Re: LifePak 12 - Monitor Mode vs. Diagnostic Mode

[Guest guest]

Heck, you got me. Hmmm - I remember this being an issue on the earlier models

of their product but, unless I slept through part of the inservice their company

provided when we bought our first LP 12 at South EMS, I don't remember

him mentioning the " diagnostic mode " issue with this version... So I would be

interested to know the answer to this one too.

Jane Hill

-------------- Original message from " Donnie " :

--------------

Hey folks,

I need some information regarding the use of diagnostic mode vs.

monitor mode while obtaining 12 lead EKGs in the LifePak 12. I have

tried to explain to the " higher ups " why we must use diagnostic mode;

however, I am having difficulties in locating any specific, tangible

evidence to back this up. The reason there is an issue is that when we

do a 12 lead in diagnostic mode (which is the current setting), the

majority of the time there is so much interference that it can not be

read. FYI: This is somewhat of a new problem and we haven't changed

our electrodes. Could this be an issue with the machines themselves?

Can anyone help me out with this? Any help would be greatly

appreciated!

D. Stone

[Guest guest]

Donnie,

I would call Mark Radford who is the Physio technical guy for our area, he

should be able to provide you with what you need. Basically the issues is

that the accuracy of the 12 lead, specifically the interpretation of ST

segment analysis is not considered to be accurate unless it is performed and

printed in diagnostic mode.

Lee

_____

From: texasems-l [mailto:texasems-l ] On

Behalf Of Donnie

Sent: Sunday, December 03, 2006 10:00 AM

To: texasems-l

Subject: LifePak 12 - Monitor Mode vs. Diagnostic Mode

Hey folks,

I need some information regarding the use of diagnostic mode vs.

monitor mode while obtaining 12 lead EKGs in the LifePak 12. I have

tried to explain to the " higher ups " why we must use diagnostic mode;

however, I am having difficulties in locating any specific, tangible

evidence to back this up. The reason there is an issue is that when we

do a 12 lead in diagnostic mode (which is the current setting), the

majority of the time there is so much interference that it can not be

read. FYI: This is somewhat of a new problem and we haven't changed

our electrodes. Could this be an issue with the machines themselves?

Can anyone help me out with this? Any help would be greatly

appreciated!

D. Stone

[Guest guest]

I emailed my medtronic rep and this is his reply

" Mann, " wrote:

Subject: Re: Fwd: LifePak 12 - Monitor Mode vs. Diagnostic Mode

Date: Sun, 3 Dec 2006 10:18:04 -0600

To:

Peggy,

Thanks for this info. Can you forward this email to the person asking the

question.

First thing I would try is to replace the ekg cable, these wear out just like

tires on a car. If that does not help then the 12 lead may need to be checked by

our technicians and recalibrated.

If they need something else have them call.

Mann

Hospital Sales Consultant

Medtronic ERS

keith.mann@...

" It's not who we are underneath, but what we do that defines us. "

---------------------------------

Need a quick answer? Get one in minutes from people who know. Ask your question

on Yahoo! Answers.

[Guest guest]

Donnie,

Some other things...first, the 12-lead has to be in diagnostic mode unless you

are just doing it to kill little pink trees....(isn't that where they get the

paper???)

Secondly, how are our electrodes supplied? The ones we have used for years come

50 to a bag (10 strips of 5). One of the things we have discovered is that if

we open that bag and we don't use them quickly (say in a day or so...depending

upon heat and humidity) the gel is actually drying enough to cause messy base

lines...so we keep them in ziplock bags...especially in our reserve units.

Also, we always attempt to get our baseline 12-lead immediately upon contact

with the patient...before going to the truck if possible. The truck moves too

much (even not rolling) and there is way too much messy electricity leaking all

over the place...

One last thing if replacing the cables and keeping your electrodes sealed up

doesn't work....where are your cell phones in comparison to the monitor and what

phones are you using? I have seen some phones " warp " the monitor screen or

almost completely turn it off if they are sitting on top of it when a call comes

in....and the blackberry's and other smart phones are a ton worse....might be

another place to look.

Just don't shut diagnostic off...

