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9650-1450-01 Rev. D January 2014

E Series

Service Manual

Summary of content (280 pages)

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E Series® Service Manual 9650-1450-01 Rev.
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The issue date for the E Series® Service Manual (REF 9650-1450-01 Rev. D) is January, 2014. If more than 3 years have elapsed since this date, contact ZOLL Medical Corporation to determine if additional product information updates are available. Copyright © 2014 by ZOLL Medical Corporation. All rights reserved.
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Table of Content Chapter 1 Maintenance Tests Overview .................................................................................................................................................................... 1-1 Before You Begin the Maintenance Tests............................................................................................................... 1-2 Equipment that You Need to Perform the E Series Maintenance Tests...............................................................
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Chapter 2 Troubleshooting Overview .................................................................................................................................................................... 2-1 Troubleshooting........................................................................................................................................................ 2-2 ZOLL E Series Error Messages ..........................................................................................................
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High Voltage Assembly Removal .......................................................................................................................... 5-23 Battery Interconnect Board Removal.................................................................................................................... 5-24 A/C Charger Assembly Removal ........................................................................................................................... 5-26 Access Detect Cable Removal ............
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9650-1450-01 Rev.
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E Series Service Manual Preface ZOLL® Medical Corporation’s E Series® Service Manual is intended for the service technician whose responsibility is to identify malfunctions and/or make repairs at the subassembly level. The ZOLL E Series Service Manual has five main sections and one appendix. Preface—Contains safety warnings and an overview of the manual’s contents. Be sure to review this section thoroughly before attempting to use or service the E Series unit.
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E Series Service Manual WARNING! This unit can generate up to 2250 volts with sufficient current to cause lethal shocks. All persons near the equipment must be warned to STAND CLEAR prior to discharging the defibrillator. Do not discharge the unit’s internal energy more than three times in one minute or damage to the unit may result. Do not discharge a battery pack except in a ZOLL SurePower™ Charger Station or compatible ZOLL Battery Charging/Testing unit.
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E Series Service Manual Conventions WARNING! Warning statements describe conditions or actions that can result in personal injury or death. Caution Caution statements describe conditions or actions that can result in damage to the unit. Note: Notes contain additional information on using the defibrillator. Service Policy Warranty In North America: Consult your purchasing agreement for terms and conditions associated with your warranty. Outside of North America, consult ZOLL authorized representative.
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E Series Service Manual ZOLL Medical Corporation 269 Mill Road Chelmsford, Massachusetts 01824-4105 Attn: Technical Service Department, SR # Technical Service for International Customers International customers should return the unit in its original container to the nearest authorized ZOLL Medical Corporation Service Center. To locate an authorized service center, contact the International Sales Department at ZOLL Medical. See back cover of this manual. 7 9650-1450-01 Rev.
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E Series Service Manual Chapter 1 Maintenance Tests Overview The E Series has two checkout procedures: the operator’s shift checklist and the extensive six-month maintenance tests checkout procedures. Because the E Series units must be maintained ready for immediate use, it is important for users to conduct the Operator’s Shift Checklist procedure at the beginning of every shift. This procedure can be completed in a few minutes and requires no additional test equipment.
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E Series Service Manual 14. Summary Report 15. Advisory Message 16. Pacer 17. SpO2 Monitor 18. EtCO2 Monitor 19. Barometric Pressure Calibration Check 20. NIBP Volume Leak Test with Fluke Biomedical NIBP Analyzer 21. NIBP Transducer Calibration Test 22. NIBP Monitor Test 23. Bluetooth Test Before You Begin the Maintenance Tests • Assemble the tools or specialized testing equipment listed in the “Equipment You Need to Perform the Maintenance Tests” section shown below.
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E Series Service Manual Equipment that You Need to Perform the E Series Maintenance Tests This section lists equipment that we use to perform the maintenance tests that we describe in this chapter. You can substitute an equivalent device for a listed device; however, not all simulators and analyzers will produce the same results. Be sure to follow the manufacturer’s recommendations for conducting the maintenance tests.
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E Series Service Manual • Fluke Biomedical Cufflink Analyzer (if NIBP option is installed) Note: 1-4 The Fluke Biomedical BP Pump NIBP Monitor Analyzer and the Fluke Biomedical BP Pump NIBP Analyzer use different technologies for testing NIBP monitors and therefore, the manual provides two different procedures for performing the NIBP Volume Leak test with each of these types of test equipment. 9650-1450-01 Rev.
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E Series Service Manual 1.0 Physical Inspection of the Unit Tools Needed: Battery. Test Setup: None. Observe this... 1.1 Housing Pass/Fail/NA o o Is the unit clean and undamaged? 1.2 Does the unit show signs of excessive wear? o o 1.3 Does the handle work properly? o o 1.4 Does the recorder door open and close properly? o o 1.5 Are input connectors clean and undamaged? o o 1.6 Are there any cracks in the housing? o o 1.
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E Series Service Manual Observe this... 1.15 Is the battery seated in the battery well correctly? Pass/Fail/NA o o Record your results on the Maintenance Test Checklist. 1-6 9650-1450-01 Rev.
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E Series Service Manual 2.0 Front Panel Button Test Tools Needed: QED 6 Defibrillator Analyzer Test Setup: 24. Install strip chart paper into the recorder tray. 25. Install the battery in the unit or connect the A/C power cord to the unit and then plug the cord into an electrical outlet. 26. Connect the universal cable and ECG cable (3 lead, 5 lead, or 12 lead) to the ZOLL simulator, or Fluke Biomedical Impulse 4000 Analyzer (or equivalent). 2.1 Do this... Verify that...
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E Series Service Manual 2.9 Do this... Verify that... Press the INC softkey. The bar graph appears on the display, indicating an increase in volume. Pass/Fail/NA o o Note: This action does not increase the volume of the unit’s audio prompts. 2.10 Press the DEC softkey. The bar graph appears on the display, indicating a decrease in volume.
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E Series Service Manual 2.24 Do this... Verify that... Press the SHOCK button. The unit discharges and the SHOCK button is no longer illuminated.  A 15 second strip chart automatically prints, displaying the number of joules delivered (if equipped with recorder and configured to print event). Pass/Fail/NA o o o Record your results on the Maintenance Test Checklist. 9650-1450-01 Rev.
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E Series Service Manual 3.0 3, 5, and 12 Leads Test Tools Needed: 3 lead, 5 lead, and 12 lead cables. Test each cable separately. QED 6 Defibrillator Analyzer. Test Setup: 1. The E Series unit must be configured to display ECG LEAD OFF message. 2. Connect the lead wires appropriate to each test to the QED 6 Defibrillator Analyzer. Do this... Observe this... Pass/Fail/NA 3.1 Turn the selector switch to MONITOR. Select leads. The monitor displays the NO ECG LEADS OFF message. o o o 3.
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E Series Service Manual 4.0 Power Supply Test (Optional) Tools Needed: • 1 red miniature alligator to miniature alligator test lead. • 1 black miniature alligator to miniature alligator test lead. • DC power supply (15 Amp minimum). • 0.1 ohmresistor (¼W or greater). • 1000 ohm 1% resistor (¼W or greater). • Fluke 75 multimeter or equivalent. Test Setup: 1. Make sure the unit and power supply are turned off. 2. Connect one end of the black lead to the “-” terminal in the battery well. 3.
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E Series Service Manual Red Battery Well ? ? 15 Amp Supply Black 4.1 Do this... Verify that... Pass/Fail Turn the selector switch to MONITOR. The unit does not turn on. o o (For AED units, turn the selector switch to ON and select Manual mode.) 4.2 Turn the selector switch to the OFF position. 4.3 Adjust the power supply voltage to 10.3V and turn the selector switch to MONITOR (for AED units, turn the selector switch to the ON position). The unit turns on. o o 4.
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E Series Service Manual 5.0 Leakage Current Test Tools Needed: See the manufacturer’s instructions or supplied specifications for the leakage tester you use. Test Setup: See the manufacturer’s instructions or supplied specifications for the leakage tester you use. Repeat leakage test with accessories: MFC, external paddles, and anterior/posterior paddles.
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E Series Service Manual 6.0 Paddles Test (If applicable) Tools Needed: QED 6 Defibrillator Analyzer. Test Setup: If applicable, connect the universal cable to the paddles and place the paddles in paddle wells. Do this... Verify that... Pass/Fail/NA 6.1 Turn the selector switch to DEFIB. Press and hold the ENERGY DOWN button on the sternum paddle. The energy selection decreases to 1J. o o 6.2 Press and release the ENERGY UP button on the sternum paddle for each setting.
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E Series Service Manual 7.0 Heart Rate Display Test Tools Needed: • ECG Cable (3 or 5 leads). • QED 6 Defibrillator Analyzer. Test Setup: 1. Turn the selector switch to MONITOR. Press LEAD button until “I” displays. 2. Connect the ECG leads to the QED 6 Defibrillator Analyzer. 3. Connect the ECG cable to the unit. 7.1 Do this... Verify that... Set the QED 6 Defibrillator Analyzer to 120BPM.
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E Series Service Manual 8.0 Calibrating Pulses on Strip Chart Test Tools Needed: None Test Setup: None. Do this... 8.1 Press the RECORDER button. 8.2 Press and hold SIZE button to activate the calibration signal. Verify that... The strip chart displays a signal of 300 ppm with an amplitude of  10 mm +/- 1 mm. The signal also appears on the video display. Pass/Fail/NA o o o Record your results on the Maintenance Tests Checklist. 1-16 9650-1450-01 Rev.
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E Series Service Manual 9.0 Notch Filter Test Tools Needed: QED 6 Defibrillator Analyzer. Test Setup: 1. Connect the ECG cable to the QED 6 Defibrillator Analyzer. 2. Connect the ECG cable to the unit. Do this... 9.1 Verify that... Pass/Fail/NA Turn the selector switch to MONITOR mode. (For AED units, turn the selector switch to ON and select Manual mode.) 9.2 Select lead I, size 3x. Select 60Hz (or 50 Hz for a 50Hz unit) on  the QED 6 Defibrillator Analyzer. 9.3 Press RECORDER button.
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E Series Service Manual 10.0 Heart Rate Alarm Test Tools Needed: QED 6 Defibrillator Analyzer 10.1 Do this... Verify that... Turn the selector switch to MONITOR mode. The monitor screen displays the Lead II message and the waveform for NSR ECG at 120 BPM +/- 2. o o o (For AED units, turn the selector switch to ON and select Manual mode.) Pass Fail/NA Connect the ECG leads to the QED 6 Defibrillator Analyzer. Set the QED 6 Analyzer to 120 BPM and the defibrillator to lead II. 10.
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E Series Service Manual Do this... 10.14 Press and hold ALARM SUSPEND for 4 seconds to disable alarms. Verify that... Pass Fail/NA o o o Record your results on the Maintenance Tests Checklist. 9650-1450-01 Rev.
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E Series Service Manual 11.0 Defibrillator Self Test WARNING! SHOCK HAZARD! TAKE THE NECESSARY PRECAUTIONS TO GUARD AGAINST SHOCK OR INJURY BEFORE YOU START CONDUCTING THE DEFIBRILLATOR TESTS. Keep hands and all other objects clear of the multi-function cable connections and defibrillator analyzer when discharging the defibrillator. Before you discharge the defibrillator, warn everyone near the equipment to STAND CLEAR. Caution Do NOT internally discharge the unit more than 3 times in 1 minute.
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E Series Service Manual Note: 11.1 The universal cable should not be connected to any equipment at the beginning of this test. Do this... Verify that... Pass/Fail Turn the selector switch to DEFIB mode. The unit displays the CHECK PADS/POOR PAD CONTACT message. o o (For AED units, turn the selector switch to ON and select Manual mode.) Set leads to PADS. 11.2 Connect the universal cable to the MFC test port. DEFIB PAD SHORT message displays. o o 11.
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E Series Service Manual 12.0 Synchronized Cardioversion Test Tools Needed: QED 6 Defibrillator Analyzer. Test Setup: 1. Connect the universal cable via the adapter (D.N.I #3010-0378) to the defibrillator analyzer. 2. Set ECG on analyzer to 60 -120 BPM. Do this... 12.1 Press LEAD button to select PADS and Size x1. 12.2 Press the SYNC softkey on the defibrillator. Enter synchronized cardioversion timing test mode on the defibrillator analyzer. 12.3 Select 200J, and then press the CHARGE button.
