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User's Guide HP CodeMaster 100 Portable Defibrillator/Monitor

1. Menu Ln F2 rs Fa Ls a w E R J eI Oot Ce A E lt D gt F3 87 mn o Oo Cel O Shit z amp x c e v B N1 m Shitt Can JG Fil Ci 12 Lead Keyboard and Display M2475 B0004 1 17 Figure 1 11 Getting Acquainted Operating Controls and Indicators Indicator Lights The HP CodeMaster 100 contains several status lights that illuminate to indicate the device status This topic provides details for each indicator Refer to Figures 1 11 and 1 12 Table 1 1 lists audible indicators CHARGE DONE Paddle Contact Indicator M2475 B0003 Indicator Lights Indicator Function Charge Done Indicates that the unit is charged and ready to use Sync Light indicates that the unit is in synchronized shock mode as opposed to defibrillator mode Flashes off each time an R wave is detected Paddle Contact Indicator PCI on the Sternum paddle indicates how well the paddles contact the patient 1 18 Getting Acquainted Operating Controls and Indicators Figure 1 12 Battery capacity gauge B U id X E Z A M2475 B0007 Quick change battery Battery Indicator Lights Indicator Function Battery Capacity Gauge After you press the button below the indicator the battery capacity gauge indicates t
2. CAUTION Maintenance CodeMaster 100 Cleaning the Electrodes and Cables Defibrillator pads are single use and do not require cleaning Monitoring electrodes are single use and do not require cleaning Clean the defibrillator paddles and handles the SpO2 sensors and leads and the ECG leads with a soft cloth moistened with a recommended disinfectant or cleaning agent from the following list Cidex amp Alcohol free hand soap 10 solution of Clorox in water may discolor cable Wring any excess moisture from the cloth before cleaning Remove all electrolyte medium from paddle surfaces and handles Do not clean the patient cable with alcohol Alcohol can cause the plastic to become brittle and may cause the cable to fail prematurely Do not autoclave the cable or use ultrasonic cleaners Do not immerse the patient cable Do not use abrasive materials to clean metal surfaces scratches on them can cause artifacts on the ECG Do not wet the connectors especially the 12 pin connector Inspect disposable electrode packaging and disposable defibrillator pads packaging for seal integrity and expiration date before use Cleaning the Carry Bag M3710A Remove all contents from the side pouches including the shorting bar HP part number M3710 80030 which is stored in a small pocket inside the left pouch Machine wash the carry bag in cold water with a mild detergent Do not use bleach or wring Line dry only
3. Maintenance CodeMaster 100 Maintaining the Defibrillator This section contains information about maintaining and cleaning the HP CodeMaster 100 Changing the Recorder Paper To change the recorder paper perform the following steps 1 Slidethe recorder door to the right of the defibrillator as shown Figure 13 1 The paper platen will tilt up 2 Pull up on the plastic removal tag to remove the empty or low paper roll M2475 12 Changing the Recorder Paper 3 Placea new roll of recorder paper HP 40457C D in the recorder so that the paper unrolls from the top of the roll and the grid faces down as it comes out of the recorder 4 Pull the end of the paper past the recorder platen 5 While holding the recorder door open to the right press the platen down over the paper 6 Allow the door to close over the platen roller Maintenance CodeMaster 100 7 Turn on the defibrillator and press Record to verify the paper is loaded properly Cleaning the Recorder Printhead If the ECG strip has light or varying density printing clean the printhead to remove any possible buildup of paper residue To clean the printhead perform the following steps 1 Slide the recorder door to the right of the defibrillator The paper platen will tilt up Remove the paper roll Clean the printhead surface above the brush with rubbing alcohol and a cotton swab Re install the paper roll While holding the recorder door o
4. User s Guide Including HP M2475B CodeMaster 100 Portable Defibrillator Monitor with 12 Lead ECG option HP M2480B Battery Support System HP M2478A DC Power Module HP M2479A AC Power Module HP CodeMaster 100 Portable Defibrillator Monitor HP Part No M2475 91980 Printed in USA February 1999 Edition 1 Notice Notice The information in this document is subject to change without notice Hewlett Packard makes no warranty of any kind on this material including but not limited to the implied warranties of merchantability and fitness for a particular purpose Hewlett Packard shall not be liable for errors contained herein or for incidental or consequential damages in connection with the furnishing performance or use of this material This document contains proprietary information which is protected by copyright All rights are reserved No part of this document may be photocopied reproduced or translated to another language without the prior written consent of Hewlett Packard Company Before using the HP CodeMaster 100 the battery support system or the power modules read this guide and become thoroughly familiar with the contents Responsibility of the Manufacturer Hewlett Packard only considers itself responsible for any effects on safety reliability and performance of the HP CodeMaster 100 the battery support system and the power modules if assembly operations extensions re adjustmen
5. Using the 12 Lead Option Using the 12 Lead Main Menu Managing Stored ECGs In this screen one or more Stored ECGs can be managed at a time Once selected ECGs can be Deleted Printed or Edited To print or edit a stored ECG Highlight the desired ECG by using the Arrow button on the keypad Once the ECG is highlighted choose the soft key function that you want for managing the ECG To print or delete one or more stored E CG s You can select more than one ECG at a time Simply highlight a desired ECG as above and then push the Select soft key to select that ECG Once an ECG has been selected a will appear next to it indicating that it has been selected Additional ECGs can be selected in the same manner After ECGs have been selected choose the soft key function that you want for managing the ECGs Manage Stored ECGs 2 ECGs Stored Screen 1 of 1 Name ID Time and Date Frank Smith ID 12345678 10 02 10 Apr 97 Charlotte Web ID 87654321 10 00 10 Apr 97 Sent Selected Edit Print Delet Select IDs Exit y 4 F1 F2 F3 F4 ES Using the 12 Lead Option Using the 12 Lead Main Menu Printing the Log of ECGs Stored A list of all Stored ECGs can be printed on the printer The printed ECG Log report includes the date time ID Patient Name and ECG report format Print the Configuration When you select this entry the system will print the current configuration Send Event Summar
6. 12 Lead ECG with Standard Adult Pediatric 6 20 Using the 12 Lead Option Setting Up the Printed Report Changing the Layout and Content of the Printed Reports The default format is set through the Configuration Menu You can change the format and size gain through the ECG main screen To change the report lead format l Press Stop 2 Usethe F2 softkey to toggle through the available formats Press F4 to change the size The ECG Report Figure 6 4 shows a sample report with all the fields identified in Table 6 5 Note that some fields must be selected in order to properly interpret analyze the acquired ECG Figure 6 4 illustrates a two page report Using the 12 Lead Option Setting Up the Printed Report Figure 6 4 23456 Hewlett Packard CodeMaster iS pue TRA FSI Mess sel Ha LH bo 1 eee el i P E iuo onagni uf 3EORDEI 04 Be p 1998 Beas Harrison Dan E CodeMaster up ient STkg pi pmp BE E39 99 95min imqe T xircumpiajnt Diabetey amt hyper igasiop T 2 i i i i i THM RATE 45 a psf rete ime DEGREE AV iBLDCK fate 317 91 L Lod Custom Field One JURY P i T B5mv virvs i aM 1 NN WIE Si m a f E 1 Uiisch Wield 5 H i a beast i 2 i cu uy i pb
7. 13 10 Maintenance CodeMaster 100 Cleaning Exterior Surfaces on the AC and DC Power Modules The Power Module should be kept clean and free of dust The module is chemically resistant to common hospital cleaning solutions and non caustic detergents The following list includes some approved cleaning solutions e 90 Isopropyl alcohol e Soap and water e Chlorine bleach 30 ml l water When cleaning the Power Module Do not allow fluids to penetrate the instrument case avoid pouring fluid on the unit Do not use abrasive cleaners or strong solvents such as acetone or ace tone based compounds Maintaining the Battery Use only the HP M2480B battery support system to charge HP M2476B M 2477B battery packs You should also use only the HP M2480B battery support system to discharge recondition and perform a capacity test on these batteries It is recommended that you charge batteries at room temperature 10 30 C Be sure to alternate batteries between the HP CodeMaster 100 and the battery support system Install a freshly charged battery pack in the HP CodeMaster 100 whenever the unit displays the warning message LOW BATTERY Return the depleted battery pack to the battery support system to be charged Perform the capacity test on each battery every 90 days or when the battery support system indicates a capacity test should be performed If capacity test fails remove the battery pack from service Use batteries reg
8. If the patient does not meet the HP TPI criteria the HP CodeMaster 100 will printthe standard interpretation report in place of the HP TPI report For HP TPI criteria refer to the HP Predicti vel nstruments Physi ci an s Gui de Using the 12 Lead Option Setting Up the Printed Report Making Additional Printed Copies of the ECG Reports If you require additional copies of an ECG you may print a copy of the last ECG that was recorded To print a copy of the ECG just acquired press the Copy key The message Printing is displayed and the copy is printed Setting Up the Printed Report This section describes the ECG report Note that a physician must review the preliminary report Like any computer assisted ECG interpretation program the Hewlett Packard predictive instrument evaluation is not a substitute for the physician s decision process Just as cardiologists may disagree on ECG interpretations they may also at times disagree with an interpretation given by the HP predictive instruments evaluation Configuring the Contents of the Report The 12 Lead option prints a report that can include a summary of all 12 leads interpretation statements and measurements See Table 6 5 Select the report type through the Setup Miscellaneous selection on the Configuration Menu The reports that are available include 12 Lead ECG 12 Lead ECG with HP ACI TIPI 12 Lead ECG with HP TPI 12 Lead ECG with Measurements only
9. No electrode adapter attached Paddles attached Internal paddles attached PADS OFF Electrode adapter cable is attached and an Attach electrode for pacing electrode is not connected ATTACH Electrode adapter cable is attached Attach the pacer electrode PADS Charge is pressed and electrodes are not attached Start Stop is pressed and elec trodes are not attached 12 5 Table 12 4 Troubleshooting CodeMaster 100 Troubleshooting SpO Sp0 Messages Message Cause SPO2 FAILUR Lj The unit detected a failure in Sp0 subsystem hardware This failure does not affect other parts of the instrument Possible Solutions Press SpO On Off twice to power cycle SpO If the error hap pens again call for service SPO2 SENSOR FAIL The sensor or adapter cable is broken Replace the sensor or adapter cable SPO2 CABLE OFF Sensor or cable is disconnected Check Sp0 connections between HP CodeMaster 100 portable defibrillator monitor and the sensor cable or adapter cable Dashes appear on display instead of Sp reading Can t derive measurement because The sensor is not on the patient No pulse is detected The sensor is incorrectly positioned The sensor is defective Check the patient for a pulse Reapply the sensor and make sure it is correctly positioned If it doesn t work replace the sensor SPO2 NOISY Irregular pulse patterns
10. Table 5 5 Monitoring Using Leads to Monitor 5 Wire Patient Cable 10 Wire Patient Cable Table 5 4 describes a typical lead wire placement using the 5 wire or 10 wire patient cable Table 5 5 shows how the individual leads are formed using the individual leadwires Electrode Placement Electrode Placement RA White Near right midclavicular line directly below clavicle LA Black Near left midclavicular line directly below clavicle LL Red Below the left pectoral muscle on the left midclavicular line RL Green Below the right pectoral muscle on the right midclavicular line V Brown As appropriate for the V lead to be monitored V1 V6 Note that for the 10 wire Lead Definitions patient cable all V Vg leads are monitored on the 12 Lead display and that the CRT only displays V4 Lead Lead Formation l LA RA Il LL RA Ill LL LA aVR LA LL RA 5 aVF E RA LA LL 5 aVL RA LL LA 5 V V RA 7 LL 5 4 NOTE WARNING Monitoring Preparing the Patient Preparing the Patient Proper application and placement of electrodes is essential for quality ECG monitoring Good contact between the electrode and the skin reduces the effects of motion artifact and signal interference 1 If necessary shave hair from the site to ensure good electrode to skin contact 2 Clean and abrade the skin then wipe it dry You can safely monitor a patient duri
11. Urea i i Uncont roied diagnosis accRBRWS olie dune 4254546789 25 mmis t im mV DEIN TEUIEUM MM Q P 0 The ECG Report 6 22 Table 6 5 Using the 12 Lead Option Setting Up the Printed Report Report Annotations Description ID number Sex Age Patient Name Height Weight Systolic Diastolic Blood Pressure BP Custom Field One Custom Field Two Note These fields are for user defined labels such as insurance number or medications Requested by the name of the requesting physician Basic measurements See Table 6 6 Interpretation Reasons Calibration signal See Table 6 7 Filter settings Artifact filter F AC Filter Frequency response Baseline Wander filter W settings for speed and for limb and chest lead sensitivity Location code and12 Lead ID number Chest Pain Status Acute Ischemic Sx Time History Hypertension History Diabetes Name of Institution 6 23 Table 6 6 Using the 12 Lead Option Setting Up the Printed Report Basic Measurements The basic measurements table gives standard interval and duration measurements in milliseconds and limb lead axis measurements in degrees These are representative values for the dominant beat pattern in the ECG Basic Measurements Item Description Units RATE Heart rate beats per minute PR PR interval millise
12. 8 3 READY indicator 13 14 receiving devices 10 2 recharging time of battery 1 24 reconditioning battery 13 15 record on Alarms 2 12 5 11 on Charge 2 12 5 11 10 3 10 7 on Mark 2 12 5 11 10 3 10 7 on Shock 2 12 5 11 10 3 10 7 recorder automatic recordings 5 11 bandwidth 2 12 10 3 10 4 cleaning printhead 13 8 delay 2 12 2 13 10 3 errors 5 13 opening door 13 7 operating controls 1 9 output 5 10 paper loading 13 7 post shock data 5 12 specifications 14 5 recording 5 10 to 5 13 ECG 6 8 report format changing 6 21 report formats 2 17 resetting selected energy level 3 4 RESTORE FACTORY SETTINGS 2 8 2 9 reviewing E vent Summary 4 17 reviewing ID 6 15 rhythm leads Auto ECG 2 17 RJ 1lconnection 10 7 routine testing 13 1 R wave detection 1 20 4 5 7 1 S safety 6 6 Sap 9 1 selecting energy 3 1 selecting the ECG source for monitoring 5 8 semi automatic external defibrillation 4 1 6 1 11 1 service manual 12 12 13 6 setup 2 7 to 2 12 SETUP LOST 2 7 12 2 SETUP MENU 1 2 8 2 11 SETUP MENU 2 2 8 setup menus Advisory mode 4 20 setup menus configuring with 2 12 setup mode 2 9 setup diagnostic menu 2 9 shift checks 13 1 shock b defibr uttons Index illating with during pacing 8 7 defibrillating with using external adhesive pads 3 8 defibrillating with using paddles 3 4 disarming defibrillator 1 21 performing synchronized cardioversion using
13. Charge the battery completely before replacing it in the HP CodeMaster 100 portable defibrillator monitor Because it is not always possible to fully charge a battery pack you can use the HP CodeMaster 100 with a partially charged battery pack You may store the battery pack at temperatures from 30 C to 50 C If storage will last longer than three months store it below 35 C for optimal performance 13 12 NOTE WARNING Maintenance CodeMaster 100 A new HP M2477B 4 0 amp hour battery will provide 75 360 joule charge shock cycles or a minimum of 3 hours of monitoring time Replace the battery when it fails to provide the minimum3 hours of monitoring time or 10 minutes of Low Battery warning time starting from a fully charged battery Properly dispose of depleted batteries according to local regulations Do not disassemble puncture or incinerate the disposed batteries Be careful not to short the battery terminals because this can cause a fire hazard New Batteries To assure optimal performance of a new battery all newly purchased batteries should be capacity tested in the M2480B charger prior to being put into service Accomplish this by placing the battery in the charger and performing the Battery Capacity Test on page 13 15 Battery Life Recommended battery pack replacement After two years of service After failure of battery capacity test Replace the battery only with one of the battery pac
14. Continued Cause Possible Solutions Poor electrode contact Dry electrodes Clean the electrode site Reapply electrodes Check expiration date on disposable electrodes Faulty lead wires Replace faulty patient cable After powering on the unit or during normal operation the message Attach the HP 12 Lead ECG cable to take a 12 Lead displays The cable isn t properly connected Attach the 12 Lead cable to the device Table 12 8 Problem After acquiring an ECG the associated report does not print Identifying Recorder Problems The following table shows symptoms and solutions to problems that can occur when the recorder will not start Recorder Problems and Solutions Cause Possible Solutions The recorder or paper is out and the message Load the paper and check recorder door Check recorder displays If you continue to have problems with the 12 Lead option call your local Hewlett Packard service representative see Service on page 12 21 12 15 Table 12 9 Troubleshooting The 12 Lead Option Sampling Characteristics of the 12 Lead Option Physiological factors such as breathing can cause variation in amplitudes of heart beats independent of the heart rate In addition sampled systems as opposed to continuous systems may show changes in the apparent height of the R wave when sampling of the R wave occurs slightly off peak Because the sampling rate and the heart rate are asynchronous the t
15. ECG Manager Receiving Station and Gateway Destination Fax Machine HP PageWriter 200 200i 300pi amp XLi HP ECG TraceMaster ECG Manager System Fax Machine Laser or Inkjet Printer HP TraceMaster ECG Manager System 10 3 Transmitting Data from the 12 Lead Option Using Landline Communications Table 10 2 lists the direct communications capabilities via the RS 232 cable HP recommends that you replace the serial cable on a regular basis based on used rate or at any time communications problems arise through the RS232 port especially for units used outside of North America and the UK Table 10 2 Direct CommunicationsCcapabilities Sent From Via Destination HP CodeMaster 100 12 Lead Direct Cable HP PageWriter 200 200i 300pi amp XLi HP CodeMaster 100 12 Lead Direct Cable HP TraceMaster ECG Manager System NOTE The internal modem will not work with a digital phone system or a digital Public Branch Exchange PBX Figure 10 2 illustrates a standard landline connection using the internal modem Figure 10 3 shows the HP CodeMaster 100 connecting to a landline connection using an external modem 10 4 Transmitting Data from the 12 Lead Option Using Landline Communications Figure 10 2 Transmit Standard Receiving Site Phone System Personal Computer running ECG Manager Ea Example 1 M1765A or Event Summary Host Example 2 gt Fax Machine Internal Modem z
16. Remote site stopped communi cation nn Press any key to continue Cannot send to a TraceMaster AIB PageWriter 200 300 or PageWriter XLi using a cellular line without the use of a Gate way Communication speed of the remote device does not match that of the 12 Lead or remote site modem malfunction Sending ECGs to these receiver types over a cellular line requires the use of a Gateway Call the remote location to verify that the communication speed is correct and that the modem is functioning correctly Reduce the communication speed of both the 12 Lead and remote site modems Configure the Gateway phone number with the number of your Gateway Change the line type on the home screen to Tone or Pulse and use a land landline 12 18 Table 12 10 Transmission Problems and Solutions Continued Message The ECG Manager gateway can only receive one ECG The first ECG has been successfully sent Sales Likely Cause The Gateway is limited to receiving one auto forwarded ECG Troubleshooting Sales Possible Solutions Select one ECG at a time for transmission from the Send ECGs screen For the HP sales office nearest to you please refer to your local phone book or call your HP regional office 12 19 Troubleshooting Sales United States of America Hewlett Packard Company Medical Products Group Headquarters 3000 Minuteman Road Andover Massachusetts 01810 Medical Cus
17. and fixed asynchronous pacing modes The patient is connected to the pacer by multifunction defib electrodes The patient can be paced and defibrillated through the same set of electrodes 8 1 WARNING Pacing Pacer Operating Controls Pacer Operating Controls The pacer operating controls on the HP CodeMaster 100 are detailed in Pacer Operating Controls on page 1 11 While pacing avoid touching the gelled area of the multifunction defib electrodes or the patient to prevent electrical shock Use only Hewlett Packard recommended electrodes with the external pacer The HP CodeMaster 100 delivers pacer pulses through a low impedance multifunction defib electrode The HP CodeMaster 100 does not pace effectively with high impedance pace only electrodes Do not use the same defib electrodes for more than eight hours of continuous pacing Using the Pacer To use the pacer perform the following steps 1 Apply the multifunction defib electrodes as instructed on the package 2 Attach the ECG monitoring electrodes as instructed in Preparing the Leads for Monitoring on page 5 3 3 Attach the patient cable to the ECG Input connector of the HP CodeMaster 100 4 Attach the patient cable leads to the ECG monitoring electrodes 5 Attach the electrode adapter cable M2472A to the defibrillator output connec tor Pull the latch connector toward the front of the defibrillator to lock the con nector in place
18. control to Off Disarming the Defibrillator There are three ways to disarm a charged instrument Turning the E nergy Select control from an energy level setting to the Monitor On position Placing the paddles in their holders and depressing both shock 4 buttons simultaneously Waiting for the instrument to automatically disarm The unit disarms auto matically after it has been left charged for 60 seconds in the Manual mode and after 30 seconds in the Advisory Mode Do not leave the instrument turned on when it is not in use Do not discharge the defibrillator with the paddles shorted together which can cause burning and pitting of the metal paddle contacts Disconnect any other medical electronic equipment from the patient during defibrillation unless labeled as defibrillator protected 4 Q9 p 4 A P WARNING Getting Acquainted Safety Considerations Avoid open paddle discharges Dangerous high voltage exists on the paddles when the defibrillator is discharged Contact with this high voltage could cause death or serious injury Avoid touching any metal surfaces on the instrument during discharge Avoid connecting the patient to several devices at once because leakage current limits may be exceeded Never touch the bed gurney the patient or any equipment connected to the patient during defibrillation Keep the HP CodeMaster 100 and the immediate area clean and dry at all times
19. dashed line on display 2 5 5 8 date 2 11 decreasing selected energy level 3 4 DEFIB DISARMED 122 124 DEFIB FAILURE 12 1 defibrillating during pacing 8 7 pediatric 3 6 with alternate paddle sets 3 6 with external adhesive pads 3 7 defibrillator charging 3 3 controls 4 11 4 14 maintenance 13 7 not charging 12 3 not shocking 12 4 operating controls 1 4 1 5 restoring after use 4 15 7 8 defibrillator protection v DEMAND MODE 8 3 demand mode pacing 8 3 8 4 diagnostic mode 2 9 diagnostics 12 11 disarming defibrillator 1 21 3 4 display adjusting contrast 2 14 display lead groups 6 12 disposable electrodes attaching 5 5 disposal battery 13 13 E ECG checking quality 6 12 improving quality 6 12 quality 6 11 6 12 recording 6 8 ECG gain mode 12 11 ECG input connecting to defibrillator 2 6 connecting to external monitor 7 2 connector 2 4 ECG output 5 14 ECG problems AC interference 12 14 identifying 12 14 12 15 intermittent waveform 12 15 jittery waveform 12 15 muscle artifact 12 14 respiratory interference 12 14 tremor 12 14 ECG size adjusting 5 8 ECG source automatic analysis 4 4 ECG strip light printing 13 8 ECG trace 2 12 electrode part numbers 5 2 energy delivered advisory mode 4 13 energy select power control using 3 1 entering patient ID 6 14 ES message 1 10 5 12 Event Summary Advisory mode 4 16 printing 4 16 reviewin
20. press the 12 Lead key the system displays the HP ACI TIPI Data Entry screen as follows ACI TIPI Data Entry ID Name Year of Birth Sex Chest LA pain Blood Pressure Erase Exit This screen only appears if you have not pressed the ID key and entered all necessary fields required for HP ACI TIPI The system acquires the ECG and prints a report with the HP ACI TIPI probability 6 18 NOTE Using the 12 Lead Option Acquiring a 12 Lead ECG Using HP TPI The 12 Lead option includes the HP Thrombolytic Predictive Instrument TPI This feature is used to identify patients having acute myocardial infarction AMI who might benefit from thrombolytic therapy Patient age gender time since ischemic symptom onset history of diabetes history of hypertension blood pressure and ECG features are used to predict patient outcome probabilities If you have configured HP TPI as your interpretation option when you press the 12 Lead key the system displays the HP TPI Data Entry screen as follows TPI Data Entry ID Name year of Birth Sex Chest LA pain Time Since Acute Ischemic Sx Min History of Diabetes History of Hypertension Blood Pressure Erase Exit p This screen only appears if you have not pressed the ID key and entered all necessary fields required for HP TPI The system acquires the ECG and prints a report with the HP TPI probability
21. 100 Refer to Monitor Operating Controls on page 1 7 To monitor a patient s ECG with the HP CodeMaster 100 perform these steps 1 Prepare the patient for ECG monitoring as described in Preparing the Patient on page 5 5 2 Turnthe Energy Select control to the Monitor On position 3 Press Lead Select to select the ECG source The selected source appears in the upper right corner of the display For example PADS appears on the display when it has been selected If the message LEADS OFF Or PADS OFF appears on the display inspect the electrodes patient cable leadwires and associated connections If the selected ECG source is not connected a dashed line replaces the normal ECG trace 4 Ensure that the ECG size has been automatically adjusted for optimal size If you wish to reduce the ECG size press ECG Size The gain bar along the left side of the display represents 1 mV of signal amplitude Autogain allows an initial quick setup when the HP CodeMaster 100 is turned on to automatically size the ECG based on the signal from the patient To turn off Autogain press E CG Size You then must adjustthe ECG size manually It is recommended that you manually adjust the gain during routine patient monitoring 5 Adjust the QRS beeper volume using v ORSA 4 to the desired volume 5 8 NOTE Monitoring Heart Rate Alarms Heart Rate Alarms The HP CodeMaster 100 provides three confi
22. 500 hPa Transport and storage 40 C to 70 C 10 to 100 relative humidity including condensation 15000 ft altitude 500 hPa 14 11 Specifications HP M2479A AC External Power Module HP M2479A AC External Power Module For use only with CodeMaster 100 Defibrillator Monitor Size 3 625 in H by 8 375 in W by 9 0 in D 9 21 cm H by 21 3 cm W by 22 9 cm D Weight 4 0 Ib 1 8 kg Input cable 6 6 ft 2 0 m Output cable 4 0 ft 1 2 m Input 100 240 V AC 75 A 75 VA 2 75 A 275 VA maximum Output Battery charging 12 V DC 1 0 A 12 W 90 0 mA 1 1 W trickle CodeMaster 100 operation 15 V DC 1 0 A 15 W 7 A 105 W maximum Charge time With defibrillator monitor turned to Off Standby typically four hours HP M2476B 2 5 Ah Battery typically six hours HP M2477B 4 0 Ah Battery Recommended charging temperature 10 C to 30 C Environmental operating conditions 0 C to 55 C 5 to 90 relative humidity non condensing 15000 ft altitude 500 hPa Transport and storage 40 C to 70 C 10 to 10096 relative humidity including condensation 15000 ft altitude 500 hPa Equipment classification Classification with respect to protection from electric shock Class 1 Degree of protection against ingress of liquids IPX0 Equipment not suitable for use in the presence of a flammable anesthetic mixture with air or with nitrous oxide Mode of operation Continuous battery charging a
23. Definitions The following symbols appear on the HP CodeMaster 100 gt gt Ik Oo O gt EI yp ag Oct Monitor On Do not confuse with 1 Joule Off Standby On Off Ground Shock hazard Caution See operating instructions in user s guide Meets IEC type BF leakage current requirements and is defibrillator protected Patient Applied Part is isolated and defib proof suitable for direct patient contact except the heart or major arteries Meets IEC type CF leakage current requirements and is defibrillator protected Patient Applied Part is isolated and defib proof suitable for direct patient contact including the heart and major arteries Equipotential Protective earth ground Nickel Cadmium rechargeable battery Must be recycled or disposed of properly Recyclable material Audible tone Alarms are active Alarms are inactive Symbol Definitions The following symbols appear on the HP M2480B battery support system Do not use in the presence of flammable anesthetics or in oxygen rich environments AC AC power on Start battery capacity test ry Battery charging Battery capacity test Q Additional information The following symbols appear on the HP M2478A DC power module Power Battery charging EJ DC power Input Output uS Caution See operating instructions The following symbols appear on the HP M2479A AC power module U Attenti