Dudley

LifePak 12 - Monitor Mode vs. Diagnostic Mode

Hey folks,

I need some information regarding the use of diagnostic mode vs.

monitor mode while obtaining 12 lead EKGs in the LifePak 12. I have

tried to explain to the " higher ups " why we must use diagnostic mode;

however, I am having difficulties in locating any specific, tangible

evidence to back this up. The reason there is an issue is that when we

do a 12 lead in diagnostic mode (which is the current setting), the

majority of the time there is so much interference that it can not be

read. FYI: This is somewhat of a new problem and we haven't changed

our electrodes. Could this be an issue with the machines themselves?

Can anyone help me out with this? Any help would be greatly

appreciated!

D. Stone

________________________________________________________________________

Check out the new AOL. Most comprehensive set of free safety and security

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[Guest guest]

The two biggest contributors to poor quality, diagnostic mode EKGs from

Physio or any other manufacturer are electrodes and skin prep - not the

machines.

Electrodes - buy high quality, wet gel electrodes. Dry gel electrodes

need time to " melt " into the skin. This becomes more of a problem

during colder months. Dudley makes a good point about the quantity per

package. Regardless of the quantity, work to keep them airtight and

within an appropriate temperature range.

Skin prep is a big killer of good tracings in diagnostic mode.

Cleaning and shaving the skin as well as providing a light abrasion to

the skin greatly enhances the likelihood of a clear tracing. Six years

ago, our manufacturer spend thousands of dollars to evaluate everything

about our machines (without saying we were at fault) - even flew in

engineers to observe the machines in actual use. They bought new

electrodes for us to try and provided new cables. Eventually, skin prep

was the only thing left. Proper skin prep technique is vitally

important.

Checking the cables is another step. They do wear out with constant

use. I have heard about bad lots although this is reportedly rare.

Electrode placement and patient instructions may impact diagnostic

quality tracings. You might have a hospital 12 lead tech observe your

practice to seek tips on subtle changes to improve technique.

Obtaining clear tracings in diagnostic mode requires perfect technique,

optimal conditions, and finesse. Our environment rarely promotes all

three.

************************************************

, MPA, LP

Chief Administrative Officer

Montgomery County Hospital District

________________________________

From: texasems-l [mailto:texasems-l ] On

Behalf Of Donnie

Sent: Sunday, December 03, 2006 10:00 AM

To: texasems-l

Subject: LifePak 12 - Monitor Mode vs. Diagnostic Mode

Hey folks,

I need some information regarding the use of diagnostic mode vs.

monitor mode while obtaining 12 lead EKGs in the LifePak 12. I have

tried to explain to the " higher ups " why we must use diagnostic mode;

however, I am having difficulties in locating any specific, tangible

evidence to back this up. The reason there is an issue is that when we

do a 12 lead in diagnostic mode (which is the current setting), the

majority of the time there is so much interference that it can not be

read. FYI: This is somewhat of a new problem and we haven't changed

our electrodes. Could this be an issue with the machines themselves?

Can anyone help me out with this? Any help would be greatly

appreciated!

D. Stone

***************************************************************************

The contents of this communication are intended only for the addressee and may

contain confidential and/or privileged material. If you are not the intended

recipient, please do not read, copy, use or disclose this communication and

notify the sender. Opinions, conclusions and other information in this

communication that do not relate to the official business of Montgomery County

Hospital District shall be understood as neither given nor endorsed by it.

***************************************************************************

[Guest guest]

Peggy, but he doesn't mention anything in his e-mail response about diagnostic

mode. This is the same fellow who taught our inservice and I don't recall him

mentioning it there either. Can you get back with him and clarify his e-mail

response?

Jane Hill

--------- Re: Fwd: LifePak 12 - Monitor Mode vs. Diagnostic Mode

Date: Sun, 3 Dec 2006 10:18:04 -0600

To:

Peggy,

Thanks for this info. Can you forward this email to the person asking the

question.

First thing I would try is to replace the ekg cable, these wear out just like

tires on a car. If that does not help then the 12 lead may need to be checked by

our technicians and recalibrated.

If they need something else have them call.

Mann

Hospital Sales Consultant

Medtronic ERS

keith.mann@...

" It's not who we are underneath, but what we do that defines us. "

---------------------------------

Need a quick answer? Get one in minutes from people who know. Ask your question

on Yahoo! Answers.

[Guest guest]

When I worked in Rockport, we had the same issue while in diagnostic

mode. Physio was quick to try and isolate the problem and send us new

cables, didn't help

We eventually tracked it down to older electrodes, even after opening

new bags from our own supply, we still had the same problem, we started

ordering electrodes in smaller quantities, and smaller bags, cured the

problem. Ours had become somewhat deteriorated, and we would get a

constant interference regardless of where we were.