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E Series Service Manual 13.0 Shock Test Tools Needed: QED 6 Defibrillator Analyzer, Stop Watch. Test Setup: 1. Connect the universal cable via the adapter (D.N.I #3010-0378) to the defibrillator analyzer. 2. Ensure that a fully charged battery is installed in the unit. Note: If your E Series AED does not have manual override capability, do not perform this test. Do this... 13.1 Verify that... Pass/Fail/NA Turn the selector switch to DEFIB mode.
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E Series Service Manual Do this... Verify that... Pass/Fail/NA 13.10 Press the CHARGE button. Wait for the SHOCK button to illuminate. The unit displays the message, DEFIB 100J RDY. o o o 13.11 Press the SHOCK button. The unit discharges 83J-122J into the simulator. o o o 13.12 Press the ENERGY SELECT up arrow until the unit displays 200J. The unit displays the message, DEFIB 200J SEL o o o 13.13 Press the CHARGE button. Wait for the SHOCK button to illuminate.
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E Series Service Manual 14.0 Summary Report Test Tools Needed: QED 6 Defibrillator Analyzer. Test Setup: 1. Connect the universal cable to the QED 6 analyzer. 2. If you are using paddles, place the paddles on the analyzer’s discharge plates. Do this... Verify that... Pass/Fail 14.1 Press and hold the SUMMARY softkey for 4 to 8 seconds to display erase options. Press the ERASE SUMMARY softkey to erase any previously stored data erase any previously stored data.
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E Series Service Manual 15.0 Advisory Message Test Tools Needed: QED 6 Defibrillator Analyzer. Test Setup: 1. Connect the universal cable via the adapter (D.N.I #3010-0378). 2. Attach the E Series to the QED 6 Defibrillator Analyzer. Do this... 15.1 Verify that... Pass/Fail Turn the selector switch to DEFIB mode. (For AED units, turn the selector switch to ON.) 15.2 Select VF (ventricular fibrillation) on the simulator, then press the ANALYZE button.
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E Series Service Manual 16.0 Pacer Test Tools Needed: QED 6 Defibrillator Analyzer. ? Note: The following tests are to be performed only on E Series units equipped with the optional pacing function. The pacer output can be measured using an oscilloscope set to DC coupling connected across a load resistor. (See diagram in column for universal cable connector polarity.) The load resistor is a 100 ohm, 5 watt or greater.
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E Series Service Manual Do this... Verify that... Pass/Fail 16.6 Decrease the output to 40mA. Output on the QED 6 analyzer is 40mA or +/- 5mA. Pulse width is  40mS +/-2mS. o o 16.7 Increase the output to 60mA. Pacer rate on QED 6 analyzer is 29-31 ppm o o Decrease the rate to 30 ppm. 16.8 Increase the rate to 180ppm. Pacer rate on QED 6 analyzer is 177-183 ppm o o 16.9 Connect the ECG cable to the E Series and QED 6 analyzer. Select the ECG at 60 BPM on the QED 6 analyzer.
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E Series Service Manual 17.0 SpO 2 Monitor Test for SpO 2 Option Tools Needed: • MasimoReusable Sensor. • Masimo Patient Cable • Fluke Index Series 2 SpO2 Simulator. Test Setup: 1. Connect the universal cable to the MFC test plug. 2. DO NOT connect the ECG cable to the simulator. 3. Connect the Masimo Patient Cable and attach the Masimo sensor to the patient cable. 4. Connect the Masimo sensor to the finger simulation post. 5.
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E Series Service Manual 17.5 17.6 17.7 Do this... Verify that... Using the Index SpO2 Simulator, press the BPM- softkey until the heart rate is 50 BPM The SpO2 simulator screen displays an SpO2 saturation of 96-100%. The E Series monitor displays a heart rate of 46-54 BPM. Pass/Fail o o o o Using the Index SpO2 Simulator, press the 02+ softkey until the SpO2 output is at 72%. The SpO2 simulator screen displays an SpO2 saturation of 70-74%. The E Series monitor displays a heart rate of 46-54 BPM.
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E Series Service Manual 18.0 EtCO 2 Monitor Test (for EtCO 2 Option) Tools Needed: CAPNOSTAT 5 Mainstream cable with airway adapter, or CAPNOSTAT 5 Sidestream cable with cannula. Test Setup: 1. Install the battery. Do this... Verify that... 18.1 Connect the CAPNOSTAT 5 CO2 Mainstream cable with airway adapter attached, or the CAPNOSTAT 5 Sidestream cable with the cannula attached, to the yellow connector at the back of the E Series.
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E Series Service Manual 19.0 Barometric Pressure Calibration Check Tools Needed: None. Test Setup: None Do this... Verify that... Pass/Fail/NA 19.1 Obtain the local barometric pressure in mmHg.* 19.2 Turn the E Series unit off, and then wait  10 seconds. While pressing and holding the second softkey from the left, turn the selector switch to Monitor (ON for AED units). The unit displays the EtCO2 Calibration screen. o o o 19.3 Wait for the sensor to warm up.
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E Series Service Manual 20.0 CO 2 Accuracy Check (Optional test to check EtCO 2 sensor) Tools Needed: CAPNOSTAT 5 Mainstream cable with airway adapter (or CAPNOSTAT 5 Sidestream cable with cannula), Gas regulator, 5% calibration gas, Thermometer. Test Setup: None Do this... Observe this... Pass/Fail/NA 20.1 Connect the CAPNOSTAT 5 CO2 Mainstream cable with airway adapter attached, or the CAPNOSTAT 5 Sidestream cable with the cannula attached, to the yellow connector at the back of the E Series. 20.
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E Series Service Manual Do this... Observe this... 20.9 Attach a regulated flowing gas mixture of 5% CO2/balance Nitrogen (N2) to the airway adapter. The gas flow rate should already be preset to 2 to 5 liters per minute. 20.10 Set the Gas Balance settings of the CAPNOSTAT 5 CO2 Sensor to that of the calibration gas mixture (N2, N2O, or He). Pass/Fail/NA The default gas balance is N2. 20.11 Allow a few seconds for the gas mixture to stabilize and observe the CO2 Percent value. 20.
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E Series Service Manual 21.0 NIBP Volume Leak Test with Fluke Biomedical NIBP Analyzer The volume leak test verifies the integrity of the pneumatic system on the NIBP module. This test is optional at 6 months, but should be performed annually or every 10,000 readings, whichever comes first. Tools Needed: Fluke NIBP simulator (the values and procedure that we provide are specific to the BP Pump 2). Test Setup: 1. Connect the Analyzer’s simulator hose to the NIBP connector on the E Series unit. 2.
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E Series Service Manual 21.5 Do this... Verify that... Press the START TEST softkey within 30 seconds after closing the valve. After approximately 1 minute, a number appears in the upper middle area of the NIBP simulator display. Note: This test takes approximately 3 minutes. If the simulator: Pass/Fail o o • Displays a Volume Leak reading <5,5 then the E Series unit has passed the test. • Displays a Volume Leak reading >5,6 then the E Series unit has failed the test.
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E Series Service Manual 22.0 NIBP Transducer Calibration Test The NIBP module’s pressure transducers are factory-calibrated prior to shipment. However, you can perform a two-point calibration procedure periodically to ensure accurate pressure measurements. This procedure is optional at 6 months, but should be performed annually or every 10,000 readings, whichever comes first. Tools Needed: Fluke NIBP simulator (the values and procedure that we provide are specific to the BP Pump 2). Test Setup: 1.
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E Series Service Manual 22.6 Do this... Verify that... Pass/Fail On the E Series unit, press the Set High softkey to calibrate the transducer to a 250 mmHg pressure reading. The NIBP pressure transducer registers its voltage output at a known pressure of 250 mmHg. The field adjacent to the 250 mmHg value changes to PASS. o o Note: If the E Series unit displays a FAIL reading, verify the NIBP Analyzer’s pressure setting and connection to the E Series and repeat the step. 22.
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E Series Service Manual 23.0 NIBP Monitor Test The NIBP monitor test verifies the repeatability of the systolic, diastolic, and mean blood pressure measurements, as well as the patient pulse rate calculation. Tools Needed: Fluke NIBP simulator (the values and procedure that we provide are specific to the BP Pump 2). Note: The primary propose of an NIBP simulator is to reproduce a pressure profile similar to a live patient to be used for testing t h e repeatability and functionality of the system.
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E Series Service Manual Do this... 23.1 Verify that... Pass/Fail Turn the selector switch to MONITOR mode. (For AED units, turn the selector switch to ON and select Manual mode.) 23.2 Ensure that the LEADS parameter is set to PADS (default). The E Series unit displays PADS in the Lead selection field on the monitor. o o The E Series displays the following measurements: o o If necessary, press the LEADS button to cycle through the values to select PADS. 23.3 23.
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E Series Service Manual 24.0 Bluetooth Test Tools Needed: USB Bluetooth dongle with driver CD. Bluetooth application software BlueSoleil. Test Setup: Verify that the E Series unit is configured as follows: Bluetooth -- INSTALLED; Bluetooth Baud Rate -- 115200. Do this... Verify that... Pass/Fail 24.1 Power up the E Series unit while pressing in and holding the left-most soft key. The E Series unit displays the System Utilities Menu. o o 24.
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E Series Service Manual (This page is intentionally left blank) 1-42 9650-1450-01 Rev.
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E Series Service Manual Chapter 2 Troubleshooting Overview This chapter describes the most common technical problems that biomedical technicians experience when checking the E Series during routine maintenance or when there is a malfunction of the unit. It also contains a list of error messages that users may see if the unit is not operating properly.
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E Series Service Manual Troubleshooting The following tables show the most common troubleshooting issues and their solutions. First, attempt to solve the problem with “Recommended User Action.” If these steps do not solve the problem, follow the steps listed in the “Recommended Technical Action” column. Reported Problem Recommended User Action Recommended Technical Action ECG LEAD OFF message displays.
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E Series Service Manual Reported Problem Recommended User Action Recommended Technical Action CHECK PADS/POOR PAD CONTACT message displays. • • • • • Remove and reinsert PADS connector into the universal cable. Check for damaged defibrillator pads, wires and or connector. Check for dried out or expired defibrillator pads. Clip (not shave) the patient’s hair and wipe pad contact area dry. Connect the cable to the test plug.
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E Series Service Manual Reported Problem Recommended User Action Recommended Technical Action Displayed HR not accurate; artifact present. • Reduce or eliminate ECG artifact due to electrode or patient cable movement. Route cables so that they don’t pull on electrodes or swing excessively. • Ensure patient is motionless. • Check for possible excessive radio frequency interference. • Verify a good connection of electrodes to the patient. • Prepare the patient’s skin prior to the electrode attachment.
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E Series Service Manual ZOLL E Series Error Messages The following is a list of ZOLL E Series error messages that may appear on your display. The “User Advisory” column informs you about an action in progress or provides feedback on a user correctable situation that typically does not require further technical support. The “Technical Action” column describes what you as a technician can do to correct the situation. Note that these messages will sometimes overlap part of the waveform display.
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E Series Service Manual Error Message CABLE FAULT Explanation User Advisory Technical Action (Auto defib mode only.)  Replace paddle set, universal cable and/or system board. Incorrect A/D reading for paddle ID (similar to PADDLE FAULT). CARD FULL Memory Card Full.  CHECK CO2 SENSOR EtCO2 Sensor is unplugged or defective.  Check that sensor cable is plugged in and seated properly. Check that sensor is not exposed to excessive heat. If problem persists, replace the sensor.
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E Series Service Manual Error Message Explanation User Advisory CONFIRM MANUAL MODE Displayed when manual mode is entered. Alerts user to confirm that manual mode is desired.  DEFIB DISABLED User prompt issued simultaneously with other faults if defib is disabled. Possible configuration problem. Replace high voltage module. Call ZOLL Technical Support. DEFIB FAULT 71 More than 50 internal dumps occurred in less than 20 minutes. Turn the unit to OFF and back on.