24. ECGs directly to standard fax machines Transmitting directly to a fax machine does not require a special receiving station however transmitting ECGs direct to a fax machine has the following considerations and limitations lengthens transmission time cannot forward ECGs to HP TraceMaster unable to store and retrieve ECGs elsewhere is likely to be used for other business purposes If the FAX machine is used for other business purposes this increases the risk that it will be busy when emergency medical personnel are attempting to transmit an ECG 10 2 Transmitting Data from the 12 Lead Option Using Landline Communications Using Landline Communications You can attach the CodeMaster 100 with the 12 Lead option to most landline RJ11C connectors regular phone jack using either the internal modem or a Hayes compatible external modem Note that the RJ11C cable running from the CodeMaster 100 that attaches to the phone jack is a standard phone cable and not provided with the HP CodeMaster 100 Table 10 1 lists the landline communications capabilities Table 10 1 Landline Communications Capabilities Sent From HP CodeMaster 100 12 Lead HP CodeMaster 100 12 Lead HP CodeMaster 100 12 Lead HP CodeMaster 100 12 Lead HP CodeMaster 100 12 Lead HP CodeMaster 100 12 Lead Via Directly with Landline Directly Directly ECG Manager Receiving Station and Gateway ECG Manager Receiving Station and Gateway
25. External Power Module Indicators External Power Module Indicators m2478 00 11 4 CAUTION Figure 11 3 Connect the black wire to ground and the red wire to 12 Volts Using Auxiliary Power Using the DC External Power Module Installing the External DC Power Module You must be a qualified mechanic or electrician to install the power module If the cable provided for input to the External Power Module is not long enough make sure that you use 14 gauge or larger wire to extend the cable Incorrect polarity connection will cause fuse to open External Power Module 12 V Supply Connection of External Power Module The External Power Module can be connected to any 12 Volt negative ground source The circuit which supplies power to the external power module should be protected by a fuse between 10 amps and 20 amps This allows sufficient power to operate the External Power Module and still provides electrical protection in case of faulty or defective wiring to the External Power Module The power module attempts to draw power from the vehicle 12 Volt system whenever the defibrillator monitor is on and whenever the defibrillator monitor battery is charging If you do not want power drawn from the vehicle when the vehicle is not running then install the External Power Module so that it is electrically disconnected when the vehicle is off Using Auxiliary Power Using th
26. M 1765A Using the 12 Lead Option 12 Lead Keyboard and Display 12 Lead Keyboard and Display This section discusses the 12 Lead keyboard and provides detailed descriptions of all the function keys Refer to Figure 6 1for an illustration of the 12 Lead keyboard 62 Using the 12 Lead Option 12 Lead Keyboard and Display Figure 6 1 f QN _ JU Menu Ft F2 F3 Fa Fs 6 w 8 GJ3 0 0 30 606 ce eeg D 3S 6 amp 3 F3 2 amp 3 G3 9 J cJ 36 3 Shit z amp x c e v B N M Shift G s 3 q Car ey Finer Cony V J M2475 B0004 12 Lead Keyboard and Front Panel Using the 12 Lead Option 12 Lead Keyboard and Display Table 6 1 12 Lead Keyboard Key Menu Description Displays the Main menu unless an ECG report is in process Use the STOP key to return to the home screen on the 12 Lead display softkeys These five keys F1 F5 located directly beneath the display window perform different functions at different times They are called softkeys When a softkey is active a label describing its function is displayed above it on the screen Press the key to perform the function displayed on the screen Shift Used to enter shifted characters Alt To enter the characters shown above the letter
27. On to monitor while using the Power Module Power for monitoring comes from the Power Module and does not deplete the defibrillator monitor battery Charging the Battery with an Auxiliary Power Module If the battery is not already charged and it is at operating temperature it will charge whenever you plug the external power module into the defibrillator The charging indicator on the external power module appears when the battery is charging The indicator may disappear briefly after you turn the defibrillator off When you charge the defibrillator the battery does not charge so the indicator disappears until the defibrillator is charged The Power Module charges the battery more quickly if the defibrillator is in Off mode If you turn the Energy Select Power Control to Monitor On or to an energy level the battery still charges but not as quickly The battery charges more slowly when the temperature is below 5 C 41 F or above 40 C 104 F The battery does not charge at temperatures above 60 C 140 F Repeated charging at very high or very low temperatures may shorten the life of your battery The Power Module charges only the HP M2476B and HP M2477B batteries Use it only with the HP CodeMaster 100 CAUTION NOTE Using Auxiliary Power Defibrillating with External Power The Power Module does not replace the HP M2480B Battery Support System If you regularly charge batteries with the Power Module perf
28. RJ11C a i HP TraceMaster Landline Connection ECG Management CodeMaster 100 with 12 Lead Option Example 3 i HP PageWriter XLi EN Cardiograph M1700A p D Example 4 NCC Standard Landline Connection Internal Modem 10 5 Transmitting Data from the 12 Lead Option Using Landline Communications Figure 10 3 Transmit Standard Receiving Site Phone System l Personal Computer running ECG Manager Example 1 p FE M17654A or Event Summary Host Landline Connection Example 2 Fax Machine CodeMaster 100 with External Modem with 12 Lead Option RS232 Port B I HP TraceMaster External RJ1C ECG Management Modem Example 3 HP PageWriter XLi Cardiograph M1700A Example 4 Standard Landline Connection External Modem 10 6 Transmitting Data from the 12 Lead Option Using Cellular Communications Using Cellular Communications Transmitting from the CodeMaster 100 with the 12 Lead option using a portable cellular phone has several advantages can be used in EMS vehicles or outdoors can be used when there is no convenient access to a phone jack Table 10 3 lists
29. Time Less than 5 seconds to 360 joules with a fully charged battery installed Time required to charge fully discharged energy storage device to maximum energy 360 joules Armed Indicators Charge done tone charge done lamp on apex paddle and available energy indicated on display Paddle Contact Indicator 3 color LED bar graph array on STERNUM paddle indicates quality of defibrillator paddle contact before discharge Paddles Standard paddles are water resistant anterior anterior adult and pediatric with PCI Contact indicator External paddles are water resistant Adult electrodes 83 cm sq slide off to expose pediatric electrodes 21 cm sq Paddle cord is 10 ft 3 m Full range of internal paddles available Synchronizer SYNC message appears on monitor and is annotated periodically on recorder while in synchronous mode An audible beep sounds with each detected R wave while a marker on the monitor and sync designator on the recorder strip indicate the discharge point Environmental Operating Conditions 0 to 55 C 15 to 9596 relative humidity noncondensing for 24 hours at 40 C 15 000 ft altitude Readability of the 12 Lead display may be degraded outside the range of 0 to 40 C Environmental Storage Conditions 20 to 70 C 90 relative humidity noncondensing for 24 hours at 65 C 15 000 ft altitude See also Battery Storage Specification 14 1 NOTE Specifications Defibrillator Monitor Equipment
30. Use F3 to change a field Configurable Report Characteristics Parameter Choices Comments Lead Format Standard Cabrera 12 Lead Report Format 3x4 3x4 1R 3x4 3R Custom Rhythm Leads for 3x4 1R 3x4 3R Custom 3 M Ill aVR aVL aVF V1 C1 V2IC2 V3 C3 VAIC4 V5 C5 V6IC6 M IIl aVR aVL aVF V1 C1 V2IC2 V3 C3 V4 C4 V5 C5 V6 C6 Select any lead Select any V three leads Phone Line Tone Pulse Direct Cell a Default values are shown in boldface type 2 17 Setup and Configuration Configuring the 12 Lead Option Setup 12 Lead Settings Lead Format 12 Lead Report Format Custom Rhythm Leads for 3x4 1R 3x4 3R Manual 3 Phone Line Change Format Standard 3x4 T TI aVF V2 Tone Exit F1 F2 F3 F4 F5 2 18 Setup and Configuration Configuring the 12 Lead Option Setting Up Filters From the Configuration Menu select Setup ECG Filters The 12 Lead option has been factory configured with the filter settings which remove the most noise from the ECG In addition to the default settings 12 Lead offers a choice of several filter configurations These filter settings are detailed below and in Table 2 5 Setup ECG Filters 12 Lead Report Filters Wander Filter JB Noise Filter 40 Hz Front Panel Filter Key Muscle Artifact Filter Yes 40 Hz Noise Filter Yes 0 5 Hz Wander Filter Yes Change Va
31. a Allow the recorder to run for approximately 20 seconds and check that Date Time HR heart rate Sp0 PADDLES ECG source and AUTOGAIN ECG gain mode are noted on the ECG strip b Press Mark and verify that the mark w symbol is printed It will be delayed 6 seconds if the recorder is in the delayed mode c Press Record to stop the recorder Press HR Alarm Verify that the configured alarm limits appear briefly then are replaced by the bell symbol in the upper right of the display With no ECG signal an audible alarm tone should sound within four seconds Press HR Alarm to turn off the alarms Verify that the adult paddle electrodes are installed Turn the E nergy Select control to 100 joules Leaving the paddles in their holders press the Charge on front panel or on the right Apex paddle e The Charge Done indicators should occur within two seconds when oper ated with a fully charged battery e The Delivered Energy display should indicate 100 joules 1211 Troubleshooting CodeMaster 100 WARNING Keep hands clear of the paddle electrode edges Use your thumbs to depress the Shock buttons on the paddle handles 10 Grasp the paddle handles and without removing the paddles from their holders press both Shock buttons simultaneously A brief automatic recorder run prints the delivered energy test report 11 Press Sync to placethe instrument in Sync mode 12 Verify that the messages Sy
32. an Advisory Event Summary to simplify documentation The 12 lead ECG option allows users to acquire store and transmit 12 lead ECGs for help with early detection of acute cardiac ischemia acute myocardial infarction and other arrhythmias The HP CodeMaster 100 is used as an advanced defibrillator monitor in the pre hospital arena and as a transport defibrillator in the hospital environment It can be used with adult paddles pediatric paddles and multi function defib electrodes Multi function defib electrodes allow the user to pace monitor and defibrillate from the same electrodes Theory of Defibrillator Operation Defibrillation is a recognized means of terminating certain potentially fatal arrhythmias such as ventricular fibrillation and symptomatic ventricular tachycardia A direct current defibrillator applies a brief high energy pulse of electricity to the heart muscle up to 360 joules The HP CodeMaster 100 delivers this energy through multi function defib electrodes or paddles applied to the patient s chest Delivery of this energy in the synchronized mode is useful in treating supraventricular tachycardia atrial fibrillation atrial flutter and in relatively stable patients ventricular tachycardia viii Preface Intended Use The HP CodeMaster 100 is for use by emergency care personnel specifically trained in the operation of the device and qualified by training in advanced cardiac life support basic life support
33. available choices for this parameter 7 Press Lead Select to set your selection 8 Press ECG Size until the highlight appears on the next value you wish to change 2 8 WARNING Setup and Configuration Configuring the CodeMaster 100 9 Repeat steps 5 through 8 until you are finished configuring the settings in Setup Menu 1 10 Depress both sides of the ECG Size key simultaneously to return to the Setup Diagnostic Menu 11 To change settings in Setup Menu 2 select SETUP MENU 2 from the Setup Diagnostic Menu and repeat the above steps 12 Turn the Energy Select control to Off to exit Setup Diagnostic mode Restoring Factory Settings You can use the factory setting for most values by selecting RESTORE FACTORY SETTINGS from the Setup Diagnostic Menu Highlighting and selecting this setting does NOT bring up an additional menu Selecting this line will undo user configured parameters and restore factory defaults This process restores factory settings on the defibrillator monitor and not on the 12 Lead option HP recommends that you not use the 12 Lead option to acquire view store print or transmit when in Diagnostic Mode as the ECG may be lost and the 12 Lead capability may be reset 2 9 Example Setup and Configuration Configuring the CodeMaster 100 To set the time on the CodeMaster 100 1 10 11 12 13 Press Sync and HR Alarm at the same time while turning the Energy Se
34. first press Record to stop the recorder then press Review See Printing the Event Summary Record on page 5 12 for more information Getting Acquainted Operating Controls and Indicators Pacer Operating Controls This section details the pacer operating controls associated with pacing Refer to Figure 1 7 Figure 1 7 Pacer On lt gt Rate 4 Start Mode Stop lt Output SpO2 e ECG Input J M2475 B0005 Pacer Operating Controls NOTE Getting Acquainted Operating Controls and Indicators Control Button Function Pacer On Provides setup functionality Rate Adjusts the pacer rate ppm higher or lower Start Stop Starts and stops pacing Output Adjusts the pacer output current mA up or down Mode Changes between fixed and demand pacing modes Pacing does not start until you press Start Stop Pressing Pacer On enables the pacer setup function but does not start pacing Refer to Chapter 8 Pacing for more information about using the pacer Getting Acquainted Operating Controls and Indicators SpO Operating Controls This topic details the SpO operating controls associated with the SpO feature on the HP CodeMaster 100 Refer to Figure 1 8 Figure 1 8 9 ons o SpO2 SpO2 Sei Alarm SpO2 e ECG Input A Sp05 Con
35. full energy discharges or 1 75 hours combined ECG and SpO2 monitoring while pacing M2475B with the 12 Lead Option 2500 mAH 2 0 hours ECG monitoring or 50 full energy discharges or 1 5 hours combined ECG and SpO2 monitoring while pacing Battery Indicators LOW BATTERY warning message appears on the monitor when approximately 30 minutes of battery capacity remains Battery dimensions 3 35 in H by 2 96 in W by 7 25 in D 85 mm H by 75 mm W by 184 mm D Battery weight 2 7 Ib 1 22 kg Battery storage Range of 30 to 50 C Should not be stored above 35 C for extended periods of time HP M2477B 4 0 amp hour battery Type Rechargeable nickel cadmium battery 4 0 Ah 12 V nominal Capacity M2475B Standard 4000 mAH 4 hours ECG monitoring or 75 full energy discharges or 3 hours combined ECG monitoring while pacing M2475B with the 12 Lead Option 4000 mAH 3 hours ECG monitoring or 75 full energy discharges or 2 5 hours combined ECG monitoring while pacing Battery Indicators LOW BATTERY warning message appears on the monitor when approximately 30 minutes of battery capacity remains Battery dimensions 3 34 in H by 2 96 in W by 7 25 in D 85 mm H by 75 mm W by 185 mm D Battery weight 4 3 Ib 1 95 kg 14 9 Specifications HP M2480B Battery Support System Battery storage Range of 30 to 50 C Should not be stored above 35 C for extended periods of time HP M2480B Battery Support System C
36. guides you through defibrillation 1 1 Getting Acquainted Figure 1 1 Quick change battery Adult Pediatric paddle Paddles electrodes cable connector The CodeMaster 100 Defibrillator Monitor with 12 Lead ECG Option Overview Top View Getting Acquainted Figure 1 2 M2475 B0002 SpO Connector ECG Connector The CodeMaster 100 Defihrillator Monitor with 12 Lead ECG Option Overview Front View 1 3 Figure 1 3 Getting Acquainted Operating Controls and Indicators Operating Controls and Indicators This topic provides figures and tables which detail the controls and indicators on the HP CodeMaster 100 Defibrillator Operating Controls The defibrillating operating controls on the HP CodeMaster 100 include Energy Select Charge Sync and Shock See Figures 1 3 and 1 4 M2475 B0003 Defibrillator Operating Controls 1 of 2 14 Getting Acquainted Operating Controls and Indicators Figure 1 4 Energy Select Control ENERGY SELECT DEFIBRILLATOR eo M2475 B0006 Defibrillator Operating Controls 2 of 2 1 5 Getting Acquainted Operating Controls and Indicators Control Button Energy Select Charge Sync Shock Function The E nergy Select or Power Control turns the CodeMaster 100 power on an
37. in the carry bag front top panel Proper patient preparation and electrode placement are the most important elements in producing a high quality ECG trace The patient should be supine when acquiring an ECG If this is not possible note the patient s position and ensure this factor is considered for diagnosis Prepare the patient by performing the following steps l Reassure and relax the patient 2 Make sure the electrode site is not covered by hair or clothing Prepare the skin to ensure good contact between the skin and the electrode by gently cleaning and abrading the surface of the skin with dry gauze 3 Place electrodes on the patient 4 Attach each lead wire to the correct electrode 5 The upper left corner of the screen displays the electrodes that are not placed firmly on the patient and or the lead wires that are not attached securely to the electrodes See Table 6 2 This is an indication of leads off Correct the attachment of any lead electrode pair that appears on the screen Table 6 2 Using the 12 Lead Option Acquiring a 12 Lead ECG Leads Off Labels Tae Meaning RLIN Right leg electrode not connected or only right leg electrode is connected and all other limb electrodes are not connected RAIR Right arm electrode is not connected LAIL Left arm electrode is not connected LLIF Left leg electrode is not connected V1 V6 One or more chest electrodes are not connected For example V2
38. instrument is used in manual mode This allows you to turn the instrument off or enter manual mode and later return to advisory mode to print the advisory event summary record NOTE Turn the defibrillator off between patients to ensure that the advisory event summary records are patient specific 4 19 Using Shock Advisory Mode Optional Advisory Mode Default Settings Advisory Mode Default Settings The HP CodeMaster 100 contains default settings for use in Advisory mode Some of the settings can be altered using the Setup Menu The following settings can be changed Default energy select sequence You can choose to change the sequence from the factory default settings for a sequence of 200 200 and 360 Joules to a sequence of 200 300 and 360 Joules The energy level for the third shock and all subse quent shocks will be 360 Joules Post Shock Data On Off When operating in Advisory mode the following settings cannot be changed Charge done tone always sounds CRT alert tones always sounds Alert tone volume always at the maximum volume Recorder delay no delay Recorder Bandwidth always Monitor bandwidth Automatic Recordings always off Power on Lead always PADS PADDLES Notch Filter always on 4 20 CAUTION Monitoring This chapter contains information about monitoring a patient with the HP CodeMaster 100 details of patient preparation that apply to the syn
39. or other physician authorized emergency medical response It must be used by or on the order of a physician When operating as a manual defibrillator the HP CodeMaster 100 is suitable for use by personnel trained in advanced cardiac life support In Shock Advisory Mode the HP CodeMaster 100 is suitable for use by EMS personnel with basic life support training Indications and Contraindications Defibrillation Indications Defibrillation therapy is indicated for patients that exhibit the following combi nati on of symptoms unconsciousness absence of breathing absence of detectable pulse ventricular fibrillation or ventricular tachycardia NOTE NOTE Preface Defibrillation Contraindications Defibrillation therapy is contraindicated for patient that exhibit any of the following consciousness presence of breathing presence of detectable pulse In addition the HP CodeMaster 100 should not be used in Shock Advisory Mode where it functions like an AED for children who weigh under 90 pounds patients who have an implanted pacemaker The shock advisory algorithm is not designed or tested to interpret pediatric cardiac arrhythmias or administer energy at pediatric joule settings For children older than 8 years the American heart Association recommends that standard operating procedures for AEDs be followed American heart Association Textbook of Advanced Cardiac Life Support Dallas Tex AH
40. page 12 4 If you must disarm the charged defibrillator if counter shock is not needed turn the Energy Select control to Monitor On Any stored energy will be discharged internally and the available energy on the display will scroll down to 0 3 4 Defibrillating Defibrillating a Patient Preparing the Defibrillator for the Next Use If you want to print an Event Summary now press Review See Printing the Event Summary Record on page 5 12 After you use the defibrillator perform the following steps to prepare the defibrillator for its next use O Clean all paddles controls and cables Visually check the patient cables paddles paddle cables and pads adapter cables for wear insulation nicks and other damage Refer to the Maintenance chapter for additional information O Turn on the HP CodeMaster 100 If the instrument displays LOW BATTERY replace the battery pack with a charged battery O Perform the test described in Delivered Energy and Shock Button Functional Test on page 13 3 O Turn the Energy Select control to Off and return the HP CodeMaster 100 to its storage location O Check that sufficient recorder paper and electrolyte medium or multifunction defib electrodes are available for the next use of the defibrillator O Make sure that a battery is in the battery support system being charged See Charging the Battery on page 13 14 3 5 WARNING WARNING Defibrillating Defibrillating a
41. specifications 14 1 TEST 100J PASSED 134 13 5 testing battery capacity 13 15 every three months 13 6 pacer functionality 13 5 pads adapter cable 13 4 time 2 10 2 11 tones 1 20 4 5 TPI 2 22 transmission 2 24 transmission problems 12 17 transmission setup 2 13 transmitting event summaries 10 1 transmitting 12 Lead ECG 10 10 transmitting event summary 10 12 troubleshooting 12 1to 12 7 U understanding reports 6 20 upper alarm limits 2 11 USE LEADS 122 Using 7 2 V verifying defibrillator operation 13 1 visual inspections 13 1 W X Y Z weekly checks 13 6 Index 6
42. the cellular communications capabilities Table 10 3 Cellular Communications Capabilities Sent From Via HP CodeMaster 100 12 Lead ECG Manager Receiving Station and Gateway HP CodeMaster 100 12 Lead ECG Manager Receiving Station and Gateway HP CodeMaster 100 12 Lead ECG Manager Receiving Station and Gateway Destination Fax Machine Laser or Inkjet Printer HP TraceMaster ECG Manager System Figure 10 4 and Figure 10 5 illustrate standard cellular communication connections NOTE Use only a Data Interface Adapter to connect the portable cellular phone to either nnn the internal or external modem This cellular Data Interface Adapter provides an RJ11C connection from the modem to the cellular phone creates and translates the necessary signals for cellular communication 10 7 Transmitting Data from the 12 Lead Option Using Cellular Communications Figure 10 4 Transmit Receiving Site Cellular CodeMaster 100 Internal Modem with 12 Lead Option Personal Computer running ECG Manager LI E M1765A or Event Cellular Cellular Summary Host Data Interface Bag Phone Adapter 3 watt RJ11C Adapter Standard Cellular Connection Internal Modem 10 8 Transmitting Data from the 12 Lead Option Using Cellular Communications Figure 10 5 Transmit Receiving Site CodeMaster 100
43. the connector slot If the ECG leads cable falls out or is incorrectly connected the message LEADS OFF appears on the display WARNING Monitoring Preparing the Patient ECG Monitoring Electrodes Using Multifunction Defib Electrodes Multifunction defib electrodes M3501A M 3502A M3503A M 3504A allow you to monitor defibrillate and perform synchronized cardioversion In order to perform pacing you must attach both ECG monitoring electrodes and defib electrodes To use defib electrodes perform the following steps 1 Attach multifunction defib electrodes as instructed on the package 2 Attach the electrode adapter cable M2472A to the defibrillator 3 Connectthe defib electrodes to the electrode adapter cable The elec trodes are correctly connected when the locking ring is twisted locking the ears of the connector to the adapter cable 4 Usethe Lead Select button to select PADS as the ECG source Using Paddles For an emergency evaluation you can monitor a patient s ECG through the paddles electrodes when leads are not attached to the patient Do NOT use paddles to monitor the ECG during elective cardioversion procedures when the HP CodeMaster 100 is in synchronous SYNC mode Refer to Chapter 7 Performing Synchronized Cardioversion for detailed information on performing elective cardioversion 5 7 NOTE Monitoring Monitoring a Patient the CodeMaster 100 Monitoring a Patient the CodeMaster
44. transmission speed for each type of transmission Your equipment may require a different speed 2 28 Setup and Configuration Configuring the 12 Lead Option Table 2 3 Remote Sites Transmission Types and Recommended Speeds Receiver Type Recommended Speed TraceMaster 2400 9600 PageWriter XLi 2400 PageWriter 200 200i 300pi 2400 PC Running ECG Manager 19200 6 Press F5 twice to exit the directory and return to the Configuration Menu Setup Automated Operations This field allows you to configure the steps to send ECGs after acquisition If you enter Yes into this field the device will automatically go to the telephone directory immediately after an ECG is acquired In this case you will not be required to push the Send button until after you have selected the site for which the ECG is to be sent This automated function removes one step in the process for sending an ECG If you enter No into this field the instrument will return to the Home screen after an ECG is acquired To send an ECG you will always be required to push the Send button to enter into the telephone directory Once you are in the telephone directory select the site for which the ECG is to be sent and push the Send button again 2 29 Setup and Configuration Configuring the 12 Lead Option 2 30 CAUTION Defibrillating This chapter contains information about defibrillating a patient using different paddle sets or multifunction defib ele
45. 0 i PR 144 CONSIDER ANTEROSEPTAL INFARCT POSSIDLY ACUTE 3T2 15aV Q230mS dimin R V V3 ORSD 79 or 283 OTe 400 Axis P 46 ORS a0 Edited T 81 ABNORMAL ECG UnconCirmed diagnosis Page 3 of 3 25 mm s 10 mmjmV fy 0 15 Hz 40 Hz HP709 An Auto 3x4 ECG with Three Rhythm Strips 3x4 3R 6 28 Using the 12 Lead Option Using the 12 Lead Main Menu Using the 12 Lead Main Menu When the 12 Lead first powers on the initialization screen briefly appears as follows Hewlett Packard CodeMaster 100 12 Lead M2475 English 1989 1998 Hewlett Packard Co 7 The system displays a message requesting that you attach the 12 Lead patient cable Attach the HP 12 Lead take a 12 Lead 3x4 Format ECG cable to 1 0 Size Pulse Line 6 29 Using the 12 Lead Option Using the 12 Lead Main Menu After you attach the cable the system then displays the ECG home screen as follows II III 3x4 Js Format Size Pulse Line Press the Menu key on the 12 Lead keyboard The system displays the Main Menu From the Main Menu you can perform several functions This section describes how to use each entry on the Main Menu Hewlett Packard 12 Lead 04 53 44 Wed 23 Apr 1997 Main Menu Send ECGs anage Stored ECGs Print the Log of ECGs Stored Print the Configuration Configure the 12 Lead Event Summaries Sele
46. 00 Operation Checks These checks are intended to briefly verify the proper operation of the HP CodeMaster 100 Regularly perform a test routine incorporatingthe following checks along with visual inspection of all cables paddles and controls Every Shift Perform the following checks every shift Make sure that a battery is charging in the battery support system Turn on the HP CodeMaster 100 If the system displays the Low BATTERY message replace the battery with a charged battery Check for adequate thermal paper in the recorder Check for ECG leads electrodes and adequate electrolyte medium If you have an external power module perform these additional checks every shift o Unplugthe AC or DC external power module Turn on the HP CodeMaster 100 If it displays the Low BATTERY message replace the battery with a charged battery Turn off the defibrillator o Pluginthe external power module Make sure that the power indicator on the external power module appears and that the external power indicator on the HP CodeMaster 100 appears o Removethe battery from the HP CodeMaster 100 Make sure that the charging indicator on the external power module disappears Replacethe battery Maintenance CodeMaster 100 Every Day Inspect the battery in the HP CodeMaster 100 for visible signs of wear Turn on the HP CodeMaster 100 If the instrument displays the Low BATTERY message replace the battery with a charged batt
47. 1V mV Patient Cable Length 10 ft 3 m External Pacer Current Pulse Amplitude 10 mA to 200 mA Pulse Width 20 msec Rate 40 ppm to 180 ppm Modes Demand or fixed rate Refractory Period 340 msec 40 to 80 ppm 240 msec 90 to 180 ppm 14 3 Specifications Defibrillator Monitor SpO Measurement Range 0 to 100 Accuracy with HP M1190A sensor 1 standard deviation 65 100 42 5 resolution 1 Averaging 8 beats SpO alarm limits range 100 90 100 85 100 80 SpO alarm delay ten seconds after value drops below the low alarm setting INOP alerts Triggered by disconnected sensor noisy signal light interference or low signal Pulse rate measurement range 30 to 300 bpm 2 resolution bpm Pulse amplitude indicator Indicates pulsatile activity Maximum operating temperature 35 C 14 4 Specifications Defibrillator Monitor Thermal Array Recorder Event Summary Stores and prints 3 seconds pre and 8 seconds post critical event data for up to 28 events Data retained after unit is turned off Annotates Time date HR SpO event marker ECG mode defibrillator mode selected energy actual delivered energy peak current patient impedance and pacing current and rate Speed 25 mm sec Paper Size 50 mm by 30 m 100 ft Recorder Mode Automatically documents events and ECG during defibrillation episodes The recorder can be configured to run in either real time or with a si
