2. ©2010 Physio-Control, Inc. All rights reserved. LIFEPAK ® 1000 Defibrillator Orientation Guide You’re Ready.

3. ©2010 Physio-Control, Inc. All rights reserved. Your LIFEPAK ® 1000 defibrillator may not have all the settings or features (e.g. ECG monitoring) shown in this presentation. Please be familiar with the features available on your 1000 and its setup, which may vary according to local Medical Director protocols. Additional information to aid in presentation is provided in the notes section of most slides. Important Safety Information This orientation program is not a substitute for hands-on device training. The LIFEPAK 1000 defibrillator is intended for use by personnel who have been trained in the use of the LIFEPAK 1000 defibrillator. Refer to Operating Instructions for complete instructions for use, indications, contraindications, warnings, precautions, and potential adverse events associated with device use. About this Presentation

4. ©2010 Physio-Control, Inc. All rights reserved. Objectives Review the operation and features of the LIFEPAK 1000 defibrillator including:  Electrode pad placement  AED and Manual mode  ECG monitoring  Pediatric patient  Battery  Troubleshooting  Maintenance  Setup

5. ©2010 Physio-Control, Inc. All rights reserved. LIFEPAK 1000 Defibrillator Uses:  Automated External Defibrillation -For use only on patients in cardiopulmonary arrest  Manual defibrillation therapy -For the treatment of certain fatal arrhythmias  ECG monitoring -For the purpose of ECG rhythm recognition and heart rate monitoring

6. ©2010 Physio-Control, Inc. All rights reserved. Get to Know the Device

7. ©2010 Physio-Control, Inc. All rights reserved. Basic Steps for AED Use  Establish patient is in cardiac arrest  Turn on the 1000  Apply electrodes  Follow screen messages and voice prompts

8. ©2010 Physio-Control, Inc. All rights reserved. Electrode Placement  Remove clothing from patient’s chest  Remove excessive hair  Clean and dry the skin  Do not apply alcohol, tincture of benzoin, or antiperspirant to the skin

9. ©2010 Physio-Control, Inc. All rights reserved. Electrode Placement Press electrodes firmly onto patient’s skin

10. ©2010 Physio-Control, Inc. All rights reserved. Electrode Placement Correct electrode position optimizes the amount of current flowing through the ventricles Correct electrode position Incorrect electrode position

11. ©2010 Physio-Control, Inc. All rights reserved. ECG Analysis  When an analysis occurs, the 1000 will prompt to stand clear of the patient  Do not touch the patient during analysis  Make sure everyone is clear of the patient  Prompt:

12. ©2010 Physio-Control, Inc. All rights reserved. Shock Advised!  The 1000 has detected a shockable ECG rhythm  The 1000 will charge automatically

13. ©2010 Physio-Control, Inc. All rights reserved. Shock Advised!  Clear everyone from the patient or any equipment touching the patient  Press the SHOCK button  Prompt:

14. ©2010 Physio-Control, Inc. All rights reserved. CPR Time  Start CPR prompt occurs immediately after shock is delivered  A text message and countdown timer appear for the remaining CPR time  At the end of CPR time, the 1000 automatically reanalyzes the heart rhythm  Prompts:

15. ©2010 Physio-Control, Inc. All rights reserved. Shock Advised Continue to follow prompts until patient has return of spontaneous circulation or until advanced EMS provider arrives

16. ©2010 Physio-Control, Inc. All rights reserved. No Shock Advised  The 1000 has determined the heart rhythm is not shockable  The 1000 will prompt to start CPR  Perform CPR until the patient has return of spontaneous circulation or the 1000 automatically reanalyzes the heart rhythm  Prompts:

17. ©2010 Physio-Control, Inc. All rights reserved. Return of Spontaneous Circulation  Position the patient according to training if consciousness and/or signs of circulation and breathing return  Leave electrodes attached  Keep patient as still as possible  Electrodes may be connected to another LIFEPAK defibrillator

18. ©2010 Physio-Control, Inc. All rights reserved. Manual Mode  Intended for advanced users  Overrides AED features  Provides responder-initiated charge, shock, and disarm functions