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E Series Service Manual Error Message Explanation User Advisory Technical Action DEFIB FAULT 109 Defib capacitor voltage is greater than selected energy when defibrillator is charging or ready. Replace high voltage module or capacitor. DEFIB FAULT 111 Defib capacitor voltage has exceeded the absolute maximum acceptable voltage. Replace high voltage module, capacitor, and or system board.
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E Series Service Manual Error Message Explanation User Advisory Technical Action ECG LEAD OFF One or more ECG leads are not properly connected when leads are selected as input.  Check cable and patient connection. Change electrodes. Prepare patient’s skin. ECG TOO LARGE ECG signal too large for accurate shockable rhythm analysis.  Reduce ECG size. ECG V LEAD OFF V LEAD cable is not properly attached.  Attach V LEAD cable.
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E Series Service Manual Error Message Explanation User Advisory INSERT CARD No card installed in unit during manual or semi-automated modes.  Check memory card LOW BATTERY Low battery.  Replace battery or plug into AC power. Replace charger. NO QRS DETECT Unit is in sync mode and heart rate is < 20 BPM or QRS amplitude is too low for proper synchronization.  Increase ECG size and/or change lead. NO SHOCK ADV No shock advised. Advisory message when analysis finds non-shockable rhythm.
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E Series Service Manual Error Message Explanation User Advisory Technical Action PADDLE FAULT Cannot detect type of accessory attached to the universal cable. PERFORM CPR Advisory message in AED auto defib mode.  POOR LEAD CONTACT One or more ECG leads are poorly connected or not connected to patient. (User configurable.)  Check electrode attachment to patient, cable connector to electrode, cable to unit connector. Broken unit. POOR PAD CONTACT Electrode impedance exceeds threshold.
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E Series Service Manual Error Message Explanation User Advisory Technical Action REPLACE BATTERY Battery voltage is less than absolute minimum. Shutdown imminent.  Replace with charged battery. REPLACE CARD Write errors during manual or semi-automated modes.  May have configuration card installed or write protection on. REPORT FULL Summary report memory full.  Erase summary report. REPORT HALTED Summary report stops printing unexpectedly.
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E Series Service Manual Error Message Explanation User Advisory Technical Action SpO2 COMM ERR No transmissions from SpO2unit received. Communication error or no communication from Sp02 module. SpO2 PULSE SEARCH Pulse search in progress.  STAND CLEAR (Auto defib mode only.) Single analysis mode just turned on and defib idle. Patient rhythm is being analyzed.  SYSTEM FAULT 1 No Watchdog. Turn off unit and then turn on to reset. If fault persists, replace system board.
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E Series Service Manual Error Message Explanation User Advisory Technical Action USER SETUP REQ Both copies of stored cal/config data are bad or have never been programmed.  Perform configuration setup. VF ALARMS OFF VF alarms disabled in pace mode or when paddles are selected as leads.  VX LEADS OFF V lead not properly attached to patient. “X” denotes lead number.  Reattach V lead. ZERO CO2 ADAPTER New EtCO2 airway adapter needs to be zero calibrated.  Zero EtCO2 adapter.
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E Series Service Manual Chapter 3 Replacement Parts This section contains a listing of the replacement parts available for the ZOLL E Series devices. Replacement parts may be ordered through an authorized ZOLL distributor or directly from ZOLL Medical Corporation. The prices for parts are available from ZOLL Medical Corporation’s Technical Service Department.
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E Series Service Manual Replacement Parts Item numbers correspond to the parts diagrams beginning on page 3-7.
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E Series Service Manual Description Part Number Item # ASSY, PCB, COMMUNICATION CARRIER, W/BLUETOOTH, E SERIES 9301‐0390‐02 18 SCR.PPH.#4 X.0.375"ZI.
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E Series Service Manual 3-4 Description Part Number Item # ASSY, MID FRAME, GENERIC, E SERIES 1005‐0005‐01 36 SCR,#4‐40,MCH,1/2",PNH,PHL,SST,EXT, RoHS 0163‐0410 37 TYWRAP CABLE .070"Wx.030"x2.8"LG NYLON 0501‐0023 38 MX‐1 BOARD 3005‐0005 39 SCR.PPH.4 X.0.250"..ZI.
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E Series Service Manual Description Part Number Item # CABLE, CONTROL TO DISPLAY, POWER 9500‐0712 57 CABLE, DF9, CONTROLS TO SYSTEM PWBA, E SERIES 9500‐0776 58 ASSY, DISPLAY BACKER, PLATE, E SERIES 1005‐0010 59 GASKET, BEEPER, M‐SERIES 9161‐0010 60 WASHER, ANTI‐ROTATION 9160‐0012 61 CUP, PACER 9310‐0519 62 WASHER, ANTI‐ROTATION 9160‐0011 63 DIFFUSER, REVIVER 9310‐0590 64 PANEL, FRONT, PUSHBUTTON, REVIVER 9310‐0549 65 ISOPROPANOL.REAGENT GRADE.99.
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E Series Service Manual Description Part Number Item # ASSY, CABLE, MULTI FUNCTION AND TEST PORT 1001‐0194‐01 78 GREASE CHEMICAL RESISTANT 0550‐0500 79 ASSY, HANDLE, E SERIES 1005‐0028 80 WASHER 0.010 IN SHIM.FOR SHDR SCR.0.251 IN ID X.0.375 IN OD.18‐8 SST. 0163‐0452 81 SCR.SKT HD/HEX.10‐32.0.250".303 SS.0.
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E Series Service Manual Parts Diagrams 9650-1450-01 Rev.
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E Series Service Manual Chapter 4 Functional Description This chapter provides functional descriptions of the components contained in the ZOLL E Series and the E Series options. Refer to the interconnect diagram that delineates the different components of the defibrillator.
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E Series Service Manual • PCMCIA Slots • Front Panel and Display • E Series Options • 12 Lead Monitoring • Pulse Oximetry (SpO2) • End Tidal Carbon Dioxide (EtCO2) • Noninvasive Blood Pressure Main System Board The E Series electrical circuitry consists of several functional modules. Each module is physically located on one or more of the printed wiring board assemblies (PWBA). In some cases, a functional module is distributed across several assemblies within the unit.
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E Series Service Manual Refer to the E Series Interconnect diagram to identify unit components described in this manual.
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E Series Service Manual Main System Board Functions The Main System Board contains the major computing and control elements for the E Series unit. The printed wiring board assembly (PWBA) receives signals from the front panel control switches, ECG input connectors and functional modules, such as the AC/DC charger, pacer/defibrillator modules, stripchart recorder and PCMCIA card interfaces, and if applicable, the SpO2, EtCO2 and NIBP modules.
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E Series Service Manual Power Supply The power supply converts DC power from a removable battery or the AC/DC Battery Charger module to voltages required by the E Series hardware. The power supply circuit converts the raw battery or the Charger PWBA output voltages of +8.5 VDC to +16 VDC into the voltages shown in the table below, including load and line regulation.
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E Series Service Manual ECG Front End The ECG front end provides an electrically isolated serial interface between the main system board functions and patient interface ECG connectors. It performs the following: • Analog ECG amplification and signal conditioning. • Pacemaker pulse detection. • ECG signals acquisition and analog to digital conversion. • ECG 3/5/12-lead detection. • ECG leads off detection. • Front-end defibrillator protection. • Isolated power conditioning.
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E Series Service Manual High Voltage Module The High Voltage (HV) module includes the high voltage circuitry required for pacing and defibrillation, including the defib charge circuitry, patient relay, safety relay, defib capacitor, defib choke and front end protection circuitry for the MFC ECG. The following table describes the high voltage board components: Component Function Solid State Patient Relay Controls the delivery of therapeutic energy to patient.
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E Series Service Manual discharged, the energy is dissipated into the internal discharge resistor by closing the safety relay (XSAFREL). The unit discharges internally and displays a warning message if it is not functioning properly. Unlike previous ZOLL designs that isolated the patient from defib circuitry via an electromechanical patient relay, the E Series utilizes a bank of siliconcontrolled rectifiers (SCRs).
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E Series Service Manual The patient relay discharges via the signal PATREL_DRV generated by XPATREL and Q304, Q323, and Q322. PATREL_DRV is disabled when XPACE_SEL is at a logic low. When the patient relay activation completes, the Main System Board releases the XPATREL signal. Several hundred milliseconds later, the safety relay closes to ensure the high voltage capacitor energy is completely dissipated. The Pacer circuit produces and delivers user-controllable pace pulses to the pacing electrodes.
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E Series Service Manual Logic Control Signal Operation XPWR_ENABLE This logic signal from the gate array enables the charging circuit when true, and inhibits the charging circuit when false. SAFE This logic control signal is generated by the Main System Board to halt the pace/defib function in the event of a detected fault. SHUTDOWN This logic signal is true during reset and fault conditions. (VCC error, watchdog error, etc.) and halts operation of the PD generator.
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E Series Service Manual System Interconnect Module The system interconnect PWBA receives signals from the Main System Board and in turn controls operation of the stripchart recorder and PCMCIA functions. Stripchart Recorder The Stripchart Recorder module includes a microprocessor, serial interface to the main system board and circuitry which drive the stripchart recorder’s motor and printhead in response to the main CPU signals.
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E Series Service Manual E Series Options The following sections describe the E Series options. 12 Lead Option The ZOLL E Series 12 lead option is used to acquire ECG data needed to assist in the diagnosis of myocardial infarction (“heart attack”), often caused by a coronary artery occlusion. The 12 lead ECG can be viewed on the display one lead at a time in monitoring and diagnostic bandwidths and printed in the standard 4x3 format with 12 simultaneously acquired leads.
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E Series Service Manual by the blood flowing through a suitable peripheral area of the body, such as the finger in adults and the foot in neonates, can be used to calculate the ratio of oxygenated hemoglobin to total hemoglobin in the arterial blood. The monitor displays this ratio as percent SpO2. Normal values typically range from 95% to 100% at sea level.
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E Series Service Manual The E Series unit displays EtCO2 (the concentration of carbon dioxide detected at the end of each exhalation) as a numerical value in millimeters of mercury (mmHg), percent (%), or kilopascals (kPa). In addition, the unit can display a capnogram. This capnogram is a valuable clinical tool that can be used to assess patient airway integrity and proper endotracheal (ET) tube placement.
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E Series Service Manual Chapter 5 Disassembly Procedures This chapter provides instructions on how to disassemble and reassemble the E Series unit, and includes the following sections: “Front Panel Removal” on page 3 “Front Panel Disassembly” on page 5 “Bottom Panel Removal” on page 10 “NIBP Pump Removal” on page 11 “System Board Removal” on page 13 “System Interconnect Board Removal” on page 16 “SPO2 Board Removal (MS-11)” on page 17 “SPO2 Board Removal (MX-1)” on page 17 “Isolated Power Supply Removal” o
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E Series Service Manual Required Equipment • #1 Philips head screwdriver • #2 Philips head screwdriver • #24 Hex head screwdriver • Wooden stick • Needlenose pliers • Wire Cutters • Exactor Knife • 1/2” Nut Driver Safety Precautions Warning! SHOCK HAZARD! Caution TAKE THE NECESSARY PRECAUTIONS TO GUARD AGAINST SHOCK OR INJURY BEFORE YOU CONDUCT DEFIBRILLATOR TESTS OR REPAIRS. • Only properly trained technicians should service the unit.
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E Series Service Manual Front Panel Removal 1. Remove handle by removing the screw and washer on each side. 2. Remove the 3 screws on the top of the panel. 3. Front panel assembly slides down. Use caution when removing the front panel, cables run from the front panel to the System Board. Do NOT pull the front panel far from the main chassis. 4. Gently remove black stranded cable by pulling the connector straight out of board. 9650-1450-01 Rev.
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E Series Service Manual 5. Remove the clear plastic spacer from between the cable connector and upper housing by grasping the center with needlenose pliers, and pushing straight up. Note: 5-4 6. Disconnect the cable from the system board by pulling straight away from the board. Place front panel on top of unit to get better access to the spacer and cable. 9650-1450-01 Rev.
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E Series Service Manual Front Panel Disassembly Note: There are 3 styles of front panel assemblies. (Original style has 1 cutout in back plate, the 2nd release had 2 cutouts, and the latest release has 2 cutouts along with a slot for the display invertor.) Original Style 2nd Style Latest Style Slot 1. Remove 8 screws from backing plate (Both Styles). 9650-1450-01 Rev. D 2. Lift backing plate out of the frame by prying from the top (Both styles).