I would honestly start there.

W. Hatfield FF/EMT-P

www.canyonlakefire-ems.org

" Ubi concordia, ibi victoria "

Re: LifePak 12 - Monitor Mode vs. Diagnostic Mode

Peggy, but he doesn't mention anything in his e-mail response about

diagnostic mode. This is the same fellow who taught our inservice and I

don't recall him mentioning it there either. Can you get back with him

and clarify his e-mail response?

Jane Hill

--------- Re: Fwd: LifePak 12 - Monitor Mode vs. Diagnostic

Mode

Date: Sun, 3 Dec 2006 10:18:04 -0600

From: " Mann, " <keith.mann@medtroni

<mailto:keith.mann%40medtronic.com> c.com>

To: <stinnett_ems@ <mailto:stinnett_ems%40yahoo.com> yahoo.com>

Peggy,

Thanks for this info. Can you forward this email to the person asking

the question.

First thing I would try is to replace the ekg cable, these wear out just

like tires on a car. If that does not help then the 12 lead may need to

be checked by our technicians and recalibrated.

If they need something else have them call.

Mann

Hospital Sales Consultant

Medtronic ERS

keith.mann@medtroni <mailto:keith.mann%40medtronic.com> c.com

" It's not who we are underneath, but what we do that defines us. "

---------------------------------

Need a quick answer? Get one in minutes from people who know. Ask your

question on Yahoo! Answers.

[Guest guest]

Donnie, I am certain you have tried it, and seen it suggested but I will for the

sake of putting in my 2cents say it again.

We have 24 LP12's, our biggest issue has been employees putting the

electrodes on before use and placement of the leads while " hanging around "

being right where the AC/Heat blows. We told our employees to look at the

package and read where it says " do not open until patient use " and if there is

a problem with the interpretation or the baseline to open a new package. This

has solved all but the old cables and the employee's who have taped the lead

wires together (LL and RL) and (RA and LA).

Ok, I feel better now,

Chris

Donnie wrote:

Hey folks,

I need some information regarding the use of diagnostic mode vs.

monitor mode while obtaining 12 lead EKGs in the LifePak 12. I have

tried to explain to the " higher ups " why we must use diagnostic mode;

however, I am having difficulties in locating any specific, tangible

evidence to back this up. The reason there is an issue is that when we

do a 12 lead in diagnostic mode (which is the current setting), the

majority of the time there is so much interference that it can not be

read. FYI: This is somewhat of a new problem and we haven't changed

our electrodes. Could this be an issue with the machines themselves?

Can anyone help me out with this? Any help would be greatly

appreciated!

D. Stone

---------------------------------

Want to start your own business? Learn how on Yahoo! Small Business.

[Guest guest]

You are gonna laught at this but I recently had one of those, " Wow, I could have

had a V8 " moments when I had difficulty getting a clean 12 lead reading on a

patient. It just looked like gobbledygook each time I ran it - like we were

bouncing down the road instead of sitting still. Then my student and I looked

at each other as the lightbulb came on in both of our heads instantaneously when

we noticed that we had placed his aluminum cane on the stretcher with him. The

leads were lying across the cane....... We removed the cane, and WALA - a

perfect 12 lead strip. LOL

Jane Hill

-------------- Original message from Weinzapfel :

--------------

Donnie, I am certain you have tried it, and seen it suggested but I will for the

sake of putting in my 2cents say it again.

We have 24 LP12's, our biggest issue has been employees putting the electrodes

on before use and placement of the leads while " hanging around " being right

where the AC/Heat blows. We told our employees to look at the package and read

where it says " do not open until patient use " and if there is a problem with

the interpretation or the baseline to open a new package. This has solved all

but the old cables and the employee's who have taped the lead wires together (LL

and RL) and (RA and LA).

Ok, I feel better now,

Chris

Donnie wrote:

Hey folks,

I need some information regarding the use of diagnostic mode vs.

monitor mode while obtaining 12 lead EKGs in the LifePak 12. I have

tried to explain to the " higher ups " why we must use diagnostic mode;

however, I am having difficulties in locating any specific, tangible

evidence to back this up. The reason there is an issue is that when we

do a 12 lead in diagnostic mode (which is the current setting), the

majority of the time there is so much interference that it can not be

read. FYI: This is somewhat of a new problem and we haven't changed

our electrodes. Could this be an issue with the machines themselves?