19. ©2010 Physio-Control, Inc. All rights reserved. Manual Mode Basic Steps  Press the MENU key  Select YES to enter manual mode  ECG tracing and HR appear on screen  Press CHARGE if heart rhythm is shockable  Press SHOCK button when charge is complete  Press DISARM to remove an unwanted charge

20. ©2010 Physio-Control, Inc. All rights reserved. Pediatric Patient  Use the 1000 with Infant/Child Reduced Energy Defibrillation Electrodes on children less than 8 years old or less than 55 lb (25kg)  Do not delay therapy to determine precise age or weight

21. ©2010 Physio-Control, Inc. All rights reserved. Pediatric Patient  With Infant/Child Electrodes, energy from the 1000 is reduced by a factor of 4  Approximately 50-75-86 Joules are delivered if the1000 is set at 200-300-360 Joules

22. ©2010 Physio-Control, Inc. All rights reserved. Pediatric Patient Basic Steps:  Remove Infant/Child Electrodes from package  Disconnect and remove any electrodes or cables from the 1000  Insert the Infant/Child Electrode connector directly into the 1000  Apply electrodes to patient’s chest  Follow prompts

23. ©2010 Physio-Control, Inc. All rights reserved. Pediatric Patient Infant/Child Electrodes are not compatible with manual defibrillation cables or QUIK-COMBO defibrillation cable

24. ©2010 Physio-Control, Inc. All rights reserved. Pediatric Patient Place the Infant/Child Electrodes in the anterior- lateral position

25. ©2010 Physio-Control, Inc. All rights reserved. Pediatric Patient Alternate placement: anterior-posterior position

26. ©2010 Physio-Control, Inc. All rights reserved. ECG Mode  Provides ECG display of the patient’s heart rhythm using a 3-wire cable  Basic steps: Connect the ECG cable Attach ECG electrodes to ECG cable Apply ECG electrodes to patient’s chest The 1000 displays the heart rhythm and heart rate in a Lead II configuration

27. ©2010 Physio-Control, Inc. All rights reserved. ECG Mode ECG electrode placement

28. ©2010 Physio-Control, Inc. All rights reserved. ECG Mode If a shockable rhythm is detected:  Follow prompts to connect therapy electrodes  Remove ECG cable  Connect therapy cable  Apply therapy electrodes to chest  Prompt:

29. ©2010 Physio-Control, Inc. All rights reserved. Battery  Non-rechargeable lithium manganese dioxide battery  Charge level indicated by battery pak fuel gauge  Fully charged battery: all green lights illuminated

30. ©2010 Physio-Control, Inc. All rights reserved. Battery  Low battery: single steady green light.  Replace battery as soon as possible.  Empty battery: single flashing green light  Replace battery immediately

31. ©2010 Physio-Control, Inc. All rights reserved. Battery  The approximate level of charge in the battery appears on the readiness display when the 1000 is off  Low battery: battery symbol has one bar  Replace battery: battery symbol has no bars

32. ©2010 Physio-Control, Inc. All rights reserved. Battery  The approximate level of charge in the battery appears on the screen when the 1000 is on  Replace the battery when the device displays a low battery warning  Always have access to a spare, fully-charged, properly maintained battery.  Prompt:

33. ©2010 Physio-Control, Inc. All rights reserved. Troubleshooting Tips  Message: “Connect electrodes”  “Check connector and electrodes”  Possible causes:  Electrodes are not adhered to the patient’s skin  Electrodes are disconnected from the 1000  Patient impedance measurement outside of range

34. ©2010 Physio-Control, Inc. All rights reserved. Troubleshooting Tips  Message: “Connect electrodes”  “Check connector and electrodes”  What to do  Firmly press electrodes onto skin  Check that connector is completely inserted into 1000  Clean, shave and dry skin  Replace electrode pads  If prompt continues, perform CPR until ALS arrives  Prompt:

35. ©2010 Physio-Control, Inc. All rights reserved. Troubleshooting Tips  Message: “Motion detected, stop motion”  Possible causes:  Patient movement due to: breathing, CPR being performed during analysis, some internal pacemakers, vehicle motion, or electrical/radio frequency interference  What to do:  Check patient for normal breathing  Stop CPR during analysis  Stop vehicle during analysis  Move communication or other suspected devices away from 1000 when possible  Prompt:

