Manual Usuario TEC5600 - INGLES

OPERATOR’S MANUAL
Defibrillator
TEC-5600 series
Operator’s Manual
Defibrillator
TEC-5601/TEC-5611
TEC-5621/TEC-5631
TEC-5600 series
1st Edition: 04 Apr 2014

4th Edition: 25 Feb 2015
0614-907188C
Printed: 2015/03/05
About This Manual
In order to use this product safely and fully understand all its functions, read this manual before using the
product.
Keep this manual near the instrument or in the reach of the operator and refer to it whenever the operation is
unclear.
Accompanying Documentation
The TEC-5600 series defibrillator comes with the following manuals. Refer to the manual depending on
your needs.
Operator’s Manual (this manual)

Describes general information, defibrillation, pacing and parameter monitoring. Read
this manual before use.
Administrator’s Guide
For administrators. Describes the settings on the SYSTEM SETUP screen. Read the
Operator’s Manual together with this manual.
Service Manual
For qualified service personnel. Describes information on servicing the defibrillator.
Only qualified service personnel can service the defibrillator.
Trademark
The company name and model name are trademarks and registered trademarks of each company.
The mark printed on the SD card that is used in this instrument is a trademark.
Bluetooth® and its logo are trademarks of Bluetooth SIG, Inc.
Copyright Notice
The entire contents of this manual are copyrighted by Nihon Kohden. All rights are reserved. No part of this
document may be reproduced, stored, or transmitted in any form or by any means (electronic, mechanical,
photocopied, recorded, or otherwise) without the prior written permission of Nihon Kohden.
This product stores personal patient information. Manage and operate the information appropriately.
Patient names on the screen shots and recording examples in this manual are fictional and any resemblance to
any person living or dead is purely coincidental.
The contents of this manual are subject to change without notice.
If you have any comments or suggestions on this manual, please contact us at: www.nihonkohden.com
WARNING: A warning alerts the user to the possible injury or death associated with
the use or misuse of the instrument.
CAUTION: A caution alerts the user to possible injury or problems with the instrument
associated with its use or misuse such as instrument malfunction,
instrument failure, damage to the instrument, or damage to other property.
Warnings and cautions for individual functions are described on related pages.
Also read those warnings and cautions carefully.
General
WARNING WARNING
Never use the defibrillator in the presence of any Never use the defibrillator in a hyperbaric oxygen
flammable anesthetic gas or high concentration chamber. Failure to follow this warning may cause
oxygen atmosphere. Failure to follow this warning explosion or fire.
may cause explosion or fire.
WARNING
WARNING When the defibrillator is used with an
This defibrillator is for one patient at a time. Do not electrosurgical unit (ESU), firmly attach the entire
monitor multiple patients with different sensors area of the ESU return plate. Otherwise, the
attached. current from the ESU flows into the electrodes of
the defibrillator, causing electrical burn where the
electrodes are attached. For details, refer to the
ESU manual.
WARNING
When performing MRI test, remove all electrodes
and transducers from the patient which are
connected to this instrument. Failure to follow this WARNING
warning may cause skin burn on the patient. For After attaching electrodes, probes and sensors on
details, refer to the MRI manual. the patient and connecting cables to the
defibrillator, check that there are no error
messages and the waveforms and numeric data
WARNING are appropriately displayed on the screen. If there
is an error message, or waveform or numeric data
Do not diagnose a patient based only on data
is not appropriate, check the electrodes, probes
acquired by the defibrillator. Overall judgement
and sensor attachment, patient condition and
must be performed by a physician who
settings on the defibrillator and remove the cause.
understands the features, limitations and
characteristics of the defibrillator and by reading
the biomedical signals acquired by other
instruments.
CAUTION
If the defibrillator is affected by an RF interference
from a cellular phone, small wireless device or
other device, move that device away from the
defibrillator or turn off the power of the device. The
defibrillator may misinterpret radio waves from the
device as ECG signals or pulses and display
incorrect data.
Operator’s Manual TEC-5600 series I

