ZOLL

Defibrillators E-Series

E Series 12-Lead ECG Monitoring and Transmission Guide Rev D

Guide

30 Pages

File Type: PDF

File Size: 2MB

File Name: E Series 12-Lead ECG Monitoring and Transmission Guide Rev D.pdf

Available for download

Page 1

E Series

12-Lead ECG Monitoring

and Transmission

9650-1218-01 Rev. D

Page 2

The issue date for the E Series 12-Lead ECG Monitoring and Transmission Guide (REF 9650-1218-01

Rev. D) is June, 2014.

If more than 3 years have elapsed since the issue date, contact ZOLL Medical Corporation to determine if

additional product information updates are available.

registered trademarks of ZOLL Medical Corporation in the United States and/or other countries.

All other trademarks are the property of their respective owners.

ZOLL Medical Corporation

269 Mill Road

Chelmsford, MA USA

01824-4105

ZOLL International Holding B.V.

Newtonweg 18

6662 PV ELST

The Netherlands

Page 3

12-LEAD ECG MONITORING

AND TRANSMISSION

General Information

ECG leads are a defibrillation-protected Type CF patient connection.

Product Description

ZOLL E Series® with the 12-lead ECG Monitoring option provides simultaneous 12-lead ECG acquisition, storage,

transmission, and optional ECG analysis using the GE Marquette™ 12SL™ ECG Analysis Program.

Using a Bluetooth®-equipped cell phone, computer, or PDA, patient ECG records can be transmitted over a Wide Area

Network to a receiving server and distributed through e-mail or FAX, enabling physicians to quickly view prehospital

12-lead data.

Intended Use

The ZOLL E Series with 12SL is intended for the recording and automated analysis of 12-lead ECG signals acquired

from adult and pediatric patients in the supine, resting position.

Indications for 12-Lead Analysis Use

The 12-lead ECG Analysis is useful in the diagnosis and treatment of patients with acute myocardial infarction (AMI).

12-lead ECG Analysis is also useful in the interpretation and documentation of other transient cardiac arrhythmias that

may occur. When used in the prehospital setting, the 12-lead analysis results can be of assistance in diagnosis and

treatment decisions once the patient has arrived in the hospital emergency department.

How to Use This Manual

This manual provides instructions for using the E Series with 12-lead option. It does not contain information on how to

read or interpret electrocardiograms (ECGs). It covers the following:

• “WARNINGS” on page 2

•

“Electrode Placement” on page 3

•

“12-Lead Acquisition” on page 4

•

“Settings Softkey” on page 5

•

“12-Lead Reports” on page 7

•

“Daily Operational Verification” on page 13

•

“Transmission Setup: Sending Reports to a ZOLL Data Relay Server Via Dial Up Networking” on page 15

9650-1218-01 Rev. D

Page 4

E Series - 12 Lead ECG Monitoring Option Insert

WARNINGS

• Before use, carefully read the E Series Operator's Guide and these operating instructions.

• Always ensure that the patient is kept motionless during 12-lead ECG signal acquisition and analyses. Use of the

device to acquire ECG signals from moving or shaking patients may produce erroneous 12-lead interpretation

results.

• The E Series 12SL option is not intended for use with neonatal patients.

• Excessive body hair or wet, sweaty skin may interfere with electrode adhesion. Remove the hair and/or moisture

from the area where the electrode is to be attached.

• Remove ECG electrodes from their sealed package immediately prior to use. Using previously opened or out-ofdate electrodes may degrade the ECG signal quality.

• Monitoring electrodes may become polarized during defibrillator discharge, causing the ECG waveform to briefly

go off screen. ZOLL Medical Corporation recommends the use of high quality silver/silver chloride (Ag/AgCl)

electrodes to minimize this effect; the circuitry in the instrument returns the trace to the monitor display within a few

seconds.

• Wait 15 seconds after defibrillator discharge before attempting a 12-lead acquisition. Electrode polarization

subsequent to defibrillator discharge may result in excessive noise on the 12-lead ECG printout.

• When not in use, cover the patient cable's V-lead connector with the supplied plastic cap. Failure to do so may

result in a shock hazard during defibrillation attempts.

• To assure protection against the effects of defibrillator discharge, use only 12-lead cables supplied by ZOLL

Medical Corporation.

• To avoid a shock hazard and interference from nearby electrical equipment, keep electrodes and patient cables

away from grounded metal and other electrical equipment.

• Do NOT sterilize the E Series unit or any of its accessories.

• Check the operation and integrity of the E Series and 12-lead cable regularly by performing the Daily Operational

Verification Test.

• All computerized ECG analysis results must be reviewed by a physician prior to their use for determining patient

treatment.

• The frequency response of the monitor screen is intended only for basic ECG rhythm identification; it does not

provide the resolution required for diagnostic and ST segment interpretation. Use the stripchart recorder for this

purpose.

• Implanted pacemakers may cause the heart rate meter to count the pacemaker rate during incidents of cardiac

arrest or other arrhythmias. Carefully observe pacemaker patients. Check the patient’s pulse; do not rely solely on

heart rate meters. Dedicated pacemaker detection circuitry may not detect all implanted pacemaker spikes.

Patient history and physical exam are important in determining the presence of an implanted pacemaker.

9650-1218-01 Rev. D

Page 5

How to Use This Manual

Electrode Placement

Depending on local usage, ECG lead wires are marked

with certain labels. Refer to the following table for labels

and color codes for the different lead sets.

Location

AHA1 Labels

IEC2 Labels

Right Arm

RA (white)

R (red)

Left Arm

LA (black)

L (yellow)

Right Leg

RL (green)

N (black)

Left Leg

LL (red)

F (green)

Chest

RA/R

RL/N

1 American Heart Association

2 International Electrotechnical

AHA

Placement

LA/L

LL/F

IEC and Alternate AHA

Placement

Place the precordial electrodes across the chest in the

following locations:

V1:

Fourth intercostal space, at the patient’s right

sternal margin.

Proper skin preparation and use of proper electrodes are

very important for good signal quality.

V2:

Fourth intercostal space, at the patient’s left

sternal margin.

If necessary, prepare the patient's skin for electrode

application by:

• Shaving or clipping excess hair at electrode site.

V3:

Fifth rib, between leads V2 and V4.

V4:

Fifth intercostal space, on the patient’s midclavicular line.

V5:

Patient’s left anterior axillary line, at the horizontal level of V4.

V6:

Patient’s left midaxillary line, at the same horizontal level as V4 and V5.

Commission

• Cleaning oily skin with an alcohol pad.

• Rubbing site briskly to dry.

• Avoiding placing electrodes over tendons and major

muscle masses.

Place electrodes on the patient. All electrodes must be

connected.

When acquiring 12-lead ECG from quiet supine patients,

ZOLL Medical Corporation recommends placing the limb

electrodes anywhere along the ankles and wrists. When

it is difficult for the patient to remain motionless due to

shivering, muscle tremors, or transport vehicle

movement, place limb electrodes on patient’s thorax for

better results. (Refer to the following two diagrams for

limb electrode placement).

Locating the V1 position (fourth intercostal space) is

critically important because it is the reference point for

locating the placement of the remaining V-leads. To

locate the V1 position:

1. Place your finger on top of the jugular notch (see figure

below).

2. Move your finger slowly downward about 1.5 inches

(3.8 centimeters) until you feel a slight horizontal

ridge or elevation. This is the “Angle of Louis,” where

the manubrium joins the body of the sternum.

Jugular Notch

Angle of Louis

9650-1218-01 Rev. D

Page 6

E Series - 12 Lead ECG Monitoring Option Insert

Locate the second intercostal space on the patient’s

right side, lateral to and just below the “Angle of

Louis.”

Move your finger down two more intercostal spaces

to the fourth intercostal space which is the V1

position.

Note: When placing electrodes on female patients,

always place leads V3-V6 under the breast rather

than on the breast.

For AED units, the 12 Lead softkey is third from the left.

12 Lead Softkey

When you press the 12 Lead softkey, the following screen

appears:

Acquire

Settings

PT Info

Alar ms

Return

Acquire Softkey

12-Lead Acquisition

The E Series unit begins pre-acquisition of 12-lead data

when you attach the electrodes to the patient, as follows:

1. Attach electrodes to the patient lead wires.

2. Attach lead wires and electrodes to the patient, refer

to “Electrode Placement” on page 3.