36. ©2010 Physio-Control, Inc. All rights reserved. Data Management  Every time the 1000 is used it digitally saves patient data that can be transferred to a PC equipped with CODE-STAT ™ software  The 1000 provides an infrared method to transfer data

37. ©2010 Physio-Control, Inc. All rights reserved. Maintenance Daily Self Test  The 1000 performs automatic tests daily at 3:00 AM  OK symbol visible: AED is ready for use  Daily Auto Test will test for low or replace battery conditions  Battery gauge on the readiness display updates daily

38. ©2010 Physio-Control, Inc. All rights reserved. Maintenance Self-test  Each time the 1000 is powered on, it performs internal self-tests to check that the internal electrical components and circuits are working properly  Also detects a low or replace battery condition

39. ©2010 Physio-Control, Inc. All rights reserved. Maintenance  If the 1000 requires service, the wrench symbol appears  If the wrench is visible, remove the 1000 from service and contact authorized service personnel

40. ©2010 Physio-Control, Inc. All rights reserved. After-use Care After the 1000 has been used:  Clean foreign substances from the 1000  Replace electrodes  Replenish supplies as needed  Check battery symbol for battery status and replace battery if low  Download patient data per local protocol

41. ©2010 Physio-Control, Inc. All rights reserved. Routine Maintenance  The 1000 is easy to maintain  On a periodic basis check the following:  OK symbol is visible  Battery fuel gauge level  Use By date on electrode pads is not passed  Other emergency supplies stored with the 1000 are present (e.g., face masks, gloves, razors, etc.)  Damage to or foreign substances on the 1000

42. ©2010 Physio-Control, Inc. All rights reserved. cprMAX ™ Technology  cprMAX technology is designed to allow resuscitation protocols to maximize the quantity of CPR administered during treatment  Default settings are consistent with 2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care 1 and the European Resuscitation Council Guidelines for Resuscitation 2005 2  Know if your device settings have been changed per local protocol 1American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2005; 112 (Supplement IV). 2 European Resuscitation Council Guidelines for Resuscitation 2005. Resuscitation 2005; 67S1.

43. ©2010 Physio-Control, Inc. All rights reserved. Summary The LIFEPAK 1000 defibrillator is designed to be the most powerful BLS tool for emergency medical services (EMS):  Indicated for use on patients of all ages  Utilizes ADAPTIV™ biphasic technology  Includes manual mode capability  Incorporates fuel gauge indicators for battery  Includes cprMAX technology

44. ©2010 Physio-Control, Inc. All rights reserved. Refer to Operating Instructions for complete directions for use, indications, contraindications, warnings, precautions, and potential adverse events. You’re Ready. Always. GDR 3307602_B

45. ©2010 Physio-Control, Inc. All rights reserved. The following slides are only to be used if a pulse check has been selected in the setup option.

46. ©2010 Physio-Control, Inc. All rights reserved. Pulse Prompt You may be prompted to check for a pulse after every shock or no shock advised decision or only after a no shock advised.

47. ©2010 Physio-Control, Inc. All rights reserved. Check for Pulse  YES and NO soft keys appear on the screen  If patient does not have a pulse, press the NO soft key and CPR time begins  Prompt:

48. ©2010 Physio-Control, Inc. All rights reserved. Check For Pulse  If patient has pulse, press the YES soft key  The 1000 will prompt the user to provide rescue breaths, if needed  The 1000 enters a continuous monitoring state  Prompts:

49. ©2010 Physio-Control, Inc. All rights reserved. The following slides are only to be used only for users who require setup mode training.

50. ©2010 Physio-Control, Inc. All rights reserved. Setup Mode  To enter setup mode, hold down the two soft keys and then press the ON button  Note: Nothing should be plugged in to the cable receptacle to access setup mode  The default pass code is 0000

51. ©2010 Physio-Control, Inc. All rights reserved. Setup Mode Options  The 1000 allows easy customization using on screen menus and soft keys. Several options include:  Device ID  Manual Mode Access  Pre Shock CPR time  Initial CPR time  Pulse Check  Refer to Operating Instructions, Appendix D for more information