Can anyone help me out with this? Any help would be greatly

appreciated!

D. Stone

---------------------------------

Want to start your own business? Learn how on Yahoo! Small Business.

[Guest guest]

Remember also, that those of us who are so proud (previous posts) of our Frazer

ambulances need to remember that the LP12 cannot sit on the bench seat in most

cases, and get a decent tracing due to the magnetic field the generator coils

create...even when it is not running. Any of you using Alaris Med III pumps may

also need to relocate the pump and/or monitor, as that is a known cause of

artifact. Last but not least, last month while traveling down the road,

lightening struck very, very near the unit and the LP 12 went completely

haywire. I had to power it down, and back up, so it would reboot, before it

would do anything correctly. Makes me wonder how many " little " glitches we

experience routinely that are attributable to storm and static activity. I know

the lightning was not aimed for us...after all we EMS types are all the " clean

living " types, right!

Vernon Gresham

City of Ganado

Re: LifePak 12 - Monitor Mode vs. Diagnostic Mode

You are gonna laught at this but I recently had one of those, " Wow, I could

have had a V8 " moments when I had difficulty getting a clean 12 lead reading on

a patient. It just looked like gobbledygook each time I ran it - like we were

bouncing down the road instead of sitting still. Then my student and I looked at

each other as the lightbulb came on in both of our heads instantaneously when we

noticed that we had placed his aluminum cane on the stretcher with him. The

leads were lying across the cane....... We removed the cane, and WALA - a

perfect 12 lead strip. LOL

Jane Hill

-------------- Original message from Weinzapfel :

--------------

Donnie, I am certain you have tried it, and seen it suggested but I will for

the sake of putting in my 2cents say it again.

We have 24 LP12's, our biggest issue has been employees putting the electrodes

on before use and placement of the leads while " hanging around " being right

where the AC/Heat blows. We told our employees to look at the package and read

where it says " do not open until patient use " and if there is a problem with

the interpretation or the baseline to open a new package. This has solved all

but the old cables and the employee's who have taped the lead wires together (LL

and RL) and (RA and LA).

Ok, I feel better now,

Chris

Donnie wrote:

Hey folks,

I need some information regarding the use of diagnostic mode vs.

monitor mode while obtaining 12 lead EKGs in the LifePak 12. I have

tried to explain to the " higher ups " why we must use diagnostic mode;

however, I am having difficulties in locating any specific, tangible

evidence to back this up. The reason there is an issue is that when we

do a 12 lead in diagnostic mode (which is the current setting), the

majority of the time there is so much interference that it can not be

read. FYI: This is somewhat of a new problem and we haven't changed

our electrodes. Could this be an issue with the machines themselves?

Can anyone help me out with this? Any help would be greatly

appreciated!

D. Stone

---------------------------------

Want to start your own business? Learn how on Yahoo! Small Business.

[Guest guest]

Since there are various designs on Frazer ambulances, I am not sure I follow.

On the unit I helped purchase, the generator was on the opposite side of the box

from the bench seat. Am I just being a redhead?? LOL

Jane Hill

--------- Re: LifePak 12 - Monitor Mode vs. Diagnostic Mode

You are gonna laught at this but I recently had one of those, " Wow, I

could have had a V8 " moments when I had difficulty getting a clean 12

lead reading on a patient. It just looked like gobbledygook each time I

ran it - like we were bouncing down the road instead of sitting still.

Then my student and I looked at each other as the lightbulb came on in

both of our heads instantaneously when we noticed that we had placed his

aluminum cane on the stretcher with him. The leads were lying across the

cane....... We removed the cane, and WALA - a perfect 12 lead strip. LOL

Jane Hill

-------------- Original message from Weinzapfel <ctacdoc657 (AT) yahoo (DOT)

<mailto:ctacdoc657%40yahoo.com> com>: --------------

Donnie, I am certain you have tried it, and seen it suggested but I will

for the sake of putting in my 2cents say it again.

We have 24 LP12's, our biggest issue has been employees putting the

electrodes on before use and placement of the leads while " hanging

around " being right where the AC/Heat blows. We told our employees to

look at the package and read where it says " do not open until patient

use " and if there is a problem with the interpretation or the baseline

to open a new package. This has solved all but the old cables and the

employee's who have taped the lead wires together (LL and RL) and (RA

and LA).

