4Therapy
Therapy
LIFEPAK 20 Defibrillator/Monitor Operating Instructions 4-25
©2002–2013 Physio-Control, Inc.
To pace, perform the following:
1 Press
ON.
2 Connect the patient ECG cable, apply ECG electrodes to the ECG cable and patient, and select
Lead I, II, or III. To receive the best monitoring signal, ensure there is adequate space between the
ECG electrodes and the therapy electrodes.
3 Identify the QUIK-COMBO electrode sites on the patient. For pacing, use either the anterior-lateral
or anterior-posterior position (refer to page 4-3).
4 Prepare patient's skin for electrode application as described in Step 3 of the Defibrillation
Procedure.
5 Apply QUIK-COMBO electrodes to the patient.
6 Connect the therapy electrodes to the therapy cable.
7 Press
PACER. Confirm the LED illuminates, indicating that the power is on.
Note: If the
REMOVE TEST PLUG message appears, disconnect test plug and connect therapy
electrodes to QUIK-COMBO therapy cable.
8 Observe the ECG rhythm. Confirm that a triangle sense marker appears near the middle of each
QRS complex. If the sense markers do not appear or are displayed in the wrong location (for
example, on the T-wave)
, select another lead. (It is normal for the sense marker location to vary
slightly on each QRS complex.)
9 Press
RATE or rotate the Speed Dial to select the desired pacing rate.
Note: The
RATE button changes the rate in 10 pulse per minute (ppm) increments; the Speed
Dial changes the rate in 5 ppm increments.
10 Press
CURRENT or rotate the Speed Dial to increase current until electrical capture occurs. For
each delivered pacing stimulus, the
PACER indicator flashes off and a positive pace marker displays
on the ECG waveform.
11 Palpate the patient's pulse or check blood pressure and compare the SpO2 pulse rate with the set
pacing rate to assess for mechanical capture. Consider use of sedation or analgesia if patient is
uncomfortable.
Note: The
CURRENT button changes the current in 10 mA increments; the Speed Dial changes
the current in 5 mA increments.
Note: To change rate or current during pacing, press
RATE or CURRENT, then rotate the Speed
Dial.
Note: To interrupt pacing and view the patient's intrinsic rhythm, press and hold the
PAUSE
button. This causes the pacer to pace at 25% of the set rate. Release the
PAUSE button to
resume pacing at the set rate.
12 To stop pacing, reduce current to zero or press
PACER.
Note: To defibrillate and stop noninvasive pacing, press
ENERGY SELECT or charge the
defibrillator. Pacing automatically stops. Proceed with defibrillation.
If the monitor detects ECG leads off during pacing, pacing continues at a fixed rate until the ECG lead
is reattached. During fixed-rate pacing, the pacemaker delivers pulses at the set pace rate regardless
of any intrinsic beats that the patient may have. The monitor continues to display the pacing rate (ppm)
and the current (mA). To reestablish demand pacing, reattach the ECG lead.
While pacing, visually monitor the patient at all times, do not rely on the
ECG LEADS OFF warning to
detect changes in pacing function. Routinely assess the ECG for proper sensing, pace pulse delivery,
electrical capture, and mechanical capture.
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