3. Attach the V-lead cable to the 12-lead ECG cable.

(When V-leads are not in use, ensure the V-leads

protective cap is plugged into the V-lead connector.)

4. Attach the 12-lead cable to the ECG connector at the

back of the E Series product.

Arrange the 12-lead cable such that it is neat and not

dangling or looped, and assure that it is not pulling on

individual electrodes.

5. Turn the selector switch to MONITOR mode.

6. If PADS or PADDLES are selected, select Lead I.

(You must select leads to obtain a 12-lead printout.)

7. If the unit is configured to print 12-lead 4x3 reports,

press the RECORDER button for 3 seconds to

initiate 12-lead printout.

The unit begins printout of the 12-lead report. This

report consists of 10 seconds of 12-lead ECG data

printed in four staggered 2.5 second segments.

Note: If the V-leads are not in use, pressing and holding

the RECORDER button for 3 seconds, causes a

2 x 3 report to be printed. This report consists of 5

seconds of ECG data printed in two staggered

2.5 second segments (lead I, II and III, and lead

aVR, aVL, and aVF).

Physiological Monitoring

When the E Series device is turned to MONITOR, the

physiological monitoring menu is displayed with the

following softkeys: Param, Wave 2, ID#, Alarms and

12 Lead.

Param

Wave 2

ID#

Alar ms

12 Lead

If you enter 12-lead monitoring with 2 waveforms

displayed, both waveforms remain displayed on the

screen during the 12-lead monitoring. To remove the

second waveform prior to entering 12-lead monitor

mode, press the Wave 2 softkey.

WARNING

All computerized ECG analysis results must be reviewed

by a physician before they are used to determine patient

treatment.

For the E Series to produce a formatted ECG recording

and 12SL analysis, press the Acquire softkey. The

message ACQUIRING ECG displays and the Acquire

softkey changes to Halt.

Halt

Alar ms

Press the Halt softkey during acquisition to stop the data

collection process. The monitor displays an ACQUISITION

HALTED message and changes the leftmost softkey back

to Acquire.

During the data acquisition phase, the unit performs a lead

status check to ensure all leads are properly connected

and that 10 seconds of valid data have been acquired.

Acquisition will not occur if any of the leads are not

connected. If one or more of the V-leads is not properly

attached to the patient, an ECG VX LEAD OFF message is

displayed on the screen (“VX” indicates the specific

V-leads that are not attached to the patient).

If one or more of the limb leads is not properly attached to

the patient, an ECG LEAD OFF message is displayed on

the screen and a dashed line appears on the tracing.

When 10 seconds of valid ECG data have been acquired,

the message ACQUISITION COMPLETE is displayed. The

data is then analyzed, during which the message

ANALYZING 12 LEAD is displayed.

When the analysis is done, the message ANALYSIS

COMPLETE is displayed and the unit proceeds to the

recipient selection screen if it is configured to automatically

transmit after 12-lead analysis. Use the scroll keys on top

of the unit to select the desired recipient.

If the storage of the 12-lead ECG data does not complete,

the unit displays the messages DATA NOT

TRANSMITTED and RETRY ANALYSIS to indicate that

the patient record will be missing some or all of the 12-lead

ECG data.

9650-1218-01 Rev. D

Page 7

How to Use This Manual

Settings Softkey

To change ECG Filter, Lead Group settings or Dial Type

settings, press the Settings softkey from the 12-lead

Monitor screen. (Note that you can change defaults for

ECG Filter and Lead Group via the E Series

Configuration mode; see the E Series Configuration

Guide for more information.)

Filter

Lead Grp

Dial Type

Settings

Enter

Retur n

Once the settings screen is displayed, press the

Settings softkey again to scroll through and highlight the

different available selections. Press the Enter softkey to

select the setting that is highlighted. You can return to

the 12-lead Monitor screen by pressing the Return

softkey.

Note: AED units in Semi-Automatic mode do not

display “Filter” or “Lead Grp.” Only “Dial Type”

displays.

Filter Setting

Selecting Filter allows you to select among the following

three filter/print format settings for 12-lead monitoring:

• 0.05 - 150 Hz frequency 4x3 channel printout:

With this (0.05 - 150Hz 4x3) setting, all 4x3 12-lead

ECG reports print with a 0.05 to 150 Hz bandwidth.

• 0.05 - 150 Hz frequency continuous printout:

With this (0.05 - 150Hz Cont.) setting, pressing and

holding the RECORDER button prints a continuous

ECG strip using full diagnostic bandwidth until the

RECORDER button is released.

Note: Use a diagnostic bandwidth of 0.05 to 150 Hz for

diagnostic ECGs. ZOLL Medical Corporation

suggests using a 0.05 to 40 Hz setting in

environments prone to signal noise.

• 0.05 - 40 4x3 channel printout (0.05 - 40Hz 4x3):

With this setting, all 4x3 12-Lead ECG reports print

with a 0.05 to 40 Hz bandwidth. Use this setting to

reduce excessive muscle or other artifact. This

setting does not alter the bandwidth of ECG data

passed to the 12SL program; it only affects the

printed waveforms.

filter choices. Press the Enter softkey to save the

highlighted filter and return to the 12 Lead Monitor submenu.

Note: When the E Series is turned off for more than 10

seconds, all settings are restored to their default

settings.

Lead Group Setting

The E Series 12-Lead option allows any three ECG lead

signals to be simultaneously printed on the stripchart

recorder when using a 12-lead cable. You can choose

options Standard, Custom 1 or Custom 2, as follows:

• Standard

When programmed to this setting, 3-lead ECG

recordings are grouped and printed together as

follows:

— leads I, II, and III

— leads aVR, aVL, and aVF

— leads V1, V2, and V3

— leads V4, V5, and V6

The lead group that prints on the recorder in this

mode is the group containing the lead selected for

display on the E Series screen. For example, if lead II

is displayed, leads I, II and III are printed; if lead V3 is

displayed, leads V1, V2, and V3 are printed.

Note: When the E Series is turned off for more than 10

seconds, all settings are restored to their default

values.

• Custom

When the lead group is configured to either Custom 1

or Custom 2, 3-lead ECG recordings include the

leads preconfigured for that particular custom group.

(See the E Series Configuration Guide for more

information.)

Standard

II, III, aVF

II, III, V1

Lead Grp

Enter

Return

Press the Lead Grp softkey to scroll through and

highlight the different Lead Group selections for three

channel printing.

Press the Enter softkey to save the highlighted Lead

Group and return to the 12 Lead Monitor menu.

0.05-150Hz 4x3

0.05-150Hz Cont.

0.05-40Hz 4x3

Filter

Enter

Retur n

Select the filter you want to use by pressing the Filter

softkey. The highlight area scrolls among the different

9650-1218-01 Rev. D

Page 8

E Series - 12 Lead ECG Monitoring Option Insert

Dial Type Setting

Selecting the Dial Type setting allows you to select

either Tone or Pulse dialing.

move the cursor to the Patient ID field. Otherwise, use the

scroll keys on top of the unit to select a character on the

keypad, then press the Commit ( ) key on top of the unit

to enter the character in the Patient Name field.

Tone

Pulse

Dial Typ

Enter

Retur n

Press the Dial Type softkey to toggle between both

types of dialing modes. Press the Enter softkey to save

the highlighted dial mode and return to the 12 Lead

Monitor menu. If you want to return to the 12 Lead

Monitor menu without saving the highlighted dial mode,

press the Return softkey.

Use the scroll keys (see next figure) on top of the unit to

select a number or character on the displayed keyboard,

then press the Commit ( ) key to enter the desired

number or character.

PT NAME: J

PT ID:

ID #

Cancel

Space Bar Key

Return

Repeat for each additional character (up to 14) in the

Patient Name field.

When you have entered the patient name, select the Enter

( ) key from the keypad and press the

Commit ( ) key on top of the unit (or you can press the

Return Softkey to save the information). The highlight

automatically advances to the Patient ID# line.

Keypad on top, right side of unit.

Commit Key

PT NAME: J

PT ID:

PT Info Softkey

Press the PT Info softkey to access the patient

demographic information.

ID #

Age

Gender

Patient

Records

JANE SMITH

Retur n

ID #

You can select from the following softkeys: ID#, Age,

Gender, Patient Record or Return.

