ZOLL

Defibrillators R-Series

R Series Plus and BLS Operators Guide Rev N Feb 2019

Operators Guide

199 Pages

R Series ® PLUS R Series ® BLS Operator’s Guide 9650-0904-05 Rev. N The issue date for the R Series Operator’s Guide BLS/Plus (REF 9650-0904-05 Rev. N) is February, 2019. Copyright © 2019 ZOLL Medical Corporation. All rights reserved. R Series, M Series, CPR-D-padz, Pedi-padz, Pro-padz, Stat-padz, Real CPR Help, RescueNet, See-Thru CPR, Code-Ready, SurePower, OneStep, Smart Alarms, Perfusion Performance Indicator, Defib Mentor, Rectilinear Biphasic, and ZOLL are trademarks or registered trademarks of ZOLL Medical Corporation in the United States and/or other countries. Masimo is a registered trademark of Masimo Corporation in the United States and/or other countries. All other trademarks are 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 0123 Table of Contents Chapter 1 General Information Product Description ............................................................................................................ 1-1 R Series Model Features .................................................................................................... 1-3 How to Use This Manual..................................................................................................... 1-4 Operator’s Guide Updates .................................................................................................. 1-4 Unpacking........................................................................................................................... 1-4 Symbols Used on the Equipment ....................................................................................... 1-4 Conventions ........................................................................................................................ 1-7 Defibrillator Function ........................................................................................................... 1-7 Intended Use — Manual Operation ............................................................................ 1-8 Intended Use — Semiautomatic Operation (AED) ..................................................... 1-8 Intended Use — ECG Monitoring ............................................................................... 1-8 Intended Use — Real CPR Help ................................................................................ 1-9 Semiautomatic Operation Contraindications for Use .................................................. 1-9 Defibrillator Complications .......................................................................................... 1-9 Defibrillator Output Energy ......................................................................................... 1-9 External Pacemaker (Optional)........................................................................................... 1-9 Intended Use — Pacemaker ..................................................................................... 1-10 Pacemaker Complications ........................................................................................ 1-11 Pediatric Pacing ........................................................................................................ 1-11 Intended Use — SpO2 Monitoring .................................................................................... 1-11 Intended Use — EtCO2 Monitoring................................................................................... 1-12 Intended Use — NIBP....................................................................................................... 1-13 ECG Monitoring ................................................................................................................ 1-13 Recorder Function (Manual Mode Only)........................................................................... 1-14 Paddles and Electrodes .................................................................................................... 1-14 Batteries............................................................................................................................ 1-15 Code-Ready System......................................................................................................... 1-15 Safety Considerations....................................................................................................... 1-15 Warnings........................................................................................................................... 1-16 Operator Safety ........................................................................................................ 1-18 Patient Safety ........................................................................................................... 1-19 Cautions............................................................................................................................ 1-20 Restarting the Defibrillator ................................................................................................ 1-20 FDA Tracking Requirements ............................................................................................. 1-20 Notification of Adverse Events .................................................................................. 1-21 Software License .............................................................................................................. 1-21 Service.............................................................................................................................. 1-22 The ZOLL Serial Number.................................................................................................. 1-23 9650-0904-05 Rev. N ZOLL R Series Operator’s Guide i TABLE OF CONTENTS Chapter 2 Product Overview Defibrillator Controls and Indicators.................................................................................... 2-1 The Front Panel .......................................................................................................... 2-3 Display Screen ............................................................................................................ 2-6 Patient Cables and Connectors .................................................................................. 2-8 External Paddles (Manual Mode Only) ..................................................................... 2-10 Working with Menus (Manual Mode Only) ........................................................................ 