Installation
WARNING WARNING
Only use the specified power cord. When the Connect only the specified instrument to the
specified power cord cannot be used or when defibrillator and follow the specified procedure.
equipotential grounding is doubtful (such as in poor Failure to follow this warning may result in
grounding facility), operate the defibrillator on electrical shock or injury to the patient and
battery power. Otherwise, the patient and operator operator, and cause fire or instrument malfunction.
may receive electrical shock or injury.
CAUTION
Before connecting or disconnecting instruments,
make sure that each instrument is turned off and
the power cord is disconnected from the AC
socket. Then remove the battery pack. Otherwise,
the patient or operator may receive electrical shock
or injury.
Turning Power On
CAUTION
When the defibrillator is turned on, check that one
“bong” sounds and the red, yellow and cyan alarm
indicator lamps blink once to show that the alarm
functions properly.
Defibrillation
WARNING WARNING
Before defibrillation, make sure that no one is in The defibrillator generates high voltage. The
contact with either the patient or any metal part of defibrillator must only be operated by trained and
any equipment or cables which supports or is qualified medical personnel.
connected to the patient. Failure to follow this
warning causes serious electrical shock or injury.
WARNING
Perform defibrillation in an ambulance only with the
WARNING vehicle stopped.
Before defibrillation and cardioversion, remove
from the patient all electrodes, probes and trans-
ducers from connectors that do not have a “ ” or
“ ” mark. Otherwise, the operator may receive
electrical shock and the connected instrument may
be damaged.
II Operator’s Manual TEC-5600 series

WARNING WARNING
Before defibrillation, remove the electrodes for any When connecting the paddles or pad adapter, firmly
other instruments and patches from the positions insert the connector into the paddle connector on
where the paddles will be placed. If a defibrillator the defibrillator. Check the connection and confirm
paddle contacts such an object, the delivery of that the tab of the paddle connector lock is in the
shock may be insufficient and cause a skin burn. locked position.
After the paddles or pad adapter is replaced, do a
discharge test and confirm that the defibrillator
WARNING operates normally.
Incorrect cable connection may result in troubles
When switching to another defibrillator because of
such as failure to display “CONNECT
trouble with this defibrillator, remove the disposable
PADDLES/PAD” message, accidental removal of
pads and electrodes from the patient. If the
the cable, or insufficient delivery of electrical shock.
paddles of the defibrillator in use contact an object
on the patient, delivery of shock may be
insufficient. In addition, it may cause skin burn or
may damage the defibrillator. WARNING
Before defibrillation and cardioversion, check that
the cords and cables of the electrodes and trans-
WARNING ducers attached to the patient are properly
connected to the defibrillator. Touching the metal
Do not move or transport the defibrillator when any
parts of the disconnected cords and cables may
residual charge remains in the defibrillator. If the
cause electrical shock or injury by discharged
defibrillator receives any impact, such as from
energy.
falling, it may discharge and can cause electrical
shock.
WARNING
Never perform defibrillation to a person or object
WARNING
other than the patient or discharge test equipment
When using an ESU, use the ECG electrodes for
(test electrode plate or energy checker). When
monitoring. Do not monitor ECG with disposable
performing the defibrillation check using the
pads, external paddles or internal paddles. If ECG
external paddles, keep the paddles in the paddle
is monitored with pads or paddles, high-frequency
holders. Failure to follow this instruction may result
energy from the ESU causes abnormal current to
in electrical shock.
flow in the patient and unexpected discharge. This
may damage the defibrillator.
WARNING
When performing defibrillation on a child, be
careful of the selected energy. High energy may
cause critical damage to the cardiac muscle.
CAUTION CAUTION
If the patient’s body is wet, thoroughly wipe the Before defibrillation, make sure that the patient is
moisture off the skin so that the paddles or pads not in electrical contact with any metal part of a
will not short-circuit each other. Otherwise, delivery bed, stretcher, or other equipment via blood or
of shock may be insufficient. chemical solution on the patient. Such contact may
cause unwanted pathways for the defibrillator
current and cause insufficient delivery of electrical
shock.
Operator’s Manual TEC-5600 series III

CAUTION CAUTION
Have another defibrillator ready in case of trouble If the patient has a pacemaker or ICD:
or accident. • Do not attach the disposable pads directly over
the pacemaker or ICD. Doing so may affect the
function of the implanted pacemaker or ICD.
Attach the disposable pads at least 8 cm away
from the implanted position (bulging area) of the
pacemaker or ICD. (Do not take time selecting
the attachment position of the pads at the cost of
delaying emergency treatment.)
• If defibrillation is performed on a patient with an
implanted ICD or pacemaker, the ICD or
pacemaker function should be checked after
defibrillation.
• If the patient has an ICD that is delivering
shocks, wait 30 to 60 seconds for the ICD to
complete its treatment cycle before attaching the
disposable pads. The analysis and shock cycles
of the ICD and the defibrillator may conflict.
• Analysis results may be inaccurate if the ECG
includes a wide pacemaker pulse.
Individual Defibrillation Modes