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E Series Service Manual 3. 2 Cutout Style: Remove black rivet by pulling it straight up. Then remove plastic isolator. 3A. Original Style: Remove 2 screws, and lift out shield. 4. Remove 3 cables from the control board. 5. Remove display by lifting from the bottom. Note: 5-6 During reassembly, sit display in the bottom first and then push down on top. 9650-1450-01 Rev.
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E Series Service Manual 6. Flip front panel over. Remove main selector knob by gently lifting. (Note: Older version may be glued and need to be pried with cutter.) 7. Remove 1/2” nut from the main selector knob, then remove the anti-rotation washers. 8. (Unit with pace option) Remove the pacer controls knobs, and then remove 1/2” nut and washer. 9. Flip front panel over. Disconnect front membrane cable and data entry switch from control board. 9650-1450-01 Rev.
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E Series Service Manual 10. Cut video cable tie wrap. 11. Push on board retaining clip to release the control board from front panel frame, but do not remove board until next step. Note: When reinstalling see Table 5.1 at end of section for setting control board dip switches. Note: Below is a picture of the opposite side of control board showing the beeper gasket. 12. As you lift the control board, beeper gasket may need to be cut from the front panel membrane. Use an exacto blade.
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E Series Service Manual 13. Using an exacto knife pry corner of front panel membrane up, and remove by gently pulling off the membrane. 14. Using an exacto knife pry corner of data entry switch up, and remove by gently pulling off the membrane. Table 5-1: Control Board Dip Switches Settings 9650-1450-01 Rev.
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E Series Service Manual Bottom Panel Removal 1. Remove the 9 screws securing the base. 5-10 2. Remove bottom panel by lifting panel straight up. 9650-1450-01 Rev.
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E Series Service Manual NIBP Pump Removal 1. Cut tie wrap, and disconnect hose from the NIBP fitting. Note: 2. Remove the screw that is holding the NIBP Pump. When reinstalling, do not over tighten tie wrap. 3. Disconnect ECG flex cable from system board, by releasing jams on each end of the connector, then gently pull straight out. 9650-1450-01 Rev. D 4. Unplug cable from system interconnect.
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E Series Service Manual 5. Carefully lift and remove pump assembly. Note: 5-12 When reinstalling, lift flex cable so power connector on NIBP board is under the cable. 9650-1450-01 Rev.
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E Series Service Manual System Board Removal 1. Remove plastic spacer by gently lifting. Note: 2. Remove PCMCIA short connecting ribbon cable from both sides. During reassembly verify the spacer ridge sits on board. 3. Remove flat UBP cable from both ends by releasing jams on each end of the connector, then pull straight out. 9650-1450-01 Rev. D 4. Gently remove the 2 flat cables by releasing jams on each end of the connector, then gently pull straight out.
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E Series Service Manual 5. Remove gray printer ribbon cable straight out of the board. Gently lift system board straight up half way from the casing. Remove the black stranded cable. 6. Remove colored stranded cable by pulling cable downward from the connector. 7. Remove screw holding system board to the frame. 8. Lift system board further out of frame. Remove colored stranded cable and the black & white stranded cable. 5-14 9650-1450-01 Rev.
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E Series Service Manual 9. From the opposite corner, remove colored stranded cable. 10. Gently separate the system board from its cradle. Note: Board has tabs holding it into slots in the metal frame at the bottom. 11. Remove the 3 flat cables by pulling connector straight out, and remove system board. 9650-1450-01 Rev.
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E Series Service Manual System Interconnect Board Removal 1. Remove the 2 screws holding the interconnect board to the frame. 2. Remove board, carefully twist flat cable and feed through plastic support to remove frame. Note: 5-16 Fold cable over in 45 degree angle as shown below. 9650-1450-01 Rev.
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E Series Service Manual SPO2 Board Removal (MS-11) 1. Remove the 2 flat cables from the SPO2 board by pulling straight away from board. 2. Remove the 4 screws from each corner of the SPO2 board. Remove the SPO2 board from the device. SPO2 Board Removal (MX-1) 1. Remove the 2 flat cables from the SPO2 board by pulling straight away from board. 9650-1450-01 Rev. D 2. Remove the 4 screws from each corner of the SPO2 board. Remove the SPO2 board from the device.
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E Series Service Manual Isolated Power Supply Removal 1. Disconnect the molex connector. 2. Disconnect the 2 spade connectors. 3. Remove the 4 screws securing the board. 4a (Old Style MS-11) Carefully lift the isolated power supply and remove long grey stranded cable (EtCO2), and the 2 flat cables, then remove board. Note: 5-18 During reassembly route grey cable as shown in picture. 9650-1450-01 Rev.
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E Series Service Manual 4b (New Style MX-1) Carefully lift the isolated power supply and remove short grey stranded cable (EtCO2), and the 2 flat cables, then remove board. 9650-1450-01 Rev.
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E Series Service Manual Bridge Board Removal 1. Remove high voltage isolator (clear) by removing tape and then rotating around MFC signal cable. 2. Remove MFC retainer (if present). 3. Remove MFC socket from the chassis and wire loom. Cut tie wrap from bridge board frame. 4. Cut the 2 cable ties, and disconnect spade connector. 5-20 9650-1450-01 Rev.
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E Series Service Manual 5. Loosen the 3 screws holding plastic frame in place. Lift the entire frame out of the chassis. 6. Remove bridge board isolator (clear). 7. Disconnect flex cable from bridge board by lifting the tabs and pulling straight up. 8. Remove 3 screws. 9650-1450-01 Rev.
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E Series Service Manual 9. Remove bridge board from the mid-frame by carefully guiding cable through the slot. 5-22 9650-1450-01 Rev.
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E Series Service Manual High Voltage Assembly Removal 1. Disconnect small flat cable by lifting up jams on each side and pull straight out, then disconnect larger cable by pulling straight out. 2. Disconnect J104 cable by lifting up jams on each side and pull straight out. 3. Disconnect colored cable (MFC signal cable). Pull high voltage module straight out. 4. Disconnect black cable. Remove screw holding plastic cover in place. Slide plastic cover out. 9650-1450-01 Rev.
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E Series Service Manual Battery Interconnect Board Removal 1. Remove the 3 machine screws from the battery pins (J100, J101, J102). 2. Remove the 2 screws securing the board. 3. Gently remove board by lifting from this end. 4. Disconnect flat cable by pulling gently. Note: 5-24 Slightly lifting up on the charger assembly will allow for easier removal. 9650-1450-01 Rev.
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E Series Service Manual 5. Remove 3 ferrite rings from the battery pins, and pull pins straight out. 9650-1450-01 Rev.
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E Series Service Manual A/C Charger Assembly Removal 1. Remove cables from cable harnesses, and disconnect tie wrap on the MFC signal cable. 2. Remove screw from A/C ground cable. 3. Disconnect A/C connector cable by pulling down on latch and pull towards you. Remove cable from wire loom. Lift A/C charger assembly out of the case. 5-26 9650-1450-01 Rev.
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E Series Service Manual Access Detect Cable Removal 1. Push the 4 pin connector through the connector panel squeezing the tabs. Remove nut holding ECG Out/RS232 connector, and push connector through panel. 9650-1450-01 Rev. D 2. Disconnect ferrite from looms, and remove cable from device.
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E Series Service Manual Capacitor Removal WARNING! This unit may contain lethal voltages. You MUST completely discharge the high voltage capacitor before removing from unit. DO NOT SHORT THE TERMINAL ENDS OF THE CAPACITOR. 1. Lift capacitor out. 5-28 2. Bleed the excess voltage using a resistor with values of approximately 5 kohms, 25 watts for 10-20 seconds. Measure the voltage on the capacitor terminals. 9650-1450-01 Rev.
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E Series Service Manual Connector Panel Removal Note: There are 2 styles of SPO2 connector (MS-11 & MX-1) used on the E Series, use the appropriate instructions for disassembly. 1. (MS-11 Style) Remove the 2 screws securing the panel to the housing. 2. Lift assembly out, gently sliding rubber ground sleeve off mounting post. 3. Remove rubber gasket (black foam) from connector panel. ECG and SPO2 connectors can now be removed.
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E Series Service Manual 1. (MX-1 Style) Peel back SPO2 label using an exacto knife. 2. Remove 2 screws and gently lift up on connector panel. 3. Remove the 2 screws securing the panel to the housing. 4. Remove rubber gasket (black foam) from connector panel. ECG and SPO2 connectors can now be removed. Note: 5-30 During reassembly ensure conductive sleeve is in place next to SPO2 connector. 9650-1450-01 Rev.
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E Series Service Manual Communication Board & PCMCIA Module Removal 1. Remove the 4 screws securing the communication board to the housing. Note: To remove the board tilt the side toward the PCMCIA assembly up, and then lift out. Note: During reassembly, ensure that the isolator is installed on top of communication board. 9650-1450-01 Rev. D 2. Remove the screw that is securing the PCMCIA board to the housing. Lift PCMCIA assembly straight out.
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E Series Service Manual Recorder Removal 1. Lift up on the PCMCIA cover, and remove large screw securing bezel to housing. 2. Open printer door, then lift bezel straight out. 3. The recorder assembly can be removed by loosening 4 screws (they do not need to be removed completely from printer frame). 4. Squeeze in the paper lift to release the bosses from grooves in the roller housing. 5-32 9650-1450-01 Rev.
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E Series Service Manual 5. Pivot the roller housing back and it will come off. 6. Remove the two washers securing the printer interconnect board by gently prying up on them. Remove the board. 7. Slide pivot pin out of printer frame. 8. Disconnect printer cable from print head. 9650-1450-01 Rev.
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E Series Service Manual 9. The print head can removed by lifting out of the frame. 5-34 9650-1450-01 Rev.
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E Series Service Manual Appendix A Overview This appendix includes: • Interconnect Diagram for the E Series Unit • ZOLL E Series Maintenance Tests Checklist Photocopy the checklists and use the copies to record the results of the maintenance tests performed on the E Series equipment; keep them for your records. 9650-1450-01 Rev.
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E Series Service Manual * AC Receptacle * * 9500-0716 9301-0388-01 AC Charger Speaker 9500-0712 Display 1005-0002 Earth ground post 9301-0389-01 Battery Interconnect 9500 -0718 9500-0719 9500-0312 9500-0713-50 * 9500-0716-50 Capacitor 100 1-XXXX * 9301-0370-02 Biphasic Bridge/DAC ETCO2 Connector 9500-0313 9500-0734 * MFE Connector/Patient 9301-0384-01 Controls 9500-0720 1001-0278-02 HV Module Membrane 9500-0733-50 9301-0380-01 System 9 500-0727 -50 1001-03 45 Microphone 9 5
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ZOLL E Series  Maintenance Test Checklist 1.0 Physical Inspection Pass Fail Result of Check: 1.1 o No action required o Minor problems corrected o Disposable supplies replaced o Major problems identified  (unit out of service) 1.2 1.3 1.4 1.5 1.6 Additional Remarks 1.7 1.8 1.9 1.10 1.11 1.12 1.13 1.14 1.15 o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o N/A o o o o o o o o o o o o o o o Location Tester Signature 2.0 Front Panel Button Test Pass Fail 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.
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ZOLL E Series  Maintenance Test Checklist 13.0 Shock Test Pass Fail 13.2 13.3 13.4 13.5 13.6 13.7 13.8 13.9 13.10 13.11 13.12 13.13 13.14 13.15 13.16 13.17 13.18 13.19 13.20 o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o N/A o o o o o o o o o o o o o o o o o o o 14.0 Summary Report Test Pass Fail 14.1 14.2 14.3 14.4 o o o o o o o o N/A o o o o 9650-1450-01 Rev. D 15.0 Advisory Message Test Pass Fail 15.2 15.3 15.4 o o o o o o N/A o o o Pass Fail 16.1 16.2 16.
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E Series ® Operator’s Guide 9650-1210-01 Rev.
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The issue date for the E Series Operator's Guide (REF 9650-1210-01 Rev. R) is March, 2013. If more than 3 years have elapsed since this date, contact ZOLL Medical Corporation to determine if additional product information updates are available. Copyright © 2013 by ZOLL Medical Corporation. All rights reserved.