2-12 Common Tasks ................................................................................................................. 2-13 Replacing a Battery Pack ......................................................................................... 2-13 Adjusting Display Brightness (Manual Mode Only) ................................................... 2-14 Using Code Markers (Manual Mode Only) ............................................................... 2-14 Chapter 3 Automated External Defibrillator (AED) Operation AED Operation.................................................................................................................... 3-2 Determine Patient Condition Following Medical Protocols ......................................... 3-2 Begin CPR Following Medical Protocols .................................................................... 3-2 Prepare Patient ........................................................................................................... 3-2 1 Select ON ................................................................................................................ 3-4 2 Analyze .................................................................................................................... 3-5 3 Press SHOCK .......................................................................................................... 3-6 Operating Messages ................................................................................................... 3-8 Audio and Display Messages ..................................................................................... 3-8 Switching to Manual Mode Operation ............................................................................... 3-10 Chapter 4 Manual Defibrillation Emergency Defibrillation Procedure with Paddles .............................................................. 4-1 Determine the Patient’s Condition Following Local Medical Protocols ....................... 4-1 Begin CPR Following Local Medical Protocols ........................................................... 4-2 1 Select ON ................................................................................................................ 4-2 2 Charge Defibrillator .................................................................................................. 4-4 3 Deliver Shock ........................................................................................................... 4-5 Autoclavable External Paddles ........................................................................................... 4-5 Emergency Defibrillation Procedure with Hands-Free Therapy Electrodes........................ 4-6 Determine the Patient’s Condition Following Local Medical Protocols ....................... 4-6 Begin CPR Following Medical Protocols .................................................................... 4-6 Prepare Patient ........................................................................................................... 4-6 1 Select ON ................................................................................................................ 4-8 2 Charge Defibrillator .................................................................................................. 4-9 3 Deliver Shock ......................................................................................................... 4-10 Autoclavable Electrodes ................................................................................................... 4-10 ii www.zoll.com 9650-0904-05 Rev. N Chapter 5 Advisory Defibrillation Advisory Defibrillation Procedure........................................................................................ 5-2 Determine the Patient’s Condition Following Local Medical Protocols ....................... 5-2 Begin CPR Following Local Medical Protocols ........................................................... 5-2 Prepare Patient ........................................................................................................... 5-2 1 Select ON ................................................................................................................ 5-2 2 Press ANALYZE Button ........................................................................................... 5-4 3 Press SHOCK .......................................................................................................... 5-5 Advisory Function Messages .............................................................................................. 5-7 Warning Messages ............................................................................................................. 5-7 Chapter 6 Synchronized Cardioversion Synchronized Cardioversion Procedure ............................................................................. 6-2 Determine the Patient’s Condition and Provide Care Following Local Medical Protocols .................................................................................................................. 6-2 Prepare Patient ........................................................................................................... 6-2 1 Select ON ................................................................................................................ 6-3 2 Charge Defibrillator .................................................................................................. 6-4 3 Deliver SHOCK ........................................................................................................ 6-5 Remote Synchronized Cardioversion Procedure................................................................ 6-5 Determine the Patient’s Condition and Provide Care Following Local Medical Protocols .................................................................................................................. 6-6 Prepare Patient ........................................................................................................... 6-6 1 Select ON ................................................................................................................ 6-6 2 Charge Defibrillator .................................................................................................. 6-7 3 Deliver SHOCK ........................................................................................................ 6-7 Chapter 7 Real CPR Help Real CPR Help Field........................................................................................................... 7-2 Perfusion Performance Indicator (R Series Plus/Adult Only) ..................................... 