Note: If no information is entered, the default age of 60

is displayed above the Age softkey and the

default gender of Male is displayed above the

Gender softkey. The 12SL algorithm processes

ECG data based on age. All patients age 41 and

older are handled in the same manner by the

algorithm.

If a patient is under 41 years of age, you must enter the

patient's age. This is especially important because the

12SL algorithm contains age-specific criteria. For

patients 15 years of age or younger, the 12SL algorithm

performs a pediatric analysis.

Cancel

Return

The Patient ID# characters are entered exactly the same

way as patient name characters above. When the ID# has

been entered, select the Enter ( ) key from the keypad

and press the Commit ( ) key on top of the unit to store

the name and ID number and return to the Patient

Information menu (or you can press the Return Softkey to

save the information).

If you do not want to enter a Patient ID#, use the scroll

keys to select the Enter () key from the keypad, and

then press the Commit ( ) key. If no patient ID # is

entered, the E Series automatically generates a 12 digit

patient ID# based on the year/date/time (200002151320)

of the first 12-lead acquisition.

Patient Identification Number (ID#)

Use the Cancel softkey to exit this screen without saving

the information.

Press the ID # softkey to access the Name and ID#

screen. The cursor goes directly to Patient Name field. If

you don’t want to enter a name, press the ID # softkey to

Note: Whenever possible, enter a patient identification

number (ID #) before transmitting 12-lead ECG data

9650-1218-01 Rev. D

Page 9

12-Lead Reports

to a medical facility. If the data does not have a

unique ID number, the receiver must search

through all of its unidentified records to find the

patient's information.

Patient Age

To set the patient age, press the Age softkey, to display

the keypad. Use the scroll keys to select a number, then

press the Commit ( ) key to enter the digit in the Age

field (both scroll keys and the Commit key are on top of

the unit). Repeat for each digit (up to 3 digits). Press the

Return softkey to save the highlighted age and return to

the Patient Information screen.

If you want to return to the Patient Information screen

without saving the age, press the Cancel softkey.

---

NIBP

kPa

---

CO2

‹‹‹

‹‹‹ 0

SpO2%

m Hg

ECG

---

II x1.5 96

--- RR

Age:

Cancel

Retur n

Patient Gender

Press the Gender softkey to toggle the highlight

between both genders displayed above the Gender

softkey. Press the Enter softkey to save the highlighted

gender and return to the Patient Information screen.

If you want to return to the Patient Information screen

without saving the highlighted gender, press the Return

softkey.

17 JUN 04

14:07:32

13:24:03

11:52:48

Record

200406171407

14:07:32

200406171324

200406171152

All

Use the scroll keys on top of the unit to navigate through

the list of stored 12-lead records.

Press the appropriate softkey depending on what you

want to do:

• Print All — When this softkey is selected, the unit

prints all stored 12-lead patient records on the strip

chart.

• Print Record — When this softkey is selected, the

unit prints the selected 12-lead patient record on the

strip chart.

• Transmit — When this softkey is selected, the unit

allows you to transmit the selected 12-lead patient

record. Use the scroll keys at the top of the unit to

select a recipient from the list, then chose Xmit Now,

Manual Dial, or Cancel Xmit.

• Return — When this softkey is selected, the unit

exits the Patient Records screen and displays the

12-lead menu.

Note: An asterisk (*) after the Patient Identification

Number (ID#) indicates that the 12-lead ECG

record was not stored completely.

12-Lead Reports

Immediately after acquisition, the 12-lead data prints in

the following order:

Female

Male

Gender

Enter

Retur n

Patient Records

Press the Patient Records softkey to access the Patient

Records screen. Use this screen to transmit or print

specific 12-lead ECG records denoted by patient

identification number (ID #), date, and time.

Approximately 20 patient records can be stored on the

E Series. You can erase 12 lead patient record memory

by pressing and holding the summary button for 4

seconds and then pressing the Erase 12 Lead softkey.

9650-1218-01 Rev. D

1. 12-Lead ECG waveforms

2. Patient information

3. ECG analysis using the GE Medical Systems

Information Technologies 12SL Analysis Program (if

configured)

4. Measurements matrix (if configured)

See the figures in the next section, “12-Lead ECG

Waveforms,” for a view of numbers 1, 2, and 4 above.

Optionally, you can configure the unit to print median

complexes in a 4x3 format or standard data in a 2x6

format (direct FAX only). Refer to the E Series

Configuration Guide for more details.

Page 10

E Series - 12 Lead ECG Monitoring Option Insert

CAUTION

Transmission of 12-lead ECG data via cellular phones

can be less reliable than transmission via landline

connections. A strong signal and stationary

transmission improves the transmission’s success rate.

Follow the directions provided with your cellular phone.

Sending Reports Via Bluetooth or Direct

FAX

The E Series unit can send 12 lead data in three different

modes:

• In ZOLL Data Relay mode, reports are sent to a

single predefined recipient automatically with no

action required on the part of the user. Prior to

enabling Data Relay mode, the transmission method

(ZDR Mobile, ZDR Server, or ZDR RS-232) must be

set. For the ZDR Server method, the recipient must

be set.

• In automatic transmission mode, the Transmission

setup menu appears after acquisition to allow the

user to select a destination from a pre-defined list, or

enter a phone number manually.

• In the 12-lead menu on the unit, stored patient

records can be sent at any time.

There are three transmission methods for sending 12

lead data:

• To a PDA or PC using either the ZDR Mobile or

ZDR RS-232 connection. ZDR Mobile uses the

Bluetooth wireless connection in the E Series unit to

communicate with a PDA or PC running ZOLL Data

Relay software. ZDR RS-232 uses a serial cable to

connect to the PDA or PC. The PDA or PC then

forwards the received information to a ZOLL Data

Relay server for delivery to the designated recipient.

• To a ZDR server. This transmission method uses the

Bluetooth wireless connection in the E Series unit to

connect to a cellular phone using Dial Up

Networking. The cellular phone then connects

through the Internet to a ZOLL Data Relay server,

which then sends the report to the designated

recipient. The ZDR server transmission can be used

in any of the sending modes described above.

• To a Direct FAX. Direct FAX sends a FAX via the

PCMCIA modem card in the E Series unit,

connecting to either a land line or a FAX capable

cellular phone. Direct FAX can be used in automatic

transmission mode, or for sending patient records.

Sending reports:

• Data Relay mode: Prior to sending reports, the Data

Relay Configuration must be set. This is only

available on units with the Bluetooth option. Press the

Param softkey, highlight ZDR Dest. using the Select

softkey, then press the Enter softkey. Choose either

•

ZDR RS-232 or ZDR Mobile to send to a PDA or PC.

Selecting the ZDR Server entry brings up a screen of

available contacts. Use the scroll keys on top of the unit

to highlight the desired recipient, then press the Return

softkey.

To start Data Relay automatic transmission of 12 lead

reports (and trend data if enabled), press the Summary

button and then the Data Relay On softkey. To stop

Data Relay transmission, press the Summary button,

then the Data Relay Off softkey.

Automatic Transmission after acquisition: this mode

must be enabled by setting the Auto Transmit After 12

Lead option to Yes in the System Configuration menu.

After successful acquisition of a 12 lead, the

Transmission Setup screen will appear (see below).

Patient Record transmission: To send previously

acquired patient records, press the 12 Lead softkey,

then PT Info and then Patient Records. Use the scroll

keys on top of the unit to select the desired record, then

press the Transmit softkey. After retrieving the record,

the Transmission Setup screen appears.

Transmission Setup:

The screen displays a list of recipients; use the scroll keys

on top of the unit to select the desired recipient.

TRANSMISSION SETUP

ZDR

ZDRMobile

Mobile

station1@central.com

station2@central.com

Xmit

Now

Manual

Dial

Cancel

Xmit

Press Xmit Now to send the report, or Cancel Xmit to

cancel. The transmission icon will appear in the upper

left-hand corner of the screen during a Bluetooth

transmission. When the transmission is finished, the

message TRANSMISSION COMPLETED appears.

Note: For DUN transmission to succeed, the receiving

Bluetooth phone must be turned on. The phone

display may ask the user to accept the connection

to the E Series unit. If possible, the receiving phone

should be set to automatically accept connections

from the E Series unit.

To send a report via Direct FAX to a phone number not on

the list, press the Manual Dial softkey.