48. 2475 B0013 Connecting the Sp0 Sensor CAUTION To avoid damaging the pins on the cable connector do not force the SpO connector into the ECG input socket Start Monitoring Turn the defibrillator on if necessary by turning the E nergy Select control to Monitor On Press SpO On Off to display the SpO reading in the upper right corner of the display 9 8 Figure 9 4 Sp0 reading Pulse rate Pulse amplitude indicator Sp0 Monitoring Patient Monitor Using Sp02 SpO Readings The pulse ampli tude i ndi cator shows the quality of the SpO signal Since it is derived from the patient s plethysmograph signal it varies with the pulse of the patient If the patient has a very low signal the pulse amplitude indicator does not vary through its full range If the signal is noisy the pulse amplitude indicator does not vary rhythmically with the pulse The pulserateis derived from the pulse oximeter It should correlate closely with the patient s heart rate ode e LEAD CodeMaster 100 Display with Sp0 Reading 9 9 NOTE Sp0 Monitoring Sp0 Alarms SpO Alarms Activating SpO Alarms There are three preset high low SpO alarm limits 100 90 100 85 and 100 80 Press SpO alarm repeatedly to cycle through the alarm options and the no alarm option Stop when you see the alarm you would like to choose and after three seconds that alarm will take effect A A symbol repl
49. 8 2 NOTE Pacing Using the Pacer 6 Attach the multifunction defib electrodes to the electrode adapter cable The electrodes are correctly connected when the locking ring is twisted locking the ears of the connector to the adapter cable 7 Turn the Energy Select control to the Monitor On position elf the message NO PADDLES is displayed check that the pads adapter cable con nector is properly seated and latched elf the message PADS OFF is displayed check the electrodes connection to the patient and to the electrode adapter cable 8 Press Pacer On to set up the pacer Pacer parameters will now be displayed at the bottom of the display PACER STOP DEMAND MODE 70 PPM 30 MA The rate ppm and output mA settings for when the pacer is turned on can be selected in Setup Menu 1 The original rate and output settings from the factory are 70 ppm and 30mA The pacer is always in Demand mode when it is turned on At this point no pacer pulses are being delivered to the patient The pacer must be started before the pacer pulses are delivered at the selected rate ppm and output mA If the pacing mode is ON and the configuration settings are altered the user can move in and out of pacing provided the defibrillator is not shut off and the settings will not revert back to the factory default For example if the user is pacing then shocking then pacing again the pacing mode will return to the last pacing configur
50. A 1994 The shock advisory algorithm is not designed to handle erratic spiking problems caused by a properly or improperly functioning pacemaker Preface Noninvasive Pacing Indications The HP CodeMaster 100 provides non invasive pacing that delivers an electrical stimulus to the heart causing cardiac depolarization and myocardial contraction The energy is delivered through multifunction defib electrodes placed on the chest Non invasive pacing as a therapy is indicated for use in patients with symptomatic bradycardia or asystole In addition to noninvasive pacing other supportive measures may be necessary Among other factors successful pacing of a patient is related to the length of time between the onset of a dysrhythmia and the initiation of pacing Rapid pacing and prompt follow up care are essential The physiologic state of the patient may affect the likelihood of successful pacing or of skeletal muscle activity The failure to successfully pace a patient is not a reliable indicator of pacemaker performance Similarly the patient s muscular response to pacing is not a reliable indicator of energy delivered Contraindications Contraindications for noninvasive pacing include ventricular fibrillation xi Preface 12 Lead Electrocardiography Indications The American Heart Association AHA and the National Heart Attack Alert Program NHAAP recommend prehospital 12 Lead ECG with computer analysis and t
51. A Pain All of the patient ID fields are shown in Table 6 4 on The next line requests the patient s age It also allows you to change the age units Years page 6 16 Note that some or all of these fields may be inactive for your configuration All these fields are user configurable through the Configure 12 Lead Menu Each time you press the or v the cursor moves down to the next ID field To return to a previous field move the cursor up by pressing A or 4 6 14 Using the 12 Lead Option Acquiring a 12 Lead ECG To change or erase data you have entered press F1 Erase or use the Backspace key to delete the character to the left of the cursor You can stop entering patient ID information at any time by pressing F5 or Stop Reviewing and Changing Patient ID To review and change the current patient ID information l Press the ID key The message New Patient displays 2 Press No Edit Old ID The current patient ID screen displays and you can change any field Using the 12 Lead Option Acquiring a 12 Lead ECG Table 6 4 Patient ID Fields Char Prompt Comments Entry max ID Type the ID number Alphanumeric 16 Name Type the patient name Alphanumeric 30 Age Type the patient age Numeric 4 Press Change Units to select the age designation Years Year of Birth Months Weeks Days Hours Sex Pre
52. Data To print a record of the current ECG and of the monitor status press Record The upper line of the ECG strip contains a periodic report of monitor parameters Date Time Heart Rate ECG Source ECG Size and Recorder mode Thelower line of the ECG strip records asynchronous events such as Shock delivery or Heart Rate Alarm violations Several graphic symbols are used to annotate events such as Shock Heart Rate Alarms Mark or Sync You can print a 1 mV 200 ms calibration pulse on the ECG strip by pressing both arrows on the ECG Size key simultaneously Table 2 2 on page 2 12 contains a list of configuration settings which affect recorder operation The recorder can be configured for either monitor or diagnostic ECG bandwidth data Delayed 6 seconds or non delayed operation is also configurable 5 10 Table 5 6 Monitoring Recording Automatic Recordings As described in Table 2 2 on page 2 12 you can enable or disable any of the following automatic recordings Record on Mark Record on Charge Record on Shock Record on Alarms The automatic recordings for both delayed and non delayed recorder modes of operation are defined in Table 5 6 All event summaries except for shock advisory are 3 seconds pre and 8 seconds post events If in delayed mode each event prints with a 6 second pre event strip prior to the event Automatic Recordings vasit Delayed mode Non Delayed mode
53. I AAMI EC11 1991 Diagnostic Electrocardiographic Devices by methods A D and E Filters Noise Filter On Off capability Power line filter always enabled Configurable baseline wander noise and artifact filters Storage Capacity 30 ECGs Type 2 MB of non removable flash memory Transmission of 12 Lead ECGs to HP ECG Manager PC Based Receiving Station Software Internal cellular landline modem with RJ11C connector US Canada UK only RS232 Port for external modem Modem Command Interfaces Data Hayes standard AT command set Fax EIA TIA 578 Service Class I Recommended Modem Protocols Modulation Protocol V 34 Error Correction Protocol V 42 Compression Protocol V 42 bis FAX Modulation Protocol V 17 V 29 V 27ter V 21 channel 2 14 7 Specifications Defibrillator Monitor Reports Full 12 Lead ECG report 12 Lead ECG printed in 3X4 format with configurable rhythm strips Size and Weight Dimensions 7 25 in H by 13 75 in W by 15 13 in D 18 5 cm H by 34 9 cm W by 38 4 cm D Weight 23 5Ib 10 65 kg Includes paddles standard 2 5 Ah battery and recorder paper Additional Standard Accessories 12 Lead Patient Cable Starter kit of electrodes Soft Carrying Case 14 8 Specifications Defibrillator Monitor Battery HP M2476B 2 5 amp hour battery Type Rechargeable nickel cadmium battery 2 5 Ah 12 V nominal Capacity M2475B Standard 2500 mAH 2 5 hours ECG monitoring or 50
54. Lead ID The 12 Lead ID code identifies the particular CodeMaster 100 unit that was used to acquire the ECG The number prints at the bottom of the report If set to zero default this field will be omitted from the printed report This parameter can be any four digit numeric code 2 23 NOTE Setup and Configuration Configuring the 12 Lead Option Setup Transmission This menu allows the configuration of both the internal and an external modem Note that your CodeMaster 100 with the 12 Lead option is pre configured using Hayes compatible settings Hewlett Packard recommends that you not change any default settings if you are using the internal modem or a Hayes compatible external modem You must select the correct country to ensure compliance with telecom regulatory standards Modem initialization string is used for modem initialization commands only and should not contain dialing information Fax initialization string is used for fax initialization commands only and should not contain dialing information Cellular initialization string is used for cellular initialization commands only and should not contain dialing information Setup Transmission Country USA Canada This field will only appear if an internal modem is present Modem Initialization String A amp F MO EO amp C1 amp D2 3S0 0 amp SO amp MO A SEO Initialization String AT amp F MO EO amp C1 amp D2 amp S0 FCLASS 1 Cellular Init
55. NC and USE LEADS appear on the display 13 Press Lead Select once to select Lead I and verify that the message USE LEADS no longer appears The message LEADS OFF should now appear indicating that one or more leads are not connected 14 Turn the E nergy Select control to Off The defibrillator is ready for use if it passes the above checklist A more extensive test of defibrillator monitor functionality can be performed using the diagnostic service mode described in the HP M2475B CodeMaster 100 Portable Defi bri llator Moni tor Servi ce Manual 12 12 Troubleshooting The 12 Lead Option The 12 Lead Option If you have problems with an ECG there are several things you may check before calling for service This chapter tells how to solve basic ECG problems Checking ECG Technique Many problems in taking an ECG may be related to electrode application Review Preparing the Patient on page 6 10 to ensure the patient leads are prop erly attached to the patient Refer to Checking Signal Quality on page 6 12 for information about ensuring a good recording by using the preview screen 12 13 Table 12 7 Problem Power line AC Interference a Troubleshooting The 12 Lead Option Identifying ECG Problems The following table shows symptoms and solutions to problems that can occur when recording an ECG ECG Problems and Solutions Cause Poor electrode contact Dry or dirty electrodes Le
56. Patient Defibrillation with Alternate Paddle Sets or Multifunction Defib Electrodes The HP CodeMaster 100 will defibrillate with several different paddles electrode sets including Adult Pediatric Anterior Anterior External Paddles Adult Anterior Posterior External Paddles Multifunction Defib Electrodes Do not switch paddle sets in an environment where water may get in the paddles electrodes connector receptacle Performing Pediatric Defibrillation The HP CodeMaster 100 paddle set comes with pediatric paddles To use the pediatric paddle set depress the release latch at the front of the standard external paddles while pulling forward on the adult paddle surface This action will remove the adult paddle contact surface and expose the smaller pediatric contact surface Refer to Defibrillating a Patient on page 3 1 for defibrillation procedures The clinician must select an appropriate energy level for the pediatric patient There is no energy limit lockout for the pediatric paddle set 3 6 WARNING WARNING Defibrillating Defibrillating a Patient Defibrillating through Multifunction Defib Electrodes The HP CodeMaster 100 has a multifunction electrode adapter cable M2472A This adapter cable allows defibrillation through multifunction defib electrodes Defib electrodes have several advantages Allows hands off defibrillation Provides good quality monitoring You can perform synchronized cardio
57. Post event time Post event time Mark pressed 3 seconds 3 seconds Charge Until Shock or Disarm event Until Shock or Disarm event Shocking the patient 12 seconds 12 seconds Alarms violation 6 seconds 6 seconds Disarm 3 seconds 3 seconds Test discharge 3 seconds 3 seconds 5 11 Table 5 7 Monitoring Recording Post Shock Data As described in Table 2 2 on page 2 12 you can enable or disable the recording of post shock statistics f Post Shock Data is enabled the defibrillator will record the shock deliv ery statistics Actual Delivered Energy Patient Impedance Peak Current f Post Shock Data is disabled the defibrillator will record the energy to which it was charged as the delivered energy For example if the unit was charged to 200 the delivered energy annotation on the ECG strip would be DEL 200g Printing the Event Summary Record During defibrillator usage the monitor stores up to 28 ECG strips of critical information called events E vents include all shocks heart rate alarm violations SpO alarm violations and mark events Each event record includes date of event heart rate SpO reading ECG source and size setting as shown in Table 5 7 The time annotated on the ECG strip is within 8 seconds of the recorded event The message ES is printed at the top of the ECG strip when you print the Event Summary record Event Summary Record Information Event Event Summary Description Shock
58. RNING Using Auxiliary Power This section provides instructions for using auxiliary power sources with the HP CodeMaster 100 AC HP M2479A and DC HP M2478A Power Modules The AC Power Module The HP M2479A AC Power Module is designed to charge the battery installed in the HP CodeMaster 100 while the battery is in the unit The AC Power Module connects to an AC power source to provide continuous charging and ensure that the battery is ready for use when an emergency situation arises power the HP CodeMaster 100 and provide for long term monitoring with out the need to change the battery Using the AC Power Module To use the AC power module 1 Plug the AC Power Module power cord into an AC power source Verify that the power indicator lights up to show that power is supplied to the module See Figure 11 1 2 Connect the AC Power Module defibrillator interface cable to the HP CodeMaster 100 To do so position the cable with the red dot on the connector facing down and insert the connector into the 12 volt receptacle 3 Check that the ext power light appears on the HP CodeMaster 100 See Figure 11 4 If a battery is installed in the HP CodeMaster 100 also verify that the charging indicator lights up on the AC Power Module Battery technology used in this device still requires maintenance The power module will not cycle recondition batteries Refer to Chapter 13 Maintenance Using Auxiliary Pow
59. Reapply sensor SIGNAL Patient motion Consider using a different sensor site SPO2 LIGHT Too much interference from Reapply sensor INTERF external light Turn off lights in the room Damage to sensor or adapter cable If other options do not work replace the sensor 12 6 Table 12 4 Sp0 Messages Message SPO2 LOW SIG NAL Cause Bad connection to patient or patient has poor perfusion Troubleshooting CodeMaster 100 Possible Solutions Check the patient for poor perfu sion Reapply disposable and semi disposable sensors Readjust reusable sensors Consider using a different sensor site SpO perfusion read ing is high or erratic EMI RFI Investigate the source of the inter ference Remove the device or relo cate the patient 12 7 Table 12 5 Troubleshooting CodeMaster 100 Troubleshooting the Advisory Mode Advisory Mode Messages Message ATTACH PADS CABLE Cause The electrode adapter cable is not connected to the defibrillator Possible Solutions Connect the electrode adapter cable to the defibrillator FOR ANALYSIS ATTACH PADS Defib electrodes are not attached to the electrode adapter cable or defib electrodes are not attached to the patient Check electrode connections ARTIFACT DETECTED DO NOT TOUCH PATIENT Excessive noise was detected by the advisory algorithm during analysis Do not touch move perfor
60. ShockZ Delivered energy peak current and patient impedance Heart Rate Alarms violation Heart Rate alarm limits Sp0 Alarms violation Sp0 alarm limits Mark Marker symbol W annotates strip at point Mark was pressed To print the Event Summary on the recorder press Review The recorder must not be printing to print an Event Summary with this key To stop printing the Event Summary press Review or Record To review the Event Summary later turn the unit on and press Review NOTE Monitoring Recording The Event Summary record is cleared each time the defibrillator is turned on and a new event occurs This allows you to turn off the defibrillator and return later to review event information such as code statistics Turn the defibrillator off between uses to ensure that Event Summary records are patient specific Recorder Errors The message cH ECK R ECORD ER appears on the screen if an error occurs while recording If this message appears check the recorder paper supply This message may also appear if the recorder door is open 5 13 Table 5 8 NOTE NOTE WARNING Monitoring External Monitoring External Monitoring The ECG output provides an analog 1V mV ECG signal for connection to a Hewlett Packard external monitor Hewlett Packard compatible external monitoring divider cables are as follows External Monitoring Cables 1000 1 Voltage Divider Cable Connect
61. Sternum paddle Shock button Verify that the defibrillator does not discharge Press Sync to place the defibrillator in sync mode Press and hold both Shock buttons Verify that the defibrillator does not discharge Press Sync again to remove the defibrillator from sync mode With the paddles in their holders press and briefly hold both Shock but tons at once Verify that the defibrillator discharges 10 The recorder will print a test report Review the test report for proper operation 13 3 NOTE CAUTION Maintenance CodeMaster 100 Notify Service Personnel if the ECG strip does not print TEST 100J PASSED Or if any of the shock button tests fail If you see the CHECK SETUP message on the screen call service to replace the backup battery Electrode Adapter Cable Test To check the electrode adapter cable perform the following steps 1 2 Connect the HP M1781A test load to the electrode adapter cable Turn Energy Select to 100 joules Press Charge Wait for the Charge Done indicators Press the left Shock AN button on the pads adapter cable connector housing Verify that the defibrillator does not discharge Release the left Shock button and press the right Shock button on the pads adapter cable connector housing Verify that the defibrillator does not discharge Press Sync to place the defibrillator in sync mode Press and hold both Shock buttons Verify that the defibri
62. about performing synchronized cardioversion on a patient with the HP CodeMaster 100 Refer to Preparing the Patient on page 5 5 for information on patient preparation Performing Cardioversion Treatment for certain arrhythmias requires synchronizing a defibrillator shock with the ECG s R wave It is essential that this R wave is detected to avoid inducing ventricular fibrillation Monitoring During Cardioversion Using an External Monitor Whenever possible Hewlett Packard recommends that you perform synchronized cardioversion procedures while directly monitoring the patient through the multifunction defib electrodes or ECG leads inputs If you use an external monitor as the ECG source ask your biomedical technician to verify that the CodeMaster 100 defibrillator and external monitor combination will deliver a synchronized shock within 60 ms of the peak of the R wave See the HP M2475B CodeMaster 100 Portable Defibrillator Monitor Service Manual for test procedure Use a 1 mV QRS complex with a ORS width of 40 ms This performance cannot be guaranteed with all commercially available monitors 7 1 Performing Synchronized Cardioversion Performing Cardioversion There are three ways to monitor ECG for synchronized cardioversion use an external ECG monitor connect ECG electrodes to the HP CodeMaster 100 or use multifunction defib electrodes External ECG monitor When the patient is already connected to bedside monitori
63. aces the limits to show that the alarm is active To review the limit set press SpO gt alarm If the SpO level falls below the low alarm limit an alarm sounds and the violated limit is highlighted SpO alarms are automatically turned off when you press Charge Deactivating SpO Alarms Press SpO alarm The AN symbol to the right of the SpO display indicates that the alarms are off Recorder Output After an alarm event the recorder prints a strip The bottom of the strip shows the alarm violation and the top of the strip shows the SpO reading You may print an event summary record which contains SpO information as described in Printing the Event Summary Record on page 5 12 9 10 Figure 10 1 WARNING NOTE Transmitting Data from the 12 Lead Option This chapter provides instructions for transmitting 12 Lead ECGs and Event Summaries using the 12 Lead option of the HP CodeMaster 100 You can transmit using a landline or cellular phone with data link The HP CodeMaster 100 supports data transmission from either an internal modem with an RJ11C connector in US UK and Canada only or an external modem via the RS 232 port See Figure 10 1 M M ve em Phone Modem Direct Connector RJ11C Connector DB9 Y eC Rear View of 12 Lead Bezel Modem Connections Rear View of CodeMaster 100 with the 12 Lead Option The connection of an external modem or other telecomm
64. ad wires may be picking up interference from poorly grounded equipment near the patient Patient cable is too close to the power cords Possible Solutions Abrade skin Use new electrodes Reapply electrodes Check expiration date on disposable electrodes Route lead wires along limbs and away from other electrical equipment Fix or move poorly grounded equipment Move other electrical equipment away from patient Unplug electric bed Wandering Baseline Patient movement Electrode movement Poor electrode contact and skin preparation Respiratory interference Reassure and relax the patient Be sure that the lead wires are not pulling on the elec trodes Reapply electrodes Press the Filter key if it is configured for Baseline Wander Move lead wires away from areas with the greatest respiratory motion Tremor or Muscle Artifact Poor electrode placement Poor electrode con tact Patient is cold Tense uncomfortable patient Tremors Clean the electrode sites Reapply electrodes Be sure the limb electrodes are placed on flat non muscular areas Warm the patient Reassure and relax the patient Press the Filter key if it is configured for Artifact Attach the limb electrodes near the trunk Press the Filter key if it is configured for Artifact 12 14 Table 12 7 Problem Intermittent or Jittery Waveform twi Troubleshooting The 12 Lead Option ECG Problems and Solutions
65. aluated by local safety personnel before being put into service Do not pull on the paper while a report is being printed This can cause distortion of the waveform and can lead to potential misdiagnosis 6 6 WARNING Using the 12 Lead Option Patient and Operational Safety Notes The connection of an external modem or other telecommunications equipment may increase leakage currents beyond levels that are acceptable in a patient care environment Always request that local safety personnel verify that multiple connected equipment comply with local requlatory standards before putting such equipment into service 6 7 Using the 12 Lead Option Acquiring a 12 Lead ECG Acquiring a 12 Lead ECG This section describes how to prepare the patient for an ECG check the signal quality of the patient leads enter patient ID and printed report information record an ECG change the report format understand the printed report 6 8 Using the 12 Lead Option Acquiring a 12 Lead ECG To Acquire a 12 Lead ECG If your HP CodeMaster 100 with 12 Lead is already configured you can acquire an ECG by performing the following steps 1 2 Connect the 12 Lead ECG cable to the patient Turn the Energy Select control to Monitor On Prepare the patient and apply the electrodes as described in Preparing the Patient on page 6 10 Check the signal quality on all leads Press the ID key and enter patient ID inf
66. anada the following information is provided NOTICE The Industry Canada label identifies certified equipment This certifica tion means that the equipment meets telecommunications network protective Technical Requirements document s The department does not guarantee the equipment will operate to the user s satisfaction Before connecting this equipment users should ensure that it is permissible to be connected to the facilities of the local telecommunications company The equip ment must also use an acceptable method of connection The customer should be aware that compliance with the above conditions may not prevent degradation of service in some situations Repairs to certified equipment should be coordinated by a representative desig nated by Hewlett Packard Any repairs or alterations made by the user to this equipment or equipment malfunctions may give the telecommunications com pany cause to request the user to disconnect the equipment Users should ensure for their own protection that the electrical ground connec tions of the power utility telephone lines and internal metallic water pipe system if present are connected together This precaution may not be particularly impor tant in rural areas Users should not attempt to make electrical ground connections themselves but should contact the appropriate electric inspection authority or electrician as appropriate NOTICE The Ringer Equivalence Number REN a
67. arging the Battery with an Auxiliary Power Module 11 8 Defibrillating with External Power 11 9 Performing Operational Checks 11 10 Troubleshooting CodeMaster 100 12 1 Troubleshooting the Defibrillator 12 1 If the Defibrillator does not Charge 12 3 If the Defibrillator does not Deliver a Shock 12 4 Troubleshooting the Pacer 12 5 Troubleshooting SpO2 12 6 Troubleshooting the Advisory Mode 12 8 Troubleshooting the External Power Module M2478A or M2479A 12 9 Replacing the External Power ModuleFuse 12 10 Performing Diagnostics 12 11 The 12 Lead Option 12 13 Checking ECG Technique 12 13 XXV 13 Id entifying ECG Problems 12 14 Identifying Recorder Problems 12 15 Sampling Characteristics of the 12 Lead Option 12 16 Id Id entifying Storage Problems 12 16 entifying Transmission Problems 12 17 Sales 12 19 Med ical Supplies 12 21 Service 12 21 Maintenance CodeMaster 100 13 1 Operation Checks 13 1 Every Shift 13 1 Every Day 13 2 Delivered Energy and Shock Button Functional Test 13 3 Electrode Adapter Cable Test 13 4 Quick Pacer Functionality Test 13 5 Every Week 13 6 Every Three Months 13 6 Maintaining the Defibrillator 13 7 Mod Changing the Recorder Paper 13 7 Cleaning the Recorder Printhead 13 8 Cleaning Exterior Surfaces 13 9 Cleaning the Electrodes and Cables 13 10 Cleaning the Carry Bag M3710A 13 10 Cleaning Exterior Surfaces on the AC and DC Power ules 13 11 Maintaining t
68. ation before shocking If the defibrillator is turned off after pacing is configured then when pacing is turned on again the settings will return to the factory default 9 Press Lead Select to select the best lead for monitoring while pacing You can only select Leads as the ECG source when the pacer is on elf LEADS OFF is displayed check all patient cable connections 10 Press Rate to adjust the rate The monitor displays the selected rate ppm 11 Press Mode to select the pacing mode demand mode fixed mode The monitor displays the selected mode 8 3 WARNING Pacing Using the Pacer Demand Mode Pacing When in demand mode the pacer will only deliver pacer pulses when the patient s heart rate is lower than the selected pacer rate Fixed Mode Pacing When in fixed mode the pacer will deliver pacer pulses at the selected pacer rate Use demand pacing mode whenever possible Use fixed pacing mode asynchronous for cases when reliably monitoring the patient is impractical For example use fixed mode when there is motion artifact or other ECG noise that makes R wave detection unreliable 12 Press Start Stop to start pacing The monitor displays the message PACING as well as the selected mode rate and output The pacer will not start pacing if there is a problem with either the multifunction defib electrode connections or the ECG monitoring electrode connections If there is a problem with the multifunction defib ele
69. atric paddles 3 6 pads defibrillating with 3 7 selecting as ECG source 3 8 using for synchronized cardioversion 7 6 pads adapter cable testing 13 4 using for monitoring 5 2 PADS OFF 3 8 8 3 12 5 part numbers supplies 13 16 patient cable 3 wire 5 3 5 wire 5 4 5 5 and abrasives 13 10 and autoclaving 13 10 and isopropyl alcohol 13 10 and ultrasonic cleaners 13 10 configuring 2 12 connecting 2 3 2 5 2 6 immersing 13 10 part numbers 13 16 testing 13 6 patient ID 6 14 entering 6 14 patient ID fields 6 16 patient information 2 16 patient movement effect on SpO 9 6 patient preparation 6 11 pediatric defibrillation 3 6 phone line 2 17 pitting 13 6 post CV mode 2 11 post shock data configuring 2 12 recording 5 12 power cords part numbers 13 17 power on lead 2 12 preparing defibrillator for next use 4 15 7 8 preparing paddles for defibrillation 3 1 preparing the patient 6 11 preparing the patient for monitoring 5 5 printed report understanding 6 20 printhead cleaning recorder 13 8 Printing Event Summary 4 16 printing calibration pulse 5 10 printing ECG record 5 10 printing event summary record 5 12 printing light 13 8 pulse amplitude indicator 9 9 pulse oximetry 9 2 See also SpO pulse rate determined by SpO gt 9 9 Q QRS beeper 1 20 4 5 QRS beeper volume Index 4 adjusting 5 8 quick pacer functionality test 13 5 R rate button using
70. ayed on the monitor If there is no pulse measurements cannot be made See Figure 9 1 Positioning of the Light Emitters and Photodetector 9 2 Sp0 Monitoring Sp02 Operating Controls For accurate measurements the following conditions must apply o All transmitted light must pass through the extremity to the detector o The patient must have at least a minimum pulse o Thelight emitter and the photodetector must be opposite each other SpO Operating Controls The SpO operating controls on the HP CodeMaster 100 SpO Operating Controls are detailed in SpO2 Operating Controls on page 1 13 Patient Monitor Using SpO Sensor Types There are three types of sensors Disposable Disposable sensors should be used once only and then discarded However they can be relocated to a different application site on the patient if the first location does not give the desired results Disposable sensors must not be reused on different patients Semi Disposable Semi disposable sensors can be reused but the adhesive wrap must be discarded after each use Semi disposable sensors are recommended for single patient use only Reusable Reusable sensors can be reused on different patients 9 3 Sp0 Monitoring Patient Monitor Using Sp02 Using SpO Before you start SpO monitoring refer to the following steps 1 Estimate the patient s weight and determine the best site for the sensor 2 Usethe Sensor Guide