Ok, I feel better now,

Chris

Donnie <wdstone (AT) sbcglobal (DOT) <mailto:wdstone%40sbcglobal.net> net> wrote:

Hey folks,

I need some information regarding the use of diagnostic mode vs.

monitor mode while obtaining 12 lead EKGs in the LifePak 12. I have

tried to explain to the " higher ups " why we must use diagnostic mode;

however, I am having difficulties in locating any specific, tangible

evidence to back this up. The reason there is an issue is that when we

do a 12 lead in diagnostic mode (which is the current setting), the

majority of the time there is so much interference that it can not be

read. FYI: This is somewhat of a new problem and we haven't changed

our electrodes. Could this be an issue with the machines themselves?

Can anyone help me out with this? Any help would be greatly

appreciated!

D. Stone

---------------------------------

Want to start your own business? Learn how on Yahoo! Small Business.

[Guest guest]

I had heard about the Frazer issue in the past, but have never had an

issue with it myself, and have run countless 12 leads while the LP12 was

on the bench.

Interesting piece of information though.

W. Hatfield FF/EMT-P

www.canyonlakefire-ems.org

" Ubi concordia, ibi victoria "

Re: LifePak 12 - Monitor Mode vs. Diagnostic Mode

Remember also, that those of us who are so proud (previous posts) of our

Frazer ambulances need to remember that the LP12 cannot sit on the bench

seat in most cases, and get a decent tracing due to the magnetic field

the generator coils create...even when it is not running. Any of you

using Alaris Med III pumps may also need to relocate the pump and/or

monitor, as that is a known cause of artifact. Last but not least, last

month while traveling down the road, lightening struck very, very near

the unit and the LP 12 went completely haywire. I had to power it down,

and back up, so it would reboot, before it would do anything correctly.

Makes me wonder how many " little " glitches we experience routinely that

are attributable to storm and static activity. I know the lightning was

not aimed for us...after all we EMS types are all the " clean living "

types, right!

Vernon Gresham

City of Ganado

Re: LifePak 12 - Monitor Mode vs. Diagnostic Mode

You are gonna laught at this but I recently had one of those, " Wow, I

could have had a V8 " moments when I had difficulty getting a clean 12

lead reading on a patient. It just looked like gobbledygook each time I

ran it - like we were bouncing down the road instead of sitting still.

Then my student and I looked at each other as the lightbulb came on in

both of our heads instantaneously when we noticed that we had placed his

aluminum cane on the stretcher with him. The leads were lying across the

cane....... We removed the cane, and WALA - a perfect 12 lead strip. LOL

Jane Hill

-------------- Original message from Weinzapfel <ctacdoc657 (AT) yahoo (DOT)

<mailto:ctacdoc657%40yahoo.com> com>: --------------

Donnie, I am certain you have tried it, and seen it suggested but I will

for the sake of putting in my 2cents say it again.

We have 24 LP12's, our biggest issue has been employees putting the

electrodes on before use and placement of the leads while " hanging

around " being right where the AC/Heat blows. We told our employees to

look at the package and read where it says " do not open until patient

use " and if there is a problem with the interpretation or the baseline

to open a new package. This has solved all but the old cables and the

employee's who have taped the lead wires together (LL and RL) and (RA

and LA).

Ok, I feel better now,

Chris

Donnie <wdstone (AT) sbcglobal (DOT) <mailto:wdstone%40sbcglobal.net> net> wrote:

Hey folks,

I need some information regarding the use of diagnostic mode vs.

monitor mode while obtaining 12 lead EKGs in the LifePak 12. I have

tried to explain to the " higher ups " why we must use diagnostic mode;

however, I am having difficulties in locating any specific, tangible

evidence to back this up. The reason there is an issue is that when we

do a 12 lead in diagnostic mode (which is the current setting), the

majority of the time there is so much interference that it can not be

read. FYI: This is somewhat of a new problem and we haven't changed

our electrodes. Could this be an issue with the machines themselves?

Can anyone help me out with this? Any help would be greatly

appreciated!

D. Stone

---------------------------------

Want to start your own business? Learn how on Yahoo! Small Business.

