E Series 12-Lead ECG Monitoring and Transmission Guide Rev D.pdf
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.
Copyright © 2014 ZOLL Medical Corporation. All rights reserved. E Series and ZOLL are trademarks or
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
1
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.
2
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
V1
C1
Chest
V2
C2
Chest
V3
C3
Chest
V4
C4
Chest
V5
C5
Chest
V6
C6
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
3
Page 6
E Series - 12 Lead ECG Monitoring Option Insert
3.
4.
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.
4
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
5
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
J
wx
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
6
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
1
2
3
4
5
6
7
8
9
‹‹‹
‹‹‹ 0
SpO2%
m
m Hg
w
ECG
24
---
II x1.5 96
--- RR
Age:
61
w
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
17 JUN 04
17 JUN 04
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.
7
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
8
•
•
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
m Hg
--- RR
MANUAL DIAL
1
2
3
4
5
6
7
8
9
*
0
#
+
,
wx
‹‹‹
›››
The Retry screen is displayed whenever one of these
things occur:
• The transmission is complete.
Phone #
|
w
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
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
1
2
3
5
6
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
7
8
9
*
0
,
#
+
wx
‹‹‹
›››
Phone #
16175551234
w
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
4
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
9
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.
10
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
11
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:
60
166 ms
82 ms
QT/QTc
358 / 358 ms
P-R-T axes
54 43
47
Measurements Matrix
You can configure the unit to print out a measurements matrix, which consists of measurements for each segment of
each lead. 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 160Vms, the wave is considered to be
significant. If the area is less than 160Vms, 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.
12
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.
13
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).
14
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
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
Prev
Item
Yes
Next
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
15
Page 18
E Series - 12 Lead ECG Monitoring Option Insert
You will then be asked to confirm your server
information.
System Configuration
System Configuration
ZDR SERVER LIST
Confirm Ser ver Information
ZDR Ser ver1
1
1
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.
Prev
Accept
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
1
ER fax
Add
Record
16
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
1
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)
Prev
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
1
Direct FAX
Next
Cancel
To set up a Bluetooth phone and pair with the E Series:
Select Transmission Type
Prev
Accept
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
1
• 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
MORE
17
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
Bluetooth Utilities
Discovered Devices
1
00174378nq6y
0013abc3ef123
1
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
1
discoverable mode.
Use PIN 0000
Search
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,
18
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
PIN
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,
login name (optional), and login password (optional).
• 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
login password, if your carrier requires this feature. If
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
Bluetooth Utilities
Select Recipient
Confir m Device Record
1
Name:
Address:
Phone No.:
Login ID:
Password:
Card. email
DrA email
Nursing
fax
1
ER fax
Verizon phone
0013abc3ef123
#123
Cancel
Prev
Accept
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
19
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.
20
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
LOGIN FAIL, SERVER TIMEOUT, or
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.
22
•
There may be an internal problem with the E Series unit; contact
ZOLL technical support.
9650-1218-01 Rev. D
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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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