoring

    Lesson Introduction Introduce the lesson, including the learning objectives, estimated time to complete, and applicable resources. This lesson describes how to monitor invasive pressures using the HeartStart MRx. Objectives Upon completion of this lesson, students should be able to: 1. Set up a pressure measurement.
  • Page 136: Lesson Presentation

    (i.e., pressure cable, transducer, flush solution, and catheter) to display a pressure measurement on the MRx. Alternatively, have a simulator and appropriate invasive pressure cable(s) set up. 1. Turn the HeartStart MRx to Monitor. 2. Connect the pressure cable to the MRx.
  • Page 137: Selecting A Pressure To Monitor

    Lesson Presentation 12 Invasive Pressures Monitoring Additional points/notes: ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ Selecting a Pressure to Monitor Demonstrate how to select a pressure to monitor on the MRx. • You need to assign a label to each pressure channel as it is connected. Channels are identified as Press 1 and Press 2.
  • Page 138: Pressure Waves

    12 Invasive Pressures Monitoring Lesson Presentation Label Description Label Description Arterial Blood Pressure Left Atrial Pressure Arterial Blood Pressure Pulmonary Artery Pressure Aortic Pressure Right Atrial Pressure Central Venous Pressure Non-specific pressure label (Channel 1) Intracranial Pressure* Non-specific pressure label (Channel 2) *Important notice to students: Cerebral Perfusion Pressure (CPP) is automatically displayed with ICP when one pressure is already set to ABP, ART or Ao and the other pressure is set to ICP.
  • Page 139: Zeroing The Pressure Transducer

    Lesson Presentation 12 Invasive Pressures Monitoring Practice Exercise 1 Have students attach a simulator and pressure cable(s) to the MRx, select different pressure waves and associated scales, and display and print out the results, as appropriate. Pose the following questions: 1.
  • Page 140 12 Invasive Pressures Monitoring Lesson Presentation Zeroing Using the Menu Select Button Demonstrate zeroing using the Menu Select button. 1. Place the transducer at the appropriate level for the measurement site. 2. Close the transducer stopcock to the patient and vent the transducer to atmospheric pressure. 3.
  • Page 141: Calibration

    Please refer students to the Calibration topic of the Invasive Pressures chapter in the HeartStart MRx Instructions for Use for details – setting a known calibration factor on the MRx –...
  • Page 142: Alarms

    12 Invasive Pressures Monitoring Lesson Presentation Alarms Mention the following invasive pressure alarm characteristics and details in the following table, as appropriate. • Invasive pressure alarms (except are all categorized as ABP, ART, Ao, PAP, P1, or P2 disconnect alarms) “non-latching”...
  • Page 143 Lesson Presentation 12 Invasive Pressures Monitoring Viewing/Changing/Setting Source for Alarms Demonstrate how to view or change alarm settings for a given pressure label. 1. Press the Menu Select button. 2. Using the Navigation buttons, select Measurements/Alarms and press Menu Select. 3.
  • Page 144: Wedge

    12 Invasive Pressures Monitoring Lesson Presentation Wedge Briefly mention the pulmonary artery wedge procedure, as appropriate. • Perform a pulmonary artery wedge procedure, according to your hospital protocol. • The wedge numeric will not be stored in the Vital Signs Trending. Note the following: •...
  • Page 145 Lesson Presentation 12 Invasive Pressures Monitoring • If the pulse source you are using to obtain a pulse rate is disconnected during active measuring and a secondary pulse source is available, the pulse rate does not automatically switch to the secondary source.
  • Page 146 12 Invasive Pressures Monitoring Lesson Presentation Changing Default Pulse Source and Alarm Limits Mention that you can change the default pulse source in the pulse section of Configuration Mode and default pulse alarm limits in the ECG section of Configuration Mode (the latter because pulse and heart rate share the same default alarm limits).
  • Page 147: Review

    Review 12 Invasive Pressures Monitoring Review Have students answer the following questions individually or as a group. (Correct answers are in bold. Consider having students correct FALSE statements to ensure comprehension.) 1. You must flush the tubing system to remove air bubbles to prevent potential incorrect readings. 2.
  • Page 149: Temperature Monitoring