71. ble 12 2 Troubleshooting CodeMaster 100 Defibrillator Messages Continued Message Cause Possible Solutions CHECK The battery pack is not fully inserted into Reinsert the battery pack making BATTERY the defibrillator or it is faulty sure it latches If the message reappears perform a battery capacity test CHECK The backup battery for the setup configura Call service to replace the backup SETUP tion memory is low battery If the Defibrillator does not Charge If the defibrillator does not charge perform the following steps 1 2 Verify the proper setting of the Energy Select control If itis correct follow these steps a Turn the Energy Select control to Off and then back to the desired energy setting b Press Charge again If the instrument remains unable to charge turn the E nergy Select con trol to Off and use a backup defibrillator Press Review to print an event summary and keep any ECG strips from the defibrillator for later evaluation Alert HP service personnel 12 3 Troubleshooting CodeMaster 100 If the Defibrillator does not Deliver a Shock If the defibrillator does not deliver a shock perform the following steps 1 Makesurethe unit is not in synchronized shock mode by checking that the Sync light is not on 2 If the unit discharges internally that is the energy display decrements slowly then beeps three times and displays the screen message DEFIB DISARMED ve
72. both emitted and received interference Emission tests deal with interference generated by the device being tested According to the EMC standards the CodeMaster 100 defibrillator monitor does not generate abnormal interference Reducing Electromagnetic Interference The HP CodeMaster 100 is susceptible to interference from other RF energy sources and continuous repetitive power line bursts Examples of other sources of RF interference are medical devices cellular products information technology equipment and radio television transmission Should interference be encountered as demonstrated by artifact on the ECG or dramatic variations in SpO2 values attempt to locate the source Assess the following Is the interference intermittent or constant Does the interference occur only in certain locations Does the interference occur only when in close proximity to certain medi cal devices Does the SpO2 value change dramatically when the external device is unplugged Once the source is located attempt to attenuate the EMC coupling path by distancing the defibrillator from the source as much as possible If assistance is needed call your local HP service representative xiii NOTE Preface Restrictions for Use Artifact on the ECG caused by electromagnetic interference should be evaluated by a physician or physician authorized personnel to determine if it will negatively impact patient diagnosis or treatment Immunity Le
73. cable plug with the slot in the ECG Input connector 2 Push the cable plug firmly into the ECG Input connector If Leads is selected as the ECG source the message LEADS OFF will appear on the monitor display if the patient electrode becomes disconnected A dashed line appears on the display in place of an ECG trace 2 5 Setup and Configuration Setting Up the CodeMaster 100 Figure 2 3 M2475 11 Connecting a Patient Cable 2 6 CAUTION Setup and Configuration Configuring the CodeMaster 100 and 12 Lead ECG Option Configuring the CodeMaster 100 and 12 Lead ECG Option This section provides instructions for configuring the CodeMaster 100 and 12 Lead ECG option To configure general items such as the date and time as well as all defibrillating and monitoring settings use the Setup Menus accessible through the front panel keys and front display Table 2 1 and Table 2 2 list the selections available on the Setup Menus To configure 12 Lead ECG and transmission settings use the Configuration Menu accessible from the top keypad and upper display Table 2 3 lists the selections available on the Configuration Menu A small internal battery provides back up power to store the configuration information Under normal conditions the backup battery may last for five years Extreme conditions such as prolonged high temperatures may reduce the life of the backup battery After running the Delive
74. ceeding those established by applicable standards Federal law USA restricts this device to sale by or on the order of a physician THIS PRODUCT IS NOT INTENDED FOR HOME USE This product complies with the requirements of the Medical Device Directive 93 42 EEC and carries the CE 54 marking accordingly Authorized EU representative Hewlett Packard GmbH Department MPG E Regulations Herrenberger Str 110 140 71034 Boblingen FAX 49 7031 14 2346 This product complies with the telecom regulatory standards for internal modems set by the Federal Communications Commission FCC in the United States Industry Canada and the Department of Trade and Industry in the United Kingdom Notice Associated Documents Document Title HP Part Number HP M2475B CodeMaster 100 Portable M2475 97800 Defibrillator Monitor Quick Reference Guide HP CodeMaster Series Defibrillator Monitor M1722 94920 Pacing Application Note Understanding Pulse Oximetry M1722 93950 SpO Concepts HP M2475B CodeMaster 100 Portable M2475 90905 Defibrillator Monitor Service Manual Sensor Guide M1722 93970 Predictive Instruments Physician s Guide M 1792 93900 HP M2476B amp M2477B Battery Evaluation M2475 92100 and Care M3710A Carry Bag Instructions for Use M2475 94000 Printing History February 26 1999 Edition1 Copyright 1999 Hewlett Packard Company Andover MA 01810 USA Symbol Definitions Symbol
75. chronized cardioversion and pacing procedures The HP CodeMaster 100 can be used for either short term or long term cardiac monitoring A fully charged HP M2476B 2 5 amp hour NiCd battery provides a minimum of two hours of continuous monitoring A fully charged HP M2477B 4 0 amp hour NiCd battery provides a minimum of three hours of continuous monitoring time Not intended for use with internal electrodes 5 1 Table 5 1 NOTE Monitoring Using Leads to Monitor Using Leads to Monitor The monitoring functions of the HP CodeMaster 100 may be performed through any of the ECG sources shown in Table 5 1 The leads which may be monitored are dependent upon the ECG source and whether the defibrillator is configured to monitor a 3 or 5 wire patient cable Once an ECG source is determined the Lead Select control is used to choose the desired lead to monitor Table 5 1 lists ECG sources and appropriate Lead Select choices for each source Cardiac Monitoring Configurations For this ECG source Use this lead wire set cable type Set Lead Select to 3 wire 12 pin M1605A M1500A AAMI or 1 H Il 12 pin M1615A M1510A IEC 5 wire 12 pin M1625A M1520A AAMI or Il Ill aVR aVL aVF V 12 pin M1635A M1530A IEC 10 wire 12 pin patient cable M3714A AAMI or Il Ill aVR aVL aVF V 12 pin patient cable M3715A IEC Multifunction Defib Electrode Electrode adapter cable M2472A PADS Pa
76. conds ORSD ORS duration milliseconds QT OT interval milliseconds OT QT interval corrected for rate milliseconds P Frontal P axis degrees ORS Frontal mean ORS axis degrees T Frontal T axis degrees 6 24 Calibration Signals Using the 12 Lead Option Setting Up the Printed Report The following table shows how the height of the calibration pulse indicates ECG sensitivity Table 6 7 Calibration Signals ECG Size mmimV ae Display Label Limb Leads T 12 Lead 0 5 5 5 1 0 5 V 5 25 Pu 1 0 10 10 F1 1 0 V 10 5 20 20 20 2 0 V 20 10 B Report E xamples The following figures illustrate ECG report formats with standard adult interpretation Figure 6 5 Using the 12 Lead Option Setting Up the Printed Report 03 Sep 1998 16 56 34 Younger Greg Hewlett Packard CodeMaster 100 1 u jira PACKARD Hewlett Packard CodeMaster 100 12 Lead 2443 joj amp UYtacs DM pH C 89 pecus _ PRA 73 ANTERIOR c ES s li T por ase 1 gfe gapped tot rhe AK Ege mp pet j al 8p ro nae qRS i kB a ca Puke 2 o WEOROER WO VOeSTC TOeETO A Standard 3x4 ECG 3x4 6 26 Using the 12 Lead Option Setting Up the Printed Report Figure 6 6 43458 di Augcl998 Le
77. ct Exit Fl F2 F3 F4 ES 6 30 Using the 12 Lead Option Using the 12 Lead Main Menu Sending ECGs One or more Stored ECGs can be Sent at a time This is useful for sending ECGs to an HP TraceMaster ECG Management System for long term archival Stored ECGs appear in this screen The most recent ECG will appear at the top of the ECG list Stored ECGs can be selected and sent in three different ways Highlight the desired ECG by using the Arrow button on the keypad Once the ECG is highlighted push the Send ECGs soft key This will take you to the Telephone Directory Highlightthe site for which you want the ECG to be sent and push the Send soft key f more than one ECG is to be sent simply highlight a desired ECG as described above and then push the Select soft key to select that ECG Once an ECG has been selected a will appear next to it indicating that it has been selected Additional ECGs can be selected in the same manner After ECGs have been selected choose the Send soft key All stored ECGs can be selected at once by choosing the Select All soft key This is a quick and convenient way to select and send all old ECGs if desired Send ECGs 2 ECGs Stored Screen 1 of 1 Name ID Time and Date Frank Smith ID 12345678 10 02 10 Apr 97 Charlotte Web ID 87654321 10 00 10 Apr 97 Sent Selected Select Send Select All ECGs Exit d EJ F1 F2 F3 F4 F5
78. ctrode connection the mes sage ATTACH PADS will be displayed briefly when you press Start Stop 13 Verify that the pacer pulses are well positioned in the diastole 14 Increase output mA by pressing Output until the beat is captured Selecting an alternate lead can help you determine capture 8 4 NOTE Pacing Using the Pacer 15 To set the lowest possible output level to capture decrease the current by decre ments of 5 mA by pressing Output If the monitoring ECG lead falls off while pacing in demand mode the pacer will stop delivering pulses and the messages PACER STOP and LEADS OFF will appear To resume pacing reattach the lead and press Start Stop Pacing in fixed mode does not require ECG leads to be attached for the pacer to deliver pulses If a multifunction defib electrode comes off during pacing the pacer will stop delivering pulses and the messages PACER STOP and PADS OFF will appear To resume pacing reattach the electrode and press Start Stop 8 5 WARNING NOTE Pacing Using the Pacer HR meters and HR alarms function during pacing but they can be unreliable The HR meter attempts to count ORS activity in both demand and fixed pacing modes Observe the patient closely while pacing Do not rely on heart rate alarms or the indicated heart rate as a measure of the patient s perfusion status If the battery runs out during pacing and you replace it with a charged battery the ins
79. ctrodes Refer to Defibrillator Operating Controls on page 1 4 Defibrillating a Patient This section describes the three steps to defibrillating a patient 1 Select Energy 2 Charge 3 Shock Note that for quick reference these steps appear on both the outer case of the HP CodeMaster 100 and on the quick reference card attached to the carry bag 1 Select Energy 1 Turn the Energy Select control to the desired energy level The defibrillator is now on 2 Prepare the paddles by following these steps a Remove the paddles from their holders by grasping the handles and lifting them straight up b Holding both paddles in one hand apply electrolyte medium to the electrode surface of each paddle Placing the electrode surfaces together increases the risk of an accidental paddle to paddle discharge and can cause damage to the surface of the paddles 3 1 WARNING Defibrillating Defibrillating a Patient Do not spread electrolyte medium between the paddle electrodes on the chest The patient can be burned if the medium forms a path between the electrodes To avoid risk of electrical shock do not allow the electrolyte medium to accumulate on your hands or on the paddle handles Use of a defibrillator in the presence of flammable agents or in an oxygen enriched atmosphere presents an explosion and fire hazard Do not touch the patient or patient cable during defibrillation Death or injury may occur fr
80. d off This control also selects the energy level J oules for delivering a shock The Charge button charges the defibrillator to the energy level set on the E nergy Select control Charge buttons are located on the front panel of the CodeMaster 100 and on the apex paddle The Sync button changes the operating mode between immediate shock asynchronous mode and synchronized with next R wave shock Sync mode Note that the default is asynchronous mode The orange Shock buttons located on both paddles administer a shock when pressed simultaneously Refer to Chapter 3 Defibrillating for more information 1 6 Figure 1 5 Getting Acquainted Operating Controls and Indicators Monitor Operating Controls This section details the operating controls on the HP CodeMaster 100 that enable you to monitor a patient Refer to Figure 1 5 Refer to Chapter 5 Monitoring for more information about patient monitoring MONITOR Lead Select Monitor Operating Controls 1 7 Getting Acquainted Operating Controls and Indicators Control Button Function Lead Select Selects an ECG source to monitor ECG Size Changes the displayed ECG size HR Alarm Controls heart rate alarms vORSC A Controls the volume of the QRS beeper ECG Output connector Located on the right side of the unit provides analog 1V mV output for external m
81. ddles Standard with instrument M2471A PADDLES The Lead Select choices are always I II III when the defibrillator is configured for a 3 wire cable the choices are always I II III aVR aVL aVF V when config ured for a 5 wire cable The actual V lead shown is dependent upon electrode placement 5v With 12 Lead only will be displayed when the V lead is selected When multifunction defib electrodes are used to pace on demand an alternate ECG source must be used for monitoring and Lead Select should be set to the desired monitoring lead 5 2 Table 5 2 Table 5 3 Monitoring Using Leads to Monitor Preparing the Leads for Monitoring You can configure the HP CodeMaster 100 to use either a 3 wire 5 wire or 10 wire patient cable with the 12 Lead option Use the procedure as described in Table 2 2 on page 2 12 to set up the patient cable type 3 wire 5 wire 10 wire 3 Wire Patient Cable Table 5 2 describes typical lead wire placement using the 3 wire patient cable Table 5 3 shows how the individual leads are formed using the individual leadwires 3 Wire Electrode Placement Electrode Placement RA White Near right midclavicular line directly below the clavicle LAJBlack Near the left midclavicular line directly below the clavicle LL Red Below the left pectoral muscle on the left midclavicular line Lead Formation Lead 7 ref LA RA LL Il LL RA LA Ill LL LA RA 5 3 Table 5 4
82. des to the adapter cable can result in a failure to deliver energy to the patient C Press the Analyze Button When you place the HP CodeMaster 100 in Advisory mode the monitor displays the following message FOR ANALYSIS 2007 PRESS ANALYZE SELECTED Begin analyzing the patient s ECG by pressing Analyze on the instrument front panel See Figure 4 3 4 10 Figure 4 3 WARNING Energy Select Using Shock Advisory Mode Optional Using Shock Advisory Mode ENERGY SELECT 1 o o o o o o o o o o o oJ Off Standby Advisory On DEFIBRILLATOR e ou Analyze Analyze Analyze Button When you press Analyze the monitor displays ANALYZING ECG DO NOT TOUCH PATIENT nnnJj SELECTED where nnn is the configured setting for the energy sequence To perform accurate analysis you must not touch or move the patient during this time Stop CPR ventilation and transport NOTE NOTE Using Shock Advisory Mode Optional Using Shock Advisory Mode The advisory algorithm needs 7 to 10 seconds of continuous artifact free ECG data to decide whether the patient requires defibrillating If excessive artifact due to CPR or patient transport is detected the monitor displays the messages ARTIFACT DETECTED DO NOT TOUCH PATIENT If the artifact ends within 20 seconds analysis continues Otherwise th
83. disarm tone Sounds during the last ten seconds of the Charge Done tone Beeps intermittently until disarmed ORS beeper Sounds whenever an R wave is detected Volume controlled by Y QRS Q A located on the lower right keypanel CRT Screen alerts Three beeps each time a message appears on the screen and when a shockable rhythm is detected Shutdown warning Alternating pitch sounds for 60 seconds when the system is about to turn off An alert to replace the battery Check battery alert Set of 3 beeps with a message CHECK BATTERY on the monitor indicating that the battery is faulty or not latched securely You cannot disable the charge done tone and CRT screen alerts for advisory mode in setup NOTE Using Shock Advisory Mode Optional Using Shock Advisory Mode When you turn the Energy Select control to Advisory On you disable other HP CodeMaster 100 functions including charge key 2 Lead option pacing synchronized cardioversion SpO monitoring lead selection leads monitoring heart rate alarms automatic recordings standard event summary generation recorder delay mode external paddles pediatric energy levels To restore these functions turn the Energy Select control to Monitor On or an energy setting If you turn the Energy Select control to Monitor On or a specific energy setting you place the HP CodeMaster 100 in manual mode and the advisory fea
84. e DC External Power Module Testing the External Power Module Installation To verify that the External Power Module is correctly installed 1 Connectthe external power module to the HP CodeMaster 100 external power input Verify that the power indicator on the external power module and the external power indicator on the HP CodeMaster 100 both appear 2 Install a battery in the HP CodeMaster 100 and verify that the charging indicator appears on the External Power Module 3 Remove the battery and turn the Energy Select Monitor On control on the HP CodeMaster 100 to 360J Press Charge and verify that the defibrillator charged to 360J in 15 seconds or less Figure 11 4 Press the battery capacity gauge to show the charge level of the battery The external power indicator light appears whenever the Power Module is supplying power The defibrillator interface cable of the Power Module attaches to the external power input Using Auxiliary Power CodeMaster 100 External Power Indic ators CodeMaster 100 External Power Indicators This section discusses the external power indicators on the HP CodeMaster 100 see Figure 11 4 m2478 01 CodeMaster 100 External Power Indicators NOTE Using Auxiliary Power Monitoring with External Power Monitoring with External Power Turn the Energy Select Power Control to Monitor
85. e done tone press both electrode adapter cable Shock buttons simultaneously 4 3 Using Shock Advisory Mode Optional Using Shock Advisory Mode Verify Patient Condition Confirm that the patient is unresponsive breathless pulseless A Select Advisory On Turn the Energy Select Power Control to Advisory On to turn on the defibrillator and operate it in advisory mode The monitor displays FOR ANALYSIS 200J3 PRESS ANALYZE SELECTED where 200J is the first energy setting You can configure the energy settings for the first second and third shocks by using the Setup Menu refer to Chapter 2 Setup and Configuration NOTE You must turn the Energy Select Power Control to Advisory On before analyzing the ECG Pressing Analyze has no effect unless the Energy Select Power On control is set to Advisory On In advisory mode you can use the HP CodeMaster 100 to analyze the patient s cardiac rhythms by pressing Analyze to determine whether a defibrillation shock is needed record events with the advisory event summary 4 4 Table 4 1 Using Shock Advisory Mode Optional Using Shock Advisory Mode In advisory mode the HP CodeMaster 100 emits distinct sounds as described in Table 4 1 Audible Indicators in Advisory Mode Indicator Description Charge Done tone Continuous tone sounds when the instrument is charged and ready to deliver a shock Auto
86. e following messages appear on the monitor and analysis stops You can restart analysis by pressing Analyze ARTIFACT DETECTED CANNOT ANALYZE Pressing the Analyze key during analysis will stop analysis The message ANALYSIS STOPPED will be displayed momentarily and then the following message appears FOR ANALYSIS 200J PRESS ANALYZE SELECTED If the multifunction defib electrodes are not properly attached to the patient when you press Analyze the following message appears FOR ANALYSIS 2007 ATTACH PADS SELECTED The electrodes must be attached to the patient and the electrode adapter cable to start analysis 4 12 NOTE Us ing Shock Advisory Mode Optional Using Shock Advisory Mode If the electrode adapter cable is not connected to the HP CodeMaster 100 the message ATTACH PADS CABLI connected to start analysis E appears The electrode adapter cable must be D Follow Prompts Look frequently at the monitor and follow the displayed instructions The monitor may display SHOCK ADVIS Shock Advised EDorNO SHOCK ADVIS ED When a shockable rhythm is detected the message SHOCK ADVISED displays and the defibrillator begins charging The defibrillator charges to the pre set energy select sequence for the first second and third shocks Subsequent shocks are delivered at the third shock energy level The charge done to
87. ent 9 Wait for the charge done indicators 10 Press both Shock buttons simultaneously to defibrillate The Shock but tons for the multifunction defib electrodes are on the cable connector housing Figure 3 2 3 8 Figure 3 2 Defibrillating Defibrillating a Patient Shock Electrode adapter NO connector housing N IF D KR PA Multifunction defib electrodes adapter cable CES Connector i M2475 07 Multifunction Defib Electrode Adapter Cable Defibrillating with Anterior Posterior Paddles The HP M2495A Anterior Posterior Paddles are similar to the anterior anterior paddles but provide a posterior electrode placed on the patient s back Refer to the packaging provided with the paddles for placement and usage guidelines 3 9 Defibrillating Defibrillating a Patient 3 10 Using Shock Advisory Mode Optional This chapter details the use of Shock Advisory an option that is available with the HP CodeMaster 100 In shock advisory mode the HP CodeMaster 100 acts as a semi automatic external defibrillator When in shock advisory mode the HP CodeMaster 100 can analyze the patient s ECG rhythms advise when a shock should be administered automatically charge the defibrillator when a shock is advised prompt the user to deliver the shock provide advisory event documentation 4 1 Using Shock Advisory Mode Optional Und
88. ent cable 2 12 Setup and Configuration Configuring the 12 Lead Option Configuring the 12 Lead Option This topic provides procedures for configuring the 12 Lead option Table 2 3 lists the selections available on the Configuration Menu Table 2 3 12 Lead Configuration Menu Settings Menu Selection Setup ID Entry Setup 12 Lead Settings Setup ECG Filters Setup Miscellaneous Setup Transmission Setup Gateway Setup Telephone Directory Setup Automated Operations Function Identify which patient information fields will be used Define the text contained in user defined fields Identify ECG lead format and nomenclature used on printed 12 Lead ECG reports Identify which filters will be used to clarify ECGs in Noisy environments Set the Institution label set type of interpretation set the number of ECG copies printed set 12 Lead keypad to upper or lower case set 12 Lead location code and ID Define modem initialization strings cellular dialing prefix Define telephone number for gateway if a gateway is used Define names telephone numbers and type of equipment used at receiving sites Enable automatic transmission of ECGs if desired 2 13 Setup and Configuration Configuring the 12 Lead Option Navigating the Configuration Menus When you need to edit the 12 Lead configuration use the following techniques To enter the 12 Lead configuration menu press the Menu key on the
89. epare the defibrillator for its next use O Clean all paddles controls and cables Visually check the patient cables paddles paddles cables and electrode adapter cables for wear insulation nicks and other damage Refer to the Chapter 13 Maintenance for additional information O Turn on the HP CodeMaster 100 If the instrument displays LOW BATTERY replace the battery pack with a charged battery O Perform the test described in Delivered Energy and Shock Button Functional Test on page 13 3 O Turn the Energy Select control to Off and return the HP CodeMaster 100 to its storage location O Check that sufficient recorder paper and electrolyte medium or multifunction defib electrodes are available for the next use of the defibrillator O Make sure that a battery is in the battery support system being charged See Charging the Battery on page 13 14 7 8 Pacing This chapter contains instructions for using the pacer For more concise details regarding noninvasive pacing refer to HP CodeMaster Series Defibrillator Monitor Pacing Application Note What is Noninvasive Transcutaneous Pacing Noninvasive transcutaneous pacing is a technique of electrically stimulating the heart externally through a set of electrodes Pacing is required when the heart s own conduction system slows dangerously The HP CodeMaster 100 with the pacer can perform external transcutaneous pacing The pacer provides demand synchronous
90. ephone network wiring using compatible modular plugs and cabling which complies with the requirements of FCC Part 68 rules The Ringer Equivalence Number or REN is used to determine the number of devices that may be connected to the telephone line An excessive REN may cause the equipment not to ring in response to an incoming call In most areas the sum of the REN s of all equipment on a line should not exceed five 5 0 In the unlikely event that this equipment causes harm to the telephone network the telephone company can temporarily disconnect your service The telephone com pany will try to warn you in advance of any such disconnection but if advance notice isn t practical it may disconnect the service first and notify you afterwards In the event such a disconnection is deemed necessary you will be advised of your right to file a complaint with the FCC From time to time the telephone company may make changes in its facilities equipment or operations which could affect the operation of this equipment If this occurs the telephone company is required to provide you with advance notice so that you can make the modifications necessary to maintain uninterrupted service For servicing information see Service on page 12 21 For troubleshooting transmission problems see Identifying Transmission Prob lems on page 12 17 XV CAUTION Telecom Regulatory Information Canada In compliance with the Industry C
91. er The AC Power Module Indicators Figure 11 1 power indicator charging indicator AC Power Module Indicators Charging Indicator The charging indicator appears when the battery is installed in the HP CodeMaster 100 and the battery is being charged Power Indicator The power indicator lights up when power is supplied to the AC Power Module Using Auxiliary Power Using the DC External Power Module Using the DC External Power Module The HP M2478A external power module is a 12 Volt DC power source for the HP CodeMaster 100 This module is designed specifically for emergency vehicles with 12 Volt electrical systems With this module your vehicle s 12 Volt system can power the HP CodeMaster 100 saving the defibrillator monitor battery for remote use Additionally the HP CodeMaster 100 battery is recharged when it is attached to the external power module Figure 11 2 The charging indicator appears when the battery is installed in the HP CodeMaster 100 Defibrillator and the battery is being charged The power indicator appears when power is supplied to the external power module Access the fuse through the fuse holder Do not disconnect the HP M2475 69531 Defibrillator Monitor connector cable under normal use This connection prevents damage in case you forget to disconnect the defibrillator from external power before moving it Using Auxiliary Power Using the DC External Power Module
92. er the name primary and alternate telephone numbers receiver type and speed Press v or to move the cursor to a blank field line Note that the modem ignores spaces and hyphens in the telephone number Use the following special symbols to specify how you want the modem to dial the telephone number comma causes the modem to pause for two seconds before continuing to dial W causes the modem to wait for a second dial tone before continuing to dial Use this symbol if you have to dial 9 wait for a dial tone and then dial the telephone number to place a call outside your house telephone system P indicates pulse dialing with a rotary dial instead of tone with a keypad For example if you are using a pulse telephone with your modem and your house telephone system requires dialing a 9 before placing an outside call you would enter the telephone number as P9W5553334444 4 Select the transmission type by pressing F3 until the appropriate transmission type appears The transmission type will cycle through Receiving Sta tion Fax TraceMaster A B PageWriter XLi Page Writer 200 300 Other SCP HP1 Other DT Event Summary Event Summary is the only transmission type displayed if con figuring entries 10 18 Screen 2 of 2 5 Select the transmission speed for your transmission type by pressing F3 until the appropriate transmission speed appears The following table shows the rec ommended
93. erstanding Shock Advisory Operating Controls Understanding Shock Advisory Operating Controls The Shock Advisory mode operating controls on the HP CodeMaster 100 include the Advisory On selection on the Energy Select control and the Analyze button See Figure 4 1 Figure 4 1 ENERGY SELECT DEFIBRILLATOR o o o e T o Bises Anelia Analyze Off Standby Advisory On oO F oO Ain BD 7x Shock Advisory Mode Operating Controls 4 2 WARNING Using Shock Advisory Mode Optional Using Shock Advisory Mode Using Shock Advisory Mode This section provides instructions for using the HP CodeMaster 100 in Shock Advisory mode Make certain that you observe all safety precautions noted throughout this chapter Do not use the HP CodeMaster 100 in Shock Advisory mode for echildren who weigh less than 90 pounds e patients who have an implanted pacemaker The advisory algorithm is not designed to detect pediatric cardiac arrhythmias or handle erratic spiking problems caused by a properly or improperly functioning pacemaker The advisory algorithm does not charge the defibrillator to energy levels appropriate for pediatric patients To use advisory mode first verify patient condition Then A Select Advisory On B Apply multifunction defib electrodes to the patient C Stop patient motion Press Analyze If SHOCK ADVISED stand clear D When you hear the charg
