Here are a few Frequently Asked Questions about the ZOLL R Series™.

Why Biphasic?

Quite simply, biphasic is better for your patients!
Biphasic shocks, allow for lower energy levels to be used to deliver the current (or flow of electricity) to the heart required for defibrillation. High energy, monophasic shocks, are associated with more post-shock dysfunction and complications in patients, due to the high peak currents required to deliver a monophasic shock.

Why use 200J? Isn’t 360J better?

Energy is not what defibrillates the heart, average current (or current density) is.
Energy is a combination of Voltage, Current and Time(duration) of shock.
Energy can be changed by varying voltage, current or time.

So what happens when we change these variables?

Voltage
(or potential) is limited by the capacitor in the defibrillator. Any defibrillator has a set amount of electrical energy that it can store for a shock. ZOLL defibrillators have the largest capacitors.

Time
The time of the shock can be varied, however, longer shock times are associated with post shock dysfunction also. Long shock times reduce the average current applied because the whole time the shock is applied, the current level decays.

Current
Current is limited by the patient’s resistance or impedance. Ohm’s Law states, the higher the patient’s resistance, the more voltage is required to pass the energy through at the same flow rate.

All current is not the same and it is not constantly delivered; it decays. The pattern of delivery (or waveform) counts. It is the rate of decay and length of shock that effects the amount of harmful high peak current required to generate the current density (or average current) required.

We need to deliver current in such a way that rapid decay of the current does not occur and therefore a high peak (or initial) current is not required. That is the basis of using a rectilinear waveform.

You can see that units that vary time to increase the number of Joules are really dealing in a false economy and that high energy does not equal high current.

Why use electrodes rather than paddles?

  1. Reduce the time to first shock
  2. Provide defibrillation and pacing through one mechanism
  3. Simplify and speed the use of defibrillation and external pacing together
  4. Increase operator safety during defibrillation
  5. Reduce potential for inconsistent/inaccurate paddle placement or paddle pressure
  6. Being able to use all features on your defibrillator such as Real CPR Help® and See-Thru CPR™
  7. Being able to fully use self checking features

Are you able to shock conscious ventricular tachycardia (VT)?

The decision over whether to shock is always in the hands of the clinician. ZOLL defibs will shock if the decision is made to proceed with this course of treatment if the clinician wishes to do so.

How do I upgrade my parameters?

R series units have the parameter options of Pacing and SpO2. If you have an R Series and if wish to upgrade your parameters, the unit will have to be sent back to ZOLL to have the relevant modules switched on internally. Once this is done, you are free to plug in the appropriate probe for measurement of the parameter.

Is the R Series available with invasive lines?

The R Series is not available at this time for use with invasive lines.
The M Series® CCT units do have invasive lines as an optional parameter.

Which electrodes are designed for the R Series units?

The OneStep™ Resuscitation Electrodes are specifically designed for the R Series. All OneStep Resuscitation Electrodes have readiness checks and ready pack as standard features, and feature solid gel technology. There are a number of electrodes in this series. These are:

  • Complete — Allows defibrillation with full Real CPR Help, See-Thru CPR, integrated Pacing (without additional 3 lead)
  • Pacing — Allows defibrillation with integrated Pacing (without additional 3 lead)
  • CPR — Allows defibrillation with Real CPR Help, See-Thru CPR
  • AA — Allows defibrillation with Real CPR Help, See-Thru CPR, with AA placement
  • Basic — Allows defibrillation with readiness checks and readypack

AA vs AP placement?

Anterior Anterior placement is the most accessible placement of electrodes, as it does not involve a great deal of movement of the patient.

Anterior Posterior electrode placement is the optimal electrode placement for treatment of patients that require pacing.

Both placements have advantages and disadvantages and determination of placement should be made in accordance with your hospitals and facilities policy.

See-Thru CPR… How does it work?

When using your Complete or OneStep Resuscitation Electrode with your R Series, you will be able to use See-Thru CPR. First you need to make sure that you are set up so that your traces include ECG and filtered lines. When you perform CPR you will be able to see the ECG trace and underlying rhythm.

The complete and OneStep Resuscitation Electrode contain a “CPR puck” that not only acts a landmark for positioning the electrode, but is actually an accelerometer that measures the depth and rate of compressions. This accelerometer feeds information back to the R Series unit and a processor in the unit provides a filtered ECG based on the data from the puck.

What does the self check feature check on the unit?

The R Series does over 40 individual checks on the units’ different systems. These include:

  • Battery — Verifies that the battery state of charge is sufficient for at least one hour of continuous monitoring and ten shocks at maximum energy
  • Therapy Electrodes — Verifies that OneStep Pacing, CPR, or Complete electrodes are attached to the unit, have not expired, and that the electrode gel has not dried out
  • Note: The Code Readiness system automatically verifies the integrity of the specific electrodes listed above. Other electrodes (including members of the OneStep family) should be verified manually for connection, condition, and expiration date
  • ECG circuitry — Verifies that the ECG signal acquisition and processing electronics are functional
  • Defibrillator charge and discharge circuitry — Verifies that the defibrillator electronics are functional and can charge and discharge at 30 joules through the patient cable and into paddles, OneStep Resuscitation Electrodes, or the Test Port
  • Microprocessor hardware and software — Verifies the proper function of the microprocessor electronics and the integrity of software
  • CPR circuitry and sensor — Verifies that the Real CPR Help…..NEED COPY HERE