[Guest guest]

First of all, thanks for all of your input. Secondly, after much

discussion, we have narrowed it down to an issue that we will be

working on. We currently have electrodes on the cables at all

times. So, we are looking at changing this and only getting the

electrodes out per individual need. Also, about 6 months ago, we

began ordering our electrodes in bulk (30 per package). This means

that each time a new package was opened the ones that were used last

could have easily dried out prior to use. We currently use the

Silvon Diaphoretic electrodes and they seem to only have a minimal

amount of conductive get to begin with. We will be hitting the

electrode issue hard to see if this will correct our problems.

After a discussion with our Physio rep, he stated that the diagnostic

mode was more for hospital use and not EMS. This is something that I

totally do not agree with as the diagnostic mode is the only true way

to zero in on the j-point and ST segment for analysis of changes from

the baseline (as beautifully stated by Lee . I had to give

him the credit for that statement). Monitor mode only zeros in on

the QRS to give the rate and rhythm.

Lastly, we also have Frazer ambulances, but have only had this issue

for the last 6 months or so. Seems to be around the same time we

changed the way the electrodes are packaged. Thanks again for all of

your input!!!

D. Stone

> Hey folks,

>

> I need some information regarding the use of diagnostic mode vs.

> monitor mode while obtaining 12 lead EKGs in the LifePak 12. I have

> tried to explain to the " higher ups " why we must use diagnostic

mode;

> however, I am having difficulties in locating any specific,

tangible

> evidence to back this up. The reason there is an issue is that when

we

> do a 12 lead in diagnostic mode (which is the current setting), the

> majority of the time there is so much interference that it can not

be

> read. FYI: This is somewhat of a new problem and we haven't changed

> our electrodes. Could this be an issue with the machines

themselves?

> Can anyone help me out with this? Any help would be greatly

> appreciated!

>

> D. Stone

>

> ---------------------------------

> Want to start your own business? Learn how on Yahoo! Small Business.

>

>

[Guest guest]

We use the Blue Dot SP-00S electrodes with great success in diagnostic mode.

They are packaged in 30 count packages but have a great deal of conductive

gel on them to begin with. We also keep electrodes on the cables at all

times and have not had an issue with them drying out. Then again the

average time the electrodes stay on the cables without use is less than 24

hours at the longest. These electrodes also tend to be more adhesive with

diaphoretic pts than those we used before. I would recommend these to

anyone but they do tend to cost a little bit more than our previous ones but

the results are well worth the money.

Ince

From: texasems-l [mailto:texasems-l ] On

Behalf Of Donnie

Sent: Monday, December 04, 2006 7:32 PM

To: texasems-l

Subject: Re: LifePak 12 - Monitor Mode vs. Diagnostic Mode

First of all, thanks for all of your input. Secondly, after much

discussion, we have narrowed it down to an issue that we will be

working on. We currently have electrodes on the cables at all

times. So, we are looking at changing this and only getting the

electrodes out per individual need. Also, about 6 months ago, we

began ordering our electrodes in bulk (30 per package). This means

that each time a new package was opened the ones that were used last

could have easily dried out prior to use. We currently use the

Silvon Diaphoretic electrodes and they seem to only have a minimal

amount of conductive get to begin with. We will be hitting the

electrode issue hard to see if this will correct our problems.

After a discussion with our Physio rep, he stated that the diagnostic

mode was more for hospital use and not EMS. This is something that I

totally do not agree with as the diagnostic mode is the only true way

to zero in on the j-point and ST segment for analysis of changes from

the baseline (as beautifully stated by Lee . I had to give

him the credit for that statement). Monitor mode only zeros in on

the QRS to give the rate and rhythm.

Lastly, we also have Frazer ambulances, but have only had this issue

for the last 6 months or so. Seems to be around the same time we

changed the way the electrodes are packaged. Thanks again for all of

your input!!!

D. Stone

> Hey folks,

>

> I need some information regarding the use of diagnostic mode vs.

> monitor mode while obtaining 12 lead EKGs in the LifePak 12. I have

> tried to explain to the " higher ups " why we must use diagnostic

mode;

> however, I am having difficulties in locating any specific,

tangible

> evidence to back this up. The reason there is an issue is that when

we

> do a 12 lead in diagnostic mode (which is the current setting), the

> majority of the time there is so much interference that it can not

be

> read. FYI: This is somewhat of a new problem and we haven't changed

> our electrodes. Could this be an issue with the machines

themselves?