9650-1218-01 Rev. D

Page 11

12-Lead Reports

NIBP

SpO2%

-----

kPa

CO2 -

---

II x1.5 96

ECG

For direct FAX only: If you need to abort the

transmission, press the Abort softkey. Note that if you

turn the selector switch to another mode of operation

(DEFIB or PACER), the transmission is automatically

aborted.

--24

m Hg

--- RR

MANUAL DIAL

‹‹‹

›››

The Retry screen is displayed whenever one of these

things occur:

• The transmission is complete.

Phone #

Dial

Cancel

Use the scroll keys on top of the unit to select a number

or character on the keypad, then press the Commit ( )

key on top of the unit to enter the digit in the Phone #

field. Repeat for each additional digit (up to 25

characters).

When you have entered the phone number, select the

Enter ( ) key from the keypad and press the

Commit ( ) key on top of the unit to initiate dialing, or

press the Dial softkey.

NIBP

SpO2%

-----

kPa

CO2 -

---

m Hg

II x1.5 96

ECG

When transmitting to a FAX machine, the following

messages display in sequence: FAX PREPARING, FAX

DIALING, FAX SENDING, FAX DONE.

--24

• An error has occurred.

• The Abort softkey is pressed.

Retr y

For ZDR server transmissions, the E Series unit

automatically retries the transmissions up to 3 times. In

this case, the message RE-TRANSMITTING is

displayed.

Note the following fault conditions:

• Transmission Error

--- RR

‹‹‹

›››

Phone #

16175551234

Dial

Cancel

Note: If at least one digit has been entered, pressing

the Dial softkey or highlighting the Enter () key

on the keypad and pressing the Commit ( ) key

dials the entered phone number and displays the

following screen:

Abor t

Return

Pressing Retry displays the Transmission screen, so

that transmission can be performed again. Pressing

Return displays the main 12-lead screen. If 30 seconds

elapse and a softkey is not pressed, the main 12-lead

screen will be displayed.

MANUAL DIAL

Alarms

•

In the event of a failure to transmit the ECG record,

you are notified with a screen message and tones,

and the E Series unit continues to retry the

transmission until the operator aborts the

transmission or the transmission is successful. See

Troubleshooting on page 20 for possible transmission

error messages and the corrective actions you can

take.

Check Recorder

If the recorder runs out of paper or a paper jam

occurs during printout of the 12-lead report, you are

notified with a screen message and tones, and data

transmission continues. The operator can retrieve the

12-lead report by printing a summary report after the

error condition is cleared.

Alar ms

Standard modem call status messages appear as the

various phases of the transmission progress.

When transmitting to a ZDR server, the TRANSMITTING

message is displayed while transmission is in progress.

A successful transmission will display the message

TRANSMISSION COMPLETE.

9650-1218-01 Rev. D

Page 12

E Series - 12 Lead ECG Monitoring Option Insert

12-Lead ECG Waveforms

CAUTION

The 12SL analysis results can be affected by poor ECG data quality. If poor data quality is flagged by the system, the

interpretation statements are preceded by the statement, “Poor data quality, interpretation may be adversely

affected.” If this message prints, the analysis results may be invalid. Check for a LEADS OFF condition or other

sources of noise, correct the condition, and re-acquire. The ECG waveform should always be reviewed by a

physician to confirm any automatic interpretation.

4x3 Format

By default, the 4x3 format prints 10 seconds of 12-lead ECG data in four staggered 2.5 second segments. Each 2.5

second segment displays the ECG reading for one set of three leads (see the following figure). You can configure the

report for either standard or Cabrera print formats. 1 mV calibration pulses are printed at the beginning of the report for

each data channel.

You can also configure the E Series unit to print 5, 7.5, or 10 seconds of ECG data for each set of leads. If you specify

a setting of 5, 7.5, or 10 seconds, the E Series unit prints data acquired during the same time period (5, 7.5, or 10

seconds) for each set of ECG leads; the E Series unit does not present the ECG data for the 5, 7.5, or 10 second

periods in the staggered time format that it uses for the 2.5 second setting. (The option applies only to real time 4x3

printouts and does not apply to reports or to the data stored to the data card.)

For information on how to change this default setting, see the E Series Configuration Guide.

Standard 12-lead printout is always in 4x3 format unless configured differently.

1st 2.5 second segment

(ECG data)

2nd 2.5 second segment

(ECG data)

3rd 2.5 second segment

(ECG data)

4th 2.5 second segment

(ECG data)

4x3 Median Complexes

This format prints a single median beat for each of the 12 leads. The median beat is computed by the 12SL algorithm

and is denoted by a squiggle at the end of each median lead. You can configure the report for either standard or

Cabrera print formats. 1 mV calibration pulses are printed at the beginning of the report for each data channel.

9650-1218-01 Rev. D

Page 13

12-Lead Reports

2x6 Format (Direct FAX Report Only)

The 2x6 Format prints all 12-lead ECG data recorded during the first 5 second interval. The 2x6 format inhibits printing

of the 12SL analysis and the lead II rhythm strip normally printed on the FAX page. The stripchart always prints in the

4x3 format.

In order to FAX using the 2x6 format, set the 12 LEAD FAX FORMAT configuration option to 2x6, and the Auto

Transmit After 12 Lead configuration option to Yes. Refer to the E Series Configuration Guide for instructions on

setting these options.

Be sure to FAX immediately after acquisition, as the 2x6 FAX image is not stored in the patient records. Patient data

can, however, be reproduced in 4x3 format at a later time.

Note: This format is not available transmitted via FAX from a Bluetooth device and the ZOLL Data Relay server.

Direct FAX must be selected in the System Configuration menu (see page 17) in order to be able to send in

this format.

9650-1218-01 Rev. D

Page 14

E Series - 12 Lead ECG Monitoring Option Insert

Patient Information

DEVICE ID: 00000000000

RECORDED: 16:09:27

31 MAY 05

Normal sinus rhythm

Normal ECG

*** Unconfirmed ***

PATIENT NAME : JOE SMITH

PATIENT ID: 200505311609

PATIENT AGE: 60

PATIENT SEX: Male

Vent. Rate :

PR interval

QRS Duration:

166 ms

82 ms

QT/QTc

358 / 358 ms

P-R-T axes

54 43

Measurements Matrix

You can configure the unit to print out a measurements matrix, which consists of measurements for each segment of

each lead. To print the measurements matrix at the end of an analysis, you must change the default setting in the

E Series device. (For more details, see the E Series Configuration Guide.)

12SL Wave Measurement

After the P, QRS, and T complexes have been demarcated, the waves for each complex are identified. This is done

separately for each lead. The program finds the points at which the signal crosses the baseline within each complex. If

the crossing points define a wave that has an area greater than or equal to 160Vms, the wave is considered to be

significant. If the area is less than 160Vms, the program considers the wave to be insignificant and does not label it

as a separate wave. The measurement matrix contains the amplitudes (with respect to QRS onset) and durations of all

of these individual waves.

9650-1218-01 Rev. D

Page 15

12-Lead Reports

Reviewing an ECG

ECG data can be viewed in three different ways:

• ECG Strip — The unit displays a 12-lead strip with 10

seconds of ECG data, in four staggered 2.5 second

segments. For more information, see “4x3 Format”

on page 10.

• Interpretation — The unit displays the results of

interpretation of the ECG recording by the 12SL

program.

• Measurements — The unit displays measurements

based on all 12 leads.

The global measurements include heart rate, PR

interval, QRS duration, QT, QTc, P axis, QRS axis, and T

axis. These measurements are described as follows:

Measurement

Description

Heart Rate

Frequency is shown in beats per minute.

Normal range is 60-100.

PR Interval

This time interval is between beginning

of P wave and beginning of QRS

complex. It is sometimes referred to as

PQ duration. Smaller values indicate

premature excitation of the ventriculars;

larger values indicate conduction defects

in the atrioventricular (AV) node.

QRS Duration

Duration of the QRS complex in

milliseconds. Larger values indicate

ventricular conduction defects.

QT, QTc

Duration

Time in milliseconds from beginning of

QRS complex to end of T wave. The QTc

value is QT corrected for heart rate to

estimate the value it would have been if

the heart rate were 60 beats per minute.

Abnormal values can be due to

electrolyte imbalances or drugs: short

QT due to hyperkalaemia, long QT due

to hypocalcemia, or quinidine-like drugs

(procainamide, amiodarone).

