4Therapy
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LIFEPAK 20 Defibrillator/Monitor Operating Instructions 4-15
©2002–2013 Physio-Control, Inc.
To use the LIFEPAK 20 defibrillator/monitor primarily as a manual defibrillator, configure the
defibrillator before placing the device in use. To configure the defibrillator, refer to Section 8.
Impedance
LIFEPAK biphasic defibrillators measure the patient's transthoracic impedance and automatically
adjust the defibrillation waveform voltage and current duration to meet the needs of the individual
patient.
Impedance is measured whenever the defibrillator is charged. To ensure correct patient impedance
readings, you should always charge the defibrillator when the standard paddles (hard paddles) or
QUIK-COMBO electrodes are in contact with the patient's chest.
If the standard paddles are in the paddle wells or touching face to face (shorted paddles) when the
defibrillator is charged, the defibrillator limits the available energy to 79 joules. This prevents damage
to the internal circuits, in the event the energy is discharged while the hard paddles are still in the
paddle wells or shorted together. If the defibrillator is charged to 80 joules or more and energy is
discharged when the hard paddles are seated in the paddle wells, the display indicates the selected
energy available and the automatic printout annotates time, date and Shock 79 J.
If the defibrillator is charged to 80 joules or more with paddles in the paddle wells, and then the
paddles are removed and placed on a patient, the defibrillator continues charging to the selected
energy and defibrillation may be completed as usual. When the defibrillator is charged with the
paddles on the patient’s chest, the defibrillator automatically adjusts the waveform voltage and current
duration based on the patient's impedance. It is important to understand that this automatic
adjustment does not occur when the defibrillator is charged with the paddles seated in the paddle
wells.
When the paddles or QUIK-COMBO electrodes are on the patient's chest when the defibrillator is
charged and the defibrillator measures an impedance of 15 ohms or less, the defibrillator disarms the
capacitor and automatically recharges to a lower energy setting. When this condition occurs, the
LOW
IMPEDANCE-RECHARGING
message appears on the display. When charging is complete, defibrillation
may be completed as usual.
Defibrillation Procedure
You can setup the LIFEPAK 20 defibrillator/monitor to automatically sequence energy levels. Refer to
Manual Mode Setup Menu, page 8-4.
1 Press
ON.
2 Identify the electrode or paddle sites on the patient. Use either the anterior-lateral or anterior-
posterior position as described on page 4-3.
Possible burns and ineffective energy delivery.
A gel pathway on the skin between the standard paddles will cause defibrillating energy to arc
between paddles and divert energy away from the heart muscle. Do not allow conductive gel (wet or
dry) to become continuous between paddle sites.
Possible damage to defibrillator and defibrillator shutdown.
When used in conjunction with another defibrillator to deliver more than 360J, one or both
defibrillators may be damaged and shutdown may occur due to excessive currents. Avoid
simultaneous discharge from both defibrillators and maintain a backup device in case one or both
defibrillators shut down. If the defibrillator shuts down, take the device out of service and contact a
qualified service technician.
WARNINGS!
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