7-2 CPR Idle Time Display ................................................................................................ 7-2 CPR Rate and Depth Display ..................................................................................... 7-2 Compression Release Bar (R Series Plus/Adult only) ................................................ 7-3 CPR Metronome ......................................................................................................... 7-3 Fully Release prompt .................................................................................................. 7-4 CPR Voice Prompts (R Series Plus/Adult only) .................................................................. 7-4 Chest Compressions Bar Graph (Manual Mode Only) ....................................................... 7-4 Displaying the CPR Bar Graph (Manual Mode Only) ......................................................... 7-4 Chapter 8 See-Thru CPR (R Series Plus Only) Using See-Thru CPR (R Series Plus Only) ........................................................................ 8-2 Examples .................................................................................................................... 8-2 9650-0904-05 Rev. N ZOLL R Series Operator’s Guide iii TABLE OF CONTENTS Chapter 9 Noninvasive Temporary Pacing (Optional) Noninvasive Temporary Pacing .......................................................................................... 9-2 Determine Patient Condition and Provide Care Following Local Medical Protocols ... 9-2 Prepare the Patient ..................................................................................................... 9-2 1 Apply ECG Electrodes/Hands-Free Therapy Electrodes ......................................... 9-2 1 Select ON ................................................................................................................ 9-3 2 Turn Mode Selector to PACER ................................................................................ 9-4 3 Set Pacer Rate ........................................................................................................ 9-4 4 Set Pacer Output ..................................................................................................... 9-5 5 Determine Capture .................................................................................................. 9-5 6 Determine Optimum Threshold ................................................................................ 9-6 Special Pacing Applications ................................................................................................ 9-8 Standby Pacing ........................................................................................................... 9-8 Asynchronous Pacing ................................................................................................. 9-8 1 Select ON ................................................................................................................ 9-9 2 Turn Mode Selector to PACER ................................................................................ 9-9 Press the Async Pacing On/Off softkey .................................................................... 9-10 Pediatric Pacing ........................................................................................................ 9-10 Chapter 10 ECG Monitoring Preparations ..................................................................................................................... 10-2 Electrode Placement......................................................................................................... 10-2 Monitoring Electrodes Attachment .................................................................................... 10-3 Monitoring the Patient’s ECG ........................................................................................... 10-4 Set the Controls ........................................................................................................ 10-4 Implanted Pacemakers ..................................................................................................... 10-5 5-Lead Monitoring............................................................................................................. 10-7 Simultaneous 3-Lead Printing ................................................................................... 10-7 See-Thru CPR Filter (R Series Plus Only) ................................................................ 10-7 Adding Traces to Be Displayed ................................................................................ 10-8 Printing the ECG on a Stripchart ...................................................................................... 10-8 Diagnostic Bandwidth ............................................................................................... 10-8 Alarms............................................................................................................................... 10-9 Setting Alarm Limits .................................................................................................. 10-9 Heart Rate Alarm Limits .......................................................................................... 10-10 Vital Sign Alarms .................................................................................................... 10-10 Suspending and Silencing Alarms .......................................................................... 10-10 Smart Alarms .......................................................................................................... 10-11 Alarm Settings for Unattended Monitoring .............................................................. 10-12 Chapter 11 Event Records and Reports Summary Report............................................................................................................... 11-1 Summary Report Formats ........................................................................................ 11-2 Printing the Entire Summary Report ......................................................................... 11-7 Printing a Partial Summary Report ........................................................................... 11-8 Full Disclosure Recording ................................................................................................. 11-8 iv www.zoll.com 9650-0904-05 Rev. N Incident Logs .................................................................................................................... 