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TABLE OF CONTENTS SECTION 1 GENERAL INFORMATION.................................................................. 1-1 Product Description.............................................................................................. 1-1 How to Use This Manual....................................................................................... 1-2 Manual Updates..................................................................................................... 1-2 Unpacking................................
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E Series Operator’s Guide SECTION 2 OPERATING CONTROLS AND INDICATORS ................................... 2-1 Code Markers .........................................................................................................2-4 Summary Report Function....................................................................................2-4 Summary Report Formats....................................................................................2-4 Defibrillation Format....................................
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Table of Contents FULLY RELEASE Prompt....................................................................................7-2 CPR Voice Prompts .............................................................................................7-2 Compressions Bar Graph ....................................................................................7-2 Displaying the CPR Compressions Bar Graph ....................................................7-3 CPR Dashboard ...............................................
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E Series Operator’s Guide NIBP Trend Operation .......................................................................................10-6 Clearing Vital Signs Trend Records...................................................................10-7 SECTION 11 GENERAL MAINTENANCE .............................................................. 11-1 Inspection ............................................................................................................. 11-1 Cleaning................................
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Table of Contents PCMCIA Card ........................................................................................................ A-5 Battery Packs ........................................................................................................ A-5 Guidance and Manufacturer’s Declaration — Electromagnetic Emissions .... A-7 Electromagnetic Immunity Declaration (EID) ..................................................... A-8 EID for Life-Support Functions ........................................
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SECTION 1 GENERAL INFORMATION NOTE: Your E Series® may or may not contain all the features listed in this manual, depending on your particular configuration. Product Description The ZOLL® E Series products combine defibrillation, ECG display, advanced monitoring capabilities, and Noninvasive Transcutaneous Pacing (NTP) with communication, data printing and recording capabilities in a single lightweight portable instrument.
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E Series Operator’s Guide How to Use This Manual The E Series Operator's Guide provides information operators need to know for the safe and effective use and care of the E Series products. Before operating this device, be sure to read and understand all the information contained within. This manual is organized for Manual mode operators, Advisory mode operators and Semiautomatic mode operators. If you will only use the device in Manual mode or Advisory mode you do not need to read Section 5.
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General Information AAMI 5-Lead Wire ECG Patient Cable 8000-1005-01 IEC 5-Lead Wire ECG Patient Cable 8000-0091 Power Cord Extension Cable (12”) 8000-0730 Batteries and Chargers REF ZOLL Base PowerCharger 4x4 Battery Charger 8050-0012-01 Smart Battery Pack 8004-0103-01 SmartReady Battery Pack 8004-0104-01 ZOLL SurePower Charger 8050-0030-01 SurePower defibrillator battery 8019-0535-01 Miscellaneous REF Storage Bag Set 8000-0916 Recorder Paper, 80mm Fan Fold 8000-0301 (20 packages) 800
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E Series Operator’s Guide Symbols Used on the Equipment Any or all of the following symbols may be used in this manual or on this equipment: Type B equipment. Type BF equipment. Type CF equipment. Defibrillator-proof type BF equipment. Defibrillator-proof type CF equipment. Attention, consult accompanying documents. Fragile, handle with care. Keep dry. This end up. Temperature limitation. Fusible Link. Equipotentiality. Protective (earth) ground terminal. DANGER High Voltage present.
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General Information Conformité Européenne Complies with the medical device directive 93/42/EEC. ,%! $ 2. 45 2% 2%#9#,% 0B Contains lead. Recycle or dispose of properly. Keep away from open flame and high heat. Do not open, disassemble, or intentionally damage. Do not crush. Nonrechargeable battery Do not discard in trash. Recycle or dispose of properly. Date of manufacture. Use by. Latex-free. Do not reuse. Do not fold. Not sterile. Nonionizing electromagnetic radiation.
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E Series Operator’s Guide Manufacturer. Authorized representative in the European Community. Serial Number. Catalogue number. Consult instructions for use. IP34 1-6 Protected against ingress of solid foreign objects > 2.5 mm in diameter. Protected against splashing water. 9650-1210-01 Rev.
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General Information Defibrillator Function Intended Use — CPR Monitoring The E Series products contain a DC defibrillator capable of delivering up to 200 joules of energy. It may be used in synchronized mode to perform synchronized cardioversion by using the R-wave of the patient’s ECG as a timing reference. The unit uses paddles or disposable, pre-gelled, MFE Pads for defibrillation.
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E Series Operator’s Guide External Pacemaker Function (Pacer version only) • Noninvasive pacing may be useful as a standby when cardiac arrest or symptomatic bradycardia might be expected due to acute myocardial infarction, drug toxicity, anesthesia or surgery. It is also useful as a temporary treatment in patients awaiting pacemaker implants or the introduction of transvenous therapy.
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General Information This reddening should substantially lessen within 72 hours. There have been reports of burns under the anterior electrode when pacing adult patients with severely restricted blood flow to the skin. Prolonged pacing should be avoided in these cases and periodic inspection of the underlying skin is advised.
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E Series Operator’s Guide • PAD CONTACT are alternately displayed, and energy will not be delivered If a short circuit exists between MFE Pads, the message DEFIB PAD SHORT is displayed. Monitor The patient’s ECG is monitored by connecting the patient to the unit via the 3 lead or 5 lead wire patient cable, MFE Pads, or through the paddles.
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General Information Safety Considerations The E Series products are high energy devices capable of delivering up to 200 joules. To completely deactivate the device, you must turn the selector switch to the OFF position.
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E Series Operator’s Guide • • • • • • • • • The potential equalization connector on the rear connector panel of the device has no function during physiological monitoring or delivery of therapy. Follow all recommended maintenance instructions. If a problem occurs, obtain service immediately. Do not use the device until it has been inspected by the appropriate personnel. Do not use the unit’s ECG out signal as a sync pulse for another defibrillator or cardioverter.
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General Information • • • • • • • • • • • • • • • The AutoPulse Plus is only intended for use on adults 18 years of age or older. When using the E Series and AutoPulse Plus as a system, this age restriction applies to the E Series as well. Carefully route the patient cables to reduce the possibility of patient entanglement or strangulation. Do not use the unit’s AED function on patients under 8 years of age.
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E Series Operator’s Guide Restarting the Device Certain events require the E Series products to be restarted after they shut off or become inoperative. One example is when the battery runs down and the unit shuts off. In this case, perform these steps in this order: 1. 2. 3. 4. Turn the selector switch to the OFF position Remove the battery. Insert a new battery. Turn the selector switch to the desired operating mode to resume operation.
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General Information FDA Regulations Tracking Requirements U.S. Federal Law (21 CFR 821) requires the tracking of defibrillators. As an owner of this device, you have the responsibility under this law to notify ZOLL Medical Corporation if this product has been: • • • received lost, stolen or destroyed donated, resold, or otherwise distributed to a different organization. If any of the events described above occur, please contact ZOLL Medical Corporation in writing with the following information: 1.
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E Series Operator’s Guide For customers Return the unit to In the U.S.A. ZOLL Medical Corporation 269 Mill Road Chelmsford, MA 01824-4105 Attention: Technical Service Department (SR number) Telephone: 1-800-348-9011 In Canada ZOLL Medical Canada Inc. 1750 Sismet Road, Unit #1 Mississauga, ON L4W 1R6 Attention: Technical Service Department (SR number) Telephone: 1-866-442-1011 In other locations The nearest authorized ZOLL Medical Corporation representative.
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SECTION 2 OPERATING CONTROLS AND INDICATORS 9 6 7 8 10 21 3 #(!2'% ,%!$ ECG Sp02 % ll 3):% ,%!$ (2 x1. 204 !.!,):% 4 2 %.%2'9 3%,%#4 3):% !,!23530%.$ 98 RR CO2 2%#/2$%2 $%&)" -/.)4/2 1 20 /&& ECG 0!#%2 2!4% PPM 0!#%2 04:48 Alarms Sync On/Off 0!#%2 /540/24 M! 5 3(/#+ Param #(!2'%2 .)"0 35--!29 #/$% -!2+%2 15 16 22 14 /. 11 12 13 17 18 19 ZM-04-36 Rev. A 1. Selector Switch Allows selection of OFF, MONITOR, DEFIB, and PACER, (Pacer version only) modes.
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E Series Operator’s Guide 4. SHOCK Button 10. RECORDER Buttons The SHOCK button illuminates when the defibrillator is charged and ready. Press and hold the button to discharge the defibrillator. Located on the unit’s front panel and another located on the sternum paddle (not shown), starts and stops the stripchart recorder. The SHOCK button is active only when using MFE Pads. The SHOCK button is not functional when external paddles are connected to the unit.
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Operating Controls and Indicators 17. Pacer Output mA (Pacer Version Only) When pacing is selected, this control sets the amount of current delivered to the MFE Pads. For conscious patients, it should be gradually increased until capture is recognized. The selected current setting is indicated on the display. The next three items are located on the top of all units, as shown in the following figure. Data Card Slot 18.
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E Series Operator’s Guide important that the electrode is locked correctly in position on the paddle handle. PEDI Button Adult Electrode (Shoe) clinical action without having to scroll through the list. If no code marker has been entered, the cursor highlights the first item in the list. Note: Selecting code markers out of order disables this feature.
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Operating Controls and Indicators as well as space for patient name, date and comments. On the last event recorded, “SUMMARY COMPLETE” is printed at the bottom left of the recorder strip. Defibrillation Format The summary report function records 6 seconds of pre-shock and 9 seconds of post-shock patient ECG data. Also recorded are joules selected, joules delivered, sync if active (includes sync markers), ECG lead, ECG size, patient impedance, actual event time and date.
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E Series Operator’s Guide Pacer Format (Pacer version only) The summary report function records 6 seconds of pre-pacer patient ECG data. Also recorded are the ECG lead, ECG size, patient's heart rate, actual event time and date. The date/time printed on the top of the strip corresponds to the ECG data occurring 6 seconds before the event. Actual event date/time After establishing a paced rhythm, turning the recorder on briefly records the paced rhythm for later reports.
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Operating Controls and Indicators Heart Rate Alarm Activated Format The summary report function records 6 seconds of pre-alarm patient ECG. Also recorded are the ECG lead, ECG size, patient's heart rate, actual event time, and date. The date/time printed on the top of the strip corresponds to the ECG data occurring 6 seconds before the event. If the pacer is on during this event, the pacing rate and pacing current are also recorded.
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E Series Operator’s Guide and pacing current are also recorded. If async pace is active, the annotation “ASYNC PACE” is recorded. AED units additionally include shock count and AED mode annotations. Actual event date/time Analyze Format The summary report function records six seconds of pre analysis ECG and 12 seconds of ECG recorded during the ECG analysis interval with the annotation “SHOCK ADVISED” or “NO SHOCK ADVISED.” AED units additionally include shock count and AED mode annotations.
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Operating Controls and Indicators Manual Mode Activated AED versions of the E Series will record a “MANUAL MODE STARTED” summary report event when the device is switched from Semiautomatic mode to Manual mode. 3. Use the scroll keys on top of the unit to scroll through the list of start times associated with different calls. --- NIBP kPa To print the stored information, press the SUMMARY button below the screen display.
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E Series Operator’s Guide • • • • • Manual mode started (AED only) Alarms triggered Code markers Recorder turned on NIBP measurements activated (if option is included) • Select the Enter ( ) key from the keypad and press the Commit ( ) key on top of the unit. The highlight automatically advances to the Patient ID# line.
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Operating Controls and Indicators Note: You cannot add a patient name to summary report events already stored in memory. The patient name is stored only with those summary events saved after the patient name has been entered. 5. When you have modified the patient name, move the cursor to the Enter ( ) key on the keypad and press the Commit ( ) key on top of the unit. Modifying a Patient Name and ID Number To change an existing patient name and identification number: 1.
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SECTION 3 MANUAL DEFIBRILLATION Paddles/pads are a defibrillation-protected Type BF patient connection. ECG leads are a defibrillation-protected Type CF patient connection. Emergency Defibrillation Procedure with Paddles or MFE Pads WARNING • • • To avoid risk of electrical shock, do not allow electrolyte gel to accumulate on hands or paddle handles. When defibrillating with paddles, use your thumbs to operate the SHOCK buttons in order to avoid operator shock.