    Lesson Introduction Introduce the lesson, including the learning objectives, estimated time to complete, and applicable resources. This lesson describes how to monitor temperature using the HeartStart MRx. Objectives Upon completion of this lesson, students should be able to: 1. Select a temperature to monitor.
  • Page 150: Lesson Presentation

    13 Temperature Monitoring Lesson Presentation Lesson Presentation Overview Introduce the Temperature option associated with the MRx. • The MRx offers one channel of real-time continuous temperature monitoring while in Monitor, Pacer or Manual Defib Modes. • It can monitor nasopharyngeal, esophageal, rectal, skin, arterial, venous, core and urinary bladder (vesic) temperatures.
  • Page 151: Monitoring Temperature

    Lesson Presentation 13 Temperature Monitoring Monitoring Temperature Demonstrate how to monitor temperature. 1. Connect the temperature cable to the MRx. 2. Select the correct temperature label for your measurement. 3. Check that the current device settings (including alarm settings) are appropriate for the patient. 4.
  • Page 152: Alarms

    13 Temperature Monitoring Lesson Presentation Alarms Setting Temperature Alarms Mention the following temperature alarm characteristics and details in the following table, as appropriate. • Temperature alarms are all categorized as “non-latching” alarms, meaning they are automatically removed when their alarm condition no longer exists. •...
  • Page 153: Disabling The Temperature Function

    Lesson Presentation 13 Temperature Monitoring Disabling the Temperature Function Demonstrate how to disable the Temperature function. • Disconnect the temperature cable from the MRx Temperature port. The message Temp (or the label currently activated) Unplugged. Turn Off Temp (or the label currently activated)? appears. Select Yes and press the Menu Select button.
  • Page 154: Review

    13 Temperature Monitoring Review Review Have students answer the following questions individually or as a group. (Correct answers are in bold. Consider having students correct FALSE statements to ensure comprehension.) 1. True or false? When you change a temperature label, you need to activate its related alarm limits. (F - All settings (including alarm limits) associated with a label become active as soon as you change the label.) 2.
  • Page 155: 12-lead Ecg Monitoring

    The ACI-TIPI/TPI topic in this lesson is optional, so advise students accordingly on objectives and how long the lesson will take to complete. This lesson describes how to use the diagnostic 12-Lead ECG function of the HeartStart MRx. Objectives Upon completion of this lesson, students should be able to: 1.
  • Page 156: Lesson Presentation

    • It previews, acquires, analyzes, prints, copies, and stores 12-Lead ECGs. • It provides computerized ECG analysis and a report, using the Philips DXL ECG Algorithm (on MRxs using software version F.xx and later). The algorithm provides an analysis of the amplitudes, durations, and morphologies of the ECG waveforms and the associated rhythm.
  • Page 157: Preparation

    • The patient should be supine and relaxed when an ECG is acquired. Demonstrate how to prepare for ECG acquisition. 1. Connect the 10-Lead cable to the HeartStart MRx. 2. Prepare the patient’s skin at appropriate electrode sites. – If necessary, clip hair at the electrode sites (or shave sites if needed).
  • Page 158: Acquiring The 12-lead Ecg

    14 12-Lead ECG Monitoring Lesson Presentation Additional points/notes: ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ Acquiring the 12-Lead ECG Demonstrate how to acquire a 12-Lead ECG. 1. Press the [12-Lead] soft key. 2. Check the signal quality on each lead and, if necessary, make adjustments. 3.
  • Page 159: Acquiring A 12-lead Ecg With Aci-tipi Or Aci-tipi/tpi Analysis

    Lesson Presentation 14 12-Lead ECG Monitoring Practice Exercise 1 Have students complete a 12-Lead acquisition. Ask them to point out what display changes they see when completing each step. Additional points/notes: ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ Acquiring a 12-lead ECG with ACI-TIPI or ACI-TIPI/TPI Analysis (Optional topic: This topic is for students who have and use the ACI-TIPI and TPI option.) Before covering this topic, check the MRx configuration for the ACI-TIPI and TPI option.
  • Page 160 14 12-Lead ECG Monitoring Lesson Presentation – If the ECG is a candidate, you’re prompted to input more patient information. Continue with Step 3. 3. When required, the MRx displays a list of TPI data and related values that must be entered. The following table provides the required TPI data.
  • Page 161 Lesson Presentation 14 12-Lead ECG Monitoring • Pregnant female • Serious systemic disease • Pulmonary edema • Signs of shock The default value for each contraindication is Unknown. You have the ability to change each contraindication to Yes or No or leave it as Unknown. Once entered, the contraindications are retained for the current patient.
  • Page 162: 12-lead Report