11-8 Printing an Incident Log ............................................................................................ 11-8 Erasing Summary Report and Full Disclosure .................................................................. 11-9 Manual Erasure ........................................................................................................ 11-9 Automatic Erasure .................................................................................................... 11-9 Formatting the Disk ................................................................................................... 11-9 Related Messages .......................................................................................................... 11-10 Chapter 12 File Transfer Transferring Files to an External Device........................................................................... 12-1 Wi-Fi (Optional)................................................................................................................. 12-2 Installing or Removing a Compact Flash Card ................................................................. 12-2 Transferring a Full Disclosure File to a Compact Flash Card ...................................................................................................................... 12-3 Transferring Device Check and Activity Log Files to a Compact Flash Card.................... 12-4 Transferring Files Through the USB Port (R Series Plus Only) ........................................ 12-4 Transferring Full Disclosure Files Through Wi-Fi (R Series Plus Only) ............................ 12-5 Transferring Device Check and Activity Log Files Through Wi-Fi (R Series Plus Only) ... 12-6 Related Wi-Fi Messages ........................................................................................... 12-8 Chapter 13 Maintenance Routine Procedures .......................................................................................................... 13-2 Daily Visual Inspection .............................................................................................. 13-2 Code Readiness Test ............................................................................................... 13-3 Manual Defibrillator Testing............................................................................................... 13-3 Defibrillator Testing with Paddles ............................................................................. 13-4 Defibrillator Testing with Hands-Free Therapy Electrodes ....................................... 13-5 Pacer Testing ............................................................................................................ 13-6 Recorder Check ........................................................................................................ 13-6 Code Readiness Log ................................................................................................ 13-7 Setting Time and Date .............................................................................................. 13-8 Cleaning the R Series Unit ....................................................................................... 13-9 Loading Stripchart Paper ........................................................................................ 13-10 Cleaning the Print Head .......................................................................................... 13-11 Operator’s Checklist for R Series Product ............................................................. 13-12 Chapter 14 Troubleshooting Code-Ready .............................................................................................................. 14-1 Monitor ...................................................................................................................... 14-2 Recorder ................................................................................................................... 14-4 Pacer ........................................................................................................................ 14-4 Defibrillator ................................................................................................................ 14-5 AC Charger ............................................................................................................... 14-8 CPR .......................................................................................................................... 14-8 9650-0904-05 Rev. N ZOLL R Series Operator’s Guide v TABLE OF CONTENTS Appendix A Specifications Defibrillator Specifications ..................................................................................................A-2 Battery Pack Specifications ........................................................................................A-7 IEC 60601-1-2 Specifications .............................................................................................A-7 Electromagnetic Emissions Declaration .....................................................................A-7 Electromagnetic Immunity Declaration (EID) ..............................................................A-8 Electromagnetic Immunity ..........................................................................................A-9 Recommended Separation Distances from RF Equipment for the R Series Functions ................................................................................................................A-11 R Series Rectilinear Biphasic Waveform Characteristics .................................................A-12 Clinical Trial Results for the Biphasic Waveform ..............................................................A-24 Randomized Multicenter Clinical Trial for Defibrillation of Ventricular Fibrillation (VF) and Ventricular Tachycardia (VT) ...................................................................A-24 Randomized Multi-Center Clinical trial for Cardioversion of Atrial Fibrillation (AF) ........................................................................................................................A-25 Synchronized Cardioversion of Atrial Fibrillation ......................................................A-26 ECG Rhythm Analysis Algorithm Accuracy .......................................................................A-28 Appendix B R Series Accessories Appendix C Wi-Fi Radio Module Information vi www.zoll.com 9650-0904-05 Rev. N Chapter 1 General Information Product Description The