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E Series Operator’s Guide Note: When the unit is turned to MONITOR or DEFIB, the ECG source is set either to PADDLES (if paddles are connected to the Multi-Function cable), or to Multi-function pads (if paddles are not connected to the Multi-Function cable). If connected to the AutoPulse Plus, the APLS icon will be displayed and PADS will be the ECG source.
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Manual Defibrillation 2 Charge Defibrillator 3 Deliver SHOCK Press the CHARGE button on the front panel (if using MFE pads) or on the apex paddle handle (if using paddles). WARNING • • #(!2'% !.!,9:% 3(/#+ %.%2'9 3%,%#4 or CHARGE Button on Apex Paddle CHARGE Button on Front Panel Note: If using paddles, if both SHOCK buttons on the paddles are depressed when you press the CHARGE button, the device does not charge and a RELEASE SHOCK BUTTON or other message appears on the display.
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E Series Operator’s Guide device disarms. The charge ready tone stops, the charge indicator light, or the front panel SHOCK button light goes off, and the monitor message changes to DEFIB XXXJ SEL. Press the CHARGE button again to recharge the unit. Paddle Cleaning Paddle plates and handles must be thoroughly cleaned after each use. See “General Maintenance” on page 111 for correct cleaning procedure.
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SECTION 4 ADVISORY DEFIBRILLATION When MFE Pads are used, the patient connection is considered to be defibrillationprotected Type BF. Advisory Defibrillation WARNING • • Do not use the unit’s Advisory function on patients under 8 years of age. The AutoPulse Plus is only intended for use on adults 18 years of age or older. When using the E Series and AutoPulse Plus as a system, this age restriction applies to the E Series as well.
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E Series Operator’s Guide 1 Select DEFIB An ANALYZING ECG message is displayed for approximately 9 to 12 seconds while the patient’s ECG is analyzed. -/.)4/2 $%&)" /&& ECG 0!#%2 ANALYZING ECG The unit displays the DEFIB 120J SEL message on the monitor until you press the ANALYZE button. 00:01 Param Wave 2 ID# Alarms Sync On/Off ECG Once the analysis is complete, the unit indicates whether or not a shock is advised. When a non-shockable rhythm is detected, the message NO SHOCK ADV.
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Advisory Defibrillation . NO SHOCK ADV. SCE LOW SHOCK ADVISED ECG ECG DEFIB 200J SEL. DEFIB 200J SEL. 00:01 00:01 Param Param Wave 2 ID# Alarms Sync On/Off ID# Alarms Sync On/Off If the patient’s SPI value is greater than the configured SPI threshold, the unit operates as previously described and issues the SHOCK ADVISED prompt.
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E Series Operator’s Guide 3 Press SHOCK Continue Patient Care Continue patient care according to medical protocols. WARNING Advisory Function Messages Warn all persons in attendance of the patient to STAND CLEAR prior to defibrillator discharge. Do not touch the bed, patient, or any equipment connected to the patient during defibrillation. A severe shock can result.
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Advisory Defibrillation and does not require depression of the ANALYZE button for operation. • CHECK PADS / POOR PAD CONTACT The MFE Pads are no longer properly attached to the patient or the cable connections have become loose. Check that the MFE Pads are making good contact with the patient’s skin and that the cables are all securely connected. This voice prompt is issued only if MFE pads were previously connected to the patient.
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SECTION 5 AUTOMATED EXTERNAL DEFIBRILLATOR (AED) OPERATION MFE Pads are a defibrillation-protected Type BF patient connection. The AED unit has two modes of operation: Semiautomatic or Manual. This section describes the recommended method for analysis and defibrillation for the AED unit in Semiautomatic mode. However, if your local protocol requires a different procedure, follow that protocol. WARNING • • • Do not use the unit’s AED function on patients under 8 years of age.
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E Series Operator’s Guide AED Semiautomatic Operation Before you begin: • • • Determine the patient’s condition following medical protocols and by verifying: – Unconsciousness – Absence of breathing, and – Absence of pulse If appropriate, begin CPR following medical protocol, and request additional assistance. Prepare the patient and attach the MFE pads as described in “MFE Pad Application/Connection” on page 1-9.
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Automated External Defibrillator (AED) Operation When a non-shockable rhythm is detected, the unit displays a NO SHOCK ADV. message. 3 Press SHOCK WARNING • NO SHOCK ADV. ECG • 120J SEL. NO SHOCK ADVISED 00:15 Manual Mode Param ID# In this case, immediately check pulse and breathing and resume other treatment per protocol. If the patient’s rhythm is shockable, the unit displays a SHOCK ADVISED message. Warn all persons in attendance of the patient to STAND CLEAR prior to defibrillator discharge.
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E Series Operator’s Guide ready for operation. Additional tone signals are described below. The messages that appear on the monitor depend upon the function the unit is performing, the mode selected, and the ECG information from the patient. The unit alternately displays two different messages in the same field of the display when two conditions are detected at the same time. For example, a LOW BATTERY message may alternately display on the same line of the monitor as the CHECK PADS prompt.
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Automated External Defibrillator (AED) Operation • This prompt appears when the unit has detected a non-shockable rhythm. Check the patient’s pulse. have entered the access code correctly and the unit enters Manual mode. IF NO PULSE, PERFORM CPR* If you press the Return to Auto softkey, the unit returns to the Semiautomatic mode of operation. If you cannot detect a pulse, begin CPR protocols.
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SECTION 6 SYNCHRONIZED CARDIOVERSION Paddles are a defibrillation-protected Type BF patient connection. ECG leads are a defibrillation-protected Type CF patient connection. WARNING • • • Only skilled personnel trained in ACLS (Advanced Cardiac Life Support) and familiar with equipment operation should perform synchronized cardioversion. The precise cardiac arrhythmia must be determined before attempting defibrillation.
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E Series Operator’s Guide Turn Selector Switch to MONITOR -/.)4/2 Press the SYNC softkey again to reactivate SYNC mode. Changing the selected energy does not turn off Sync mode. $%&)" You can configure the unit to stay in Sync mode after defibrillation if desired. /&& 2 Charge Defibrillator 0!#%2 Press the CHARGE button on the front panel or on the apex paddle handle (if paddles are used). Press the LEAD button to select the desired ECG lead.
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Synchronized Cardioversion Once energy is delivered, the display simultaneously shows the XXXJ DELIVERED and DEFIB XXXJ SEL. messages. After approximately 5 seconds the XXXJ DELIVERED message disappears, and the DEFIB XXXJ SEL. message remains to indicate the selected energy level. If additional countershocks are necessary, re-adjust the energy level as necessary, press the SYNC softkey and repeat. Note the SYNC XXXJ SEL. message must be displayed prior to pressing the CHARGE button.
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SECTION 7 REAL CPR HELP The CPR sensor is defibrillation-proof Type BF equipment. WARNING • • • ® The Real CPR Help function is not intended for use on patients under 8 years of age. The CPRD-to-MFC connector is intended for use with the E Series, or other ZOLL defibrillators where indicated. Real CPR Help is disabled when using CPR-D-padz through an AutoPulse Plus.
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E Series Operator’s Guide compression indicators and CPR idle time described in the next sections. compressions have been delivered for more than 20 minutes, dashes (---) will be displayed in this time field. CPR Compressions Indicator CPR Idle Time This rectangular bar shaped figure provides a quick, overall indicator of how well the rescuer's combined rate and depth of chest compressions match the AHA/ERC recommendations for adult CPR.
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Real CPR Help Displaying the CPR Compressions Bar Graph When an appropriate rate and depth are achieved, these labels are not highlighted. To manually display the CPR compression bar graph, press the Wave 2 softkey until the bar graph is displayed. * * NIBP mmHg CO2 Whenever CPR-D-padz or CPR stat-padz are connected to the E Series unit and the CPR Dashboard is configured on, the unit illuminates the CPR Dashboard, replacing the right half of the Wave 2 display area.
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SECTION 8 SEE-THRU CPR WARNING • • • • • The See-Thru CPR filter works only when the E Series defibrillator is monitoring CPR in Manual mode. The See-Thru CPR filter stops if: — Diagnostic bandwidth mode is active. — The unit is in pace mode. — Patient impedance is invalid. — CPR-D-padz electrodes are no longer detected. The See-Thru CPR filter will not remove all CPR artifact. Always stop CPR to verify the patient’s ECG rhythm before making treatment decisions.
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E Series Operator’s Guide The following figure shows a patient in Fine VF. It is difficult for a rescuer to discern this rhythm during CPR compressions. When the CPR filter turns on, the Fine VF rhythm becomes more obvious.
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See-Thru CPR The following figure shows a patient in VF, which, during compressions, is slightly more difficult to discern. When viewing this ECG, it is possible to view the underlying rhythm as the filter is able to reject all of the CPR artifact.
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E Series Operator’s Guide The following figure shows a patient in PEA, which could easily be mistaken for Fine VF because enough of the compression artifact leaks through to distort this signal. When the CPR filter turns on, the PEA is still not obvious because of the left over ripples from the CPR signal. About 14 seconds into this chart, the rhythm changes to asystole, which could easily be mistaken for coarse VF.
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See-Thru CPR The following figure shows a patient with an organized rhythm where See-Thru CPR effectively filters out artifact created by CPR. SinusRhythm Raw ECG Raw ECG • | Filter ON Filtered ECG Filtered ECG CPR 0:00 CPR 0:12 SinusRhythm Raw ECG Raw ECG • | Filter OFF • | Filter ON Filtered ECG Filtered ECG CPR 0:12 CPR 0:24 SinusRhythm Raw ECG Raw ECG • | Filter OFF Filtered ECG Filtered ECG CPR CPR 0:24 0:36 12.5 mm/sec, 5 mm/mV 9650-1210-01 Rev.
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SECTION 9 NONINVASIVE TEMPORARY PACING (PACER VERSION ONLY) Paddles are a defibrillation-protected Type BF patient connection. ECG leads are a defibrillation-protected Type CF patient connection. WARNING • • • • • • To avoid risk of electrical shock, do not touch the gelled area of the MFE Pads while pacing. MFE Pads should be replaced after 8 hours of continuous pacing (2 hours for Radiolucent stat-padz) to ensure maximum patient benefit. Pacing with CPR-D-padz is not recommended.
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E Series Operator’s Guide The pacer rate increments or decrements by a value of 2 ppm on the display when you turn the knob. Electrical Capture Electrical capture means that the unit is delivering sufficient electrical current to stimulate the heart as seen on the ECG trace. 0!#%2 2!4% PPM 0!#%2 /54054 M! WARNING • • Observe the pacing stimulus marker on the display or stripchart ( ) and verify that it is well-positioned in diastole.
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NonInvasive Temporary Pacing (Pacer Version Only) by increasing the pacer output (mA) until every pacing marker is immediately followed by a wide QRS complex. • • Note that changing ECG leads and size can sometimes be helpful in determining capture. • Mechanical Capture The alarm continues to sound until the Clear Pace Alarm softkey is pressed. Mechanical capture is indicated when the patient’s pulse approximates the displayed pace rate.
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E Series Operator’s Guide rate drops below the set pacing rate. The pacing rate should be set at a level sufficient for adequate cardiac output. 4. Check the threshold periodically. Asynchronous Pacing If ECG electrodes are not available or there is some circumstance that prevents or interferes with the surface ECG, it may be necessary to operate the pacemaker asynchronously. Perform asynchronous pacing only in emergency situations when there are no other alternatives. To pace asynchronously: 1.
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SECTION 10 ECG MONITORING ECG leads are a defibrillation-protected Type CF patient connection. Introduction You can use the E Series products for either short-term or long-term ECG monitoring. IEC Color Coding AHA Color Placement of Electrodes Coding E Series products have built-in protection circuitry to prevent damage to their ECG monitoring circuits during defibrillation attempts.
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E Series Operator’s Guide Monitoring Electrodes Attachment Attach snap-on leads to electrodes and check for good contact between the electrode and the lead termination. ,%!$ 3):% Peel the protective backing from the ECG electrode. Be careful to keep adhesive surface free of electrolyte gel. !,!23530%.$ 2%#/2$%2 CAUTION Only use electrodes that are well within the expiration date indicated on the package.
