2-Lead ECG Monitoring October 2008 9650-1213-01 Rev.
The issue date or revision level for this operation guide is shown on the front cover. ZOLL and E Series are registered trademarks of ZOLL Medical Corporation. 12SL and MUSE are trademarks of General Electric Company. Copyright © 2008 by ZOLL Medical Corporation. All rights reserved.
12-LEAD ECG MONITORING General Information ECG leads are a defibrillation-protected Type CF patient connection. Product Description ZOLL E Series® with the 12-lead ECG Monitoring option provides simultaneous 12-lead ECG acquisition, storage, transmission, and optional ECG analysis using the GE Marquette™ 12SL™ ECG Analysis Program. The GE MUSE® interface allows direct transmission of 12-lead ECG records to a GE MUSE system.
E Series - 12 Lead ECG Monitoring Option Insert WARNINGS • Before use, carefully read the E Series Operator's Guide and these operating instructions. • Always ensure that the patient is kept motionless during 12-lead ECG signal acquisition and analyses. Use of the device to acquire ECG signals from moving or shaking patients may produce erroneous 12-lead interpretation results. • The E Series 12SL option is not intended for use with neonatal patients.
Electrode Placement Electrode Placement Depending on local usage, ECG lead wires are marked with certain labels. Refer to the following table for labels and color codes for the different lead sets.
E Series - 12 Lead ECG Monitoring Option Insert 3. Locate the second intercostal space on the patient’s right side, lateral to and just below the “Angle of Louis.” 4. Move your finger down two more intercostal spaces to the fourth intercostal space which is the V1 position. second waveform prior to entering 12-lead monitor mode, press the Wave 2 softkey. Note: When placing electrodes on female patients, always place leads V3-V6 under the breast rather than on the breast.
12-Lead Acquisition mode; see the E Series Configuration Guide for more information.) Note: When the E Series is turned off for more than 10 seconds, all settings are restored to their default settings. Lead Group Setting The E Series 12-Lead option allows any three ECG lead signals to be simultaneously printed on the stripchart recorder when using a 12-lead cable.
E Series - 12 Lead ECG Monitoring Option Insert Press the Dial Type softkey to toggle between both types of dialing modes. Press the Enter softkey to save the highlighted dial mode and return to the 12 Lead Monitor menu. If you want to return to the 12 Lead Monitor menu without saving the highlighted dial mode, press the Return softkey. PT Info Softkey Press the PT Info softkey to access the patient demographic information. Return Softkey to save the information).
12-Lead Reports • Print All — When this softkey is selected, the unit 1,%3 N3D &2 (&* ¾¾¾ ¾¾¾ 6S2 P P +J ,, [ • 55 • " $JH " • &DQFHO 5HWXU Q prints all stored 12-lead patient records on the strip chart. Print Record — When this softkey is selected, the unit prints the selected 12-lead patient record on the strip chart.
E Series - 12 Lead ECG Monitoring Option Insert 12-Lead ECG Waveforms CAUTION The 12SL analysis results can be affected by poor ECG data quality. If poor data quality is flagged by the system, the interpretation statements are preceded by the statement, “Poor data quality, interpretation may be adversely affected.” If this message prints, the analysis results may be invalid. Check for a LEADS OFF condition or other sources of noise, correct the condition, and re-acquire.
12-Lead Reports 2x6 Format (Fax Report Only) The 2x6 Format prints all 12-lead ECG data recorded during the first 5 second interval. The 2x6 format inhibits printing of the 12SL analysis and the lead II rhythm strip normally printed on the fax page. The stripchart always prints in the 4x3 format. Fax the 2x6 format immediately after acquisition. The 2x6 fax image is not stored in the patient records. You can, however, reproduce patient data in 4x3 format at a later time. 9650-1213-01 Rev.
E Series - 12 Lead ECG Monitoring Option Insert Patient Information DEVICE ID: 00000000000 RECORDED: 16:09:27 31 MAY 05 Normal sinus rhythm Normal ECG *** Unconfirmed *** PATIENT NAME : JOE SMITH PATIENT ID: 200505311609 PATIENT AGE: 60 PATIENT SEX: Male Vent. Rate : PR interval QRS Duration: 60 166 ms 82 ms QT/QTc 358 / 358 ms P-R-T axes 54 43 47 Measurements Matrix You can configure the unit to print out a measurements matrix, which consists of measurements for each segment of each lead.