Synchronized Cardioversion
WARNING WARNING
Confirm that there is no artifact on the ECG. Check that the vertical dotted line indicating
Artifact may be misinterpreted as QRS and synchronization position is displayed on the rising
discharge might not synchronize with the patient’s slope of every QRS wave (between the Q and R
QRS. points). If the position of the vertical dotted line is
incorrect, adjust the position as follows:
• Change the amplitude of the ECG waveforms
WARNING with the [SENSITIVITY] function key.
• Change the ECG lead with the [LEAD] function
Before using the defibrillator, check that
key.
synchronized cardioversion occurs within 60 ms of
• Change the electrode position.
the peak of the ECG’s R wave with the defibrillator
If the position of the vertical dotted line is incorrect,
and an external monitor connected.
synchronized cardioversion may not be performed
properly and may cause ventricular fibrillation to
the patient.
CAUTION CAUTION
Synchronized cardioversion with the paddle lead When performing synchronized cardioversion,
does not provide stable ECG because it is difficult confirm that SYNC MODE is displayed on the
to hold the paddles steady. Artifact on the ECG defibrillator screen before every discharge.
may be misinterpreted as QRS and discharge Depending on the setting made on the SYSTEM
might not synchronize with the patient’s QRS. SETUP screen, the defibrillator automatically
returns to the asynchronous defibrillation mode
after synchronized cardioversion.
IV Operator’s Manual TEC-5600 series

AED
WARNING WARNING
When the patient is a child age 0 to 7, perform While the defibrillator is analyzing the patient’s
defibrillation in AED mode (child mode). ECG, stop CPR and do not move or shake the
When using the defibrillation pads, make sure that patient’s body. If the patient is in a car, stop the car.
the pads do not touch each other. Otherwise, the defibrillator cannot analyze the
patient’s ECG correctly.
WARNING
Only use the AED mode (child mode) for children
age 0 to 7. If the AED mode (child mode) is used
for adults, the discharged energy may be
insufficient.
CAUTION CAUTION
Before ECG analysis or defibrillation, confirm that Asystole is not judged as a shockable rhythm.
the patient is unconscious and has no respiration
and no pulse.
CAUTION
For some ECG waves, the defibrillator may
CAUTION incorrectly judge that defibrillation is not necessary.
Do not perform defibrillation if the electrodes of the When the defibrillator judges that defibrillation is
disposable pads overlap each other or are not necessary, it provides instructions for
short-circuited by anything conductive such as performing CPR. In very rare cases, the
contact gel. Failure to follow this warning may defibrillator may incorrectly judge that defibrillation
cause skin burn or insufficient delivery of shock to is necessary.
the heart.
CAUTION
The defibrillator may not be able to correctly
analyze an ECG of a patient with an implanted
pacemaker. For such a patient, follow a physician’s
instructions.
Defibrillation Using Various Types of Paddles

With External Paddles
WARNING WARNING
Before defibrillation, remove everything including Pay careful attention to the energy setting when
electrodes and patches from the patient’s chest. If using the pediatric electrode plates. Applying high
the defibrillator paddle/pad contacts an object on energy with the pediatric electrode plates can
the patient’s chest, the discharged energy may be cause skin burn, because the electrode plates are
insufficient and cause skin burn. small.
WARNING WARNING
Do not hold the paddle handles if your hands are Apply contact gel only to the electrode plates of the
wet or have contact gel on them. This may cause external paddles. Otherwise, it may cause electrical
electrical shock to the operator. shock to the operator.
Operator’s Manual TEC-5600 series V