94. ery o Visually check the patient cables paddles cables and pads adapter cables for wear insulation nicks and other damage o Perform the Delivered Energy and Shock Button Functional Test on page 13 3 Perform the Electrode Adapter Cable Test on page 13 4 Perform the Quick Pacer Functionality Test on page 13 5 Make sure that a battery is charging in the battery support system If you have the advisory option o TurntheEnergy Select control to Advisory On and check that the instrument turns on 132 NOTE WARNING Maintenance CodeMaster 100 Delivered E nergy and Shock Button Functional Test To check the HP CodeMaster 100 with the paddles perform the following steps The HP CodeMaster 100 is designed to protect against delivering a shock when only one switch on the paddle set is pushed 1 2 3 Turn the Energy Select control to the 100 joules position Verify that the adult paddle electrodes are installed Push the paddles completely into their holders Apex paddle in right pocket Sternum in left and press either Charge Wait for the Charge Done indicators Keep hands clear of the paddle electrode edges Use your thumbs to depress the Shock buttons on the paddle handles With the paddles in their holders grasp the paddle handles and press the Apex paddle Shock CAN button Verify that the defibrillator does not discharge Release the Apex paddle Shock button then press the
95. es Continued Message Cause USE LEADS Paddles are connected to the defibrillator and Sync was pressed when PADDLES is selected Defibrillator is in sync mode and PAD DLES is selected Defibrillator is in defib mode and PADDLES is selected when leads are attached to the patient Defibrillator is in defib mode PAD DLES is the ECG source when attach ing leads to the patient Possible Solutions Press Sync to remove the defibrillator from sync mode Select LEAD I II or III instead of PAD DLES Select LEAD I II or III instead of PAD DLES Select LEAD I II or III instead of PAD DLES 50J Internal paddles are attached and the CodeMaster 100 defibrillator moni MAXIMUM Energy Select control has been turned past tor will charge to 50 joules 50 joules LOW Battery voltage is below the low battery Install a charged battery BATTERY threshold figuration memory has depleted SETUP LOST Theinternal battery which backs up the con Call for service DEFIB CodeMaster 100 defibrillator monitor has Solution not applicable DISARMED internally discharged energy and is now dis armed CHECK The recorder door is open Close the recorder door or replace RECORDER or the paper roll as described in The recorder is out of paper Changing the Recorder Paper page 13 7 12 2 Ta
96. ess the Send key or select Send Event Summaries from the Main Menu The Event Summaries screen appears Event Summaries ADVISORY EVENT SUMMARY Time and Date Frank Smith ID 12345678 10 02 10 Apr 97 Incident ID 00105567 EVENT SUMMARY Charlotte Stephens ID 87654321 10 00 10 Apr 97 JY Transmitted Selected Send Select Edit I D E S Exit d F1 F2 F3 F4 F5 3 Select the Event Summaries you want to send Press the Send key or F4 Send The Event Summary Telephone Directory screen appears 4 Press F2 or Send to transmit the event summary The HP CodeMaster 100 transmits the event summary and indicates that it is executing the dialing sequence The system then confirms the number it is dial ing and that the sequence is being sent 5 The system displays a message indicating successful transmission and then returns to the home display If the event summary does not transmit the system displays the Event Summaries screen 10 12 Transmitting Data from the 12 Lead Option Transmitting an Event Summary If the system does not transmit the event summary successfully refer to the sec tion Identifying Transmission Problems on page 12 17 NOTE Press the STOP key to halt the transmission process For configuration information refer to Chapter 2 Setup and Configuration 10 13 Transmitting Data from the 12 Lead Option Transmitting an Event Summary 10 14 WA
97. exter na adhesive pads 7 7 performing synchronized cardioversion using pa ddles 7 5 testing 13 3 to 13 4 shock h azard v 6 6 shocking the patient 3 4 shocking problems with 12 4 shutdown warning 1 20 4 5 sounds audible indicators 1 20 4 5 specifications 14 1 to 14 10 ECGt SpO gt 0 paper 12 16 alarms 9 10 circulation at application site 9 7 compared to SaO 9 1 connecting sensor 9 7 determining which sensor to use 9 4 inspecting application site 9 6 monitoring xii 9 1 patient movement effects of 9 6 preparing the sensor 9 4 readings 9 9 recorder output 9 10 sensor application troubleshooting 9 6 sensor applying 9 5 types of sensors 9 3 SpO alarm button 9 10 SPO2 SPO2 SPO2 SPO2 SPO2 SPO2 START CABLE OFF 12 6 FAILURE 12 6 LIGHT INT wn start stop button using steam s monitoring leads 13 9 8 4 terilization paddles 13 9 Stop key 6 4 STOP PACER 12 5 surfaces cleaning 13 9 symbol definitions xvii sync mode 1 6 synchronized cardioversion delive ring shock 7 5 ERF 12 6 LOW SIGNAL 12 7 NOISY SIGNAL 12 6 ENSOR FAIL 12 6 indicator 13 14 13 15 monitoring with external ECG monitor 7 2 Index 5 Index performing 3 5 4 15 7 1 to 7 8 using paddles 7 3 using pads 7 6 SYSTEM FAILURE 121 T telephone directory 2 13 2 27 temperature
98. fibrillator perform the following steps 1 Slide the paddle connector lock on the paddles plug to the unlock position To do this push the lock towards the top of the connector 2 Insert the paddles electrode adapter cable plug into the cable connector on the defibrillator Figure 2 2 3 Slide the cable connector latch to the lock position to secure the plug in place To remove the paddles electrode adapter cable slide the paddle connector lock to the unlock position and pull the connector housing up and out N M2475 10 Y Connecting External Paddles Internal Paddles or Multifunction Defib Electrodes 2 4 WARNING NOTE Setup and Configuration Setting Up the CodeMaster 100 ECG Input Connector The HP patient cable supplied with this device or an HP approved substitute patient cable is an integral part of the defibrillator monitor safety features Using any other patient cable may compromise defibrillation protection as well as performance Only qualified personnel may service the device The ECG Input connector on the defibrillator is a 12 pin connector Connecting the Patient Cable The 3 wire 5 wire and 10 wire patient cables connect to the ECG Input connector located on the front right side of the defibrillator below the QRS volume and pacer controls The patient cable plug has 12 pins To install the patient cable Figure 2 3 1 Align the keyed
99. g 4 17 stopping 4 17 event summary record printing 5 12 every day 13 2 every shift 13 1 every three months 13 6 every week 13 6 Exit softkey 6 15 exterior surfaces cleaning 13 9 external adhesive pads defibrillating with 3 7 external ECG monitor using for synchronized cardioversion 7 2 external modem 10 4 external monitoring cables 5 14 F factory settings 2 9 FAULT indicator 13 14 fax problems 12 18 Filter key 6 4 filters artifact 2 20 baseline wander 2 19 noise Auto 2 20 filters setup 2 19 fixed mode pacing 8 3 8 4 functional inspection 12 11 G gas sterilization paddles 13 9 gatew ay setup 2 13 Index 2 H hands off defibrillation 3 7 heart rate alarms defining limits 2 11 using 5 9 HR alarm audible indicator 1 20 button location 1 6 1 8 See also heart rate alarms LJ K ID key 6 4 ID patient 6 14 changing 6 15 custom fields 6 16 entering 6 14 reviewing 6 15 immediate mode 1 6 increasing selected energy level 3 4 indicator lights 1 17 1 18 1 19 inspection functional 12 11 internal modem 10 1 internal paddles connecting 2 4 testing 13 6 interpretation setting values 2 22 L andline connection 10 4 anguage 2 11 ead groups 6 12 ead select button location 1 8 eads off indication 6 11 eads preparing for monitoring 5 3 ights location 1 17 1 18 1 19 sync 12 4 oading recorder paper 13 7 13 11 13 12 ower alarm l
100. ge capacity after the LOW BATTERY message appears than if the battery is merely depleted Recording during this time will also impact monitoring time and the number of charge shock cycles remaining Getting Acquainted Battery Operation 1 26 Setup and Configuration This chapter provides steps for setting up and configuring the HP CodeMaster 100 Your HP CodeMaster 100 ships protected within a carry bag For instructions on s how to attach the side pouches and shoulder strap refer to M3710A Carry Bag Instructions for Use M2475 94000 Setting Up the CodeMaster 100 The HP CodeMaster 100 is ready for operation after you perform the following tasks nsert the Battery Load Recorder Paper Seat and lock the paddles or defib electrode cable Connect the patient cable Select configuration settings for both the CodeMaster 100 and the 12 Lead option including such parameters as date and time 12 Lead keyboard to uppercase or lowercase mode 12 Lead telephone directory for transmission 12 Lead acquisition information 12 Lead report content information 12 Lead location and ID codes 2 1 Figure 2 1 Setup and Configuration Setting Up the CodeMaster 100 Inserting the Battery Before using the battery supplied with your HP CodeMaster 100 make sure it is fully charged and functional Remove the battery from the defibrillator by pinching the latch and pulling the battery out and up Pe
101. gurable pairs of upper and lower heart rate alarm limits Each pair of heart rate alarm limits can be defined as described in Table 2 1 on page 2 11 While monitoring you can select and enable any pair of pre defined limits using HR Alarm When heart rate alarms are inactive the monitor will display AN To select a pair of heart rate alarm limits press HR Alarm until the pair of limits you wish to use are displayed If you do not press the key again the displayed heart rate alarm limits become active and the limits are replaced by the bell symbol If the heart rate alarm limits are violated the heart rate alarm limits replace the bell symbol and the violated limit is highlighted Pressing HR Alarm at this point will turn off the heart rate alarms If the heart rate alarms are active and you wish to review the limits press HR Alarm The currently active pair of heart rate alarm limits are displayed momentarily If the heart rate alarms are active and you wish to select another pair of limits press HR Alarm until the pair of limits you wish to use are displayed Pressing HR Alarm repeatedly cycles through the three pairs of heart rate alarm limits and the heart rate alarms inactive choice Heart rate alarms are automatically turned off when you press Charge Monitoring Recording Recording Recording operating controls are detailed in Recorder Operating Controls on page 1 9 Recording Printing ECG and Monitoring
102. harging Specifications Charging capacity Two batteries Charge time Typically 2 to 3 hours Capacity test time Approximately 24 hours Recommended battery charging temperature 10 to 30 C Environmental operating conditions 0 to 55 C 15 to 95 relative humidity noncondensing for 24 hours at 40 C 15 000 ft altitude Storage conditions 20 to 70 C 90 relative humidity noncondensing for 24 hours at 65 C 15 000 ft altitude Size and Weight Dimensions 5 1 in H by 14 6 in W by 12 5 in D 13 0 cm H by 37 1 cm W by 31 8 cm D Weight 14 5 lb 6 58 kg not including battery pack 14 10 Specifications HP M2478A DC External Power Module HP M2478A DC External Power Module For use only with CodeMaster 100 Defibrillator Monitor Size 1 75 in H by 5 5 in W by 3 25 in D 4 44 mm H by 14 0 mm W by 8 25 mm D Weight 1 1 Ib 0 5 kg Input cable 10 ft 3 0 m Output cable 3 0 ft 0 91 m Input 11 8 16 V DC 1 0 A 12 W 8 A 100 W maximum Battery charging output 12 V DC 1 0 A 12 W 90 0 mA 1 1 W trickle Instrument operation output 12 V DC 1 0 A 12 W 7 A 85 W maximum Charge time With defibrillator monitor turned to Off Standby typically four hours HP M2476B 2 5 Ah Battery typically six hours HP M2477B 4 0 Ah Battery Recommended charging temperature 5 C to 35 C Environmental operating conditions 0 C to 55 C 5 to 90 relative humidity non condensing 15000 ft altitude
103. he Battery 13 11 Achieving Optimal Battery Life 13 12 New Batteries 13 13 Battery Life 13 13 Charging the Battery 13 14 Battery Capacity Test 13 15 xxvi Supplies 13 16 Battery 13 16 External Power Module 13 16 Patient Cables 13 16 Battery Support System Power Cords 13 17 Paddles 13 17 Defib Electrodes 13 17 Monitoring Electrodes 13 18 Paper 13 18 Cases 13 18 14 Specifications Defibrillator Monitor 14 1 Equipment Classification 14 2 Monitor 14 3 External Pacer 14 3 SPO 144 Measurement Range Oto 100 14 4 Thermal Array Recorder 14 5 Size and Weight of the CodeMaster 100 without the 12 Lead Option 14 5 Advisory Mode Option C80 14 6 12 Lead Option C90 14 7 Battery 14 9 HP M2480B Battery Support System 14 10 Charging Specifications 14 10 Size and Weight 14 10 HP M2478A DC External Power Module 14 11 HP M2479A AC External Power Module 14 12 xxvii xxviii Getting Acquainted This user s guide provides operational and basic maintenance instructions for safe use and proper care of the HP CodeMaster 100 It also details setup configuration and troubleshooting procedures This section serves two purposes to familiarize you with the major CodeMaster 100 features and to show their respective locations on the device Figures 1 1 and 1 2 identify the main features of the HP CodeMaster 100 The HP CodeMaster 100 enables you to change from manual mode the default to Shock Advisory optional which
104. he Gateway phone number and transmit the ECG report along with the phone number of the final destination 2 25 Setup and Configuration Configuring the 12 Lead Option In the Gateway Setup menu there are two telephone fields Primary and Alternate The Primary field will be the first Gateway number dialed If this number fails the Alternate gateway number will be used The Alternate field can be left blank if no alternate gateway number is available Setup Gateway Telephone numbers Primary Alternate Erase Exit 2 26 Setup and Configuration Configuring the 12 Lead Option Setting Up the Telephone Directory To transmit ECGs you must identify the receiving site its telephone number and the type of transmission to send You can enter the telephone numbers of up to 18 sites in the directory To setup the telephone directory perform the following steps 1 From the Configuration Menu press F3 to select Setup Telephon Directory Setup Telephone Directory Screen 1 of 2 Primary Number Rcvr Type 1 2 3 4 5 6 7 8 9 2 Press FI The system displays the setup fields for this directory entry Setup Telephone Directory Entry 1 of 18 Name Telephone numbers Primary Alternate Receiver Type Receiving Station Speed 57600 Next Erase Entry Exit 2 27 Setup and Configuration Configuring the 12 Lead Option 3 Ent
105. he charg ing indicator light goes out on the Power Module Re insert the battery 11 10 Table 12 1 Table 12 2 Troubleshooting CodeMaster 100 This chapter contains information about troubleshooting and performing diagnostics on the CodeMaster 100 the pacer SpO2 advisory the external power module and the 12 Lead option Refer to the following table for messages that relate to the CodeMaster 100 display and actions to take to correct them Failure Messages Message Possible Solutions DEFIB Use a back up defibrillator and call service FAILURE MONITOR Use a back up defibrillator and call service If there is no alternative try to use the FAILURE defibrillator without the monitor Use Charge Done indicators to verify defibrillator functionality SYSTI FAIL Use a back up defibrillator and call service If there is no alternative try to use the defibrillator Use Charge Done indicators to verify defibrillator functionality c A x 1 Troubleshooting the Defibrillator Defibrillator Messages Message Cause Possible Solutions NO PADDLES Paddle set is not connected to the defibrilla Attach external paddles internal tor paddles or electrode adapter as required LEADS OFF Leads are not securely attached to the Attach lead patient or the cable is not connected to the defibrillator 12 1 Table 12 2 Troubleshooting CodeMaster 100 Defibrillator Messag
106. he remaining battery charge Table 1 1 Getting Acquainted Operating Controls and Indicators Audible Indicators Indicator Charge Done tone Description Sounds when the instrument is charged and ready to deliver a shock It can be disabled in setup Auto disarm tone Sounds during the last ten seconds of the Charge Done tone Beeps intermittently until disarmed ORS beeper Sounds whenever an R wave is detected Volume controlled by Y QRS Q A located on the lower right keypanel CRT Screen alerts Three beeps each time a message appears on the screen It can be disabled in setup HR alarms Sounds if the heart rate is above the higher alarm limit or below the lower alarm limit Shutdown warning Alternating pitch sounds for 60 seconds when the system is about to turn off An alert to replace the battery Check battery alert Set of 3 beeps with amessage CHECK BATTERY onthe monitor indicating that the battery is faulty or not latched securely Low battery alert Continuous beeps with a message LOW BATTERY on the monitor indicating that the battery needs to be replaced 1 20 CAUTION Getting Acquainted Safety Considerations Safety Considerations The HP CodeMaster 100 stores high voltage energy and is capable of delivering up to 360 joules of DC energy to a 50 ohm impedance To remove power from the instrument you must turn the E nergy Select
107. hour battery 50 2 hours 2 hours M2477B 4 0 amp hour battery 75 3 hours 3 hours Testing a Battery To test the remaining charge in the battery press the button below the battery capacity gauge Lights within the battery capacity gauge show the amount of charge left in the battery Each light represents 20 of the battery capacity When only one light is on the battery has between zero and 20 capacity remaining When all lights are on the battery has between 80 and 100 capacity remaining Recharging a Battery To recharge the battery remove it from the defibrillator and insert it into the Battery Support System To charge the battery see Charging the Battery on page 13 14 The battery support system can recharge two batteries simultaneously Test the capacity of a new battery or one that has been stored more than one month as described in Battery Capacity Test in Chapter 13 Maintenance Continuous recording reduces the monitoring time available CAUTION Getting Acquainted Battery Operation When the LOW BATTERY message is displayed on the monitor replace the battery pack with a charged battery pack From the time the LOW BATTERY message appears until the battery is fully depleted and the instrument shuts down there is approximately thirty minutes of monitoring and five 360 joule charge shock cycles If the battery is defective there may be significantly less monitoring time or char
108. i ng Pulse Oxi mery Gui de You can use the SpO monitor with sensors made by other manufacturers as well as with Hewlett Packard sensors For a list of approved sensors see the Sensor Gui de Understanding Pulse Oximetry This section provides a brief description of SpO SaO and SpO Hewlett Packard is adopting the convention of referring to the SpO parameter Previously it was referred to as SaO SaO is the term used to indicate the oxygen saturation of arterial blood SpO is the term used to indicate the oxygen saturation of arterial blood as measured by pulse oxi metry 9 1 Figure 9 1 Sp0 Monitoring Understanding Pulse Oximetry What is SpO gt A blood oxygen saturation reading indicates the percentage of hemoglobin molecules in the arterial blood which are saturated with oxygen The reading is referred to as SpO Readings vary from 0 to 100 Normal readings in a healthy adult however range from 94 to 100 How Does Pulse Oximetry Work The pulse oximetry method used for measuring SpO uses LE Ds light emitting diodes to transmit red and infrared light through suitable peripheral areas of the body typically the foot in neonates or the finger in adults The oxygen saturation is gauged by measuring the redness of the blood in the arterial pulse A photodetector positioned opposite the light emitter compares light absorption before and after pulsation to provide measurements that are displ
109. ialization String AT amp F MO EO amp Cl amp D2 S020 amp S0 amp MO AT Cellular dialing prefix Erase 2 24 Setup and Configuration Configuring the 12 Lead Option Setup Transmission Fields The modem initialization strings are sent from the 12 Lead option to the modem before dialing begins This string must be present before sending ECGs using the modem There is a string for landline fax and cellular communications Cellular Dialing Prefix If the receiving modem does not support MNP 10EC cellular enhanced protocol an optional prefix may be used to enable data transfer over the cellular phone via your service provider s modem pool This prefix may be obtained from your cellular service provider Setup Gateway The Gateway is where the ECG Manager PC gateway resides To setup the ECG Manager gateway function configure the Gateway in the Setup Gateway field You can configure the ECG Manager gateway by entering phone numbers on the Telephone Directory screen After an ECG is acquired from the patient it can be transmitted through the ECG Manager gateway by pushing the Send key Select the desired final destination site on the Telephone Directory screen This is the site where the ECG Manager gateway will forward the ECG report automatically These ECGs can also be autoforwarded to other destinations set up in the telephone directory During the transmission process the HP CodeMaster 100 will dial t
110. ibed briefly in a list then each is described in more detail in the sections that follow Default configuration settings are also listed in the tables 2 15 Setup and Configuration Configuring the 12 Lead Option Setting Up Patient Information The Setup ID Entry screen allows you to choose the patient identification entries requested prior to recording an ECG The following screen shows the patient identification entries available for configuration Enter data for patient information Use F3 to change the value of a field Setup ID Entry ID Entry Yes Name Entry Yes Age Entry Yes Years Sex Entry Yes Chest LA Pain Entry Yes Acute Ischemic Sx Time Entry No History Diabetes Entry No History Hypertension Entry No Blood Pressure Entry No Height Entry No Change Next Exit A 4 F1 F2 F3 F4 ES NOTE The patient age sex and height and weight affect the standard interpretation of the ECG For the most accurate interpretation include them in the patient ID entry Ata minimum enter age and sex If you do not enter data into these fields the analysis software or 12 Lead algorithm will use default values for the analysis 2 16 Table 2 4 Setting Up 12 Lead Fields Setup and Configuration Configuring the 12 Lead Option This screen allows you to choose the default formats that will be used when you power on the system Table 2 4 shows the available report formats
111. ies This functionality will transmit the Event Summary to an event summary host Using the 12 Lead Option HP CodeMaster 100 and 12 Lead Option Interactions HP CodeMaster 100 and 12 Lead Option Interactions This section describes the interactions that occur between the HP CodeMaster 100 and the 12 Lead option If the HP CodeMaster 100 is reset or a shock is delivered while the 12 Lead option is attempting to acquire or store an ECG 12 Lead operation is sus pended and the ECG will be lost with no recovery The HP CodeMaster 100 resets when the following occurs delivering a shock changing modes manual to shock advisory changing the battery To resume transmitting after the unit is reset select the ECG from the Send ECGs Menu and press Send e The 12 Lead option does not operate while the HP CodeMaster 100 is set to Shock Advisory mode e Low Battery information from the HP CodeMaster 100 displays on the 12 Lead screen When the language option is changed in SETUP MENU 10n the HP Code Master 100 the 12 Lead user interface will display the new language upon the next power on e Since the HP CodeMaster 100 and 12 Lead option share the 50mm recorder any action which would normally cause the HP CodeMaster 100 to print will interrupt any report printing on the 12 Lead Press Try Again to resume 12 Lead printing 6 34 WARNING Performing Synchronized Cardioversion This chapter contains information
112. ime between the peak and an adjacent sample can vary from one QRS complex to the next This results in a slight variation of displayed QRS amplitude This effect is more pronounced with narrower signals more commonly found in some pediatric electrocardiograms and in pacemaker pulses The CodeMaster 100 with 12 Lead option minimizes this effect by using an integrating type A D converter sampling all leadwires simultaneously oversampling the signals processing the oversampled signals with appropriate digital signal processing techniques Identifying Storage Problems The following table shows symptoms and solutions to problems that can occur when storing an ECG Storage Problems and Solutions Message ECG too noisy to store Likely Cause Poor electrode contact Dry or dirty electrodes Lead wires may be picking up interference from poorly grounded equipment near the patient Possible Solutions Use new electrodes Abrade skin Reapply electrodes Check expi ration date on disposable elec trodes Route lead wires along limbs and away from other electrical equip ment Fix or move poorly grounded equipment Unable to store ECG A fault exists in the storage hard Ware Retake and store ECG If problem persists call HP Service Unable to retrieve ECG A fault exists in the storage hard Ware Retake and store ECG If problem persists call HP Service 12 16 Table 12 10 Ide
113. imits 2 11 M M1190A reusable SpO sensor 9 5 M 1500A trunk cable 13 16 M1510A trunk cable 13 16 M 1520A trunk cable 5 2 13 16 M1530A trunk cable 13 16 M 1605A lead set 13 16 M 1615A lead set 13 16 M 1625A lead set 13 16 M 1635A lead set 13 16 M 1732A patient cable 5 2 M 1734A patient cable 5 2 M 1749A multifunction adhesive pads 5 7 13 17 LEADS OFF 2 5 8 3 8 5 12 1 12 11 LOW BATTERY 3 5 4 15 7 8 12 2 13 1 13 2 Index M1749B multifunction adhesive pads 5 7 13 17 M1749C multifunction adhesive pads 5 7 13 17 M1749D multifunction adhesive pads 5 7 13 17 M1781A test load 13 4 13 5 M1782A external monitoring cable 5 14 M1783A external monitoring cable 5 14 M1900B connector cable 9 4 M2471A anterior anterior paddles 5 2 13 17 M2472A pads adapter cable 5 2 8 2 13 17 M2476B battery 1 23 13 11 13 16 M2477B battery 1 23 13 11 13 16 M2480B battery support system 13 6 13 14 13 16 maintaining battery 13 11 13 15 maintaining the defibrillator 13 7 Manual report andFilter key 2 20 mark button annotating ECG 1 9 printing ECG strip 1 9 marker dot 7 3 7 5 7 7 menu SETUP MENU 1 2 11 setup diagnostic 2 9 mode diagnostic 2 9 ECG gain 12 11 paddles ECG 12 11 setup 2 9 mode after CV 2 11 mode button using 8 3 modem 2 25 modem problems 12 17 modem internal 10 1 modes synchronous and asynchronous 1 6 MONITOR FAILURE 12 1 monitor operating c
114. instructed on the elec trode package 3 Connect the electrode cable connector to the electrode adapter cable The elec trodes are correctly connected when the locking ring is twisted locking the ears of the connector to the adapter cable 4 Turn the Energy Select control to Monitor On Ifthe PADS OFF monitor message is displayed check all patient connections 5 Select pads as the ECG source by pressing Lead Select 6 Press Sync once to place the HP CodeMaster 100 in Sync mode The message SYNC will appear on the display 7 6 NOTE Performing Synchronized Cardioversion Performing Cardioversion You can perform cardioversion in Autogain mode Always inspect the displayed ECG before delivering the counter shock Verify that an R wave marker indi cating shock point appears only with each R wave If a marker dot does not appear or if a marker dot is viewed on the T wave segment of the ECG follow these instructions Adjust the ECG size by pressing ECG Size until the marker dot appears only with each R wave Adjust the placement of the multifunction defib electrodes to improve ECG R wave quality 7 Press Charge on the front panel of the HP CodeMaster 100 8 Wait for the Charge Done indicators If you must disarm the charged defibrillator if counter shock is not needed turn the Energy Select control to Monitor On Any stored energy will be discharged internally and the available energy on the display will return t
115. keyboard e To select from a menu press v to move the cursor down or press A to move the cursor up until the desired menu line is highlighted then press F3 to display the selected item e To select a field on a data entry screen press v or gt to move the cursor down or press A or lt to move the cursor up until the desired entry line is high lighted To save the settings exit the Configuration menu To change a field select F3 to step through the choices available To exit the Configuration menu and save your configuration data press F5 Adjusting Display Screen Contrast Press Shift with the A or Y key to lighten or darken the contrast on the 12 Lead display 2 14 Setup and Configuration Configuring the 12 Lead Option Using the 12 Lead Configuration Menu The 12 Lead option can be customized to meet your particular requirements Using the Configuration Menu you can choose the screens from which you can set the 12 Lead configuration When you select Configure 12 Lead from the Main Menu the Configuration Menu appears Configuration Menu Setup ID Entry Setup 12 Lead Settings Setup ECG Filters Setup Miscellaneous Setup Transmission Setup Gateway Setup Telephone Directory Setup Automated Operations Select Exit F1 F2 F3 F4 ES Each Configuration Menu choice is descr
116. keys see Figure 6 2 for lan guage specific keys press the Alt key with the desired letter Allows patient identification entry review and edit 12 Lead Initiates 12 Lead ECG acquisition Send Initiates ECG transmission Filter Turns filters on and off The filter or filters controlled by this key are selected during 12 Lead configuration The Enter key Stop Halts any 12 Lead activity and restores the normal ECG display Copy Prints a copy of the last ECG If an ECG is not in the Copy buffer the system dis plays the Manage Stored ECGs screen and prompts you to select the ECG to print The setting for this key defaults to the number of copies set in the Copy Count fea ture 1 4 copies with a default of 2 To view lead groups use the gt or w keys to move to the next lead group and the A or J keys to move to the previous lead group The or v keys move the cursor down on configuration displays and patient ID information screens The A and 4 keys move the cursor up Using the 12 Lead Option 12 Lead Keyboard and Display Figure 6 2 Characters by Language WARNING WARNING Using the 12 Lead Option Patient a
