End Tidal Carbon Dioxide (EtCO2) October 2007 9650-1212-01 Rev.
The issue date or revision level for this Operator’s Guide is shown on the front cover. ZOLL and E Series are registered trademarks of ZOLL Medical Corporation. CAPNOSTAT is a registered trademark and LoFlo and CAPNO2mask are trademarks of Respironics Novametrix LLC. Cidex is a registered trademark of Advanced Sterilization Products, a Johnson & Johnson Company. Nafion is a registered trademark of DuPont. System 1 is a registered trademark of the Steris Corporation. © 2007 by ZOLL Medical Corporation.
END-TIDAL CARBON DIOXIDE (EtCO2) General Information Product Description E Series® units equipped with software revision 2.00.000 or higher support two End Tidal Carbon Dioxide (EtCO2) monitoring options for the continuous measurement of respiratory carbon dioxide (CO2) and respiration rate. These options use the same connector on the E Series unit and may be used interchangeably. The first option uses a unique, mainstream, solid-state, infrared sensor called the CAPNOSTAT® 5 Mainstream CO2 Sensor.
E Series - End Tidal Carbon Dioxide (EtCO2) Option Insert Safety Considerations WARNINGS General • Carefully read the E Series Operator’s Guide and these operating instructions before operating the EtCO2 monitoring option. • Ensure that the E Series EtCO2 option is operated by qualified personnel only. • Do not use the E Series EtCO2 option as an apnea monitor. • Do not immerse the E Series unit, patient cables, or sensors in water, solvents, or cleaning solutions.
Safety Considerations CAUTIONS • CAUTION: Federal (U.S.A.) law restricts this device to sale, or use by or on the order of a licensed medical practitioner. • Use only ZOLL/Respironics Novametrix CAPNOSTAT 5 sensors and LoFlo modules, airway adapters, nasal and nasal/oral cannula sets with the E Series EtCO2 option.
E Series - End Tidal Carbon Dioxide (EtCO2) Option Insert EtCO2 Indications for Use The ZOLL E Series EtCO2 option is indicated for the continuous noninvasive monitoring of end tidal carbon dioxide (EtCO2) and respiration rate in patients requiring ventilator support, transport, or anesthesia. The E Series EtCO2 option with Respironics Novametrix technology supports two methods for continuous measurement of end tidal carbon dioxide (EtCO2) and respiration rate.
Mainstream EtCO2 Setup 2. Press the sensor and airway adapter together until they click. 3. Turn the Selector switch on the E Series unit to MONITOR (ON for AED units). 4. Wait for the airway adapter and sensor to warm up. The unit will display a WARM UP message for approximately one minute while the sensor and adapter warm to operating temperature. The message disappears when the sensor is ready to use. Note Warm up time varies with ambient temperature of the sensor. 5.
E Series - End Tidal Carbon Dioxide (EtCO2) Option Insert Applying an Airway Adapter with Mouthpiece Sidestream EtCO2 Setup The disposable Pediatric/Adult airway adapter with mouthpiece can be used for spot checking CO2 on non-intubated adult or pediatric patients. There are several steps involved with sidestream EtCO2 setup. These steps include: CAUTION! The disposable Pediatric/Adult Airway Adapter with mouthpiece is intended for single patient use.
Sidestream EtCO2 Setup Selecting a Sidestream Cannula Select a sidestream cannula based on the patient's size and monitoring situation. Nasal and nasal/oral cannulas are disposable and single patient use.
E Series - End Tidal Carbon Dioxide (EtCO2) Option Insert CAUTION! The disposable (SPU) Adult/Pediatric and Pediatric/Infant airway adapter kits are intended for single patient use. Do NOT reuse or sterilize these adapters as system performance will be compromised. 1. Attach the airway adapter kit’s sample cell to the sample cell receptacle on the LoFlo module, and ensure that it clicks into place. 2. If the unit displays either of the following messages take the appropriate action.
Cleaning the CAPNOSTAT 5 CO2 Sensor and LoFlo Module If you see this message: Take this action: Cleaning the CAPNOSTAT 5 CO2 Sensor and LoFlo Module CHECK CO2 LINE Verify that the sample cell is plugged into the module and seated properly. The outside of the sensor or module may be cleaned and disinfected by wiping with 70% isopropyl alcohol, a 10% bleach solution, or mild soap. CHECK CO2 MODULE Verify that neither the sample line nor the exhaust tube are blocked, kinked, or pinched.
E Series - End Tidal Carbon Dioxide (EtCO2) Option Insert How EtCO2 is Displayed The E Series unit displays the numeric EtCO2 value in units of mmHg, unless configured for percent or kPa. Refer to the E Series Configuration Guide (Part No. 9650-1201-01) for instructions on how to configure alternate units of measure. The unit also displays the number of breaths per minute, labeled "RR" for respiration rate. In addition, a capnogram may be displayed using the Wave 2 softkey.