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ECG Monitoring LEAD ECG SIZE HR x1 70 selected State value and moves the highlight to the next field on the right (Low limit field). • If you press the Next Field softkey after selecting AUTO, the unit sets the lower and upper limits to 80% and 120% of the patient’s currently measured heart rate if valid measurements are present for the vital sign. (Refer to appropriate Operator’s Guide parameter insert(s) for percentages associated with other parameters).
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E Series Operator’s Guide 280 bpm with a default setting of 150 bpm. When the unit is monitoring a patient’s heart rate through pulse oximetry (SpO2), however, the unit automatically lowers the upper limit for the high heart rate alarm to 235 bpm. The unit restores the original high heart rate alarm limit when ECG monitoring resumes.
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ECG Monitoring standard monitoring bandwidth when you release the RECORDER button. set to Yes in System Configuration. Refer to the E Series Configuration Guide for more information. 5-Lead Monitoring Vital Signs Trending You can perform 5-lead ECG monitoring with the appropriate ECG patient cable.
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E Series Operator’s Guide If only one parameter is installed on the unit, the trend screen automatically appears when you press the Trend softkey. 09-Jun-10 CO2 TIME HR/PR SpO2 EtCO2 RR 5 MIN 36 4.1 100 13:35 120 13:30 119 100 4.3 13 13:25 120 99 3.7 15 13:20 119 99 3.7 15 Print Newer Older Zoom Data is printed on the stripchart in order of newest data to oldest data. Alarm conditions are indicated on the stripchart by placing brackets around alarmed values.
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ECG Monitoring Clearing Vital Signs Trend Records The unit stores at least 24 hours of normal (non-alarmed, non-NIBP) trending samples before it is overwritten. If the unit is powered down while recording trend data, the corresponding gap in time is indicated on the display by a series of asterisks in the time field and no data points in any parameter fields.
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SECTION 11 GENERAL MAINTENANCE Resuscitation equipment must be maintained to be ready for immediate use. Perform the following operational checks at the beginning of every shift to ensure proper equipment operation and patient safety. Cleaning the Recorder Printhead To clean the recorder printhead, perform the following steps: Note: Self-test defibrillation and pacing data is automatically recorded on the PCMCIA data card, if present.
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E Series Operator’s Guide Testing the Defibrillator (Semiautomatic Mode) Perform these tests on all AED units periodically. Power-Up Sequence Test Follow these steps to verify the unit’s power-up sequence. 1. Turn the selector switch on the front panel to the ON position 2. Verify the following: • The unit emits a 4-beep tone to indicate the power-up self test has been successfully completed. • The CHECK PADS message is displayed and announced.
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General Maintenance 5. When charge ready tone sounds, use the defibrillator ENERGY SELECT buttons on either the sternum paddle or defibrillator front panel to change the selected energy to 20 joules. 6. Verify that the unit disarms itself. 7. Use the defibrillator ENERGY SELECT buttons on either the sternum paddle or defibrillator front panel to change the selected energy back to 30 joules. MFC Setup: 1. Plug the MFC cable into the unit, making sure it is not plugged into the test connector. 2.
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E Series Operator’s Guide Changing Recorder Paper You should always check for adequate paper supply in the unit before operation. Failure to do so may result in insufficient paper to print out event information during clinical rescue. Follow these steps to change the paper: 1. Open the recorder module on top of the E Series unit. 2. Remove the paper from the tray. 3. Unfold the top sheet of a pad of thermal paper. You should not see a thick red line (which indicates the end of the pad).
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General Maintenance Setting Time and Date Check the time and date on the recorder annotation. If it is not correct, reset the time and date (from System Utilities mode) manually, by dial-up to a National Institute for Science and Technology (NIST) site, or using the GPS synchronization feature. After implementing time reset using any of the methods described below, verify that the time and date are set correctly by pressing the RECORDER button to generate a stripchart recording.
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E Series Operator’s Guide Error Message Description/Corrective Action BUSY The unit detected a busy signal from the selected NIST location. Retry. NO ANSWER The unit received no answer from the selected NIST location. Retry or select another NIST location. NO CARRIER The unit determined that the line is broken. Correct the line break and retry. HANG UP The unit received a hang up indication from the selected NIST location. Retry. MODEM DIAL ERROR The modem could not dial the phone number.
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Operator’s Shift Checklist for E Series Products (Manual) Recommended checks and procedures to be performed at the start of each shift. For more detailed information, see the E Series Operator’s Guide. Date____________________________Location________________________________Unit Serial Number__________________ 1st 2nd 3rd Remarks 1. Condition Shift Shift Shift Unit clean, no spills, clear of objects on top, case intact 2. Multi-function Pads 1 set preconnected / 1 spare (check expiration dates) 3.
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Operator’s Shift Checklist for E Series Products (Semiautomatic) Recommended checks and procedures to be performed at the start of each shift. For more detailed information, see the E Series Operator’s Guide. Date_____________________________Location __________________________Unit Serial Number ______________________ 1st 2nd 3rd Remarks 1. Condition Shift Shift Shift Unit clean, no spills, clear of objects on top, case intact 2.
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SECTION 12 BATTERY MANAGEMENT Battery Care LOW BATTERY Message Safe, reliable use of the system requires a well designed battery management program to ensure that adequate battery power is always available. Whenever the unit detects a low battery condition, a LOW BATTERY message is displayed on the monitor once every minute, and a 2-beep low battery tone sounds once every minute or once every 5 minutes.
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E Series Operator’s Guide 3. Turn the defibrillator back on to the selected mode of operation. Note: If a battery has been discharged below its safe limit (8.5 V), which could occur during long-term storage, the battery fault indicator illuminates when it is installed. In this case, the battery is not usable; remove it immediately. Replace with a fully-charged battery. (In emergency situations, you can use AC power.) If the unit is set to PACER mode, pacing may resume immediately after battery replacement.
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Battery Management : Achieving Optimal Battery Pack Performance The following general practices will ensure the longest life from your battery pack: “Do’s and Don’ts” in using battery packs: • DO charge battery packs completely. When a battery pack exchange is required, place a fully charged battery in the unit. If you use a partially charged battery pack, it may result in a very short monitor/defibrillator run time.
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E Series Operator’s Guide • DO exchange your battery packs regularly. Battery packs should be exchanged once per shift or once per day depending on their use. • DO carry a fully charged spare battery pack at all times.  DON’T remove a partially charged battery pack from the battery charger. If a partially charged battery pack is used, a full charge is recommended before its next use. Repeated use after partial charging may quickly diminish the battery’s capacity, thereby shortening its life.
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SECTION 13 TROUBLESHOOTING GUIDELINES The troubleshooting guidelines provided on the following pages are intended for use by non-technical medical personnel during device operation. This section addresses many of the common problems or questions that may arise during operation. If trouble persists after consulting this guide, contact the appropriate technical personnel or ZOLL Technical Service Department. A more detailed troubleshooting guide is found in the E Series Service Manual.
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E Series Operator’s Guide Symptom Recommended Action Unit displays the TIME SYNCHRONIZATION REQUIRED message on power down. • More than two weeks have elapsed since the clock was last synchronized. Synchronize the clock as described in “Setting Time and Date” on page 11-5.” Unit displays the CABLE FAULT or PADDLE FAULT message. • Check the connection between the Multifunction cable and the MFE pads.
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Troubleshooting Guidelines Recorder Symptom Recommended Action Unit displays the CHECK RECORDER prompt. • • • Ensure the recorder door is shut properly. Ensure adequate paper supply in recorder paper tray (see “Changing Recorder Paper” on page 11-4). Remove paper, check paper type, check recorder for paper jam, and then reload paper. Recorder makes stuttering sound when activated. • Check recorder for paper jam. Light or poor quality printing is observed.
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E Series Operator’s Guide Pacer (Pacer version only) Symptom Recommended Action Unit displays the CHECK PADS prompt. • • • • No pacing marker ( ) present on the ECG trace. • • No ventricular capture beat after pacing marker is seen • on ECG display. • • • Patient receives intermittent pacing stimulus during standby pacing. • • • Ensure MFE Pads are connected to Multi-Function cable. Ensure electrode gel is not dry. Replace MFE Pads if necessary. Ensure good electrode-to-patient contact.
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Troubleshooting Guidelines Defibrillator Symptom Recommended Action Excessive artifact when using paddles as ECG source. • • • • • • • Ensure PADDLES is selected. Firmly press paddles against patient skin. Use gel on paddles. Clean paddle surface. Check and clean between adult and pediatric shoe. Check cable for damage. Use MFE electrodes for ECG analysis. Defibrillator will not charge (energy level does not increment on display). • • Check SHOCK button(s) on paddles or front panel are not stuck on.
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E Series Operator’s Guide Symptom Recommended Action No energy delivery to patient is apparent. • • • • Unit displays PADDLE FAULT message when connected to the AutoPulse Plus. Unit displays the CHECK PADS prompt. Under certain circumstances, some patients do not twitch when energy is delivered. Perform defibrillator self test as described in “General Maintenance” on page 11-1. Check for CHECK PADS and POOR PAD CONTACT messages alternating on the monitor.
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Troubleshooting Guidelines AC Charger Symptom Recommended Action The green and orange-yellow CHARGER ON indicators • illuminate alternately. • • • Verify battery is installed. Turn unit ON to identify the fault condition. Replace battery pack with a fully charged battery pack. If problem persists, replace battery pack, unplug device from AC mains and plug device back into AC mains. Unit displays the LOW BATTERY message when it is plugged into AC mains.
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APPENDIX A SPECIFICATIONS General Size 5.75 in. high x 13.1 in. wide x 10.5 in. deep 14.6 cm high x 33.3 cm wide x 26.7 cm deep Weight Approximately 13.2 lbs (5.99 kg) Power 5 cells, 2 V/cell; wired in series (sealed lead acid battery pack) 3 cells, 4.2 V/cell; wired in series (lithium-ion battery pack) AC Power 100-120V ~ 50/60 Hz, 220-240V ~ 50 Hz, 220 VA DC Input (Optional) 10-29 V. 130 W Device Classification Class I and internally powered per IEC 60601-1.
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E Series Operator’s Guide Pacemaker (Pacer version) Type VVI demand; asynchronous (fixed rate) when used without ECG leads or in ASYNC pacing mode Pulse Type Rectilinear, constant current Pulse Shape and Duration Rectilinear, 40 milliseconds ±2 milliseconds Pulse Amplitude Variable 0 mA to 140 mA ±5% or 5 mA, whichever is greater Digitally displayed on the monitor (increments or decrements by a value of 2 mA) Pacing Rate Variable from 30 ppm to 180 ppm ±1.
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Paddles Standard apex/sternum adult and pediatric. Adult paddles slide off to expose pediatric paddles. Multi-Function Electrode (MFE) Pads Specifically designed adult anterior/posterior pregelled ZOLL MFE Pads and Multi-Function stat-padz packaged in pairs. Built-in Defibrillator Tester Provides verification of the defibrillator charging and discharging without removing paddles from storage wells or verification of unit configured with Multi-Function Cable.
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E Series Operator’s Guide Heart Rate Alarm Screen icon indicates activated/deactivated status. User-selectable. Tachycardia 60 bpm - 280 bpm, bradycardia 20 bpm - 100 bpm Tall T-wave Rejection 1.0 mV Heart Rate Averaging The E Series averages the interval between the last 5 detected beats. On startup, the E Series averages the rate between detected beats once two beats are detected, until a full 5 beats have been received. The rate is updated every beat.
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Display Screen Type High resolution, color liquid crystal display (LCD) Screen Size 5.63 inches (14.3 cm) diagonally Sweep Speed 25 mm/s Viewing Time 4 seconds Messages ERASING REPORT, INSERT CARD, CARD FULL, REPLACE BATTERY, LOW BATTERY, PERFORM CPR, ECG TOO LARGE, NOISY ECG, RETRY ANALYSIS, CHECK PATIENT, ANALYSIS HALTED, PRESS ANALYZE, NO SHOCK ADV.