P-axis

This is the axis of the P wave in

degrees.

QRS axis

This is the axis of the QRS complex.

Smaller than -30 is called left axis

deviation; larger than 90 is right axis

deviation. Deviations can be due to

conduction blocks or hypertrophy.

T-axis

This is the axis of the T-wave.

Following the global measurements table is a table of

lead-specific measurements for the standard 12-leads.

9650-1218-01 Rev. D

Measurement

Description

PA, PPA*

These values are the minimum and

maximum values of the P wave.

QA, RA, SA*

These values represent the absolute

amplitude of the indicated wave.

STJ

ST level at J-point.

STM, STE

These are the ST levels at the middle

and end point of the wave respectively.

TA, TPA*

These are the minimum and maximum

values of the T wave.

QD, RD, SD

These represent the duration of the

indicated wave in milliseconds.

RPA, RPD,

SPA*

These are measurements that reflect the

amplitude (RPA & SPA) and duration

(RPD) of secondary R and S waves that

may appear with RSR patterns such as

right or left bundle branch block.

* All amplitudes are in µV (microvolts) or mm (at 10mm/mV)

depending on the system setup.

For interpretation of these results, see the 12SL ECG

Analysis Program Physician’s Guide (P/N 3001-0203).

Daily Operational Verification

Perform these steps daily to ensure proper operation of

the E Series unit and 12-lead option. You will need either

a 12-lead simulator or a volunteer “patient”.

1. Connect the V-lead cable to the 12-lead cable.

2. Connect the lead wires of the 12-lead cable and Vleads to the patient or simulator. If connecting to a

patient, place ECG electrodes as indicated in

“Electrode Placement” on page 3.

3. Connect the 12-lead cable to the connector located

on the rear of the E Series.

4. Turn the E Series selector switch to MONITOR.

5. Select a normal sinus rhythm on the simulator (if

using).

6. Press the LEAD button to cycle through each of the

12 leads.

7. Verify that good quality, artifact-free ECG signals are

displayed and stabilized within 10 seconds on your

E Series unit.

8. Verify ECG LEAD OFF is NOT displayed on the

screen.

9. Verify LOW BATTERY is NOT displayed on the

screen.

10. Verify the filter setting is set for 0.05 - 40 Hz (4x3).

11. Press and hold the RECORDER button for 3

seconds.

12. Verify appropriate ECG signals are printed. See

“12-Lead Reports” on page 7 for reference.

13. Verify accuracy of time and date printed on the strip.

Page 16

E Series - 12 Lead ECG Monitoring Option Insert

14. Visually inspect ECG cable snaps for corrosion,

particularly on the retaining wire inside the snap.

15. Enter System Utilities mode (page 17) and verify that

the Bluetooth device(s) to be used appears on the list

of paired devices, and check that the proper device

is set as the default. If the correct device does not

appear, pair the device as described on page 17.

16. Perform a PING test on all Bluetooth devices to be

used (page 19).

9650-1218-01 Rev. D

Page 17

Transmission Setup: Sending Reports to a ZOLL Data Relay Server Via Dial Up Networking

Transmission Setup: Sending

Reports to a ZOLL Data Relay Server

Via Dial Up Networking

Note: This option requires configuration and setup by

ZOLL personnel.

When the E Series unit transmits 12-lead ECG reports

using the ZDR server method (see page 8), it uses a

Bluetooth-capable cellular phone that supports Dial Up

Networking. The E Series unit must be set up to identify

the server to which the unit sends the report, which

destination is to receive the report, and how to connect

the cellular device to the internet service.

1. Enter the System Configuration menu: first turn the

unit’s selector switch to OFF, and wait 10 seconds.

Then, simultaneously press and hold down the

right-most and left-most softkeys (below the monitor)

while turning the selector switch to MONITOR or ON

and continue to hold the softkeys for approximately 4

seconds. The unit powers on in System Configuration

mode. Enter the passcode (when you enter System

Configuration for the first time, enter the default pass

code of 00000000). Select the desired Language,

then press Enter.

System Configuration

FAX or

e-mail

recipient

12-Lead

Report

Bluetooth

Device

ZDR

Server

The E Series unit with the Bluetooth option must be

paired with a Bluetooth-equipped cellular phone for

successful transmission. Each E Series unit can pair with

up to 5 phones.

The E Series unit can be configured to transmit 12-lead

ECG records to a FAX machine, distribution list or single

e-mail address as an attached .pdf file.

Setting up a recipient contact list requires the following:

• Entering the information to connect to a ZDR server

(up to 12)

• Entering the contact information. A contact can be an

e-mail address, FAX number, or the name of a

distribution list that is stored in the server and used to

distribute the report to all entries (FAX and e-mail) on

the list. Up to 36 contacts can be entered (an

unlimited number of contacts can be entered in a

distribution list; see the ZOLL Data Relay System

Configuration Guide, version 5.00, for instructions on

how to set up a distribution list).

• Forming a secure Bluetooth pairing between the

E Series unit and up to 5 cellular phones.

Note: Not all cell phones transmit data reliably. See

your local ZOLL Medical Corporation sales

representative for a list of approved cell phones.

Config

Restore

Defaults

Read

From

Card

Change

Config

Exit

Config

2. Press the Change Config softkey. Use the Prev Item

and Next Item softkeys to scroll through the items.

Select Communications and then press Enter. A

menu appears; use the Change Value softkey to

modify the highlighted item.

System Configuration

COMM 1 of 2

UPLOAD

BAUD RATE

115200 bps

1 BLUETOOTH

115200 bps

BAUD RATE

ENABLE

Data Relay

Change

Value

Item

Yes

Item

Return

3. Using the Prev Item and Next Item softkeys on the

screen, scroll to Bluetooth Net Server List and

press the Change Value softkey. The unit displays a

list of current servers.

Setting Up a ZOLL Data Relay Server

Entry

Before adding a server, you must obtain the necessary

server parameters from your ZDR server administrator

(IP address, port number, etc).

To configure your ZOLL Data Relay server on the

E Series unit:

9650-1218-01 Rev. D

Page 18

E Series - 12 Lead ECG Monitoring Option Insert

You will then be asked to confirm your server

information.

System Configuration

ZDR SERVER LIST

Confirm Ser ver Information

ZDR Ser ver1

Add

Record

Edit

Record

Delete

Record

Name:

IP Address:

Port No.:

Password:

ZDR Server 1

12.107.33.90

1234

pencil

Retur n

4. To edit an existing record, press the Edit Record

softkey. To delete a record, press the Delete Record

softkey. Press Return to return to the previous

menu.

5. To add a server to the list, press the Add Record

softkey. You will be prompted for a server name, IP

address, port number, and password.

When you add or edit a record, enter information in

the following fields.

• Server Name: Enter a meaningful name for the

server. Use the scroll keys on top of the unit to

select a number or character on the keypad, then

press the Commit ( ) key on top of the unit to

enter the selected character, up to a maximum of

12 characters. Press the Next softkey to advance

to the next screen; press Cancel to return to the

server list menu.

• IP Address: Enter the unique IP address of the

server, including periods. Use the scroll keys on

top of the unit to select a number or character on

the keypad, then press the Commit ( ) key on

top of the unit to enter the selected number. Press

the Next softkey to advance to the next screen;

press the Prev softkey to return to the previous

screen. Press Cancel to return to the server list

menu.

• Server port number: Enter the server port

number.

• Server password: Enter the server password.

Cancel

Press Accept to save your server configuration and

return to the server list menu. Press Prev to go back to

the previous menu to make additional changes. To

cancel the server configuration and return to the server

list, press the Cancel softkey.

Adding FAX Numbers or E-mail

Addresses to the Recipient Contact

List

Four different types of recipients can be added to the list. A

FAX phone number, e-mail address, or distribution list all

go to their intended recipients via the ZOLL Data Relay

server. It is also possible to enter a FAX phone number for

sending in Direct FAX mode. Up to 36 contacts can be

added to the Recipient Contact List.

Note: For instructions on how to set up a distribution list,

see the ZOLL Data Relay System Configuration

Guide, version 5.00.

To add recipients to the Recipient Contact List:

1. Enter the System Configuration menu as described

above.

2. Press the Change Config softkey. Use the Prev Item

and Next Item softkeys to scroll through the items and

select Communications; press Enter.