    12-Lead Report Discuss the characteristics of the 12-Lead Report View and printout. • The 12-Lead Report View lets you monitor a patient and see report data simultaneously. • The report replaces Wave Sectors 3 and 4 and includes the following information, if configured: –...
  • Page 163: Adjusting Wave Size

    Lesson Presentation 14 12-Lead ECG Monitoring 5. Select Print, Copy, or Delete and press Menu Select. Note the following: A report can be transmitted from the selected 12-Lead Report menu. This procedure will be covered in the Data Transmission lesson. 6.
  • Page 164 14 12-Lead ECG Monitoring Lesson Presentation Additional points/notes: ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________...
  • Page 165: Review

    Review 14 12-Lead ECG Monitoring Review Have students answer the following questions individually or as a group. (Correct answers are in bold. Consider having students correct FALSE statements to ensure comprehension.) 1. Which of the following statements is FALSE? The 12-Lead Preview screen displays: a.
  • Page 166 14 12-Lead ECG Monitoring Review...
  • Page 167: Vital Signs Trending

    Vital Signs Trending Lesson Introduction Introduce the lesson, including the learning objective and estimated time to complete. This lesson describes the HeartStart MRx Vital Signs Trending and related report data. Objectives Upon completion of this lesson, students should be able to: 1.
  • Page 168: Lesson Presentation

    15 Vital Signs Trending Lesson Presentation Lesson Presentation Overview Introduce the MRx’s Vital Signs Trending. • The MRx lets you view and print numeric vital sign trending for the current incident in Monitor Mode. • Trending data are automatically acquired if parameters are on. •...
  • Page 169: Trending Report Intervals

    Lesson Presentation 15 Vital Signs Trending Trending Report Intervals • Trending data can be shown at selected intervals for up to 12 hours* of monitoring. You can adjust the display’s time interval for the current incident to 1, 5, 10, 15, 30 or 60 minutes. The default is 5 minutes.
  • Page 170 15 Vital Signs Trending Lesson Presentation Additional points/notes: ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________...
  • Page 171: Review

    Review 15 Vital Signs Trending Review Have students answer the following questions individually or as a group. (Correct answers are in bold. Consider having students correct FALSE statements to ensure comprehension.) 1. Which of the following statement(s) are TRUE regarding data displayed on the Trending Report? a.
  • Page 173: Intellivue Networking

    10-20 minutes Accessories Required • Access to the Philips IntelliVue Information Center • Connectivity to the Philips IntelliVue M3185 Clinical Network (System J or higher in US; System K or higher outside of US) • IntelliVue Network LAN cable and/or Philips’...
  • Page 174: Lesson Presentation

    Introduce the IntelliVue Networking option associated with the MRx. • Allows the M3535A HeartStart MRx to connect and communicate with the Philips IntelliVue M3185 Clinical Network (Requires System J or higher in US; System K or higher outside of US) •...
  • Page 175: Connecting To The Network

    “Wired” - An IntelliVue Network LAN cable is plugged into the RJ 45 connector (labeled “LAN”) on the back of the HeartStart MRx. Wired’ icon appears on the MRx display in all clinical views indicating a wired connection to the network. Data can be exchanged with and viewed at the Information Center.
  • Page 176 Center. All arrhythmia processing and controls reside at the MRx. 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. It identifies the general location of the MRx by associating it with network access points installed in the healthcare facility.
  • Page 177 MAC Address HeartStart MRx MAC address MAC Instr. Tele. Instrument Telemetry Radio Module MAC address RF Access Code Used to identify which RF channel the HeartStart MRx-Information Center communications use (Set in Configuration Mode.) IP Address Current IP address - HeartStart MRx (wired) or Radio Module (wireless)
  • Page 178: Patient Admit, Discharge, And Transfer