WARNING WARNING
Before discharging, confirm that the paddles or When charging or discharging, do not touch
pads are firmly pressed against the chest wall. anything other than the handles of the paddles. If
Failure to follow this warning may cause skin burn any other part of the defibrillator is touched during
or insufficient delivery of shock. charging or discharging, the operator receives an
electrical shock.
CAUTION CAUTION
Do not discharge the energy if the electrodes of To prevent skin burn on the patient, apply contact
paddles are short-circuited to each other by gel evenly to the electrode plates of the external
contact gel. Failure to follow this warning may paddles.
cause skin burn or insufficient delivery of shock to
the heart.
With Internal Paddles
WARNING WARNING
Do not discharge with the paddles in the air. This When charging or discharging, grip the internal
may cause electrical shock or damage the paddles between the cable and the guard at the
defibrillator. top of the handle. If the internal paddles are
gripped between the electrode and the guard, the
operator may receive an electrical shock.
WARNING
Before discharging, confirm that the internal
paddles are firmly positioned against the heart. CAUTION
Failure to follow this warning may cause skin burn Do not twist the internal paddle while holding the
or insufficient delivery of shock. electrode or impact strong impact to the paddle.
Doing so can damage or bend the electrode.
CAUTION
Pay careful attention to the selected energy when CAUTION
using internal paddles. Applying high energy to the Sterilize the internal paddles before use. Failure to
heart may cause cardiac muscle necrosis. Low sterilize the paddles may cause serious infection.
energy is recommended.
With Disposable Pads
WARNING WARNING
Before defibrillation, remove everything including Before discharging, confirm that the paddles or
electrodes and patches from the patient’s chest. If pads are firmly pressed against the chest wall.
the defibrillator paddle/pad contacts an object on Failure to follow this warning may cause skin burn
the patient’s chest, the discharged energy may be or insufficient delivery of shock.
insufficient and cause skin burn.
CAUTION
Do not perform defibrillation if the electrodes of the
disposable pads overlap each other or are
short-circuited by anything conductive such as
contact gel. Failure to follow this warning may
the heart.
VI Operator’s Manual TEC-5600 series

Disposable Pads
WARNING WARNING
Do not use the disposable pads if they are past the If the bag containing disposable pads is torn, do
expiration date on the package. Failure to follow not use the pads. Dispose of the pads. Failure to
this warning may lead to skin burn or insufficient follow this warning may lead to skin burns or
delivery of shock. insufficient delivery of shock.
WARNING WARNING
Do not reuse disposable pads. Failure to follow this Do not use the disposable pads if the gel is dark
warning may lead to skin burn or insufficient brown or dark-brown gel is on the protective sheet.
delivery of shock. Use of such pads may cause insufficient delivery of
shock or skin burn where the pads are attached.
WARNING
• Do not use the disposable pads if the gel has WARNING
become dry. Use disposal pads as soon as possible after
• Do not use the disposable pads if the gel has opening the package. Failure to follow this warning
become abnormal (the gel has become liquified may lead to skin burn or insufficient delivery of
or is coming out of the edges of the pad, etc.). shock.
Failure to follow these warnings may cause skin
burn or insufficient delivery of shock.
CAUTION CAUTION
Do not place heavy objects on the disposable pads When disposable pads are attached to a patient,
or bend the pads. The pads may become damaged replace them every 24 hours. After 24 hours, the
and deteriorated, resulting in skin burn on the gel becomes dry and this may reduce performance
patient. of the pads.
CAUTION CAUTION
Do not attach a disposable pad over another pad. When monitoring ECG with disposable pads,
It may cause skin burn on the patient. check the polarity of the pads before attaching
them on the patient. If the pad polarity is incorrect,
the waveform appears upside-down and this may
cause incorrect judgment by the operator and
CAUTION
delay of treatment.
Store the disposable pads in the environment
described on the package. If stored in an
environment other than specified, the pads will
become unusable.
Cables, Electrodes, Paddles and Probes
WARNING CAUTION
Only use Nihon Kohden specified parts and Do not reuse disposable parts and accessories.
accessories, such as connection cords, electrodes,
paddles and probes. Otherwise, the defibrillator
may overheat and be damaged, in which case
monitoring will stop or electrical shock may be
caused.
Operator’s Manual TEC-5600 series VII