3. Scroll down to Recipient Contact List; press Change

Value. The contact list appears.

System Configuration

CONTACT LIST

Card. email

DrA email

Nursing

fax

ER fax

Add

Record

Edit

Record

Delete

Record

Retur n

9650-1218-01 Rev. D

Page 19

Pairing Bluetooth-Capable Phones with the E Series Unit for DUN Operation

4. To edit an existing record, press the Edit Record

softkey. To delete a record, press the Delete Record

softkey. Press Return to save the information and

return to the previous menu.

5. To add a new entry to the list, press the Add Record

softkey. You will be prompted for a contact name,

transmission type, recipient address or phone

number, and ZOLL Data Relay server name if

applicable.

When you add or edit a record, enter information in

the following fields.

Contact Name: Enter a meaningful contact name for

the recipient. Use the scroll keys on top of the unit to

select a number or character on the keypad, then

press the Commit ( ) key on top of the unit to enter

the selected character, up to a maximum of 12

characters. Press the Next softkey to advance to the

next screen; press Cancel to return to the server list

menu.

Select Transmission Type: Use the scroll keys on

top of the unit to select the desired type of

transmission to the recipient:

• ZDR Server Dist. List

Commit ( ) key on top of the unit to enter the

selected item.

Select ZDR Server: If applicable, select the desired

ZOLL Data Relay server. To set up a server, See

“Setting Up a ZOLL Data Relay Server Entry” on

page 15.

Confirm Contact Information: You will then be

asked to confirm your contact information. Press

Accept to save your configuration and return to the

contact list menu. Press Prev to go back to the

previous menu to make additional changes. To

cancel the contact configuration and return to the

contact list, press the Cancel softkey.

System Configuration

Confirm Contact Information

Name:

Xmit Type:

Phone No.:

Server ID:

Nursing fax

ZDR Server FAX

978-555-1234

ZDR Server 1

• ZDR Server e-mail

• ZDR Server FAX

• Direct FAX (sending a FAX via modem)

Press the Next softkey to advance to the next screen;

press the Prev softkey to return to the previous

screen. To cancel the contact configuration and return

to the contact list, press the Cancel softkey.

System Configuration

Pairing Bluetooth-Capable Phones

with the E Series Unit for DUN

Operation

Note: A paired phone must not be more than 30 feet

away from the E Series unit.

1. Enter the System Utilities menu by turning the

selector switch to OFF, and wait 10 seconds.

Simultaneously press and hold down the left-most

softkey (below the monitor) while turning the selector

switch to MONITOR or ON and hold down the softkey

for approximately 4 seconds. The unit powers on in

System Utilities mode.

ZDR Ser ver Dist. List

ZDR Ser ver Email

ZDR

Ser ver FAX

Direct FAX

Cancel

To set up a Bluetooth phone and pair with the E Series:

Select Transmission Type

System Utilities

Cancel

In the next screen, you will be prompted to enter

contact information, which will be one of the following

depending on the transmission type selected:

• ZDR distribution list ID

Press a Key or

Power Off to Exit

• E-mail address

• FAX number

Note: For instructions on how to set up a distribution list,

see the ZOLL Data Relay System Configuration

Guide, version 5.00.

Use the scroll keys on top of the unit to select a

number or character on the keyboard, then press the

9650-1218-01 Rev. D

Bluetooth

Erase

Cards

Upload

Card

Upload

Trend

Page 20

E Series - 12 Lead ECG Monitoring Option Insert

2. Press the Bluetooth softkey.

and then automatically disable this mode; check

your device’s documentation for more information.

4. The unit will search for devices for about 20 seconds,

and then show a list of discovered nearby devices.

Bluetooth Utilities

Discovered Devices

00174378nq6y

0013abc3ef123

Manage

Paired

List

PING

Test

Pair

Now

Retur n

The unit displays the Bluetooth Utilities menu, which lists

the following options:

• Manage Paired List

When using your E Series unit for the first time, the first

step is to Pair Now, since no paired devices have been

set up yet.

Creating Device Pairings

Prior to pairing your cellular phone, you will need the

following information in order to connect to the ISP

service for that carrier. You will need the ISP number to

dial, account name and account password to login to the

service. The account name and password are not used

by all carriers.

To search for and pair with new devices:

1. Press the Pair Now softkey. The Discovery Mode

menu appears.

Bluetooth Utilities

Discover y Mode

Place remote device in

discoverable mode.

Use PIN 0000

Now

Retur n

2. Make sure that your mobile device has the Bluetooth

feature turned on and is in “discoverable” mode.

3. If you wish to change the PIN, select the Change PIN

softkey. When you return to the Discovery Mode

menu, the new PIN appears.

Note: Some mobile devices will only remain in

discoverable mode for a short amount of time,

Pair To

Device

Add

To List

Retur n

5. Use the scroll keys at the top of the unit to select the

desired device and select Pair To Device.

• PING Test

• Pair Now

Change

Sprint device

Verizon phone

6. Enter the PIN listed on the Discovery Mode menu. You

may need to press OK or some other command on your

device, depending on the model. The screen will say

**PAIRING**, then return to the list of devices. Refer to

your mobile phone’s documentation for more

information on pairing with a Bluetooth device.

7. If the pairing is successful, there is usually an entry on

the mobile device. If the pairing fails on the E Series

unit but not on the mobile device, repeat the pairing a

second time; this will often be successful. If the

E Series unit continues to fail at pairing, it may be

necessary to delete the pairing on the mobile device

and start over.

8. Press the Add to List softkey. You will then be

prompted for the ISP Phone Number of your device,

• Enter ISP Phone Number: enter the ISP number

supplied by your carrier. This number usually begins

with * or #. Use the scroll keys on top of the unit to

select a number or character on the keypad, then

press the Commit ( ) key on top of the unit to enter

the selected number. Press the Next softkey to

advance to the next screen; press Cancel to return

to the server list menu.

• Enter ISP Login Name (optional): Enter the login

name, if your carrier requires this feature. Use the

scroll keys on top of the unit to select a number or

character on the keypad, then press the Commit

( ) key on top of the unit to enter the selected

number. Press the Next softkey to advance to the

next screen; press Cancel to return to the server list

menu. If your carrier does not require a login name,

leave the field blank and press Next.

• Enter ISP Login Password (optional): Enter the

9650-1218-01 Rev. D

Page 21

Pairing Bluetooth-Capable Phones with the E Series Unit for DUN Operation

your carrier does not require a password, leave

the field blank and press Next.

You will be asked to confirm your device selections.

If the PING test is successful, the message PING Test

Passed appears. Press Return to return to the Bluetooth

Utilities menu.

Bluetooth Utilities

Select Recipient

Confir m Device Record

Name:

Address:

Phone No.:

Password:

Card. email

DrA email

Nursing

fax

ER fax

Verizon phone

0013abc3ef123

#123

Cancel

9. Press Accept to save your changes. The message

SAVING PAIRED LIST appears. Press Prev to go

back to the previous menu to make additional

changes. To cancel the device configuration and

return to the list of devices, press the Cancel softkey.

If the pairing is successful, the list of Discovered Devices

will appear again. When all pairings have been

completed, press the Return softkey to return to the

Bluetooth Utilities menu.

Note: A device can be added to the list without using

the Pair Now option first; the unit will simply pair

with the device when used for the first time and

ask for a device name and password. This may

take 10 seconds or more, and is not

recommended.

When finished in the Bluetooth Utilities menu, press the

Return softkey to return to the System Utilities menu.To

exit System Utilities, turn off the unit by turning the

selector switch to OFF.

Bluetooth LED display

The Bluetooth LED at the top of the device will display

green or blue during Bluetooth communication.

LED Activity

Condition

Solid green

The E Series unit is supplying

power to its internal Bluetooth

communication module.

Flashing blue

(steady)

The Bluetooth module is

attempting to connect to a

receiving device (cellular

phone, PDA, etc.).

Solid blue

The Bluetooth module is

connected to a receiving

device.

Flashing blue

(intermittent)

The Bluetooth module is

transmitting data to a receiving

device.

Managing the Paired List

Manage the list of currently paired devices. Use the

scroll keys at the top of the unit to select the desired

device. Select Set as Default to set the selected device

as the default. Select Delete Record to delete the

selected record. Select Clear List to unpair all the

devices on the list; select Return to return to the

Bluetooth Utilities menu.