    16 IntelliVue Networking Lesson Presentation Patient Admit, Discharge, and Transfer Introduce the admit, discharge, and transfer functions and then describe them in detail. The MRx can admit, discharge, and transfer (ADT) patients to or from the Information Center and update or modify patient information. It also accepts 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 179 Lesson Presentation 16 IntelliVue Networking Discharge • Discharge Patient: – Clears patient information, – Closes a patient data record, – Resets patient type (category), paced status, alarm settings and all other MRx settings to default values, and – Discharges a patient from the Information Center, if connected. •...
  • Page 180 16 IntelliVue Networking Lesson Presentation Transfer Transfer prepares the current patient’s data to be moved to another location on the IntelliVue Network by moving the patient to the transfer list at the Information Center (found under Admit). To access Transfer on the MRx: 1.
  • Page 181 Lesson Presentation 16 IntelliVue Networking Suggestion: Have students complete the above steps during or after your demonstration, stating what they see during the procedure. Clear Transfer Clear Transfer exits the 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 MRx.
  • Page 182: Sharing Information On The Network

    16 IntelliVue Networking Lesson Presentation Sharing Information on the Network Discuss the type of information and data the MRx shares with the Information Center, and how to view and manage it. Patient Information Updates After the MRx makes a network connection with the Information Center, all patient information (except height, weight, screen notes and care group which are not available on the MRx) entered at one location is automatically reflected at the other.
  • Page 183 MRx, alarms re-sound after two minutes if the condition is not cleared. • The HeartStart MRx Instructions for Use has a complete list of MRx alarms to refer to. • Pacing Stopped, Batteries Low, and Defib Shutdown alarms result in Red INOPs that cannot be silenced at the Information Center.
  • Page 184 16 IntelliVue Networking Lesson Presentation Turning a Networked Device Off • If a networked MRx is turned off, wave and alarm data may be displayed at the Information Center for 10 more seconds. After 10 seconds, a No data from bed INOP statement appears on the Information Center display.
  • Page 185 Logged when event occurs. (INOP detected) INOPs, Alarms, and Messages at the Information Center Most HeartStart MRx alarms, INOPs, and messages display at the Information Center in their entirety or in an abbreviated form. Refer to the HeartStart MRx Instructions for Use Addendum IntelliVue Networking Option for a table that lists alarms, INOPs, and messages that appear differently at the Information Center.
  • Page 186: Review

    16 IntelliVue Networking Review Review Have students answer the following questions individually or as a group. (Correct answers are in bold. Consider having students correct FALSE statements to ensure comprehension.) 1. The IntelliVue Information Center replaces equipment label on the MRx display with a bed label when the MRx connects to the network.
  • Page 187: Working With Data

    Working with Data Lesson Introduction Introduce the lesson, including the learning objectives and estimated time to complete. This lesson describes the data management features of the HeartStart MRx. Objectives Upon completion of this lesson, students should be able to: 1. Identify MRx data management features.
  • Page 188: Lesson Presentation

    17 Working with Data Lesson Presentation Lesson Presentation Overview Provide a summary of MRx’s data management features. • MRx creates Event Summaries that: – Have a unique event identification number and date/time stamp. – Contain measurements stored for viewing, reporting, and printing in the Vital Signs Trending Report.
  • Page 189 Lesson Presentation 17 Working with Data Additional points/notes: ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________...
  • Page 190: Copying From Internal Memory

    Erase Card menu entry to delete the data card contents. Note the following: If you format a Philips data card in a PC card reader, a FAT16 file system must be used to format the data card. Using a FAT32 format makes the card incompatible with the MRx.
  • Page 191: Printing During A Patient Event

    Lesson Presentation 17 Working with Data Additional points/notes: ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ Printing During a Patient Event Point out the characteristics and steps associated with printing data reports during a patient event. Event Summaries • Print the current Event Summary at any time by pressing the Summary button and selecting Event Summary from the menu.
  • Page 192: Printing From Data Management Mode

    HeartStart Event Review Pro data management system. Refer to the HeartStart Event Review Pro Instructions for Use for download instructions. Also, if you are using a HeartStart MRx M3536A with software version R.03 and later: •...
  • Page 193: Marking Events

    Lesson Presentation 17 Working with Data • The presenting waveform is part of the Event Summary. Suggestion: Have students print a data report during or after your demonstration. Additional points/notes: ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ Marking Events Discuss the characteristics associated with marking events. •...
  • Page 194: Review