> Can anyone help me out with this? Any help would be greatly

> appreciated!

>

> D. Stone

>

> ---------------------------------

> Want to start your own business? Learn how on Yahoo! Small Business.

>

>

[Guest guest]

Maybe that is why the rep who did our inservice on these things didn't even

mention diagnostic mode? They think we don't need it or use it. Ok, since it

wasn't included in OUR inservice, how do you preset the LP 12 in diagnostic mode

so it runs there and, if there is a problem, how do you get it back into regular

mode?

Jane

-------------- Original message from " Donnie " :

--------------

First of all, thanks for all of your input. Secondly, after much

discussion, we have narrowed it down to an issue that we will be

working on. We currently have electrodes on the cables at all

times. So, we are looking at changing this and only getting the

electrodes out per individual need. Also, about 6 months ago, we

began ordering our electrodes in bulk (30 per package). This means

that each time a new package was opened the ones that were used last

could have easily dried out prior to use. We currently use the

Silvon Diaphoretic electrodes and they seem to only have a minimal

amount of conductive get to begin with. We will be hitting the

electrode issue hard to see if this will correct our problems.

After a discussion with our Physio rep, he stated that the diagnostic

mode was more for hospital use and not EMS. This is something that I

totally do not agree with as the diagnostic mode is the only true way

to zero in on the j-point and ST segment for analysis of changes from

the baseline (as beautifully stated by Lee . I had to give

him the credit for that statement). Monitor mode only zeros in on

the QRS to give the rate and rhythm.

Lastly, we also have Frazer ambulances, but have only had this issue

for the last 6 months or so. Seems to be around the same time we

changed the way the electrodes are packaged. Thanks again for all of

your input!!!

D. Stone

> Hey folks,

>

> I need some information regarding the use of diagnostic mode vs.

> monitor mode while obtaining 12 lead EKGs in the LifePak 12. I have

> tried to explain to the " higher ups " why we must use diagnostic

mode;

> however, I am having difficulties in locating any specific,

tangible

> evidence to back this up. The reason there is an issue is that when

we

> do a 12 lead in diagnostic mode (which is the current setting), the

> majority of the time there is so much interference that it can not

be

> read. FYI: This is somewhat of a new problem and we haven't changed

> our electrodes. Could this be an issue with the machines

themselves?

> Can anyone help me out with this? Any help would be greatly

> appreciated!

>

> D. Stone

>

> ---------------------------------

> Want to start your own business? Learn how on Yahoo! Small Business.

>

>

[Guest guest]

another thing which will cause EMI to the monitor is the fluorescent lights in

the ambulance. the ecg monitors are in a plastic-like case and are ungrounded

jim davis

Hatfield wrote:

When I worked in Rockport, we had the same issue while in diagnostic

mode. Physio was quick to try and isolate the problem and send us new

cables, didn't help

We eventually tracked it down to older electrodes, even after opening

new bags from our own supply, we still had the same problem, we started

ordering electrodes in smaller quantities, and smaller bags, cured the

problem. Ours had become somewhat deteriorated, and we would get a

constant interference regardless of where we were.

I would honestly start there.

W. Hatfield FF/EMT-P

www.canyonlakefire-ems.org

" Ubi concordia, ibi victoria "

Re: LifePak 12 - Monitor Mode vs. Diagnostic Mode

Peggy, but he doesn't mention anything in his e-mail response about

diagnostic mode. This is the same fellow who taught our inservice and I

don't recall him mentioning it there either. Can you get back with him

and clarify his e-mail response?

Jane Hill

--------- Re: Fwd: LifePak 12 - Monitor Mode vs. Diagnostic

Mode

Date: Sun, 3 Dec 2006 10:18:04 -0600

From: " Mann, " <keith.mann@medtroni

<mailto:keith.mann%40medtronic.com> c.com>

To: <stinnett_ems@ <mailto:stinnett_ems%40yahoo.com> yahoo.com>

Peggy,

Thanks for this info. Can you forward this email to the person asking

the question.

First thing I would try is to replace the ekg cable, these wear out just

like tires on a car. If that does not help then the 12 lead may need to

be checked by our technicians and recalibrated.

If they need something else have them call.

Mann

Hospital Sales Consultant

Medtronic ERS

keith.mann@medtroni <mailto:keith.mann%40medtronic.com> c.com

" It's not who we are underneath, but what we do that defines us. "

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