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E Series Operator’s Guide Operating Time For a new, fully charged battery pack at 20 °C: (68F) • • • For a new, fully charged battery pack at 20 °C: (68F) 40 defibrillator discharges at maximum • energy (200 J), or 2.75 hours of continuous ECG • monitoring, or 2.25 hours of continuous ECG • monitoring/pacing at 60 mA, 80 beats per minute. 100 defibrillator discharges at maximum energy (200 J), or 4.25 hours of continuous ECG monitoring, or 3.
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Guidance and Manufacturer’s Declaration — Electromagnetic Emissions The E Series unit is intended for use in the electromagnetic environment specified below. Ensure that the E Series unit is used in such an environment. Emissions Test Compliance Electromagnetic Environment — Guidance RF emissions CISPR11 Group 1 The E Series unit uses RF energy only for its internal function. Therefore, its RF emissions are very low and are not likely to cause any interference in nearby electronic equipment.
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E Series Operator’s Guide Electromagnetic Immunity Declaration (EID) Immunity Test IEC 60601 Test Level Compliance Level Electromagnetic Environment — Guidance Electrostatic discharge (ESD) IEC 61000-4-2 ± 6 kV contact ± 8 kV air ± 6 kV contact ± 8 kV air Floors should be wood, concrete or ceramic tile. If floors are covered with synthetic material, the relative humidity should be at least 30%.
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EID for Life-Support Functions The life-support functionsa of the E Series unit are intended for use in the electromagnetic environment specified below. Ensure that the E Series unit is used in such an environment.
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E Series Operator’s Guide Recommended Separation Distances from RF Equipment for E Series Life-Support Functions The life-support functionsa of the E Series unit is intended for use in an environment in which radiated RF disturbances are controlled.
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EID for Non-Life-Support Functions The non-life-support functionsa of the E Series unit are intended for use in the electromagnetic environment specified below. Ensure that the unit is used in such an environment.
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E Series Operator’s Guide Recommended Separation Distances from RF Equipment for E Series Non-Life-Support Functions The non-life-support functionsa of the E Series unit is intended for use in an environment in which radiated RF disturbances are controlled.
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Rectilinear Biphasic Waveform Characteristics The following table shows the Rectilinear Biphasic™ waveform’s characteristics when discharged into 25 ohm, 50 ohm, 100 ohm, and 125 ohm loads at a maximum energy setting of 200 Joules.
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E Series Operator’s Guide Table A-1.
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25Ω 50Ω 75Ω 100Ω 125Ω 150Ω 40 175Ω 30 20 10 A 0 -10 -20 -30 -40 0 1 2 3 4 5 6 7 8 9 10 11 12 ms Figure A-1. Rectilinear Biphasic Waveforms at 200 Joules 25Ω 50Ω 75Ω 100Ω 125Ω 150Ω 40 175Ω 30 20 10 A 0 -10 -20 -30 -40 0 1 2 3 4 5 6 7 8 9 10 11 12 ms Figure A-2. Rectilinear Biphasic Waveforms at 150 Joules 25Ω 50Ω 75Ω 100Ω 125Ω 150Ω 40 175Ω 30 20 10 A 0 -10 -20 -30 -40 0 1 2 3 4 5 6 7 8 9 10 11 12 ms Figure A-3.
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E Series Operator’s Guide 25Ω 50Ω 75Ω 100Ω 125Ω 150Ω 40 175Ω 30 20 10 A 0 -10 -20 -30 -40 Figure A-4. 0 1 2 3 4 5 6 7 8 9 10 11 12 Rectilinear Biphasic Waveforms at 100 Joules 25Ω 50Ω 75Ω 100Ω 125Ω 150Ω 40 175Ω 30 20 10 A 0 -10 -20 -30 -40 0 1 2 3 4 5 6 7 8 9 10 11 12 ms Figure A-5. Rectilinear Biphasic Waveforms at 85 Joules 25Ω 50Ω 75Ω 100Ω 125Ω 150Ω 40 175Ω 30 20 10 A 0 -10 -20 -30 -40 0 1 2 3 4 5 6 7 8 9 10 11 12 ms Figure A-6.
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25Ω 50Ω 75Ω 100Ω 125Ω 150Ω 40 175Ω 30 20 10 0 A -10 -20 -30 -40 0 1 2 3 4 5 6 7 8 9 10 11 12 ms Figure A-7. Rectilinear Biphasic Waveforms at 50 Joules 25Ω 50Ω 75Ω 100Ω 125Ω 150Ω 40 175Ω 30 20 10 A 0 -10 -20 -30 -40 0 1 2 3 4 5 6 7 8 9 10 11 12 ms Figure A-8. Rectilinear Biphasic Waveforms at 30 Joules 25Ω 50Ω 75Ω 100Ω 125Ω 150Ω 40 175Ω 30 20 10 A 0 -10 -20 -30 -40 0 1 2 3 4 5 6 7 8 9 10 11 12 ms Figure A-9.
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E Series Operator’s Guide 25Ω 50Ω 75Ω 100Ω 125Ω 150Ω 40 175Ω 30 20 10 0 A -10 -20 -30 -40 0 1 2 3 4 5 6 7 8 9 10 11 12 ms Figure A-10. Rectilinear Biphasic Waveforms at 15 Joules 25Ω 50Ω 75Ω 100Ω 125Ω 150Ω 40 175Ω 30 20 10 A 0 -10 -20 -30 -40 0 1 2 3 4 5 6 7 8 9 10 11 12 ms Figure A-11. Rectilinear Biphasic Waveforms at 10 Joules 25Ω 50Ω 75Ω 100Ω 125Ω 150Ω 40 175Ω 30 20 10 A 0 -10 -20 -30 -40 0 1 2 3 4 5 6 7 8 9 10 11 12 ms Figure A-12.
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25Ω 50Ω 75Ω 100Ω 125Ω 150Ω 40 175Ω 30 20 10 A 0 -10 -20 -30 -40 0 1 2 3 4 5 6 7 8 9 10 11 12 ms Figure A-13. Rectilinear Biphasic Waveforms at 8 Joules 25Ω 50Ω 75Ω 100Ω 125Ω 150Ω 40 175Ω 30 20 10 A 0 -10 -20 -30 -40 0 1 2 3 4 5 6 7 8 9 10 11 12 ms Figure A-14. Rectilinear Biphasic Waveforms at 7 Joules 25Ω 50Ω 75Ω 100Ω 125Ω 150Ω 40 175Ω 30 20 10 A 0 -10 -20 -30 -40 0 1 2 3 4 5 6 7 8 9 10 11 12 ms Figure A-15.
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E Series Operator’s Guide 25Ω 50Ω 75Ω 100Ω 125Ω 150Ω 40 175Ω 30 20 10 A 0 -10 -20 -30 -40 0 1 2 3 4 5 6 7 8 9 10 11 12 ms Figure A-16. Rectilinear Biphasic Waveforms at 5 Joules 25Ω 50Ω 75Ω 100Ω 125Ω 150Ω 40 175Ω 30 20 10 A 0 -10 -20 -30 -40 0 1 2 3 4 5 6 7 8 9 10 11 12 ms Figure A-17. Rectilinear Biphasic Waveforms at 4 Joules 25Ω 50Ω 75Ω 100Ω 125Ω 150Ω 40 175Ω 30 20 10 A 0 -10 -20 -30 -40 0 1 2 3 4 5 6 7 8 9 10 11 12 ms Figure A-18.
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25Ω 50Ω 75Ω 100Ω 125Ω 150Ω 40 175Ω 30 20 10 A 0 -10 -20 -30 -40 0 1 2 3 4 5 6 7 8 9 10 11 12 ms Figure A-19. Rectilinear Biphasic Waveforms at 2 Joules 25Ω 50Ω 75Ω 100Ω 125Ω 150Ω 40 175Ω 30 20 10 A 0 -10 -20 -30 -40 0 1 2 3 4 5 6 7 8 9 10 11 12 ms Figure A-20.
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E Series Operator’s Guide 300, 360 J). A significance level of p=0.05 or less was considered statistically significant using Fischer’s Exact test. Also, differences between the two waveforms were considered statistically significant when the customary 95% or AHA recommended 90%* confidence interval between the two waveforms was greater than 0%. Results: The study population of 184 patients had a mean age of 63 ±14 years. 143 patients were males.
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between the two waveforms were considered statistically significant when the 95% confidence interval between the two waveforms was greater than 0%. Results: The study population of 165 patients had a mean age of 66±12 years with 116 male patients. The total efficacy of consecutive rectilinear biphasic shocks was significantly greater than that of monophasic shocks. The following table displays the Kaplan-Meier (product-limit) survival curves for each of the two waveforms.
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E Series Operator’s Guide Shock Conversion Estimator Use of a defibrillator shock is currently the best option for terminating ventricular fibrillation and restoring a life sustaining ECG rhythm [1]. Maintaining blood flow through the heart via cardiopulmonary resuscitation (CPR) has been shown to improve the chances of a successful defibrillation [1].
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Number of ECG Rhythms with SPI > Threshold that were successfully converted Sensitivity = ------------------------------------------------------------------------------------------------------------Total number of ECG rhythms that were successfully converted Number of ECG rhythms with SPI  Threshold that did not convert Specificity = ----------------------------------------------------------------------------------------- Sensitivity or Specificity Total number of ECG rhythms that did not convert SPI
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E Series Operator’s Guide Table A-2. Accuracy Table of SCE Levels and Corresponding SPI Thresholds SCE Level SPI Threshold (mV-Hz) Sensitivity % Specificity % HIGH 7.4 95 57 MEDIUM 8.3 90 65 LOW 10.8 80 80 References: [1] Eftestol T, Sunde K, Steen PA. Effects of Interrupting Precordial Compressions on the Calculated Probability of Defibrillation Success during Out-of-Hospital Cardiac Arrest. Circulation 2002; 105:2270-2273. [2] Sota Y, Weil MH, Sun S, Tang W. Xie J, Noc M, Bisera J.
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ECG Analysis Algorithm Accuracy • Sensitivity and specificity are expressions of ECG analysis algorithm performance when compared to ECG interpretation by a clinician or expert. Sensitivity refers to the algorithm’s ability to correctly identify shockable rhythms (as a percentage of the total number of shockable rhythms). Specificity refers to the algorithm’s ability to correctly identify non-shockable rhythms (as a percentage of the total number of non-shockable rhythms).
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APPENDIX B MEDICAL REPORT CAPABILITY The unit's medical report capability automatically records incident information for subsequent review and archiving. Data is stored on a removable PCMCIA Type II data card (memory card) for uploading to a properly equipped personal computer or hand held device. The medical report capability begins recording when the unit is turned on and continues until the unit is turned off. Patient ECG, unit status, date, time and control settings are recorded.
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E Series Operator’s Guide • Press the Next Item softkey and then the Enter softkey to exit. When finished erasing memory cards, return the unit to normal use by powering the unit off and then back on. Transferring Data to a PC with a PCMCIA Data Card Reader RescueNet Code Review for Windows software version 4.00 or later must be installed on the PC to access any information stored on PCMCIA cards. Remove the data card from the unit. Insert the card into the PCMCIA data card reader on the PC.
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Communication Settings upload the entire contents of the data card. You must configure the same communication settings on both the E Series unit and the PC or hand-held device for proper data transmission.
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E Series Operator’s Guide Activating Automatic Data Transmission 1. Press the Param softkey from the main menu to display the Parameter menu. The unit can be placed into realtime mode for automatic data transmission. In this mode, you can transmit data in real time to a remote device running ZOLL Data Relay software. The remote device in turn sends the data to a ZOLL Data Relay service for appropriate processing and formatting.
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3. To deactivate automatic data transmission, display the Summary menu (by pressing the SUMMARY button) and press the Data Relay Off softkey 3. Press the Patient Records softkey to display the Patient Records menu. Note: If you change the destination port while a record is already being transmitted, that transmission continues to the previously selected port. All other records in the queue will be transmitted to the newly-selected port.
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E Series Operator’s Guide Message Possible Causes and Corrective Action NOT AN E SERIES The wrong type of card is DATA CARD installed. The unit operates, but no data is being stored. Message Possible Causes and Corrective Action SERIAL FAULT or E Series unit aborted transmission. Data retrieval pre-empted by other E Series operations (such as alarm conditions or defibrillation activity); unit could not retrieve data from memory. UPLOAD ABORTED Insert the correct type of card.