Physiological Monitoring Zero Softkey Average Softkey Adapter zeroing should be performed whenever you change between reusable and disposable adapters. Module zeroing may be necessary if the unit displays the message ZERO CO2 MODULE. Adapter zeroing may also be necessary if the unit displays CHECK CO2 ADAPTER. The E Series unit provides 3 different time periods over which EtCO2 values are averaged: 1 breath, 10 seconds (default), and 20 seconds.
E Series - End Tidal Carbon Dioxide (EtCO2) Option Insert RR Filter Enable/Disable The respiration rate filter makes respiration rate counting more accurate in the presence of artifact, and is only valid when the LoFlo module is in use. Pressing the: • • RR Filter Enable softkey turns the respiration rate filter on. RR Filter Disable softkey turns the respiration rate filter off. Note that when the RR filter is in use, the E Series adapts more slowly to sudden changes in respiratory rate.
Check Out Procedures Check Out Procedures • Emits a continuous audio tone. The following procedures verify that the EtCO2 option is functioning properly. • Highlights the alarming parameter’s value and flashes the alarm symbol on the display. Mainstream EtCO2 (CAPNOSTAT 5 CO2 Sensor) 1. Connect the CAPNOSTAT 5 CO2 sensor cable to the yellow EtCO2 connector at the back of the E Series unit. 2. Connect an airway adapter to the CAPNOSTAT 5 CO2 sensor. 3.
E Series - End Tidal Carbon Dioxide (EtCO2) Option Insert Default Settings When the unit is turned on, the following default EtCO2 settings are automatically selected and remain in operation until changed. Parameter Default Setting Range Averaging Mode 10 seconds 1 breath 10 seconds 20 seconds High EtCO2 Alarm Limit 55 mmHg 7.2% 7.3 kPa 5 - 100 mmHg, OFF 0.6 - 13.1%, OFF 0.6 -13.3 kPa, OFF Low EtCO2 Alarm Limit 25 mmHg 3.2% 3.3 kPa 0 - 95 mmHg, OFF 0 - 12.5%, OFF 0 -12.
EtCO2 Accessories Table 2: LoFlo Sidestream CO2 Accessories Accessory REF LoFlo Module and Cable 8000-0367 Application Nasal CO2 Sampling Cannula, Adult 8000-0351 SPU, Nasal CO2 sampling only (adult) Nasal CO2 Sampling Cannula, Pediatric 8000-0352 SPU, Nasal CO2 sampling only (pediatric) Nasal CO2 Sampling Cannula, Infant 8000-0353 SPU, Nasal CO2 sampling only (neonate) Oral/Nasal CO2 Sampling Cannula, Adult 8000-0354 SPU, Oral/Nasal CO2 sampling only (adult) Oral/ Nasal CO2 Sampling Cannu
E Series - End Tidal Carbon Dioxide (EtCO2) Option Insert Messages and Troubleshooting The following three tables list the messages that may appear on the E Series unit, possible causes, and the action(s) to take if the message indicates a problem. You should become thoroughly familiar with this information before monitoring patients.
Messages and Troubleshooting COMMON MESSAGES (Continued) Message/Symptom Possible Cause(s) Recommended Action(s) ZERO DONE The sensor/adapter zero, or the LoFlo module zero is finished. No action required. ZERO FAILED The zero operation did not complete successfully. Clear the occlusion, remove any source of CO2, and try zeroing again. If problem persists, contact Technical Support.
E Series - End Tidal Carbon Dioxide (EtCO2) Option Insert SIDESTREAM MESSAGES Message/Symptom Possible Cause(s) Recommended Action(s) CHECK CO2 LINE Sample line blockage or damage. Verify that the sample line is plugged into the module and seated properly. Sample line is kinked or pinched. Exhaust tube is blocked. Verify that neither the sample line nor the exhaust tube are blocked, kinked, or pinched. Verify that the airway adapter is not blocked.
Specifications Specifications This section summarizes the specifications of the E Series End Tidal Carbon Dioxide (EtCO2) option. CAPNOSTAT 5® CO2 Sensor LoFlo™ Transducer Type Mainstream Sidestream Principle of Operation Non-Dispersive Infrared (NDIR) single beam optics, dual wavelength, no moving parts. Warm Up Time Full specifications within 2 minutes at an ambient temperature of 25º C. Capnogram in 15 seconds.
E Series - End Tidal Carbon Dioxide (EtCO2) Option Insert CAPNOSTAT 5® CO2 Sensor LoFlo™ Software Hazards Minimized by compliance with EN1441 Operating Time EtCO2 and SpO2 Options For a new fully charged PD4410 battery pack at 20º C (68° F): For a new, fully charged lithium ion battery pack at 20°C (68°F): • 35 defibrillator discharges at maximum • energy (200 J), or • 1.5 hours minimum of continuous ECG monitoring, or • 1.0 hour of continuous ECG monitoring/ pacing at 60 mA, 70 beats per minute.