PING Testing Bluetooth Devices

Test the Bluetooth device to make sure it is working

properly. PING (Packet Internet Grouper) is a common

way of testing any computer device. You will be

prompted for a recipient from the list of recipients. Press

the Commit ( ) key on top of the unit to enter the

selected recipient; press the Cancel softkey to return to

the Bluetooth Utilities menu.

9650-1218-01 Rev. D

Page 22

E Series - 12 Lead ECG Monitoring Option Insert

Troubleshooting

The troubleshooting section is intended to help you identify and correct problems that arise during operation. If trouble

persists after consulting this information, contact the ZOLL Technical Service Department for problems relating to the

E Series unit.

ZOLL Technical Service Department

(USA) Phone: (800) 348-9011

(UK)

Phone: +44-192-584-6400

(Other locations) Contact your local ZOLL distributor.

Symptom

Recommended Action

General

The ECG baseline does not stabilize, the ECG

is noisy, or the NOISY ECG message is

displayed.

ECG LEAD OFF or ECG VX LEAD OFF

message is displayed.

•

Verify the electrodes are connected properly to the patient.

Reposition the electrodes and/or lead wires to prevent the

electrodes from pulling away from the patient.

•

Verify the gel of the electrode is not dry. Check expiration date on

the electrode package.

•

Use Silver/Silver Chloride electrodes.

•

Verify that the ECG snaps and connectors are clean.

•

Stop vehicle while acquiring the 12-lead ECG.

•

Inspect ECG cable. Replace the cable if damaged.

•

Confirm proper ECG electrode and cable connections.

Verify that the patient cable is connected properly and held

motionless.

Make sure that the patient is motionless. Support patient’s limbs,

if necessary.

Verify correct filter (50 or 60 Hz) is selected in Configuration

menu.

Change ECG filter setting to 0.05-40 Hz 4x3, and retry

acquisition.

Prepare skin and replace electrodes.

Check the ECG cable continuity and replace the cable if you

suspect it is damaged.

Note: ECG signal may be temporarily out of range due to recent

defibrillator discharge.

DATA NOT READY / SEND FROM PAT. REC.

message is displayed.

12-lead data is not yet ready for transmission. Select the 12-lead

record from the Patient Records screen and retransmit.

9650-1218-01 Rev. D

Page 23

Bluetooth Transmission via Dial Up Networking

Symptom

Recommended Action

Bluetooth Transmission via Dial Up Networking

12-lead report will not transmit; the UPLOAD

ABORTED, PHONE CONNECT FAILED

messages are displayed consecutively.

•

Verify that your Bluetooth device is turned on.

•

Check to see if the Bluetooth device is waiting for an acceptance

of a connect request from the E Series. (Use the auto-accept

function on the device, if available.)

•

The device pairing may be incorrectly configured. Repeat the

pairing operation.

Verify that your device has its Bluetooth functionality enabled.

Verify that your Bluetooth device is within 30 feet of the E Series

unit.

Note: Cell signals vary depending on the carrier and area.

12-lead report will not transmit; the SERVER

FAULT, UPLOAD ABORTED, DATA

TRANSMIT FAILED messages are displayed

consecutively.

•

The ZOLL Data Relay server may be configured incorrectly. Verify

that the ISP address, port number, and password have been

entered correctly in the System Configuration menu, then

retransmit.

The messages ISP LOGIN FAILED, SERVER

CONNECTION FAILED may also appear.

•

The ZOLL Data Relay server may be experiencing an internal

error; try the transmission again, or select a different server.

•

The device pairing may be incorrectly configured. Repeat the

pairing operation.

•

If the problem persists, contact your ZDR server administrator.

Note: Cell signals vary depending on the carrier and area.

When attempting to transmit a 12-lead report to

a distribution list, the message INVALID LIST is

displayed.

•

The distribution list on the ZOLL Data Relay server has invalid

entries. It may have an invalid server, or invalid e-mail address or

FAX numbers. Verify that all settings are valid before attempting

to retransmit; see the ZOLL Data Relay System Configuration

Guide, version 5.00, for complete instructions on how to set

up a distribution list.

The PAIR FAIL message is displayed while

attempting to pair a Bluetooth device with the

E Series unit.

•

If the problem persists, contact your ZDR server administrator.

•

Verify that your Bluetooth device is turned on.

•

Verify that your Bluetooth device is in discoverable mode.

•

Verify that the correct PIN has been entered on the device.

Verify that your Bluetooth device is within 30 feet of the E Series

unit.

Verify that the correct device from the list of discovered devices

has been selected.

If the problem persists, contact your ZDR server administrator.

Note: Some devices will automatically turn off discoverable mode

after a very short period; check your device’s documentation.

9650-1218-01 Rev. D

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E Series - 12 Lead ECG Monitoring Option Insert

Symptom

While attempting to pair a Bluetooth device with

the E Series unit, the NO DEVICES FOUND

message is displayed.

Recommended Action

•

Verify that your Bluetooth device is turned on.

•

Verify that the correct device from the list of discovered devices

has been selected.

•

Verify that your Bluetooth device is in discoverable mode.

Verify that your Bluetooth device is within 30 feet of the E Series

unit.

Repeating the pairing will often succeed.

Note: Some devices will automatically turn off discoverable mode

after a very short period; check your device’s documentation.

When adding additional Bluetooth devices to

the list of recipients, the LIST MEMORY FULL

message is displayed.

•

The E Series unit can only pair up to 5 Bluetooth devices.

Remove one or more devices before attempting to pair any

additional ones.

When adding additional ZOLL Data Relay

servers to the list of servers, the LIST

MEMORY FULL message is displayed.

•

The E Series unit can only send data to up to 12 ZDR servers.

Remove one or more servers before attempting to add any

additional ones.

When adding additional contacts to the Contact

List, the LIST MEMORY FULL message is

displayed.

•

The E Series unit can only support up to 36 contacts. Remove

one or more contacts before attempting to add any additional

ones.

When attempting to delete a server from the

list, the SERVER RECORD USED BY

CONTACT LIST, UNABLE TO DELETE

message is displayed.

•

A server cannot be deleted if there are contacts using that server.

Remove all contacts before attempting to delete the server.

When attempting to PING a Bluetooth device

from the E Series unit, the PING TEST FAILED

message is displayed.

•

Verify that your Bluetooth device is turned on.

•

Verify that your device has its Bluetooth functionality enabled.

Verify that your Bluetooth device is within 30 feet of the E Series

unit.

Verify that the server and Bluetooth device configurations are

correct.

Note: Cell signals vary depending on the carrier and area.

When attempting to transmit a 12-lead report,

the TRANSMISSION FAULT XX message is

displayed.

•

There may be an internal problem with the E Series unit; contact

ZOLL technical support.

9650-1218-01 Rev. D

Page 25

Direct FAX Transmission

Symptom

Recommended Action

Direct FAX Transmission

Unsuccessful transmission to a FAX machine

(e.g., transmission stops before completion,

signal disappears, etc.)

•

Check modem connection to E Series.

FAX BUSY message is displayed.

•

Receiving phone line is being used. The E Series automatically

attempts to transmit until the transmission is successful or the

E Series operator presses the Abort softkey.

FAX ERROR message is displayed.

•

A dialing problem other than a busy line, no carrier, or no

connection occurred.

•

The E Series automatically re-transmits until the transmission is

successful or the E Series operator presses the Abort softkey.

FAX HANGUP message is displayed.

•

Receiving phone is not receiving transmission. The E Series

automatically attempts to transmit until the transmission is

successful or the E Series operator presses the Abort softkey.

FAX INTERRUPTED or message is displayed.

•

Power cycle E Series unit, and follow steps to attempt to

retransmit.

•

Contact ZOLL Technical Service department if problem persists.

FAX NO CARRIER message is displayed.

Check modem connection to the phone jack or cellular phone.

Power cycle cellular phone.

Make sure that receiving FAX is turned on.

Check the phone number and attempt to send again.

Check the telephone line (landline).

If you are using a cellular phone, be aware that cell signals vary

depending on the carrier and area. If you continue to experience

problems, switch to a landline.

Receiving phone line is not picking up or the sending modem is

experiencing problems. The E Series automatically attempts to

transmit until the transmission is successful or the E Series operator

presses the Abort softkey.