ZOLL® R Series® products combine a defibrillator, ECG display, advanced monitoring capabilities, and Noninvasive Transcutaneous Pacing (NTP) with communication, data printing and recording capabilities in a single lightweight portable instrument. The unit has been designed for all resuscitation situations and its small, compact, lightweight design makes it ideal for accompanying patients during transport. The product is powered by AC mains and an easily replaced battery pack that is quickly recharged in the device when it is connected to AC mains. In addition, the unit’s battery may be recharged and tested using a ZOLL SurePower™ Battery Charger. The product is designed for use in the hospital. All of its ruggedized features add to its durability in hospital applications. The R Series comes in both R Series Plus and R Series BLS models. This guide documents all the features that are available in both models. Both models can also have the additional optional features of Pacing and SpO2. The BLS model does not contain all of the functions that are included in the Plus model. The features that only apply to the Plus model are documented as R Series Plus Only within the manual, and optional features are documented as Optional. Refer to the table on page 1-3 for a listing of features that are available in the R Series defibrillator models. The R Series is a versatile external defibrillator. The device powers up in AED mode automatically. Depending on local protocols, the device may start prompting the operator to PERFORM CPR or the device may start analyzing ECG automatically, prompt the operator to STAND CLEAR, charge the defibrillator (if appropriate), and prompt the operator to PRESS SHOCK in between periods of CPR. The device can be switched to Manual mode after power 9650-0904-05 Rev. N ZOLL R Series Operator’s Guide 1–1 CHAPTER 1 GENERAL INFORMATION up. When operating in the manual configuration, the device operates as a conventional defibrillator where the device’s charging and discharging are fully controlled by the operator. In advisory mode, some of the features of the device are automated and a sophisticated algorithm is used to identify shockable ECG rhythms (VF and wide complex VT >150 bpm) that should be treated by defibrillator shock delivery. Depending on local protocols, the unit may be configured to automatically analyze the ECG, charge the defibrillator (if appropriate), and prompt the operator to PRESS SHOCK between periods of CPR. The R Series unit assists caregivers during cardiopulmonary resuscitation (CPR) by evaluating the rate and depth of chest compressions and providing feedback to the rescuer. Real CPR Help® requires the use of OneStep™ CPR electrodes or OneStep™ Complete electrodes. When using these pads, the displayed ECG waveforms can be adaptively filtered, using the See-Thru CPR® feature, to reduce the artifact caused by chest compressions. The R Series is a Code-Ready® defibrillator. It extends testing beyond shock delivery and checks more than 40 measures of readiness, including the presence of the correct cables and electrodes, the type of electrode, and other important electronic functions. The R Series also verifies the condition and expiration date of OneStep electrodes. This code readiness testing can occur automatically, without disconnecting electrodes or paddles, or requiring additional equipment to test shock delivery. The system also provides a printed, or electronic log to alert hospital personnel of any defibrillator functions or accessories that are compromised in advance of a code. Some R Series models include an optional transcutaneous pacemaker consisting of a pulse generator and ECG sensing circuitry. The pacing option supports both demand and asynchronous noninvasive pacing for adult, pediatric, or neonatal patients. OneStep™ Pacing electrodes and OneStep Complete electrodes allow demand pacing and ECG monitoring without separate ECG electrodes when the R Series is used with the OneStep™ Pacing cable. Information regarding the unit’s operation, ECG, and other physiological waveforms are displayed on a large 6.5 inch (16.5 cm) diagonal display which provides high contrast and visibility under virtually all lighting conditions. Operating and warning messages are displayed on the monitor, and the unit can also be configured with voice prompts to alert the user to unit status. The R Series performs code readiness testing when the unit is OFF but connected to AC power, when the defibrillator is initially turned on, and periodically during operation. An annotating strip chart recorder is included to provide immediate documentation as well as summary report functions about patient care and treatment in Manual mode. A sophisticated data collection system, including summary report, printer, and multiple communication ports is available for this unit. The stored data can be reviewed and archived on a properly equipped personal computer using ZOLL RescueNet® software. R Series data files may be transferred to a PC using USB, Compact Flash cards or Wi-Fi. R Series products are intended for use in either AED mode or Manual mode by personnel certified by appropriate federal, state, or local government authority to provide advanced life support care. 1–2 www.zoll.com 9650-0904-05 Rev. N R Series Model Features R Series Model Features The following features are available in the R Series Plus and R Series BLS models. Pacing and SpO2 monitoring are additional options that may be purchased separately. Feature BLS Model  Real CPR Help Plus Model  See-Thru CPR  Perfusion Performance Indicator™  OneStep system   OneStep cable   OneStep ECG leads cable (3-lead set)  OneStep Cable Manager  Code Readiness testing system   Integrated hands free electrode mounting   Rectilinear Biphasic Waveform   Universal operating system   Defib activity log    Corrective voice prompts 5.8 Ah rechargeable lithium-ion battery   3 lead ECG cable   90mm strip chart writer   Integrated AC power   Built-in test port   Compact Flash card slot   USB device port  Wi-Fi communication software  EtCO2  NIBP  Optional Items Available in Both Models Pacing SpO2 9650-0904-05 Rev. N ZOLL R Series Operator’s Guide 1–3 CHAPTER 1 GENERAL INFORMATION How to Use This Manual The R Series Operator's Guide provides information operators need for the safe and effective use and care of the R Series products. It is important that all persons using this device read and understand all the information contained within. Please read thoroughly the safety considerations