117. ks listed in Table 1 2 on page 1 24 The operating time of the battery depends on how much the battery pack is charged Press the capacity gauge button on the battery pack to determine the charge level 13 13 WARNING NOTE Maintenance CodeMaster 100 Charging the Battery Insert battery into the HP M2480B battery support system charging bay The CHARGING indicator appears to indicate that the battery is charging The battery is fully charged when the READY indicator appears A fully discharged HP M2476B 2 5 amp hour battery takes approximately 2 hours to charge a fully discharged HP M2477B 4 0 amp hour battery takes approximately 3 hours to charge It may take longer to charge the battery pack if the temperature of the battery is not between 10 C and 40 C If it is outside these temperatures the battery support system allows the battery to warm up or cool down before charging Aflashing FAULT indicator indicates a problem with the charging bay next to the indicator Notify service personnel and do not use that charging bay The other charging bay is not affected and you can continue to use it Ifthe FAULT indicator appears the battery did not charge Remove the battery from service immediately and notify service personnel If the ISTART indicator D flashes a battery pack capacity test is recommended 13 14 WARNING NOTE NOTE Maintenance CodeMaster 100 Battery Capacity Test Perf
118. le is correctly connected to the HP CodeMaster 100 4 7 Using Shock Advisory Mode Optional Using Shock Advisory Mode WARNING The unit will deliver defibrillator energy levels to a set of multifunction SS defib electrodes even if they are not attached to a patient The message PADS OFF appears when there are no electrodes or there is poor electrodes to patient contact Check all patient connections if one these messages appears 1 Attach the electrode adapter cable M2472A to the paddle connector on the front of the defibrillator 2 Slide the paddle connector lock towards the front of the defibrillator to secure the cable See Figure 4 2 4 8 Using Shock Advisory Mode Optional Using Shock Advisory Mode Figure 4 2 M2475 B0012 Connect Electrode Adapter Cable 3 Attach the multifunction defib electrodes to the patient as instructed on the package WARNING Use the Apex Anterior electrode application shown on the package This results in the modified Lead Il configuration upon which the advisory algorithm was designed and tested 4 9 WARNING Using Shock Advisory Mode Optional Using Shock Advisory Mode 4 Connect the electrodes to the electrode adapter cable The electrodes are cor rectly connected when the locking ring is twisted locking the ears of the con nector to the adapter cable Be sure to correctly connect the electrodes to the electrode adapter cable Incorrectly connecting the electro
119. lect control from Off to Monitor On Press Y ECG Size once to highlight SETUP MENU 1 Press Lead Select SETUP MENU 1 appears Press ECG Size seven times to highlight Time Press Lead Select Press ECG Size until the hours setting contains the correct time Press Lead Select Press ECG Size to select minutes Press Lead Select Press ECG Size until the minutes setting contains the correct time Press Lead Select Depress both sides of the ECG Size key simultaneously to return to the Setup Diagnostic Menu Turn the Energy Select control to Off 2 10 Table 2 1 Setting Language Upper Alarm Limits UAL Lower Alarm Limits LAL Time Date Armed Tone CRT Alerts Alert Volume Mode after CV Pacer Rate Pacer Output Setup and Configuration Configuring the CodeMaster 100 Table 2 1 and Table 2 2 show configurable parameters on the instrument Default values are shown in boldface type Setup Menu 1 Settings Choices English Dutch Swedish French German Italian Spanish Norwegian Finnish 120 140 160 20 to 280 in increments of 5 40 60 90 20 to 280 in increments of 5 HH MM DD MMM YY ON OFF ON OFF 3 to 15 SYNC DEFIB 70 ppm 40 to 180 in increments of 10 30 mA 10 to 200 in increments of 10 Description Printed and displayed text language Upper heart rate limits LAL to 280 Lower heart rate limits 20 to UAL C
120. llator does not discharge Press Sync again to remove the defibrillator from sync mode While holding down Charge press both Shock buttons on the pads adapter cable connector Verify the defibrillator discharges The recorder will print a test report NOTE CAUTION NOTE Maintenance CodeMaster 100 Notify Service Personnel if the ECG strip does not print TEST 100J PASSED Or if any of the shock button tests fail If you see the CHECK SETUP message on the screen call service to replace the backup battery 10 Disconnect the test load M 1781A from the electrode adapter cable Quick Pacer Functionality Test 1 Connect the electrode adapter cable to the defibrillator and the HP M1781A test load to the adapter cable Turn the defibrillator on by turning the Energy Select switch to the Monitor On position Press Pacer On During the test only ignore the LEADS OFF warning message if it occurs Put the pacer into the Fixed Mode of operation by pressing Mode Adjust the current to 30 mA by pressing Output Adjust the pacer rate to 60 pulses per minute by pressing Rate Start the pacer by pressing Start Stop on the pacer keypad and start the recorder by pressing Record on the recorder keypad Verify that pacer pulses are shown on the recorder strip approximately every 5 large boxes If the recorder is in delay mode it will take several seconds before pulses appear 7 A
121. llow the pacer to run for 10 12 seconds Turn the pacer off by pressing Pacer On and stop the recorder printing by pressing Record Disconnect the test load from the pads adapter cable NOTE Maintenance CodeMaster 100 Notify service personnel if the message PACER FAILURE is displayed on the monitor the unit beeps three times and displays the message PACER OUTPUT LOW or the pacer pulses are not shown on the recorder strip as described above Every Week Perform the following checks on the internal paddle set every week o Check for excessive residue from electrolyte medium on the paddle set and clean as needed See Cleaning the Electrodes and Cables on page 13 10 Oxidation can be an indication the paddle set is old and must be replaced o Check for pitting or discoloration on the electrode surfaces Replace as required o Ensure that the cable connector and electrodes have no cracks in the insulation Every Three Months Perform the following checks every three months o Have the cable set tested for electrical continuity every three months O Performa battery capacity test using the HP M2480B battery support system See the HP M2475B CodeMaster 100 Portable Defi bri llator Moni tor Servi ce Manual for extensive electrical operational and safety tests to be performed by a qualified Biomedical Equipment Technician BMET or equivalent service technician every three to six months Figure 13 1
122. lue Exit D F1 F2 F3 F4 F5 The 0 5 Hz Baseline Wander filter suppresses the greatest amount of baseline wander The 0 15 Hz Baseline Wander filter provides some baseline wander suppression without distorting the ECG s ST segment The 0 05 Hz Baseline Wander filter delivers the highest fidelity signal but pro vides the least baseline wander suppression The 40 Hz Noise filter offers maximum noise suppression but reduces the fidelity of the signal The 100 Hz Noise filter provides some noise suppression while offering an accu rate signal representation The 150 Hz Noise filter delivers the highest fidelity signal but provides the least high frequency noise suppression 2 19 NOTE Table 2 5 Setup and Configuration Configuring the 12 Lead Option The Muscle Artifact filter will be enabled when the Filter key is pressed It removes small amplitude high frequency signals characteristic of muscle tremor When the front panel Filter key is on the user configured combination of the Artifact 0 5 Hz Wander and 40 Hz Noise filters is enabled and the Filter status message appears in the upper right corner of the display Refer to Table 2 5 for information on configuring the Filter key Configurable Filters Parameter Choices Comments Wander Filter 0 05 Hz Select one baseline wander 0 15 Hz filter for ECGs 0 5 Hz Noise Filter 40 Hz Select one noise filter for 100 Hz 12 Lead ECGs 150 Hz Fron
123. m CPR ventilate or transport the patient while the advisory algorithm is analyzing cardiac rhythms Repeat analysis PADS OFF The electrode adapter cable is attached but no defib electrodes are connected Attach defib electrodes to elec trode adapter cable and to patient 12 8 Troubleshooting CodeMaster 100 Troubleshooting the E xternal Power Module M2478A or M2479A Table 12 6 External Power Module Problems Problem Cause Possible Solutions Power indicator on External power module is not receiving 1 Check connections external power power 2 Check fuse module does not 3 Check that vehicle power supply appear voltage is within range 4 Call your local HP service repre sentative to replace the external power module Charging indicator Battery is not charging 1 Make sure that external power is does not appear on on battery 2 Check connections 3 Make sure battery is properly installed in the defibrillator 4 Make sure battery temperature is less than 60 C 140 F 5 Replace the battery with another battery 6 Call your local HP service repre sentative to replace the external power module Fuse opens Installed with incorrect polarity 1 Replace fuse 2 Install with correct polarity Electrical problems during operation 1 Replace fuse 2 Check vehicle power supply 3 Call your local HP service repre sentative to replace the external power module 12 9 Table 12 6 Troublesho
124. means the V2 C1 C6 electrode is not connected Checking Signal Quality You can produce better ECGs by previewing the lead traces on the upper display before you acquire and print the ECG By observing the traces and adjusting the leads accordingly you can obtain the best possible ECG report The leads are displayed in five groups of three leads each The groups are listed in Table 6 3 Restoring the ECG Trace After application of a defibrillator pulse reconnecting one or more leads or any other time the ECG signal is off center during ECG acquisition traces can be quickly restored by pressing the Stop key 6 12 Table 6 3 NOTE Lead Groups Using the 12 Lead Option Acquiring a 12 Lead ECG Group Leads Displayed Group 1 I IL III Group 2 aVR aVL aVF Group 3 V1 V2 V3 Group 4 VA V5 V6 Group 5 user configurable e To select which three leads to display on the screen press the y or p key or the Space bar to display the next lead group or press the A or lt key to display the previous lead group Before you connect the electrodes each lead displays on the screen as a dotted line indicating that at least one of the electrodes associated with the lead is not connected The dotted line is known as a leads off trace Use the leads off labels see Table 6 2 to determine which electrodes are off As you connect the electrodes to the patie
125. mote site Check telephone number Re try transmission 12 17 Table 12 10 Troubleshooting The 12 Lead Option Transmission Problems and Solutions Continued Message No fax at remote site Check modem configuration Likely Cause Remote site answered but no fax machine was detected or a modem answered Incompatible or improperly initial ized modem Possible Solutions Verify transmission type with remote site Check telephone number Re try transmission Verify the modem initialization string Refer to modem specifications in Chapter 14 Specifications Verify that your modem is com patible Incompatible fax machine at remote site The fax machine at the remote site is not a group III device Transmission requires a group Ill fax machine at remote sites Transmission stopped unex pectedly X of N ECGs sent Cable modem problem Press any key to continue No power to modem or poor modem cable connection Check that there is power to the modem Check the data commu nication cable connections Call the other location to verify their modem is functioning correctly Transmission stopped unex pectedly X of N ECGs sent Modem was disconnected Press any key to continue Problem with telephone line Check that the modem is con nected to the telephone line Ver ify that the telephone line is working Transmission stopped unex pectedly X of N ECGs sent
126. mp monitoring 14 12 Index Numerics 12 Lead option configuration menu 2 13 12 Lead report formats 2 17 14482A external monitoring cable 5 14 1625A patient cable 5 2 3 wire patient cable 5 3 3x4 Auto report 6 26 3x4 3R Auto report 6 28 40457C recorder paper 2 3 13 7 13 18 40457D recorder paper 2 3 13 7 13 18 50J MAXIMUM 12 2 5 wire patient cable 5 2 5 4 5 5 70 PPM 30 MA 83 8120 1692 power cord 13 17 8120 1703 power cord 13 17 8120 2296 power cord 13 17 8120 2957 power cord 13 17 8120 4464 power cord 13 17 8120 4600 power cord 13 17 8120 5213 power cord 13 17 A AC interference 12 14 ACI TIPI 2 22 adapter cable testing 13 4 13 6 adhesive pads defibrillating with 3 7 adhesive pads adapter cable connecting 2 4 advisory mode default settings 4 20 energy delivered 4 13 event summary 4 16 using 4 3 alert volume 2 11 Alt char 6 4 alternate paddle sets defibrillating with 3 6 anterior posterior paddles 3 9 armed tone 2 11 artifact filter 2 20 asynchronous mode 1 6 ATTACH PADS 8 4 12 5 audible indicators 1 20 4 5 Auto baseline wander filter 2 20 auto disarm tone 1 20 4 5 Auto ECG and Copy key 6 20 copying 6 20 AUTOGAIN 12 11 automatic disarm 1 21 automatic recordings 5 11 B backup battery 2 7 baseline wander filter 2 19 battery capacity test 13 6 13 11 13 15 charging 13 14 disposal 13 13 maintenance 13 11 13 15 monit
127. n the Energy Select control to Advisory On and press Review The header record lists when power on occurred when the last event occurred and how many shocks were delivered The record also includes areas for you to write in the patient s name the operator s name and any comments about the event The directory lists all events that occurred during the resuscitation attempt and the time of their occurrence 4 17 Using Shock Advisory Mode Optional Printing the Advisory Event Summary Record The following table lists the events the directory shows Table 4 2 Advisory Event Summary Record Information Event Description Notes Analyzing Indicates when the advisory algorithm started analysis Analyze pressed Artifact Detected Indicates that the advisory algorithm detected excessive artifact Shock Advised Indicates when the advisory algorithm detected a ECG strip recorded shockable rhythm and advised a shock No Shock Advised Indicates that the advisory algorithm detected a ECG strip recorded non shockable rhythm and did not advise a shock Cannot Analyze Indicates that the advisory algorithm could not ECG strip recorded analyze the cardiac rhythm due to excessive arti fact Analysis Stopped Indicates that the user stopped the advisory algorithm analysis by pressing the Analyze key dur ing analysis Pads Off Indicates that the multifunction defib electrodes were removed from the patien
128. nd Operational Safety Notes Patient and Operational Safety Notes The HP CodeMaster 100 with the 12 Lead option isolates all connections to the patient from electrical ground This reduces the possibility of hazardous currents passing from the device through the patient s heart to ground To ensure the patient s safety and your own observe the following reminders The HP patient cable supplied with this device or an HP approved substitute patient cable is an integral part of the defibrillator monitor safety features Using any other patient cable may compromise defibrillation protection as well as performance Only qualified personnel may service the device Do not use the HP CodeMaster 100 with 12 Lead near flammable anesthetics It is not intended for use in explosive environments Do not use the HP CodeMaster 100 with 12 Lead in the presence of electrosurgical or diathermy instruments Do not touch the patient or patient cable during defibrillation Death or injury may occur from the electrical shock delivered by the defibrillator Be sure that the electrodes or connectors do not come in contact with any other conductive materials including earth grounded materials especially when connecting or disconnecting electrodes to from a patient The use of multiple instruments connected to the same patient may pose a safety hazard due to the summation of leakage currents from each instrument Any combination of instruments should be ev
129. ne sounds to alert you that the defibrillator is charged and the system displays the following messages CLEAR PATIENT PRESS SHOCK BUTTONS Defibrillating a Patient 1 Verify that no one is in contact with the patient the cable or pad electrodes the bed rails or other potential current path 2 Call out Clear to alert personnel that a defibrillator shock is about to be deliv ered and to remain away from the patient 3 Press both Shock buttons simultaneously to defibrillate The Shock AN but tons are on the cable connector housing shown in Figure 4 4 If the defibrillator does not shock refer to Chapter 12 Troubleshooting 4 13 Using Shock Advisory Mode Optional Using Shock Advisory Mode Figure 4 4 Shock Buttons 4 After the defibrillator charges press the Shock buttons promptly If the shock is not delivered within 30 seconds the HP CodeMaster 100 disarms and the energy level remains the same for the next shock NOTE You can disarm the defibrillator by switching the Energy Select control to the Off or Monitor On positions If you disarm the defibrillator by turning the Energy Select control to Off the energy select sequence is reset to its original charge settings No Shock Advised If a non shockable rhythm is detected the message NO SHOCK ADVISED displays for about 30 seconds Continue CPR and basic life support as directed by your system s protocol At any time you can anal
130. nector M2475 B0005 SpO gt Operating Controls 1 13 Getting Acquainted Operating Controls and Indicators SpO Operating Controls Control Button Function SpO On Off Starts and stops the pulse oximeter SpO Alarm Controls SpO alarms SpO Connector SpO sensors and adapter cables plug into the SpO input connector Chapter 9 SpO2 Monitoring contains further information about using the pulse oximeter Getting Acquainted Operating Controls and Indicators Advisory Mode Operating Controls Optional This section details the operating controls for the HP CodeMaster 100 in Advisory Mode Figure 1 9 illustrates the placement of the controls Figure 1 9 ENERGY SELECT DEFIBRILLATOR o o o Energy Select o o o ma i Analyze Analyze Off Standby Advisory On Advisory Mode Operating Controls Control Button Function Advisory On Places the CodeMaster 100 in advisory mode Analyze Starts automatic analysis of ECG waveforms Getting Acquainted Operating Controls and Indicators 12 Lead Operating Controls This section provides an overview of the 12 Lead portion of the CodeMaster 100 Figure 1 10 shows the keypad and operator buttons that you use to setup acquire and transmit patient data Refer to Chapter 6 Using the 12 Lead Option for more information 1 16 Figure 1 10 Getting Acquainted Operating Controls and Indicators
131. ng defibrillation However monitoring electrodes can become polarized during defibrillation shock causing the ECG waveform to briefly disappear from the display You can reduce this effect by using silver silver chloride electrodes Be sure that the electrodes or lead wire tips do not come in contact with any other conductive materials including earth grounded materials especially when connecting or disconnecting electrodes to from a patient 3 Attach disposable monitoring electrodes by performing the following steps a Peelthe protective backing from the electrode Be careful to keep adhesive surface free from electrolyte medium b Applythe electrodes firmly to the patient s skin pressing around the entire edge of the electrode c Snaplead wires onto electrodes assuring good contact between the electrode and the lead end Tape the lead wire to the skin to prevent the electrode or lead from loosening d Plugthe patient cable connector into the ECG input connector on the lower front of the defibrillator behind the carrying handle 5 5 NOTE Monitoring Preparing the Patient The HP 12 Lead patient cable can only be used with snap ECG monitoring electrodes Use only Hewlett Packard approved ECG monitoring electrodes Do not mix reusable and disposable electrodes Be careful to correctly align the cable plug when connecting the patient ECG leads cable to the HP CodeMaster 100 Correctly orient the cable plug key with
132. ng equipment there is an external monitoring cable which plugs into the ECG Output jack of the bedside monitor and connects to the HP CodeMaster 100 ECG Input for monitoring To use an external monitor perform the following steps 1 Select Lead I or Lead II on the HP CodeMaster 100 2 Plugthe cable into the external monitor ECG Output jack and plug the input end of the cable into the ECG input plug on the HP CodeMaster 100 Using ECG electrodes with the HP CodeMaster 100 Use a patient cable connected to the patient and select Lead I Lead II or Lead IIL choosing the best lead that displays a large QRS complex Using multifunction defib electrodes Use the electrode adapter cable M2472A and defib electrodes selecting PADS as the ECG source 7 2 WARNING Performing Synchronized Cardioversion Performing Cardioversion Using Paddles for Performing Synchronized Cardioversion To start cardioversion perform the following steps 1 Tur the Energy Select control to Monitor On 2 Select the desired ECG lead by pressing Lead Select 3 Press Sync once to place the HP CodeMaster 100 in Sync mode The message SYNC appears on the display If you select paddles as the ECG source the message USE LEADS will appear on the display Although the HP CodeMaster 100 will allow synchronized shock in paddles ECG mode leads mode is recommended Artifact induced by moving the paddles may resemble an R wave and trigger defibrillator shock Y
133. nk cable 5 wire 12 pin IEC M1625A Lead set 5 wire AAMI M1635A Lead set 5 wire IEC M3714A Patient cable 10 wire 12 pin AAMI M3715A Patient cable 10 wire 12 pin IEC 13 16 Maintenance CodeMaster 100 Battery Support System Power Cords 8120 1692 8120 4464 8120 1703 8120 2957 8120 1692 8120 5213 8120 2296 8120 4600 Paddles M2471A Continental Europe Australia New Zealand United Kingdom Ireland Denmark Italy North America Switzerland South Africa Anterior anterior paddle set black PCI transport a Meets CodeMaster 100 defibrillator monitor specifications for water resistance Defib Electrodes M3501A M3502A M3503A M3504A M2472A Multifunction adhesive electrode pads adult AAMI Multifunction adhesive electrode pads adult IEC Multifunction adhesive electrode pads pediatric IEC Multifunction adhesive electrode pads pediatric AAMI Pads adapter cable black a Meets CodeMaster 100 defibrillator monitor specifications for water resistance 13 17 Maintenance CodeMaster 100 Monitoring Electrodes M2202A Adult snap electrodes Paper 40457C D Recorder paper Cases M3710A Carry case for 12 Lead option 13 18 Specifications Defibrillator Monitor Waveform Damped sinusoidal Lown Output Energy Delivered 2 3 5 7 10 20 30 50 70 100 150 200 300 and 360 joules Charge Control Push button on apex paddle and on front panel Charge
134. nstrument front panel 2 Callout Clear to alert personnel to stand away from the patient 3 Wait for the charge done indicators CHARGE DONE light and Charge Done tone When the unit is armed the monitor shows the Delivered Energy available in joules If the defibrillator does not charge refer to If the Defibrillator does not Charge on page 12 3 3 3 WARNING NOTE Defibrillating Defibrillating a Patient Resetting the Selected Energy Level To increase or decrease the selected energy level after pressing the Charge button perform the following steps 1 Move the Energy Select control to the new energy level 2 Wait for the charge done indicators 3 Shock To shock the patient perform the following steps 1 Briefly adjust the paddle pressure and placement to optimize patient contact as registered on the Paddle Contact Indicator located on the Sternum paddle 2 Verify that no one is in contact with the patient the monitoring cable or leads the bed rails or another potential current pathway 3 Call out Clear to alert personnel to stand away from the patient Keep hands clear of the paddle electrode edges Use your thumbs to depress the Shock buttons on the paddle handles 4 Press and briefly hold both Shock buttons labelled A one on each paddle simultaneously to deliver energy to the patient If the defibrillator does not shock refer to the If the Defibrillator does not Deliver a Shock on
135. nt the lead waveforms are displayed on the screen The ECG traces are updated by the erase bar that moves across the screen 6 13 Using the 12 Lead Option Acquiring a 12 Lead ECG Entering Patient ID Entering patient ID information is not required to record an ECG Note that for 12 Lead some ID fields affect the interpretation of ECGs To enter patient identification perform the following steps these steps assume all ID fields are enabled l Press ID If there is an existing patient ID in the 12 Lead the question New patient is displayed If not the patient ID entry screen is displayed a Ifyou press Yes Enter New ID to answer the New patient prompt the existing patient ID information is cleared and the patient ID entry screen is displayed b Ifyou press No Edit Old ID to answer the New patient prompt the existing patient ID information is displayed for you to review or change if necessary 2 Type the ID number and press gt or v The next line requests the patient s name 3 Type the patient s name and press the gt or v Year of Birth Months Weeks Days or Hours 4 Type the patient s age Press F3 until the screen displays the age units you want to use Press or v There are more patient ID fields into which you can enter patient information such as Sex and Chest L
136. ntifying Transmission Problems Troubleshooting The 12 Lead Option The following table shows symptoms and solutions to problems that can occur when transmitting an ECG Transmission Problems and Solutions Message Telephone busy re dialing Likely Cause Busy telephone number Possible Solutions 12 Lead will automatically re dial waiting 30 seconds between attempts No answer re dialing Remote modem not connected Modem is set to give up after too few rings Report problem to remote site Check configuration of modem register S7 See your modem documentation for more informa tion Check telephone cable No dial tone Check the connection to the tele phone system Be sure the telephone system is in operation Replace the telephone cable Check with your local telephone administrator Check that the phone has ringer equivalence number REN on bot tom or back of phone unit to determine if telephone system is Public Switched Telephone Network PSTN Check modem and cable No power to modem or poor modem cable connection Check that the modem is turned on Check the data communica tion cable connections between the modem and the 12 Lead Check cable Poor cable connection Check all cable connections Replace cable No modem at remote site Remote site answered but no modem carrier was detected or a fax machine answered Verify transmission type with re
137. nts and all entered ID fields Basic measurements are defined in Chapter 6 Using the 12 Lead Option Selecting this setting prints waveform patient ID basic measurements summary and standard adult or pediatric depending on age entered computer generated diagnostic statements Selecting ACI TIPI provides waveform patient ID basic measurements summary all available patient demographics and computer calculated probability of acute cardiac ischemia Selecting TPI provides waveform patient ID basic mea surements summary all available patient demographics and predicts patient outcomes mortality with and without administering thrombolyties 2 22 Setup and Configuration Configuring the 12 Lead Option Setting Copy Count Determines how many copies are printed when you press the Copy key You can enter a value from 1 4 The default value is 2 Setting Keyboard Values Keyboard mode determines whether characters will be entered in uppercase or lowercase Press F3 to change from lowercase to UPPERCASE and vice versa The keyboard is initially set to lowercase Use the shift key to enter the opposite case Setting 12 Lead Location Code The 12 Lead location code identifies a specific department or EMS Service that acquired the ECG The number prints at the bottom of the report If set to zero default this field will be suppressed from the printed report This parameter can be any five digit numeric code Setting 12
138. o 0 Resetting the Selected Energy Level To increase or decrease the selected energy level after you press Charge move the Energy Select control to the new energy level Wait for the Charge Done indicators Delivering the Synchronized Shock To perform synchronized cardioversion refer to the following steps 1 Verify again that the ECG waveform is stable and that a marker dot appears only with each R wave of the cardiac cycle 2 Depress both Shock buttons on the cable connector simultaneously until shock occurs The defibrillator will shock with the next detected R wave 7 7 NOTE Performing Synchronized Cardioversion Performing Cardioversion 3 If additional counter shocks are required readjust the Energy Select control as necessary and repeat the synchronized cardioversion procedure Depending on how the unit has been configured the HP CodeMaster 100 will either remain in the synchronized shock mode or it will return to defibrillator mode following a synchronized shock Refer to Table 2 1 on page 2 11 for instructions on configuring the defibrillator for operation after synchronized cardioversion If the defibrillator does not shock refer to If the Defibrillator does not Deliver a Shock on page 12 4 After Using the Defibrillator If you want to print an Event Summary now press Review See Printing the Event Summary Record on page 5 12 After you use the defibrillator perform the following steps to pr
139. om the electric shock delivered by the defibrillator Be sure that the electrodes or lead wire tips do not come in contact with any other conductive materials including earth grounded materials especially when connecting or disconnecting electrodes to from a patient Avoid contact between parts of the patient s body such as exposed skin of head or limbs conductive fluids such as gel blood or saline and metal objects such as bed frame or stretcher Disconnect any other medical electronic equipment from the patient during defibrillation unless labeled as defibrillator protected 4 H 4 p 3 Apply the paddles as follows a Place the Sternum paddle near the upper sternum in the patient s right mid clavicular line just below the clavicle See Figure 3 1 b Placethe Apex paddle on the chest just below and to the left of the patient s left nipple in the anterior axillary line 4 Rub the paddles lightly against the skin to distribute the electrolyte medium and increase contact between the patient skin and the paddles Then keep the paddles still to reduce motion artifact on the monitor 5 Apply 10 to 12 kg 22 25 Ib of pressure per paddle Refer to the paddle con tact indicator on the Sternum paddle to verify paddle contact Defibrillating Defibrillating a Patient Figure 3 1 M2475 06 Placing the Paddles for Defibrillation 2 Charge 1 Press Charge on either the Apex paddle or on the i