    17 Working with Data Review Review Have students answer the following questions individually or as a group. (Correct answers are in bold. Consider having students correct FALSE statements to ensure comprehension.) 1. Which of the following statement(s) are TRUE related to MRx’s data management? a.
  • Page 195: Data Transmission

    Most topics in this lesson involve optional features, so review what material you’ll cover and advise students accordingly on objectives and how long the lesson will take to complete. This lesson describes how to transmit data from the HeartStart MRx to various external devices using a suite of available data transmission options.
  • Page 196: Technical Resources

    – Post event data can be used for quality review, billing and eventual archiving. • Depending upon what you are trying to do, the HeartStart MRx can send 12-Lead Reports, Event Summaries and/or Periodic Clinical Data to a remote location. (See the figure below for details.)
  • Page 197: Preparing For Transmission

    If using Bluetooth wireless technology, wireless devices need to be set up as well. If using Batch LAN Data transfer, set up the Data Messenger Server ahead of time and configure both devices. See the instructions which came with the HeartStart MRx Data Messenger Server for more information.
  • Page 198 18 Data Transmission Lesson Presentation Emphasize this point: Many institutions prohibit the use of cell phones on their premises. Please abide by local rules and regulations. • When transmitting periodic clinical data, waveforms for all monitored parameters can be viewed during the transmission process.
  • Page 199: Setting Up Bluetooth Transmissions

    • Once a Bluetooth device is selected from the Add Device menu, perform a passkey procedure to communicate or “pair” the wireless device with the HeartStart MRx. (The passkey is like a PIN number or password you create for a personal account.) Some Bluetooth devices only allow pairing for approximately 30 seconds, so be ready to enter the passkey.
  • Page 200 18 Data Transmission Lesson Presentation occurred. See “Transmission Problems (Bluetooth)” in the Troubleshooting chapter of the MRx Instructions for Use for support on failures. Emphasize this point: The MRx can communicate via Bluetooth with nearby devices such as computers, laptops, tablets and mobile devices. To ensure reliable transmissions, familiarize yourself with the Bluetooth configuration choices of each.
  • Page 201 Lesson Presentation 18 Data Transmission enabled devices (more than 10) in the area, or it may not be discoverable. For the latter condition, you’ll have to enable it following the device’s documentation. Keep in mind that during discovery, the MRx will pick up to 10 Bluetooth devices within the maximum communication distance based on a device’s class.
  • Page 202: Setting Up Rosetta Transmissions

    (Optional topic: This topic is for students who use Rosetta technology to transmit MRx data.) Briefly discuss Rosetta transmissions. • With an easy cable connection from a Rosetta-Lt device to the HeartStart MRx, transmit a 12-Lead Report via two-way radio to a healthcare facility running a CAREpoint or Rosetta-Rx device, as depicted below.
  • Page 203: Transmitting In 12-lead Mode

    PDAs, Philips TraceMaster ECG Management System, or other servers running Philips data viewing server software. • Using Bluetooth transmission, reports are transmitted to the hub (a web server running Philips 12- Lead Transfer Station or Telemedicine Server software) using configured wireless devices such as cell phones, handheld devices and other external devices like computers, laptops, and other mobile devices.
  • Page 204 18 Data Transmission Lesson Presentation 3. Select Fax Number from the Send To menu. 4. Enter the fax number from the numeric list using the Navigation buttons. Include any extra digits necessary (e.g., 9 for an outside line or 1 plus the area code for long distance). 5.
  • Page 205: Periodic Clinical Data Transmission

    Lesson Presentation 18 Data Transmission Periodic Clinical Data Transmission (Optional topic: This topic is for students who use Periodic Clinical Data Transmission technology to transmit MRx data.) Describe PCDT from the MRx. • Periodic Clinical Data Transmission (PCDT) enables you to transmit data from the point of care to the receiving hospital to facilitate the next level of care.
  • Page 206 • 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; timestamp of vitals • HeartStart MRx device ID • HeartStart MRx incident ID 12-lead acquired When obtained •...
  • Page 207 Lesson Presentation 18 Data Transmission Event When What data is sent Physiological alarm including: Asystole, VFIB/ VTACH, VTACH, Extreme • All data with Vital signs update Tachy, Extreme Brady, Apnea, • Event label and time Extreme Desat, Invasive pressure Disconnect, PVC/min high, •...
  • Page 208 18 Data Transmission Lesson Presentation Discuss the following priorities for sending data. In low bandwidth or poor signal quality areas, the MRx can queue periodic data transmissions. For more than one transmission in queue, data is sent according to the following preset priority: •...
  • Page 209: Transmitting Post Events