Pacing
WARNING WARNING
Do not perform pacing while using an ESU. Before Confirm that there is no artifact on the ECG.
using the ESU, turn the defibrillator power off and Artifact may be misinterpreted as QRS and correct
remove disposable pads from the patient. Other- pacing cannot be performed.
wise, high frequency energy from the ESU causes
abnormal current to flow into the patient and
causes electrical burn, shock or other injury. It also WARNING
damages the defibrillator.
When using the disposable pads for long term
pacing, replace them every hour. Failure to follow
this warning may cause skin burn or insufficient
WARNING energy discharge and pacing current to the heart.
If any disposable pad or connector gets wet, wipe
off moisture before use. If a wet pad or connector
is used, it may cause electrical shock. WARNING
When performing pacing in a vehicle, such as an
ambulance, confirm that noise due to automobile
WARNING vibrations is not misinterpreted as QRS.
Do not touch the disposable pads or the area
around the pads during pacing. Failure to follow
this warning may cause electrical shock.
CAUTION
Check that the pacing pulse is effective, by
observing the ECG on the screen.
Alarms
WARNING WARNING
Do not diagnose a patient based only on alarm A physician must be within the range where he/she
information of the defibrillator. If the alarm is set to can hear the alarm sound of the defibrillator while
off, critical changes in the patient may be over- monitoring a patient on the defibrillator. If the
looked. physician cannot hear the alarm sound, critical
changes on the patient may be overlooked.
WARNING
If more than one medical equipment is used WARNING
together in the same facility, make sure all When an alarm occurs:
equipments have the same alarm default settings • Check the patient first and take necessary
(alarm master). If the medical equipments have measure to ensure patient’s safety.
different alarm default settings and when initialized, • Remove the cause of the alarm.
the alarm settings differ with the other equipments • Check the alarm settings on the defibrillator and
and alarm cannot be managed appropriately in the change the alarm settings if necessary.
facility. If using different alarm default settings
according to areas or wings in the facility, manage
the alarms appropriately. WARNING
Check the alarm settings when you start monitor-
ing a new patient. Check the alarm settings as
WARNING required during monitoring and change them
During alarm suspension (“ALL ALARMS appropriately according to the patient’s condition.
SUSPENDED” or “ALL ALARMS OFF” message The alarm settings return to those specified in
displayed), all alarms are turned off. Be careful Alarm Setting on the SYSTEM SETUP screen
when you suspend the alarm. about 30 minutes after power-off.
VIII Operator’s Manual TEC-5600 series

WARNING WARNING
For arrhythmia monitoring, set [ARRHYTHMIA Set the alarm sound volume according to the place
ANALYSIS] on the ARRHYTHMIA SETUP to ON. where the defibrillator is used. If the alarm sound is
Otherwise, there is no sound or indication for too quiet, keep the patient under close observation
arrhythmia alarms (except for Asystole). and periodically check the defibrillator. Otherwise,
the alarm sound might not be heard and critical
changes on the patient or problems in the
defibrillator may be overlooked.
CAUTION CAUTION
When the alarm is turned Off for an arrhythmia, When the alarm limit is set to Off, there will be no
there will be no alarm for that arrhythmia type. alarm for that limit. Be careful when you set the
There is no message or mark to indicate that a alarm limit to Off.
certain arrhythmia alarm is turned off. Therefore,
be careful when you turn off an arrhythmia alarm.
CAUTION
After the defibrillator power is turned on,
parameter-related alarms do not function until the
parameters are monitored.
ECG Monitoring
WARNING WARNING
For arrhythmia monitoring, set [ARRHYTHMIA Turn the PACING REJECT to On when monitoring
ANALYSIS] on the ARRHYTHMIA SETUP to ON. a pacemaker patient. Otherwise the pacemaker
Otherwise, there is no sound or indication for pulse is not rejected. However, even when the
arrhythmia alarms (except for Asystole). PACING REJECT is set to On, the pacemaker
pulse might not be rejected. When the pacemaker
pulse is not rejected, the pacemaker pulse is
WARNING detected as QRS and false heart rate may be
indicated or critical arrhythmia such as asystole
Even when the PACING REJECT is set to On, the
may be overlooked. Keep pacemaker patients
pacemaker pulse can be overlooked or detected
under close observation.
as QRS. You cannot confirm the pacemaker
operation only from the detected pacemaker pulse.
For the pacemaker pulse rejection capability of the defibrillator, refer to
“Specifications – Pacemaker Pulse Rejection Capability”.
WARNING
After attaching the electrode to the patient and
connecting the cable to the defibrillator, check that
electrodes are attached to the patient and check
that the cable is connected to the defibrillator
properly. When the electrodes are removed from
the patient, do not touch the metal part of the
electrode with bare hands or let the metal part of
the electrode contact the metal part of the bed or
any other conductive parts. Failure to follow this
warning may cause electrical shock or injury to the
patient by discharged energy.
Operator’s Manual TEC-5600 series IX