140. on See operating instructions V Battery charging DC power Fuse replacement value P Green LED power on Protective earth ground AC Alternating current Output vi WARNING CAUTION NOTE Conventions Conventions This manual uses the following conventions Warning statements describe conditions or actions that can result in personal injury or loss of life Caution statements describe conditions or actions that can result in damage to the equipment or loss of data Notes contain additional information on usage TEXT Bold Bold Italic represents the labels that appear on the display represents buttons controls on the device represents softkeys temporary key labels that appear on the 12 Lead display vii Preface Preface Introduction This Preface provides general information which you should review before using the HP M2475B CodeMaster 100 Portable Defibrillator Monitor with 12 Lead ECG option About the HP Codemaster 100 The HP CodeMaster 100 is a portable battery pow ered defibrillator monitor with built in non invasive pacing pulse oximetry SpO2 and 3 or 5 wire ECG monitoring capability It also offers an optional Shock Advisory mode as well as an option to acquire a 12 lead ECG The Shock Advisory mode detects whether the rhythm is shockable and guides the user through the process of defibrillation It comes with
141. onitoring Getting Acquainted Operating Controls and Indicators Recorder Operating Controls This section details the recorder operating controls associated with the recorder printer on the HP CodeMaster 100 Refer to Figure 1 6 Figure 1 6 RECORDER 0 CJ 3 M2475 B0005 Recorder Operating Controls Control Button Function Record Starts and stops the recorder Record does not enter an event into the Event Summary record Mark Annotates the ECG strip and or prints an ECG strip Mark enters the event into the Event Summary record Review Prints an Event Summary record Getting Acquainted Operating Controls and Indicators The function of Mark depends on the state of the recorder When the recorder is running pressing Mark annotates the ECG and enters that event into the Event Summary record f the recorder is not running and the unit is configured to do so pressing the Mark key prints an ECG strip and enters the event into the Event Sum mary This annotation can be configured to print on the ECG strip immediately when Mark is pressed or after a 6 second delay Refer to Chapter 2 Setup and Configuration to configure the HP CodeMaster 100 for recording when Mark is pressed When you press Review to print an Event Summary record the message ES is printed at the top of the ECG strip To print an Event Summary record after starting the recorder
142. ontrols 1 7 monitoring 5 1 to 5 14 during cardioversion 7 1 external 5 14 patient preparation 5 5 preparing leads 5 3 selecting the ECG source 5 8 using leads 5 2 using multifunction adhesive pads 5 7 using paddles 5 7 monitoring time of battery 1 24 5 1 multifunction 7 2 N New patient 6 14 nickel cadmium battery technology 13 12 NO PADDLES 8 3 12 1 NO PADS 12 5 noise filters 2 19 Auto ECG 2 20 Index 3 Index notch filter 2 12 o opening recorder door 13 7 operation checks 13 1 to 13 6 output button using 8 4 oxidation internal paddles 13 6 monitoring leads 13 9 oxygen saturation 9 2 P pacer adjusting rate 8 3 functionality test 13 5 increasing output 8 4 messages 12 5 operating controls 1 11 output 2 11 rate 2 11 selecting mode 8 3 setting up the pacer 8 3 specifications 14 3 starting 8 4 troubleshooting 12 5 See also pacing PACER FAILURE 12 5 13 6 pacer on button using 8 3 PACER OUTPUT LOW 13 6 PACER STOP 8 3 8 5 PACING 8 4 pacing defibrillating during pacing 8 7 general 8 1 to 8 7 modes 8 4 See also pacer paddle connector attaching to pads adapter cable 3 7 locking 2 4 unlocking 2 4 paddle contact indicator using 3 4 paddles anterior posterior 3 9 application and placement 3 2 connecting 2 3 2 4 internal testing 13 6 part numbers 13 17 using for ECG monitoring 5 2 using for synchronized cardioversion 7 3 using pedi
143. or Type HP Part No Twelve Pin M1783A Six Pin M1782A The ECG output is also compatible with the interface to the HP Viridia Information Center and other HP central stations Do not use the ECG output to synchronize another defibrillator The ECG In to ECG Out delay is 35 milliseconds The connection of external equipment may increase leakage currents Always request that local safety personnel verify that multiple connected equipment comply with local regulatory standards before putting such equipment into service Using the 12 Lead Option Introduction The 12 Lead option adds12 Lead electrocardiograph capabilities to the HP CodeMaster 100 It enables you to view acquire store print and transmit 12 Lead ECGs You can configure this feature to provide an interpretation of the ECG to further aid in patient diagnosis The 12 Lead option includes 12 Lead acquisition and printing for on site interpretation preview display to scroll through all I2 leads computerized ECG analysis or interpretation internal modem US Canada and UK and combined landline cellular for ECG transmission RS 232 port for use with external modem phone directory with auto dial with storage of up to 18 transmission sites storage of up to 30 ECGs backlit LCD display shared patient cable connector with the HP CodeMaster 100 compatible with HP TraceMaster ECG Management System M 1730B or M1729B and HP ECG Manager
144. oring time 5 1 operating time 13 13 operation 1 23 part numbers 13 16 replacing 1 23 specifications 1 24 14 9 battery capacity gauge location 1 23 using 1 24 battery support system specifications 14 10 using 13 14 C cables See patient cable pads adapter cable capacity test 13 11 13 15 cardiac monitoring 5 2 cases part numbers 13 18 cellular phone 10 7 Change softkey 6 14 changing a report format 6 21 patient ID 6 15 changing recorder paper 13 7 charge done indicators 3 3 charge done tone 1 20 4 5 charging battery 13 14 CHARGING indicator 13 14 charging the defibrillator problems with 12 3 procedure 3 3 CHECK BATTERY 2 3 12 3 check battery alert 1 20 4 5 CHECK RECORDER 5 13 122 CHECK SETUP 2 7 12 3 134 13 5 checking ECG technique 12 13 circulation effect of SpO sensor on 9 7 Cleaning electrodes 13 10 cleaning defibrillator 13 8 clock setting 2 10 configuration modem setup 2 25 telephone directory 2 27 configuring the defibrillator monitor 2 7 2 12 configuring 12 Lead option 2 13 connecting paddles 2 3 patient cable 2 3 2 5 2 6 contrast screen 12 Lead display 2 14 controls defibrillator 1 4 1 5 4 11 4 14 Index 1 Index pacer 1 11 recorder 1 9 conventions manual vii copy count setting 2 23 Copy key 6 4 copying Auto ECGs 6 20 CRT alerts 1 20 2 11 4 5 custom ID fields 6 16 D daily checks 13 2
145. orm a battery capacity test on each battery with the battery support system every 30 days Remember that a battery capacity test takes approximately 24 hours and leaves the battery fully charged Defibrillating with External Power If a battery is installed in the HP CodeMaster 100 energy to charge the defibrillator comes from the battery If the battery is depleted not functioning or not present the Power Module provides energy for defibrillation The Power Module is not intended to eliminate the battery however Although you can operate the defibrillator with the Power Module and without a battery in the defibrillator you should only do so if a battery is unavailable The defibrillator may take up to 15 seconds to charge to 360 J when running under external power with the battery absent Using Auxiliary Power Performing Operational Checks Performing Operational Checks The following operational checks should be performed along with the shift checks described in the HP M2475B Portable Defibrillator Monitor Quick Reference Unplug the Power Module Turn on the HP CodeMaster 100 If it displays the LOW BATTERY message replace the battery with a charged battery Turn off the defibrillator Pluginthe Power Module Make sure that the power indicator on the Power Module appears and that the ext power indicator on the CodeMaster appears Remove the battery from the HP CodeMaster 100 Make sure that t
146. orm a battery capacity test every 90 days or when the START indicator lt 15 flashes after you insert the battery pack into the battery support system for charging 1 Insert the battery into charging bay The CHARGING indicator appears the READY indicator may appear instead 2 Pressthe start button lt gt The TESTING indicator appears and the CHARGING or READY indicator disappears Testing the battery takes approximately 24 hours Battery capacity testing is complete when the PASS indicator appears 3 Record the date of the test on the bottom of the battery Ifthe FAULT indicator appears the battery did not pass the test Remove the battery from service immediately and notify service personnel The battery support system will automatically charge and recondition batteries during the capacity test Dispose of equipment and accessories at the end of their useful life in accordance with local and national laws 13 15 Maintenance CodeMaster 100 Supplies This section provides part numbers for supplies Battery M2476B 2 5 amp hour battery M2477B 4 0 amp hour battery M2480B Battery support system External Power Module M2478A DC external power module M2479A AC external power module Patient Cables M1500A Trunk cable 3 wire 12 pin AAMI M1510A Trunk cable 3 wire 12 pin IEC M1605A Lead set 3 wire AAMI M1615A Lead set 3 wire IEC M1520A Trunk cable 5 wire 12 pin AAMI M1530A Tru
147. ormation Press the 12 Lead key to obtain an ECG If you are using HP ACI TIPI or TPI the system prompts you for any missing information required for HP ACI TIPI or TPI See Using HP ACI TIPI on page 6 18 and Using HP TPT on page 6 19 The status messages Acquiring ECG Processing Analyzing Storing ECG andPrinting are displayed Wait for the report to print If you have configured the 12 Lead option to Auto Send the system displays the telephone directory NOTE If the memory is full and you attempt to store a new ECG the system will DE auto delete the oldest stored ECG 6 9 Using the 12 Lead Option Acquiring a 12 Lead ECG Preparing the Patient For electrode placement information refer to Figure 6 3 Figure 6 3 RA R 1 e L E RL N LL F Position Fourth intercostal space at right sternal margin Fourth intercostal space at left sternal margin Midway between V2 and V4 Fifth intercostal space at left midclavicular line Same level as V4 on anterior axillary line Same level as V4 at left midaxillary line Inside of arm between wrist and elbow Inside of arm between wrist and elbow Inside of calf between knee and ankle Inside of calf between knee and ankle Electrode Placement 6 10 NOTE Using the 12 Lead Option Acquiring a 12 Lead ECG For tips on proper ECG technique see the quick reference card included with this product located
148. ory use the Arrow button on the key pad to highlight the destination for which you want to send the ECG and press the Send softkey or the Send button on the keypad again If Auto Send Acquired ECG has been enabled then you will automatically be taken to the Telephone Directory after the ECG has been acquired and printed Select the destination and press either the Send softkey or the Send button on the keypad 10 10 Transmitting Data from the 12 Lead Option Transmitting a 12 Lead ECG 3 Choose the transmission destination for the ECG from the phone directory using the arrow keys Use the F4 key to move through the different directory pages 4 Press F2 or Send to transmit the ECG 5 The system displays a message indicating successful transmission and then returns to the home display If the ECG does not transmit the system displays the Send ECGs screen If the system does not transmit the ECG successfully refer to the section Iden tifying Transmission Problems on page 12 17 NOTE Press the STOP key to halt the transmission process For configuration information refer to Chapter 2 Setup and Configuration 10 11 Transmitting Data from the 12 Lead Option Transmitting an Event Summary Cs Transmitting an Event Summary To transmit an event summary 1 Connect the cellular or landline connection cable to the modem 2 Select Event Summaries from the Main Menu The Event Summaries screen appears Pr
149. oting CodeMaster 100 External Power Module Problems Continued Problem Cause Possible Solutions External power Defibrillator is not receiving power 1 Check that external power module indicator on power indicator is on defibrillator does 2 Check connections not appear 3 Call your local HP service representative to replace the external power module Charge time 1 Check that any wire used for greater than 15 seconds with bat tery removed Replacing the E xternal Power Module Fuse installation is 14 gauge or larger 2 Check connections 3 Call your local HP service repre sentative to replace the external power module Replace the M2478A External Power Module fuse with a 10A Fast Blow fuse HP 2110 0051 The M2479A External Power Module has a 5A Fast Blow fuse HP 2110 0709 located under the power cord strain relief on the back of the module 12 10 Troubleshooting CodeMaster 100 Performing Diagnostics The following procedure allows functional inspection of the CodeMaster 100 portable defibrillator monitor 1 Turn the Energy Select control to the Monitor On position The moni tor trace will appear within ten seconds Press Lead Select until Lead is displayed and verify that the message LEADS OFF appears indicating that one or more leadwires are not connected Press Lead Select to return to the paddles ECG selection With the paper installed press Record once to turn on the recorder
150. ou can perform cardioversion in Autogain mode Always inspect the displayed ECG before delivering the counter shock Verify that an R wave marker indi cating shock point appears only with each R wave If a marker dot does not appear or if a marker dot is viewed on the T wave segment of the ECG follow these instructions Adjust the ECG size by pressing ECG Size until the marker dot appears only with each R wave Select a different lead or adjust the electrode placement if necessary to improve ECG R wave quality 4 Select the desired energy level with the Energy Select control 7 3 WARNING CAUTION WARNING Performing Synchronized Cardioversion Performing Cardioversion Applying the Paddles 1 Prepare the paddles by performing the following steps a Remove the paddles from their holders by grasping the handles and lifting straight up b Holding both paddles in one hand apply electrolyte medium to both paddle electrode surfaces To avoid the risk of electrical shock or burns do not allow electrolyte medium to accumulate on your hands the paddle handles or the paddle electrodes on the patients chest Do not rub the electrode surfaces together to distribute the applied electrolyte medium Placing the electrode surfaces together increases the risk of an accidental paddle to paddle discharge and may cause damage to the surface of the paddles 2 Apply the paddles to the chest as follows a Place the Ste
151. pen to the right press the platen down over the paper Allow the door to close over the platen roller Press Record to test the printer functionality 13 8 Maintenance CodeMaster 100 Cleaning Exterior Surfaces The HP CodeMaster 100 and accessories except the ECG cable and carry bag are chemically resistant to common hospital cleaning solutions and non caustic detergents The following list includes some approved cleaning solutions 9096Isopropyl alcohol except adapters and patient cable Soap and water e Chlorine bleach 30 ml l water The following list includes practices for keeping the HP CodeMaster 100 exterior surfaces clean Keep the outside of the instrument clean and free of dust and dirt Clean the paddles thoroughly to prevent build up of dried electrolyte medium Do not allow any fluids to penetrate the instrument case Avoid pouring fluid on the unit while cleaning Do not use abrasive cleaners or strong solvents such as acetone or ace tone based compounds Clean the display screen carefully It is especially sensitive to rough handling and subject to scratching Do not steam sterilize the monitoring leads submerge them for prolonged periods or heat them above 50 C If metallic surfaces become oxidized clean them with a very light abrasive toothpaste Do not use highly abrasive cleaners such as steel wool or silver polish Do not steam or gas sterilize the external paddle set
152. r shoe Kimghora Donald mM Mp4 Hc 1 tp Par Ht e MUS douces uc S IL Fal Lave v E d Lu repped nA EEG E er CK Sat n Page t of 3 23458 3l Aug 1008 16 43 56 Kinghorn Donald Hewlett Packard CodeMaster IUU l2 Lead A Se in E E loi tical tule Ue ise dedi Page 2 of 3 23 mm s 10 mm mV y 0 13 Hz 40 te X705 23458 31 Aug 1998 16 33 56 Kinghorn Donald Hewlett Packard CodeMaster 100 12 Lead 92 Years p a Rate 412 SINUS TACHYCARDIA RATE 112 ormal P axis fate gt 100 PR 183 BORDERLINF LEFT ATRIAL ABNORMALITY MEET mM P gt 30mS l0 mV VI QRSD 82 ANTEROLATFRAL INFARCT ACUTE wea vis ST 20mV Q 35mS V2 V6 or 268 QTc 366 Axis D yi QRS 2 Edited F 73 ABNORMAL ECG Unconfirmed diagnosis 25 mm s 10 mm mV fy 0 z 40 Hr Me709 Page 3 of 3 3x4 ECG with One Rhythm Strip 3x4 1R 6 27 Figure 6 7 Using the 12 Lead Option Setting Up the Printed Report esasy 23 Aug 1998 10 34 01 Anderson Margaret ave Page 1 of 3 Hewlett Packard EodeMabter 180 12 TT IMs n 10 ma sY amp 0 15 Hz 40 Hr heros PITE 23 AUg 199 10 34 01 Anderson Margaret WR AR AA RAT auam r A Page 1 of 3 23459 25 Aug 1998 10 34 01 Anderson Margaret Mevlett Packard CodeMaster 100 12 Lead 70 Years F kate 120 SINUS TACHYCARDIA RATB 120 normal P axis rate gt 10
153. ransmission to the emergency department for patients with chest pain and possible Acute Myocardial Infarction AMI The prehospital 12 Lead ECG offers paramedics and emergency physicians significant advantages over the single lead ECG typically available in EMS The prehospital 12 Lead ECG not only provides a diagnostic quality ECG for use in the detection of AMI but also allows the knowledgeable paramedic to determine the area of myocardial injury anticipate associated potential complications and implement treatment strategies accordingly In addition the prehospital 12 Lead ECG provides a baseline for serial ECG evaluations Contraindications None known SpO Monitoring Indications Pulse oximetry through plethmography SpO is a measure of oxygen saturation in arterial blood It is indicated for use when determining a patient s level of hypoxemia Contraindications None known xii Preface Electromagnetic Compatibility When using the HP CodeMaster 100 with or without the external Power Module electromagnetic compatibility with surrounding devices should be assessed A medical device can either generate orreceive electromagnetic interference Testing for electromagnetic compatibility EMC has been performed according to the international standard for EMC for medical devices IEC 601 1 2 This IEC standard has been adopted in Europe as the European Norm EN 60601 1 2 The EMC standards describe tests for
154. red Energy and Shock Button Functional Test on page 13 3 you may see a CHECK SETUP message on the screen This message appears when the backup battery has approximately 90 days of life remaining When you see the CHECK SETUP message on the screen call service to replace the backup battery If you do not replace the backup battery the SETUP LOST message appears on the screen after the internal battery depletes and you may have to reconfigure the instrument 2 7 Setup and Configuration Configuring the CodeMaster 100 Configuring the CodeMaster 100 Perform the following steps to configure the CodeMaster 100 1 Depress Sync and HR Alarm while turning the Energy Select control from Off to Monitor On A Setup Diagnostic menu will appear with the following choices CALIBRATE DEFIB SETUP MENU 1 SETUP MENU 2 RESTORE FACTORY SETTINGS PRINT LOG TEST DEFIB TEST ECG TEST CRT TEST RECORDER TEST CONTROLS TEST INDICATORS TEST BATTERY TEST PACER TEST 12 LEAD 2 Select SETUP MENU 1 by pressing the A and Y arrows on the ECG Size key until the highlight appears on SETUP MENU 1 3 Press Lead Select SETUP MENU 1 will appear with the current setup values displayed 4 Press the A and Y arrows on the ECG Size key until the highlight appears on the value you wish to change 5 Press Lead Select 6 Press ECG Size to scroll through the
155. rform the Battery Capacity Test on page 13 15 to charge and test the battery Insert a fully charged and tested battery into the CodeMaster 100 Figure 2 1 Insert the battery into the compartment with the connector to the inside Slide the battery into the compartment until it latches Battery capacity gauge M2475 B0007 Quick change battery latch Loading the Battery into the CodeMaster 100 2 2 NOTE Setup and Configuration Setting Up the CodeMaster 100 If the battery is not properly seated in the battery compartment of the CodeMaster 100 the instrument will display the warning message CHECK BATTERY accompanied by an audible warning when you power on the instrument Loading the Recorder Paper The HP CodeMaster 100 recorder uses 50mm wide thermal recorder paper HP 40457C D To load the paper refer to Changing the Recorder Paper on page 13 7 Connecting the Paddles or Multifunction Defib Electrodes and Patient Cables The defibrillator has a paddles electrode adapter cable for attaching external paddles internal paddles or multifunction defib electrodes It also has an ECG Input connector for attaching ECG leads 2 3 NOTE Figure 2 2 paddles electrode O ee adapter cable connector e O Connector lock Setup and Configuration Setting Up the CodeMaster 100 Connecting Paddles or Multifunction Defib Electrodes To connect the paddles electrode adapter cable to the de
156. rify proper connections from the patient to the defibrilla tor This includes connections to the pads paddles adapter cable if one is being used Also check for worn or broken areas along the cables 3 Press Charge again wait for the Charge Done indicators 4 Pressthe Shock CAN buttons again 5 Ifthe unit remains unable to shock turn the Energy Select control to the Monitor On or Off position and use a back up defibrillator 6 Press Review to print an event summary and keep any ECG strips from the defibrillator for later evaluation 7 Contact HP service personnel as soon as possible Table 12 3 Troubleshooting the Pacer Pacer Messages Message PACER FAILURE Cause The unit detected a delivered current error Troubleshooting CodeMaster 100 Possible Solutions 1 Change electrodes and make sure electrode adapter cable is properly connected 2 Restart the pacer If PACER FAILURE happens again use a back up pacer and call for service PACER OUTPUT LOW Pacer current highlighted on the display The pacer cannot deliver the required current 1 Stop the pacer 2 Change the pads and check the pads adapter cable for proper connection 3 Restart the pacer STOP PACER Anattempt was made to change pacing Stop the pacer before you change mode while pacing the pacing mode NO PADS Pacer is on and one of the following Attach electrodes for pacing OCCUIS
157. ring the Synchronized Shock 7 7 After Usingthe Defibrillator 7 8 8 Pacing What is Noninvasive Transcutaneous Pacing 8 1 xxiii 10 Pacer Operating Controls 8 2 Usingthe Pacer 8 2 Defibrillation During Pacing 8 7 SpO Monitoring Understanding Pulse Oximetry 9 1 Whatis SpO2 9 2 How Does Pulse Oximetry Work 9 2 SpO2 Operating Controls 9 3 Patient Monitor Using SpO2 9 3 SensorTypes 9 3 Using SpO2 9 4 Apply the Sensor to the Patient 9 4 Applying the Reusable Sensor 9 4 Troubleshooting Sensor Application 9 6 Patient Movement 9 6 Inspecting the Application Site 9 6 Circulation at Application Site 9 7 Connecting the Sensor to the Instrument 9 7 Start Monitoring 9 8 SpO Readings 9 9 SpO Alarms 9 10 Activating SpO Alarms 9 10 Deactivating SpO gt Alarms 9 10 Recorder Output 9 10 Transmitting Data from the 12 Lead Option Receiving Devices 10 2 Using Landline Communications 10 3 Using Cellular Communications 10 7 Transmitting a 12 Lead ECG 10 10 xxiv 11 12 Transmitting an Event Summary 10 12 Using Auxiliary Power The AC Power Module 11 1 Usingthe AC Power Module 11 1 Indicators 11 2 Charging Indicator 11 2 Power Indicator 11 2 Using the DC External Power Module 11 3 External Power Module Indicators 11 4 Installing the External DC Power Module 11 5 Testing the External Power Module Installation 11 6 CodeMaster 100 External Power Indicators 11 7 Monitoring with External Power 11 8 Ch
158. rnum paddle to the right of the sternum just below the clavicle b Place the Apex paddle on the chest just below and to the left of the left nip ple in the anterior axillary line 3 Rub the paddles lightly against the skin to distribute the electrolyte medium and increase the contact between the patient skin and the paddles To avoid the risk of burns to the patient do not spread electrolyte medium between the paddle electrodes on the chest The patient can be burned if the medium forms a path between the electrodes 4 Apply 10 to 12 kg 22 25 Ib of pressure per paddle Refer to the paddle con tact indicator on the Sternum paddle to verify paddle contact 5 Press Charge on either the right Apex paddle or on the instrument front panel 7 4 NOTE NOTE Performing Synchronized Cardioversion Performing Cardioversion 6 Wait for the Charge Done indicators If you must disarm the charged defibrillator if counter shock is not needed turn the Energy Select control to Monitor On Any stored energy will be discharged internally and the available energy on the display will return to 0 Resetting the Selected Energy Level To increase or decrease the selected energy level after Charge has been pressed move the Energy Select control to the new energy level and wait for the Charge Done indicators Delivering the Synchronized Shock To perform synchronized cardioversion 1 Verify again that the ECG waveform is s
159. s information about the resuscitation attempt while in advisory mode When you print the summary a header record and event summary directory print before the stored ECGs ECGs related to events print after the directory record The advisory event summary record which is available only in advisory mode is independent of the event summary described in Printing the Event Summary Record on page 5 12 which is available only in manual mode Passing through the Off position on the Energy Select switch more than once from Advisory Mode to Manual Mode and the initiation of an Event creates a new patient summary record which could cause data loss 4 16 Figure 4 5 Using Shock Advisory Mode Optional Printing the Advisory Event Summary Record PATIENT COMMENT OPERATOR POWER ON 21 AUG 00 LAST EVENT 21 AUG 00 TOTAL SHOCKS 2 13 55 22 13 57 39 PADS ON ANALYZING SHOCK ADVISED CHARGING TO 200J SHOCK 1 PADS OFF PADS ON ANALYZING NO SHOCK ADVISED ANALYZING MARK SHOCK ADVISED CHARGING TO 200J SHOCK 2 PADS OFF NO PADS PADS ON ANALYZING NO SHOCK ADVISED ANALYZING SHOCK ADVISED CHARGING TO 3607 DISARM Advisory Event Summary Record To print the advisory event summary record press Review To stop printing the advisory event summary press Review or Record To review the advisory event summary after the instrument has been turned off or is turned to manual mode tur
160. ss Change to select Male or Female or type M or F Chest LA pain Press Change to select Yes chief complaint Yes secondary complaint No chest left arm pain Time Since Acute Press Change Units to select the Hrs and Mins 3 Ischemic Sx History Diabetes Yes or No History Hyperten Yes or No sion Blood Pressure Type the systolic value then press Type the Numeric 3 each diastolic value or 6 Height Weight Type the height weight Numeric 3 Requested by Type name or number of the person requesting the ECG Alphanumeric 16 Custom Field One This label can be configured as needed Alphanumeric 16 Custom Field Two This label can be configured as needed Alphanumeric 16 Set ECG Mgmt Pri ority to STAT Yes or No 6 16 Using the 12 Lead Option Acquiring a 12 Lead ECG NOTE To obtain high fidelity ECG tracings suitable for manual interpretation of the ST SS segment use the 0 05 Hz or 0 15 Hz bandwidth filter selections The 0 5 Hz baseline wander filter should not be used for manual interpretation of the ST segment Using the 12 Lead Option Acquiring a 12 Lead ECG Using HP ACI TIPI The 12 Lead option includes the HP Acute Cardiac Ischemia Time Insensitive Predictive Instrument ACI TIPI This feature is used to provide the predicted probability of acute cardiac ischemia by using patients demographics and ECG information If you have configured HP ACI TIPI as your interpretation option when you
161. ssigned to each terminal device provides an indication of the maximum number of terminals allowed to be connected to a telephone interface The termination on an interface may consist of any combination of devices subject only to the requirement that the sum of the Ringer Equivalence Numbers of all the devices does not exceed five 5 0 xvi Telecom Regulatory Information United Kingdom In compliance with the Department of Trade and Industry the following information is provided Although this equipment can use either loop disconnect or DTMF signaling only DTMF signaling is subject to regulatory requirements for correct operation It is therefore strongly recommended that the equipment is set to use DTMF signaling for access to public or private emergency services DTMF signaling also provides faster call set up xvii Telecom Regulatory Information xviii Contents Notice ii Responsibility of the Manufacturer ii Associated Documents iv Printing History iv Symbol Definitions v Conventions vii Preface viii Introduction viii About the HP Codemaster 100 viii Theory of Defibrillator Operation viii Intended Use ix Indications and Contraindications ix Defibrillation ix Defibrillation x Noninvasive Pacing xi 12 Lead Electrocardiography xii Indications xii Contraindications xii SPO Monitoring xii Indications xii Contraindications xii Electromagnetic Compatibility xiii Reducing Electromagnetic Interference
162. stored in a car or ambulance under severe climate conditions will function until equipment reaches adjusts to operating environment listed above Equipment Classification internally powered de Is Apre eton against ingress of liquids IPX4 defibrillator pads not suitable for use in the presence of a flammable anesthetic mixture with air or nitrous oxide mode of operation continuous patient applied parts classification I Type BF defibrillator paddles 1 i Type CF SpO and ECG 14 2 Specifications Defibrillator Monitor Monitor Inputs ECG may be viewed through paddles or patient cable Lead I I III or PADDLES selectable Additional leads aVR aVF aVL V Leads and PADS are available Monitor and recorder indicate selected ECG source Lead Fault LEADS OFF message and dashed baseline appear on monitor if a lead becomes disconnected Common Mode Rejection Greater than 90 dB measured as per AAMI standards for cardiac monitors EC13 Display Size and Type 5 inch 12 7 cm diagonal CRT for 4 seconds of ECG data on screen non fade fixed trace Scrolling trace is selectable Sweep Speed Fixed trace 25 mm sec nominal Scrolling trace 28 5 mm sec nominal Frequency Response 0 5 to 40 Hz Heart Rate Display Digital readout on monitor from 15 to 300 BPM Heart Rate Alarms Three configurable pairs of high and low heart rate alarm limits from 20 to 280 BPM ECG Output