    PC locally location Table 8 Post Event Transmission Use Cases To transmit: The HeartStart MRx uses: An Event Summary to an external computer Bluetooth wireless technology to transmit data to a wirelessly Bluetooth-enabled computer. A single Event Summary or group of Event A LAN cable connecting the device to your computer.
  • Page 210: Transmitting In Data Management Mode

    18 Data Transmission Lesson Presentation Transmitting in Data Management Mode Discuss the methods data can be transmitted from MRx’s Data Management Mode. • From Data Management Mode, you can: – send an Event Summary (complete or partial) or a 12-Lead Report to a receiving Bluetooth device.
  • Page 211: Tracking Data Transmission

    Lesson Presentation 18 Data Transmission • If you print an event in Clinical Mode and switch to Data Management Mode, the printing must be complete before the event can be copied or sent; otherwise, a Cannot copy this event while printing or Cannot send this event while printing message appears.
  • Page 212: Finding Transmission Results

    • Event Summaries and 12-Lead Reports could contain information considered Patient Healthcare Information (PHI) or patient identifiable data. This information can be printed or transferred from the HeartStart MRx, and should be handled in accordance with HIPAA or local patient privacy requirements.
  • Page 213: Batch Lan Data Transfer

    1. Confirm the MRx is in Data Management Mode, Data Messenger is running on the receiving personal computer, and the LAN cable is securely connected. 2. Once the LAN cable is connected, the HeartStart MRx automatically communicates with the Data Messenger personal computer and prompts you to send data.
  • Page 214 18 Data Transmission Lesson Presentation Cancelling a BLDT Demonstrate how to cancel a BLDT. 1. Press the Menu Select button, select Cancel Transmission, and press Menu Select. The transfer stops and the MRx is placed back in the Data Management screen. Note the following: If you exit Data Management Mode while a batch download is processing, the MRx displays an “Exiting Data Management will cancel the current transfer.”...
  • Page 215: Review

    Review 18 Data Transmission Review Have students answer the following questions individually or as a group. (Correct answers are in bold. Consider having students correct FALSE statements to ensure comprehension.) 1. True or false? Excluding Rosetta transmissions, MRx requires Bluetooth wireless technology to transmit a 12-Lead ECG to a personal PC.
  • Page 216 18 Data Transmission Review...
  • Page 217: Maintenance

    Lesson Introduction Introduce the lesson, including the learning objectives, estimated time to complete, and applicable resources. This lesson describes how to care for the HeartStart MRx, including a brief look at battery maintenance and cleaning. Objectives Upon completion of this lesson, students should be able to: 1.
  • Page 218: Lesson Presentation

    – For information on cleaning the MRx and accessories, device disposal, and a listing of replacement supplies and accessories, check out the Maintenance chapter of the HeartStart MRx Instructions For Use. Also, MRx service (including calibration of optional EtCO2 and NBP modules) should only be performed by qualified service personnel, in accordance with the HeartStart MRx Service Manual.
  • Page 219: Automated Tests

    Lesson Presentation 19 Maintenance Automated Tests If appropriate to your audience, describe the three automated tests MRx runs to assess operational performance and alert users if a problem exists. Point out that they occur at regularly scheduled intervals while the device is off. Test Name Description Frequency...
  • Page 220: Ready For Use Indicator

    Charge the battery as soon as possible and/ of both batteries) is less than 20%. or replace the battery with a charged 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...
  • Page 221: Shift Check

    • The American Heart Association (AHA) recommends completion of a checklist (shift check) at the beginning of each change in personnel to ensure that defibrillators are ready when needed. Philips supports the AHA checklist recommendations and has shipped a Shift Checklist document with the MRx.
  • Page 222: Weekly Shock Test