and warnings section. Procedures for daily checkout and unit care are located in “Maintenance” on page 13-1. This manual is supplemented by manual inserts for options available on the R Series. These inserts contain additional warnings, precautions, and safety-related information. Operator’s Guide Updates An issue or revision date for this manual is shown on the front cover. If more than three years have elapsed since this date, contact ZOLL Medical Corporation to determine if additional product information updates are available. All users should carefully review each manual update to understand its significance and then file it in its appropriate section within this manual for subsequent reference. Product documentation is available through the ZOLL website at www.zoll.com. From the Products menu, choose Product Manuals. Unpacking Carefully inspect each container for damage. If the shipping container or cushion material is damaged, keep it until the contents have been checked for completeness and the instrument has been checked for mechanical and electrical integrity. If the contents are incomplete, if there is mechanical damage, or if the defibrillator does not pass its electrical self-test, U.S.A. customers should call ZOLL Medical Corporation (1-800-348-9011). Customers outside of the U.S.A. should contact the nearest ZOLL authorized representative. If the shipping container is damaged, also notify the carrier. Symbols Used on the Equipment Any or all of the following symbols may be used in this manual or on this equipment: Symbol Description Dangerous voltage. MR unsafe: keep away from magnetic resonance imaging equipment Attention, consult accompanying documents. 1–4 www.zoll.com 9650-0904-05 Rev. N Symbols Used on the Equipment Symbol Description Fragile, handle with care. Keep dry. This end up. Temperature limitation. Conformité Européenne Complies with medical device directive 93/42/EEC. Type B patient connection. Type BF patient connection. Type CF patient connection. Defibrillator-proof type BF patient connection. Defibrillator-proof type CF patient connection. Fusible link. Equipotentiality. Alternating current (AC). Direct current (DC). 9650-0904-05 Rev. N ZOLL R Series Operator’s Guide 1–5 CHAPTER 1 GENERAL INFORMATION 2. ,I Description 45 2% )/. Symbol Contains lithium. Recycle or dispose of properly. R EC Y C LE ,I )/. Keep away from open flame and high heat. Do not open, disassemble, or intentionally damage. Do not crush. Do not discard in trash. Recycle or dispose of properly. Return to a collection site intended for waste electrical and electronic equipment (WEEE). Do not dispose of in unsorted trash. Date of manufacture. Use by. Latex-free. Do not reuse. Do not fold. Not sterile. Nonionizing electromagnetic radiation from Wi-Fi during data transfer. Manufacturer. 1–6 www.zoll.com 9650-0904-05 Rev. N Conventions Symbol Description Authorized representative in the European Community. Serial Number. Catalogue number. Consult instructions for use. Prescription only. Maximum energy. Test port. Conventions This guide uses the following conventions: Within text, the names and labels for physical buttons and softkeys appear in boldface type (for example, “Press the SHOCK button or the Code Marker softkey”). This guide uses uppercase italics for audible prompts and for text messages displayed on the screen (for example, CHECK PATIENT). WARNING! Warning statements alert you to conditions or actions that can result in personal injury or death. Caution Caution statements alert you to conditions or actions that can result in damage to the unit. Defibrillator Function The R Series product contains a direct current (DC) defibrillator capable of delivering up to 200 joules. It may be used in synchronized mode to perform synchronized cardioversion using the patient’s R-wave as a timing reference. The unit uses paddles or disposable, pregelled electrodes for defibrillation. 9650-0904-05 Rev. N ZOLL R Series Operator’s Guide 1–7 CHAPTER 1 GENERAL INFORMATION Intended Use — Manual Operation Use of the R Series products in the manual mode for defibrillation is indicated on victims of cardiac arrest where there is apparent lack of circulation as indicated by: • Unconsciousness. • Absence of breathing. • Absence of pulse. This product should be used only by qualified medical personnel for converting ventricular fibrillation and rapid ventricular tachycardia to sinus rhythm or other cardiac rhythms capable of producing hemodynamically significant heart beats. In manual mode, the unit can also be used for synchronized cardioversion of certain atrial or ventricular arrhythmias. A qualified physician must decide when synchronized cardioversion is appropriate. The advisory function should be used to confirm ventricular fibrillation or wide complex ventricular tachycardia (greater than 150 beats per minute) in patients meeting the three conditions indicating lack of circulation (listed above). Intended Use — Semiautomatic Operation (AED) R Series products are designed for use by emergency care personnel who have completed training and certification requirements applicable to the use of a defibrillator where the device operator controls delivery of shocks to the patient. They are specifically designed for use in early defibrillation programs where the delivery of a defibrillator shock during resuscitation involving CPR, transportation, and definitive care are incorporated into a medically-approved patient care protocol. Use of the R Series in the Semiautomatic mode for defibrillation is indicated on victims of cardiac arrest where there is apparent lack of circulation as indicated by: • Unconsciousness. • Absence of breathing. • Absence of pulse. Specifications for the ECG rhythm analysis function are provided in the section, “ECG Rhythm Analysis Algorithm Accuracy” on page A-27. When the patient is less than 8 years of age or weighs less that 55 lbs. (25 Kg), you must use ZOLL pediatric defibrillation electrodes. Do not delay therapy to determine patient’s exact age or weight. Intended Use — ECG Monitoring The unit is intended for use when ECG monitoring is indicated to evaluate the patient’s heart rate or ECG morphology. In ECG monitoring mode, the unit is intended to be used by personnel who are qualified by training in the use of the R Series defibrillator, basic life and/or advanced life support, or other physician-authorized emergency medical training. 1–8 www.zoll.com 9650-0904-05 Rev. N
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