Daily Operational Verification Reviewing an ECG ECG data can be viewed in three different ways: • ECG Strip — The unit displays a 12-lead strip with 10 seconds of ECG data, in four staggered 2.5 second segments. For more information, see “4x3 Format” on page 8. • Interpretation — The unit displays the results of interpretation of the ECG recording by the 12SL program. • Measurements — The unit displays measurements based on all 12 leads.
E Series - 12 Lead ECG Monitoring Option Insert Troubleshooting The troubleshooting section is intended to help you identify and correct problems that arise during operation. If trouble persists after consulting this information, contact the ZOLL Technical Service Department for problems relating to the E Series unit or GE Medical Systems Information for problems relating to the MUSE system.
Troubleshooting Symptom Unsuccessful transmission to MUSE. Recommended Action • • • • Check modem connection to E Series. Check modem connection to the phone jack or cellular phone. Power cycle cellular phone. Verify with the hospital system administrator that the MUSE system’s modem is operational. • Check the phone number and attempt to send again. If multiple MUSE phone numbers are configured, follow steps to attempt to transmit to an alternate number. • Check the telephone line (landline).
E Series - 12 Lead ECG Monitoring Option Insert Symptom FAX NO CARRIER or MUSE NO CARRIER message is displayed. Recommended Action Receiving phone line is not picking up or the sending modem is experiencing problems. The E Series automatically attempts to transmit until the transmission is successful or the E Series operator presses the Abort softkey. If retransmission fails: FAX NO DIAL TONE or MUSE NO DIAL TONE message is displayed. • • • Check the modem connection to the E Series unit.
Troubleshooting APPENDIX A: Modem and Phone Setup The E Series with 12-lead option may include a modem for transmitting 12-lead ECG information to remote locations via landline or cellular phone. This section describes how to connect your E Series for phone transmission. Modem • When included, the E Series with 12-lead option ships with a cellular-ready PC card modem (domestic units only) installed in the front PCMCIA slot on top of the unit. Note: Do not attempt to insert the modem into the rear slot.
E Series - 12 Lead ECG Monitoring Option Insert Operationally, there is no difference in the way MUSE transmissions are handled with the satellite phone versus the standard fax modem card and cell phone. You perform an Acquire or Select Patient Record operation, select a phone number, and press the Transmit softkey. However, you must understand the characteristics of satellite phone behavior. Transmissions must have an unobstructed line of sight to a satellite.
Phone Company Requests • The telephone number to which the device is connected. • The ringer equivalence number (REN) which is found on the FCC sticker attached to the modem. The REN determines how many devices may be connected to the same telephone line. If too many devices are attached, they may not ring properly. In most areas, the sum of the ringer equivalence numbers of all devices connected to the same line should not exceed five. The USOC telephone jack required (RJ-11, RJ-41, or RJ-45).
E Series - 12 Lead ECG Monitoring Option Insert Shielded Cables The use of any cable other than the shielded type will allow your system to emit more radio frequency interference than the FCC limits, thereby increasing the likelihood of interference. Therefore, in order to comply with the FCC regulations, it is necessary that you use good quality shielded cables with your installation.
E Series - 12 Lead ECG Monitoring Option Insert APPENDIX B: 12-Lead ECG Data Transmission to GE MUSE System The ZOLL E Series with 12-Lead and MUSE interface allows for direct transmission of 12-lead ECG records to a GE MUSE system. The MUSE system provides access to online patient ECG records and enables physicians to quickly view and compare prehospital and hospital 12-lead data.
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Phone Company Requests APPENDIX C: 12-Lead ECG Data Transmission The E Series unit can be configured to transmit 12-lead ECG records to a fax machine or a MUSE information system. For information about the MUSE system and prerequisites for its use, see “APPENDIX B: 12-Lead ECG Data Transmission to GE MUSE System” on page 19. In order to fax using the 2x6 format, set the 12 Lead Fax Format configuration option to 2x6, and the Auto Transmit After 12 Lead configuration option to Yes.
E Series - 12 Lead ECG Monitoring Option Insert Keypad on top, right side of unit. Commit Key When you have entered the phone number, select the Enter ( ) key from the keypad and press the Commit ( ) key on top of the unit to initiate dialing, or press the Dial softkey.
Phone Company Requests • In the event of a failure to transmit the ECG record, you are notified with a screen message and tones, and the E Series continues to retry the transmission until the operator aborts the transmission or the transmission is successful. See “Troubleshooting” on page 12 for possible transmission error messages and corrective actions.
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