    19 Maintenance Lesson Presentation Additional points/notes: ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ Weekly Shock Test In addition to the shift check, verify the ability to deliver defibrillation therapy once a week by performing either a weekly shock test or an Operational Check (Op Check). Demonstrate how to perform a weekly shock test on the MRx.
  • Page 223: Operational Check

    Lesson Presentation 19 Maintenance Operational Check Discuss Op Check characteristics. • The Op Check should be performed at regular intervals to supplement Automated Tests. • The Op Check checks for electrical shorts on therapy and ECG cables, and verifies paddles, audio, the Charge and Shock buttons, Therapy Knob, and CPR meter (or Compression Sensor), along with replicating the Weekly test.
  • Page 224 19 Maintenance Lesson Presentation 9. Read and respond to applicable test prompts. Once you have answered the last prompt (Audio test), you can leave the MRx unattended and the Op Check will complete. As each test is run, the message In Progress appears, followed by Pass or Fail. At completion of the Op Check, the message Operational Check Passed is displayed if all tests have passed.
  • Page 225 Lesson Presentation 19 Maintenance Additional points/notes: ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________...
  • Page 226 19 Maintenance Lesson Presentation Operational Check Tests Discuss the Op Check tests in the order they are performed, corresponding prompts, and actions to take (if any). Test Description Prompts Action General System Tests internal clock battery, None None power supply, and internal memory card.
  • Page 227 Lesson Presentation 19 Maintenance Operational Check Tests (Continued) Discuss the Op Check tests in the order they are performed, corresponding prompts, and actions to take (if any). Test Description Prompts Action Audio If a shock was delivered Did you hear No Shock Use the navigation buttons to during the Shock test, the respond Yes or No.
  • Page 228 19 Maintenance Lesson Presentation Operational Check Tests (Continued) Discuss the Op Check tests in the order they are performed, corresponding prompts, and actions to take (if any). 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.
  • Page 229 Lesson Presentation 19 Maintenance 5. Using the Navigation buttons, select Op Check Summary and press Menu Select. 6. Press Menu Select to acknowledge the message Leaving Normal Operational Mode. The Operational Check Summary screen is displayed. 7. Press the [Print] soft key to print the report. Suggestion: Have students complete the steps to access the Op Check Summary with you or after you have demonstrated the procedure.
  • Page 230: Battery Maintenance

    • Charging a fully (or nearly fully) discharged battery as soon as possible optimizes performance. • Charging should be done in either the HeartStart MRx (with AC or DC power) or in the Philips- approved Battery Support System at temperatures between 0...
  • Page 231: Cleaning Instructions

    Discuss the following recommendations for cleaning the HeartStart MRx and its associated accessories, as appropriate. • The HeartStart MRx, along with its accessories and supplies, may not be autoclaved, steam cleaned, ultrasonically cleaned, or immersed unless otherwise indicated in the Instructions for Use that accompany the accessories and supplies.
  • Page 232 • See the Sterilizable Defibrillator Paddles Instructions for Use for cleaning and sterilizing internal and external sterilizable paddles. • Philips’ disposable sterile internal defibrillation paddles, multifunction electrode pads, and monitoring electrodes are single use items and do not require cleaning.
  • Page 233 • Examine the CPR meter vent membrane in the center of the rear cover after each use. If needed, use a soft cloth or toothbrush to gently clean the vent membrane. If soiled after cleaning or damaged, replace the rear cover. Keep sharp objects away from the vent membrane. See the HeartStart MRx Service Manual Addendum for instructions.
  • Page 234 19 Maintenance Lesson Presentation Carrying Case Clean the carrying case by hand with mild soap and water. Use fabric stain removers to remove stubborn stains. Air dry the carrying case. Do not wash or dry by machine. Additional points/notes: ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________...
  • Page 235: Review

    Review 19 Maintenance Review Have students answer the following questions individually or as a group. (Correct answers are in bold. Consider having students correct FALSE statements to ensure comprehension.) 1. Which RFU status indicates the MRx is unable to acquire an ECG? a.
  • Page 236 19 Maintenance Review...
  • Page 238 453564045041 Edition 6 Koninklijke Philips Electronics N.V. Printed in the U.S.A. Dec. 2011 *453564045041*...

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M3535aM3536a

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