If retransmission fails:

FAX NO DIAL TONE message is displayed.

MODEM REQUIRED message is displayed.

9650-1218-01 Rev. D

•

Check the modem connection to the E Series unit.

•

Check the modem connection to the E Series unit.

Power cycle the cellular phone.

Check the modem connection to the phone jack or cellular phone.

Power cycle the cellular phone.

No PCMCIA modem card is present. Insert PCMCIA modem card

and repeat transmission attempt.

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E Series - 12 Lead ECG Monitoring Option Insert

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9650-1218-01 Rev. D

Page 27

Modem

APPENDIX A: Modem and Phone Setup

The E Series with 12-lead option may include a modem for transmitting 12-lead ECG information to remote locations

via landline or cellular phone. This section describes how to connect your E Series for phone transmission.

Modem

• When included, the E Series with 12-lead option ships with a cellular-ready PC card modem (domestic units only)

installed in the front PCMCIA slot on top of the unit.

Note: Do not attempt to insert the modem into the rear slot. Only the front PCMCIA slot supports modem

communication.

Note: Before attempting to use modems other than those supplied with the unit, contact ZOLL Technical Support at

(800) 348-9011. The E Series does not support all PCMCIA type modems.

The modem can be removed for service or cleaning as follows:

1. Open the PCMCIA cover, and complete steps a and b as shown.

a. Remove these screws.

Don’t remove.

Front, right-hand button

b. Grasp these tabs and pull modem bracket up and out.

2. Press down on front right button to remove modem card.

Reverse the sequence to install a modem card, making sure that the modem bracket.

is seated properly around the PCMCIA card connector before fastening the mounting screws.

Cables

• Not all cell phones transmit data reliably. See your local ZOLL Medical Corporation sales representative for a list of

•

approved cell phones.

A landline phone cable comes with modem-equipped E Series units. This cable connects to the E Series unit on

one end and plugs into a standard RJ-11 phone jack on the other end. The RJ-11 is compatible with POTS (Plain

Old Telephone System) phone lines such as those found in most residential homes or used for FAX machines.

CAUTION

• Data transmission via cellular phones can be less reliable than transmission via landline connections. A strong

signal and stationary transmission will improve the transmission’s success rate. Follow the directions provided with

your cellular phone.

• Many hospitals prohibit the use of cellular phones on their premises. Please abide by local rules and regulations.

Transmission Specifications

FAX

• Group 3 Facsimile

• FAX Software Interfaces

Class 2.0

9650-1218-01 Rev. D

Page 28

E Series - 12 Lead ECG Monitoring Option Insert

Class 2

Class 1

Telephone Company Requirements

The following regulations apply to modems used within the United States and Canada.

FCC Regulations

• The FCC has established rules that permit this device to be directly connected to the telephone network, using a

standardized jack. Do not use this equipment on a party line or coin line.

• Malfunctioning equipment may cause damage to the telephone network. If this device is not functioning properly,

•

disconnect it until the problem has been determined and the device has been repaired. Otherwise, the telephone

company may disconnect service temporarily.

The modem card is a non-serviceable/repairable item. It is your responsibility to report the need for any service to

the device to ZOLL Medical Corporation.

If you encounter any problems with your telephone after installing any new device, disconnect it from the telephone

line to see if the device is the source of the problem.

The telephone company may make changes to its technical operations and procedures. If such changes affect the

compatibility or use of this device, the telephone company is required to provide adequate notice of the changes.

Phone Company Requests

If the telephone company requests information about the equipment connected to their lines, inform them of:

• The telephone number to which the device is connected.

• The ringer equivalence number (REN) which is found on the FCC sticker attached to the modem. The REN

determines how many devices may be connected to the same telephone line. If too many devices are attached,

they may not ring properly. In most areas, the sum of the ringer equivalence numbers of all devices connected to

the same line should not exceed five.

The USOC telephone jack required (RJ-11, RJ-41, or RJ-45).

•

• The FCC registration number, which is found on the FCC sticker attached to the modem.

Interference

WARNING

Changes or modifications to this unit not expressly approved by the party responsible for compliance could void the

user’s authority to operate the equipment.

This equipment generates, uses, and can radiate radio frequency energy and, if not installed and used in accordance

with the instructions, may cause harmful interference to radio communications. Operation of this equipment in a

residential area is likely to cause harmful interference, in which case you will be required to correct the interference at

your own expense. However, there is no guarantee that interference will not occur in a particular installation. If this

equipment does cause harmful interference to radio or television reception, which can be determined by turning the

equipment off and on, you are encouraged to try to correct the interference by one or more of the following measures:

• Re-orient the receiving antenna.

• Relocate the receiving antenna and/or equipment away from the modem.

• Relocate the modem away from the receiving antenna and/or equipment.

• Plug the modem into a different outlet so that the modem and the receiving equipment are on different electrical

circuits.

If none of these actions resolves the problem, consult your ZOLL Medical Corporation equipment distributor or an

experienced radio/television technician for additional suggestions.

9650-1218-01 Rev. D

Page 29

FCC Rules and Regulations - Part 68

This equipment complies with Part 68 of the FCC Rules. On the back of the modem card is a label that contains,

among other information, the FCC Registration Number and ringer equivalency number (REN) for this equipment. You

must, upon request, provide this information to your telephone company.

The REN is useful to determine the quantity of devices you may connect to your telephone line and still have all those

devices ring when your telephone number is called. In most but not all areas, the sum of the RENs of all devices

connected to one line should not exceed five (5.0). To be certain of the number of devices you may connect to your

line, as determined by the REN, you should contact your local telephone company to determine the maximum REN for

your calling area.

If your telephone equipment causes harm to the telephone network, the telephone company may discontinue your

service temporarily. If possible, they will notify you in advance. But if advance notice is not practical, you will be notified

as soon as possible. You will be informed of your right to file a complaint with the FCC.

Your telephone company may make changes in its facilities, equipment, operations or procedures that could affect the

proper functioning of your equipment. If they do, you will be notified in advance to give you an opportunity to maintain

uninterrupted telephone service.

If you experience trouble with this telephone equipment, please contact ZOLL Medical Corporation for information on

obtaining service or repairs. The telephone company may ask that you disconnect this equipment from the network

until the problem has been corrected or until you are sure that the equipment is NOT malfunctioning.

There are no user serviceable parts contained in this equipment.

This equipment may not be used on coin service provided by the telephone company. Connection to party lines is

subject to state tariffs.

Shielded Cables

The use of any cable other than the shielded type will allow your system to emit more radio frequency interference than

the FCC limits, thereby increasing the likelihood of interference. Therefore, in order to comply with the FCC

regulations, it is necessary that you use good quality shielded cables with your installation.

Canadian Requirements

The Industry Canada (formerly the Canadian Department of Communications) label identifies certified equipment. This

certification means that the equipment meets certain telecommunications network protective, operational, and safety

requirements. The Department does not guarantee the equipment will operate to the user's satisfaction.

Before installing this equipment, users should ensure that their local telecommunications company permits connecting

it to their facilities. The equipment also must be installed using an acceptable method of connection. In some cases,

the company's inside wiring associated with single line, individual service may be extended by means of a certified

connector assembly (telephone extension cord). 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 made by an authorized Canadian maintenance facility designated by the

supplier. Any repairs or alterations made by the user to this equipment or equipment malfunctions may give the

telecommunications company cause to request the user to disconnect the equipment.

Users should ensure, for their own protection, that the electrical ground connections of the power utility, telephone

lines, and internal metallic water pipe system, if present, are connected together. This precaution may be particularly

important in rural areas.

CAUTION:

Users should not attempt to make such connections themselves, but should contact electric inspection authorities or

electricians, as appropriate.

To prevent overloading, a Load Number (LN) has been assigned to each terminal device to denote the percentage of

the total load to be connected to a telephone loop which is used by the device. The termination on a loop may consist

of any combination of devices subject only to the requirement that the total number of devices not exceed one

hundred.

9650-1218-01 Rev. D

Page 30

E Series - 12 Lead ECG Monitoring Option Insert

9650-1218-01 Rev. D

ZOLL

Defibrillators E-Series

E Series 12-Lead ECG Monitoring and Transmission Guide Rev D

Available for download in the BioClinical Services library

If you already belong to a hospital with access, please login via your intranet.