163. t No Pads Indicates when electrode adapter cable was disconnected from defibrillator Pads On Indicates when multifunction defib electrodes were connected to the patient Mark Marker symbol t annotates strip when Mark was ECG strip recorded pressed Charging to nnnJ Indicates when automatic charge sequence began after advisory algorithm advised a shock Shock Indicates when shock was delivered delivered ECG strip recorded energy peak current and patient impedance Disarm Indicates when the defibrillator performed an internal disarm sequence 4 18 Using Shock Advisory Mode Optional Printing the Advisory Event Summary Record The HP CodeMaster 100 automatically records 11 second ECG strips for Shock Advised No Shock Advised and Cannot Analyze events You can record other events by pressing Mark For Mark events and shock events ECGs are written from 3 seconds before the event to 8 seconds after the event is over Approximately 200 events and 50 ECG strips can be stored Figure 4 6 shows a sample ECG strip Figure 4 6 Sample ECG Strip Clearing Advisory Event Memory The instrument retains event information after you turn the instrument off Memory clears when the HP CodeMaster 100 is turned on placed in Advisory Mode and Analyze pressed or a new ECG strip is recorded see Table 4 2 Advisory Event Summary Record Information Memory does not clear if the HP CodeMaster 100 is simply turned on or if the
164. t Panel Filter Key Select whether or not the Muscle Artifact filter Yes or No artifact baseline wander 0 5 Hz Baseline Wander filter Yes or No and noise filters are acti 40 Hz Noise Filter Yes or No vated by the Filter key a Default values are shown in boldface font 2 20 Setup and Configuration Configuring the 12 Lead Option Setting Up Interpretation Copy Count Institution Label and Keyboard Parameters Setup Miscellaneous Institution Label Hewlett Packard 12 Lead Interpretation Standard Adult Pediatric Copy Count 2 Set Keyboard lowercase 12 Lead location code 00000 12 Lead ID 0000 Erase Exit F1 F2 F3 F4 F5 Changing the Institution Label The Institution name is printed and transmitted with all ECGs and is displayed at the top of the Main Menu Press F1 to clear the field then type a name There are 30 character spaces available in this field 2 21 Setup and Configuration Configuring the 12 Lead Option Setting Interpretation Values Interpretation values determine which analysis is applied to an ECG report The settings are None Measurements Only Standard Adult Pediatric ACI TIPI TPI Selecting None disables printing of all computer generated interpretation of the ECG The waveform prints along with the following fields Patient ID Patient Name Date and Time Selecting this setting provides an additional page containing the basic measureme
165. table and that a marker dot appears only with each R wave of the cardiac cycle 2 Briefly adjust paddle pressure and placement to optimize contact as registered on the paddle contact indicator 3 Depress both Shock buttons one on each paddle until shock occurs The defibrillator will shock with the next detected R wave 4 If additional counter shocks are required readjust the Energy Select control and repeat the synchronized cardioversion procedure Depending on how the unit has been configured it will either remain in the synchronized shock mode or it will return to defibrillator mode following a synchronized shock Refer to Table 2 1 on page 2 11 for instructions on configuring the defibrillator for operation after synchronized cardioversion If the defibrillator does not shock refer to If the Defibrillator does not Deliver a Shock on page 12 4 7 5 Performing Synchronized Cardioversion Performing Cardioversion Using Multifunction Defib Electrodes for Performing Synchronized Cardioversion This section provides details for performing synchronized cardioversion with multifunction defib electrodes Multifunction defib electrodes can be selected as the ECG source for cardioversion because they provide a reliable contact for monitoring Applying the Multifunction Defib Electrodes 1 Attach the electrode adapter cable M2472A to the defibrillator 2 Attach the multifunction defib electrodes to the patient as
166. the Event Summary Record 5 12 Recorder Errors 5 13 External Monitoring 5 14 6 Usingthe 12 Lead Option Introduction 6 1 12 Lead Keyboard and Display 6 2 Patient and Operational Safety Notes 6 6 Acquiring a 12 Lead ECG 6 8 To Acquire a 12 Lead ECG 6 9 Preparing the Patient 6 10 Checking Signal Quality 6 12 Restoring the ECG Trace 6 12 Entering Patient ID 6 14 Reviewing and Changing Patient ID 6 15 Using HP ACI TIPI 6 18 xxii Using HP TPI 6 19 Making Additional Printed Copies of the ECG Reports 6 20 Setting Up the Printed Report 6 20 Configuring the Contents of the Report 6 20 Changing the Layout and Content of the Printed Reports 6 21 The ECG Report 6 21 Basic Measurements 6 24 Calibration Signals 6 25 Report Examples 6 25 Usingthe 12 Lead Main Menu 60 29 Sending ECGs 6 31 Managing Stored ECGs 6 32 Printingthe Log of ECGs Stored 6 33 Printthe Configuration 6 33 Send Event Summaries 6 33 HP CodeMaster 100 and 12 Lead Option Interactions 6 34 7 Performing Synchronized Cardioversion Performing Cardioversion 7 1 Monitoring During Cardioversion 7 1 Using an External Monitor 7 1 Using Paddles for Performing Synchronized Cardioversion 7 3 Applying the Paddles 7 4 Resetting the Selected Energy Level 7 5 Delivering the Synchronized Shock 7 5 Using Multifunction Defib Electrodes for Performing Synchronized Cardioversion 7 6 Applying the Multifunction Defib Electrodes 7 6 Resetting the Selected Energy Level 7 7 Delive
167. to avoid creating potentially dangerous electrical paths Never open the instrument case Dangerous high voltages can be exposed Only qualified service personnel can service the instrument Do not use the defibrillator in a flammable or oxygen rich atmosphere This will cause an explosion hazard Do not rely entirely upon heart rate alarms Rate meters on pacemaker patients can continue to count the pacemaker rates during cardiac arrest or some arrhythmias Keep pacemaker patients under close observation Avoid moving a charged defibrillator If you drop the unit it may discharge 1 22 Getting Acquainted Battery Operation Battery Operation The HP CodeMaster 100 operates from a nickel cadmium battery Figure 1 13 This battery provides optimum performance and battery life when charged and maintained using the HP M2480B Battery Support System Figure 1 13 Battery capacity gauge d M2475 05 HP M2476B M2477B Battery In addition to the standard M2476B 2 5 amp hour battery Hewlett Packard offers the M2477B 4 0 amp hour battery which provides more monitoring time and more charge shock cycles 1 23 Table 1 2 NOTE Getting Acquainted Battery Operation Supported Battery Replacements Replace the battery only with one of the batteries listed in Table 1 2 Battery Specifications sey seule Approximate Battery Charge Shock Monitoring Time PP eas Recharging Time Cycles M2476B 2 5 amp
168. to select the correct type and size of sensor for the identified location 3 Preparethe sensor Disposable Remove protective backing Semi Disposable Apply a new adhesive wrap to the sensor 4 Apply the sensor to the identified location 5 Connect the sensor to the monitor To connect sensors from other manu facturers use the HP M1900B Connector Cable Apply the Sensor to the Patient Hewlett Packard supports the use of many sensors Use the Sensor Gui deto find the sensor which is best for your case Follow the manufacturer s guidelines for applying and using the sensor Applying the Reusable Sensor Push the sensor over the fingertip so the cable lies on the back of the hand Secure the cable to the wrist with the wrist strap supplied Make sure the finger is not pinched in the end of the sensor See Figure 9 2 This ensures that the light sources in the sensor lie over the base of the fingernail giving the best measurement results If the sensor is not in the correct position inaccurate readings result In extreme cases the instrument displays dashes instead of an SpO reading When correctly positioned the end of the finger just touches the end of the sensor Figure 9 2 CAUTION WARNING Sp0 Monitoring Patient Monitor Using Sp02 Applying the HP M1190A Reusable Sensor When non HP SpO sensors are used application must be consistent with the manufacturer s own guidelines Prolonged continuous moni
169. tomer Information 1 800 934 7372 Canada Hewlett Packard Canada Ltd 5150 Spectrum Way Mississauga Ontario LAW 5G1 905 206 4725 Marketing Center Europe Hewlett Packard GmbH Medical Products Group Herenberger Strabe 140 71034 Boeblingen Germany 49 7031 14 5151 Latin America Hewlett Packard Latin America 5200 Blue Lagoon Drive 9th Floor Miami Florida 33126 305 267 4220 Medical Distribution Europe Middle East Africa 39 rue Veyrot 1217 Meyrin 1 Geneva Switzerland 41 22 780 4111 41 22 780 4266 Asia Pacific Headquarters Hewlett Packard Asia Pacific Ltd 17 21 F Shell Tower Times Square 1 Matheson Street Causeway Bay Hong Kong 852 2599 7777 12 20 Troubleshooting Medical Supplies Medical Supplies To order medical supplies including batteries n the U S only call 1 800 225 0230 Worldwide visit our Medical Supplies website at www hp com go medsupplies Service For telephone assistance call the Response Center nearest to you or visit our website at www hp com mpgcsd United States Canada East Canada Central Canada West Australia Belgium France Germany Italy Netherlands United Kingdom 800 548 8833 800 361 9790 800 268 1221 800 268 1221 131147 32 2 778 3531 0803 35 34 33 0130 4730 0292 122999 0 20 547 6333 44 344 366333 12 21 Troubleshooting Service 12 22 Maintenance CodeMaster 1
170. toring may increase the risk of undesirable changes in skin characteristics such as irritation reddening blistering or pressure necrosis particularly on neonates and on patients with impaired perfusion and varying or immature skin morphology Specific attention must be given to sensor site inspection for changes in skin quality proper optical path alignment and attachment Check the application site at regular intervals at least every two hours and change the site if any compromise in skin quality should occur More frequent checking may be required due to an individual patient s condition 9 5 Sp0 Monitoring Patient Monitor Using Sp02 Troubleshooting Sensor Application Failure to apply the sensor properly may cause incorrect measurement of arterial oxygen saturation Do not use a damaged sensor or one with exposed electrical circuits Patient Movement Make sure that the application site chosen does not move excessively which may adversely affect the performance of the sensor You may have to replace the sensor to ensure good adhesion or you may have to choose another application site Inspecting the Application Site Inspect the SpO sensor site at least once every 2 hours to ensure adhesion skin integrity and correct alignment of the light emitter and photodetector Should alterations of skin integrity occur remove the sensor and reapply at another recommended site Avoid application of the sensor to edemato
171. trument may no longer be in pacing mode To resume pacing press Pacer On and Start Stop Pacing Using the Pacer Defibrillation During Pacing If the patient must be defibrillated during pacing perform the following steps 1 2 Set the desired energy level with the Energy Select control Press Charge The defibrillator will automatically turn off the pacer and start charging The pacer status messages will be cleared and replaced with the defibrillator delivered energy display Call out Clear to alert personnel to stand away from the patient Wait for the Charge Done Indicators Simultaneously press and briefly hold both Shock buttons located on the cable connector The shock will be delivered through the multifunction defib electrodes After the shock the pacer remains off Press the Start Stop button to resume pacing if it is required 8 7 Pacing Using the Pacer 8 8 NOTE SpO Monitoring This chapter explains how to use the pulse oximeter feature of the HP CodeMaster 100 SpO monitoring gives information on both cardiac and respiratory systems and details of oxygen transportation in the body It is widely used because it is non invasive continuous easily applied and painless The quality of SpO measurements depends on careful application of the sensor Read the following section to understand the importance of sensor application For more detailed information refer to Understand
172. ts modifications or repairs are done by persons authorized by Hewlett Packard and the electrical installation complies with the IEC or national requirements and the instrument is used according to the instructions for use presented in this manual WARNING CAUTION Notice As with all electronic equipment Electromagnetic Interference EMI between the defibrillator and any existing EMI transmitting or receiving equipment at the installation site including electrosurgical equipment should be evaluated carefully and any limitations noted before the equipment is placed in service Do not attempt to perform pacing during surgery Monitoring during quiescent periods of electrosurgery is possible but electromagnetic interference generated by electrosurgical tools during operation is sufficient to mask cardiac signals A momentary recovery period is required for the monitor to return to normal operation and will be longer if the diagnostic monitoring mode is used Defib or monitoring electrodes should be placed as far from the surgical area as reasonable while still performing normal functions to minimize the possibility of burns EMI frequency generation from electrosurgical equipment and close proximity transmitters may seriously degrade performance of the HP CodeMaster 100 Hewlett Packard assumes no liability for failures resulting from EMI between HP medical electronics and any radio frequency generating equipment at levels ex
173. tting Up the Telephone Directory 2 27 Setup Automated Operations 2 29 3 Defibrillating Defibrillating a Patient 3 1 l Select Energy 3 1 2 Charge 3 3 Resetting the Selected Energy Level 3 4 3 Shock 3 4 Preparing the Defibrillator for the Next Use 3 5 Defibrillation with Alternate Paddle Sets or Multifunction Defib Electrodes 3 6 Performing Pediatric Defibrillation 3 6 Defibrillating through Multifunction Defib Electrodes 3 7 Defibrillating with Anterior Posterior Paddles 3 9 4 Using Shock Advisory Mode Optional Understanding Shock Advisory Operating Controls 4 2 Using Shock Advisory Mode 4 3 Verify Patient Condition 4 4 A Select Advisory On 4 4 B Apply Defib Electrode 4 7 C Press the Analyze Button 4 10 D Follow Prompts 4 13 Shock Advised 4 13 Defibrillating a Patient 4 13 No Shock Advised 4 14 After Using the Defibrillator 4 15 Printing the Advisory Event Summary Record 4 16 Clearing Advisory Event Memory 4 19 Advisory Mode Default Settings 4 20 xxi 5 Monitoring Using Leads to Monitor 5 2 Preparing the Leads for Monitoring 5 3 3 Wire Patient Cable 5 3 5 Wire Patient Cable 10 Wire Patient Cable 5 4 Preparing the Patient 5 5 ECG Monitoring Electrodes 5 7 Using Multifunction Defib Electrodes 5 7 Using Paddles 5 7 Monitoring a Patient the CodeMaster 100 5 8 Heart Rate Alarms 5 9 Recording 5 10 Recording Printing ECG and Monitoring Data 5 10 Automatic Recordings 5 11 PostShock Data 5 12 Printing
174. tures are disabled 4 6 WARNING NOTE WARNING Using Shock Advisory Mode Optional Using Shock Advisory Mode In Advisory Mode the Charge button is disabled and the defibrillator cannot be charged manually To perform manual defibrillation refer to Defibrillating a Patient on page 3 1 Do not use advisory mode for long term monitoring Turn the defibrillator to Monitor On for long term patient monitoring The Heart Rate HR meter is the same for manual or advisory mode when displaying or printing HR information The shock advisory algorithm uses a HR meter specifically developed for use by the algorithm for making shock decisions when rate information is required B Apply Defib Electrode You must use the electrode adapter cable and multifunction defib electrodes in the Apex Anterior position to analyze patient cardiac rhythms when in Advisory mode You must use the electrode adapter cable and multifunction defib electrodes when in advisory mode The HP CodeMaster 100 will not analyze patient cardiac rhythms through external or internal paddle sets The message ATTACH PADS CABLE displays if the defib electrode adapter cable is not connected The defib electrodes allow accurate analysis of the cardiac rhythms and allow the defibrillator shock to be delivered You must ensure the electrodes are correctly placed on the patient and attached to the electrode adapter cable Also ensure the electrode adapter cab
175. ularly If stored longer than 30 days perform a capacity test on the battery before using it 1311 NOTES Maintenance CodeMaster 100 A new HP M2476B 2 5 amp hour battery will provide 50 360 joule charge shock cycles or a minimum of 2 0 hours of monitoringtime Perform a capacity test on the battery when it fails to provide the minimum 2 0 hours of monitoring time or 10 minutes of Low Battery warning time starting from a fully charged battery Using the AC or DC external power module does not eliminate the need to condition the batteries and capacity test every 90 days Achieving Optimal Battery Life The life of the battery depends on many variables including type of usage and temperature The HP CodeMaster 100 portable defibrillator monitor uses a nickel cadmium battery which is not adversely affected by repeated deep discharges or partial charges During storage batteries begin to loose their charge This occurs in all batteries including the NiCd batteries M2476B M2477B used in the HP CodeMaster 100 Starting with a fully charged battery greater than 5096 battery capacity will remain after 25 days The discharge rate can be increased due to the age of the battery and the environment in which it is stored You will get the best battery performance if you remove the battery from the HP CodeMaster 100 as soon as you see LOW BATTERY on the display The defibrillator displays this message just after you turn it on
176. unications equipment may increase leakage currents beyond levels that are acceptable in a patient care environment Always request that local safety personnel verify that multiple connected equipment comply with local requlatory standards before putting such equipment into service This product complies with United States Canadian and United Kingdom telecom regulatory standards for internal modems See Telecom Regulatory Information on page xv for further details NOTE Transmitting Data from the 12 Lead Option Receiving Devices Receiving Devices The CodeMaster 100 with the 12 Lead option can transmit ECGs to e personal computer equipped with HP ECG Manager software M1765A referred to as ECG Manager gateway Group III facsimile machine HP TraceMaster ECG Management System M1730A B HP PageWriter XLi cardiograph M1700A HP PageWriter 300pi 2001 200 cardiograph M1770A M1771A equipped with storage and transmission option A05 The CodeMaster 100 with the 12 Lead option can transmit the Event Summary to an event summary host Transmitting to an HP ECG Manager System HP ECG Manager running on a PC acts as a gateway or receiving station which receives prints stores and forwards 12 Lead ECGs This is the recommended platform for receiving and printing 12 Lead ECGs acquired and transmitted from the CodeMaster 100 defibrillator monitor with 12 Lead option Transmitting to a Fax Machine You can send
177. urrent time Current date Beep on Charge done Beep on alert message Alerts volume Specifies mode after cardioversion Sets the pacer rate and the initial power on default rate Sets the pacer current and the initial power on default pacer current 2 11 Setup and Configuration Configuring the CodeMaster 100 Table 2 2 Setup Menu 2 Settings Setting Recorder Delay Recorder BW Advisory Energy Record on Mark Record on Charge Record on Shock Record on Alarms Post Shock Data Power On Lead Patient Cable Notch Filter ECG Trace NOTE Choices Delay 6 S Delay Monitor Diagnostic 200 200 360 or 200 300 360 ON OFF ON OFF ON OFF ON OFF ON OFF PADDLES LEAD I LEAD II LEAD III aVR aVL aVF V 3 WIRE 5 WIRE 60 HZ 50 HZ ON OFF SWEEP SCROLL Description Printout is delayed 6 seconds or immediate Bandwidth recorder only Monitoring bandwidth 0 5 40 Hz Diagnostic bandwidth 0 05 150 Hz Sets the desired advisory mode delivered energy sequence Records during mark Records during charge Records during discharge Records during alarms ON prints the delivered energy statistics OFF prints Energy Select control setting Sets the ECG monitoring source that appears when you turn on the instrument ECG trace style If you use a 10 wire cable the leads which may be monitored are dependent upon whether the defibrillator is configured to monitor a 3 or 5 wire pati
178. us or fragile tissue Check circulation distal to the sensor site routinely 9 6 Sp0 Monitoring Patient Monitor Using Sp02 Circulation at Application Site Wrappingthe tape too tightly or using supplemental tape can cause venous pulsations that could potentially lead to inaccurate saturation measure ments Avoid wrapping the adhesive too tightly and do not use additional tape to secure the sensor High positive intrathoracic airway pressures valsalva maneuvers or other consequences of impaired venous return may also cause venous pulsations Only use adhesive wraps recommended by Hewlett Packard e Avoid placing the SpO sensor on any extremity with an arterial catheter blood pressure cuff or intravascular venous infusion line Connecting the Sensor to the Instrument When you have applied the sensor to the patient plug the disposable and semi disposable sensors into the connector cable and plug this cable into the SpO gt socket on the lower right of the HP CodeMaster 100 Plug the HP M1190A sensor directly into the SpO socket of the HP CodeMaster 100 The plug is keyed and is color coded blue to distinguish it from the white ECG socket See Figure 9 3 Sp0 Monitoring Patient Monitor Using Sp02 Figure 9 3 MONITOR RECORDER Lead Select Record HU ECG Size 4 Mark HR Alarm o Review o ECG Input Sp0 Input M
179. vel The EMC standards state that manufacturers of patient coupled equipment must specify immunity levels for their systems It is recognized that the HP CodeMaster 100 is designed to receive and amplify low level signals in the same bandwidth as the interference Immunity is defined in the standard as the ability of a system to perform without degradation in the presence of an electromagnetic disturbance Degradation in ECG quality is a qualitative assessment which can be subjective Caution should therefore be taken in comparing immunity levels of different devices The criteria used for degradation are not specified by the standard and may vary with the manufacturer For additional information about compliance with the EMC standards please see the Declaration of Conformity Statement shipped with the device xiv Telecom Regulatory Information Telecom Regulatory Information United States In compliance with the Federal Communications Commission FCC the following information is provided This equipment complies with Part 68 of the FCC rules This unit bears a label which contains the FCC registration number and Ringer Equivalence Number If requested this information must be provided to the telephone company This equipment uses the following standard jack types for network connection RJ11C This equipment contains an FCC compliant modular jack It is designed to be con nected to the on premises tel
180. version without using an ECG lead set while monitoring through the electrodes You can switch between the pacing and defibrillation modes of operation quickly The defibrillator will deliver defibrillator energy levels to an open electrodes set The message PADS OFF appears when there is poor electrode to patient contact Check all patient connections if this message appears 1 Attach the electrode adapter cable M2472A to the paddle connector Figure 3 2 on the front of the defibrillator 2 Slide the cable connector latch to the lock position to secure the cable 3 Attach the multifunction defib electrodes to the patient as instructed on the package 4 Connect the defib electrodes to the electrodes adapter cable The defib elec trodes are correctly connected when the locking ring is twisted locking the ears of the connector to the adapter cable Be sure to correctly connect the defib electrodes to the electrodes adapter cable Incorrectl y connecting the defib electrodes to the electrode adapter cable can result in a failure to deliver energy to the patient 3 7 Defibrillating Defibrillating a Patient Ifthe PADS OFF monitor message displays check all patient connections 5 Select pads as the ECG source by pressing Lead Select until PADS appears on the display under the heart rate 6 Set the Energy Select control to desired energy 7 Press Charge 8 Call out Clear to alert personnel to stand away from the pati
181. with 12 Lead Option Cellular I External Modem Lo lH HH Personal Computer running ECG Manager M1765A or Event Sum Cellular om Cellular mary Host Data Interface Bag Phone Adapter RJ11C Adapter C watt Standard Cellular Connection External Modem For country specific information about cellular service contact your local cellular communication service provider NOTE Cellular service is not reliable in all areas Check with your local cellular service provider for details of coverage area 10 9 NOTE Transmitting Data from the 12 Lead Option Transmitting a 12 Lead ECG Transmitting a 12 Lead ECG To transmit an ECG 1 Connect the cellular or landline connection cable to the modem 2 Select the ECGs to send Press the Send key or select Send ECGs from the Main Menu The Send ECG Display appears Send ECGs 2 ECGs Stored Screen 1 of 1 Name ID Time and Date Frank Smith ID 12345678 10 02 10 Apr 97 Charlotte Stephens ID 87654321 10 00 10 Apr 97 Sent Selected Select Send Select All ECGs Exit P p F1 F2 F3 F4 F5 Press F1 or F2 to highlight the ECGs Press F4 The telephone directory appears Immediately after an ECG has been acquired and printed it can be transmitted by pressing the Send button on the key pad This will take you to the Telephone Directory screen Once in the Telephone Direct
182. x second delay Frequency Response CodeMaster 100 without the 12 Lead option 0 5 to 40 Hz CodeMaster 100 with the 12 Lead option 0 05 to 150 Hz selectable Size and Weight of the CodeMaster 100 without the 12 Lead Option Defibrillator dimensions 6 25 in H by 13 75 in W by 15 125 in D 15 9 cm H by 34 9 cm W by 38 4 cm D Defibrillator weight 21 5 Ib 9 75 kg Includes external paddles battery and recorder paper 14 5 Specifications Defibrillator Monitor Advisory Mode Option C80 Analysis time Seven to ten seconds Output Energy Delivered Available protocol 200J 200J 360J and 200J 300J 360J Analysis Control Push button on front panel Charge Time Less than 5 seconds to 360 joules with battery present Armed Indicators Charge done tone and available energy indicated on display Advisory Event Summary Stores approximately 200 events and 50 ECG strips Data retained after instrument turned off Waveform Damped sinusoidal Lown 14 6 Specifications Defibrillator Monitor 12 Lead Option C90 Basic ECG Controls ID 12 Lead and Transmit ON Copy and Filter Keys Alphanumeric QWERTY keyboard Signal Processing Recording Frequency response Selectable from these ranges 0 05 150 0 15 150 0 5 150Hz 0 05 100 0 15 100 0 5 100Hz 0 05 40 0 15 40 0 5 40Hz When 0 15 150Hz is selected the 12 Lead recorder tracing meets the Frequency and Impulse Response specification of ANS
183. xiii Restrictions for Use xiv Immunity Level xiv Telecom Regulatory Information xv United States xv Canada xvi United Kingdom xvii 1 Getting Acquainted Operating Controls and Indicators 1 4 Defibrillator Operating Controls 1 4 Monitor Operating Controls 1 7 xix Recorder Operating Controls 1 9 Pacer Operating Controls 1 11 SpO2 Operating Controls 1 13 SpO2 Operating Controls 1 14 Advisory Mode Operating Controls Optional 1 15 12 Lead Operating Controls 1 16 Indicator Lights 1 18 Safety Considerations 1 21 Disarming the Defibrillator 1 21 Battery Operation 1 23 Supported Battery Replacements 1 24 Testing a Battery 1 24 Recharging a Battery 1 24 Setup and Configuration Setting Up the CodeMaster 100 2 1 Inserting the Battery 2 2 Loading the Recorder Paper 2 3 Connecting the Paddles or Multifunction Defib Electrodes and Patient Cables 2 3 Connecting Paddles or Multifunction Defib Electrodes 2 4 ECG Input Connector 2 5 Configuring the CodeMaster 100 and 12 Lead ECG Option 2 7 Configuring the CodeMaster 100 2 8 Restoring Factory Settings 2 9 Configuring the 12 Lead Option 2 13 Navigating the Configuration Menus 2 14 Adjusting Display Screen Contrast 2 14 Using the 12 Lead Configuration Menu 2 15 Setting Up Patient Information 2 16 Setting Up 12 Lead Fields 2 17 Setting Up Filters 2 19 Setting Up Interpretation Copy Count Institution Label and XX Keyboard Parameters 2 21 Setup Transmission 2 24 Se
184. yze the patients cardiac rhythm again to determine if shock is needed by pressing Analyze 4 14 Using Shock Advisory Mode Optional Using Shock Advisory Mode After Using the Defibrillator If you want to print an Event Summary now press Review See Printing the Advisory Event Summary Record on page 4 16 After you use the defibrillator perform the following steps to prepare the defibrillator for its next use O Clean all paddles controls and cables Visually check the patient cables paddles paddles cables and pads adapter cables for wear insulation nicks and other damage Refer to Chapter 13 Maintenance for additional information O Turn on the HP CodeMaster 100 If the instrument displays LOW BATTERY replace the battery pack with a charged battery O Perform the test described in Delivered Energy and Shock Button Functional Test on page 13 3 O Turn the Energy Select control to Off and return the HP CodeMaster 100 to its storage location O Check that sufficient recorder paper and electrolyte medium or multifunction defib electrodes are available for the next use of the defibrillator O Make sure that a battery is in the battery support system being charged See Charging the Battery on page 13 14 4 15 NOTE CAUTION Using Shock Advisory Mode Optional Printing the Advisory Event Summary Record Printing the Advisory Event Summary Record The advisory event summary record contain

User's Guide HP CodeMaster 100 Portable Defibrillator/Monitor

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