CAUTION CAUTION
When the “Noise” or “Cannot Analyze” message is When using the defibrillator with an ESU, locate
displayed, ECG data and alarm are not reliable. the defibrillator and ESU appropriately and ground
Remove the cause by checking the electrodes, instruments properly. Otherwise noise from the
electrode leads, patient’s body movement, EMG ESU may interfere with the ECG and the heart rate
and peripheral instruments grounding. Also make and arrhythmia analysis may be incorrect.
sure that an electric blanket is not used.
CAUTION
CAUTION When the “Check Electrodes” message is
When monitoring ECG with disposable pads, displayed, ECG is not monitored properly and the
check the polarity of the pads before attaching ECG alarm does not function. Check the electrode,
them on the patient. If the pad polarity is incorrect, electrode leads and connection cord, and if
the waveform appears upside-down and this may necessary, replace with new ones.
delay of treatment.
CAUTION
At the start of ECG monitoring, check that the
CAUTION dominant QRS is appropriate. Otherwise
If there is any doubt about the arrhythmia analysis, arrhythmia monitoring may be inaccurate.
make the defibrillator relearn the patient’s ECG
and check that the dominant QRS is appropriate.
Otherwise, an important arrhythmia may be
overlooked.
CAUTION
correct patient type is set for [DETECTION TYPE]
on the QRS SETUP window.
If an inappropriate patient type is set, heart rate
cannot be counted accurately and noise or P waves
may be counted as QRS and cardiac arrest may be
overlooked.
CO2 Monitoring
WARNING
When using the airway adapter or nasal adapter
on a patient with low ventilatory volume, the CO2
may mix in the inspiration due to the airway
adapter’s dead space, resulting in inaccurate
measured values or difficulty in detecting apnea.
Perform ventilation taking into consideration the
dead space of the adapters.
CAUTION CAUTION
With the TG-900P or TG-920P CO2 sensor kit, the The CO2 data may be inaccurate when monitoring
measured value may be incorrect when the a patient with an extremely high respiration rate or
operating temperature changes greatly or there is irregular respiration. Read the measured values
excess condensation in the airway adapter or carefully.
nasal adapter.
X Operator’s Manual TEC-5600 series

CAUTION CAUTION
When using an anesthetic instrument with a Follow the CAUTION label on the CO2 gas
volatile anesthetic agent, the CO2 measurement cylinder.
may be inaccurate.
CAUTION
CAUTION Only use Nihon Kohden specified CO2 sensor kit.
When the “Adapter Failure” or “Sensor Failure” Otherwise, the maximum performance from the
message is displayed, check the CO2 sensor kit defibrillator cannot be guaranteed.
and replace it if necessary. CO2 cannot be
monitored while the message is displayed.
CO2 Monitoring (TG-900P CO2 Sensor Kit)
CAUTION CAUTION
Supply adequate oxygen when measuring CO2 With the TG-900P or TG-920P CO2 sensor kit, the
partial pressure of a patient connected to a measured value may be incorrect when the
Jackson Rees, Mapleson D or any other operating temperature changes greatly or there is
respiration circuit where CO2 gas may be present excess condensation in the airway adapter or
during inspiration. The semi-quantitative method nasal adapter.
measures CO2 partial pressure based on the
assumption of no CO2 gas in the inspired air; it
assumes CO2 partial pressure 0 mmHg (0 kPa) in
the inspiration of every respiration. If the inspired
air contains CO2 gas, the measured CO2 value
may be lower than the actual value.
CAUTION
The TG-900P and TG-920P CO2 sensor kits do not
adjust the measurement value to compensate for
different atmospheric pressure. Be careful when
reading the value when using the CO2 sensor kit at
high altitudes because the measurement value
may be inaccurate.
The measurement value drops 0.13 kPa (1 mmHg) for 5.33 kPa
(40 mmHg) CO2 gas when an atmospheric pressure drops 3.3 kPa.
CAUTION
With the TG-970P CO2 sensor kit, measured value
may be incorrect when the operating temperature
changes greatly. In this case, wait for about 30
minutes to acquire correct measurement.
Operator’s Manual TEC-5600 series XI

CAUTION CAUTION
Supply adequate oxygen when measuring CO2 When measuring CO2 partial pressure of a patient
partial pressure of a patient connected to a with an oxygen mask, set the oxygen supply to
Jackson Rees, Mapleson D or any other 5 L/min or more. If CO2 gas remains in the oxygen
respiration circuit where CO2 gas may be present mask and mixes with the inspired air, the
during inspiration. The semi-quantitative method measured value may be lower than the actual
measures CO2 partial pressure based on the value.
the inspiration of every respiration. If the inspired CAUTION
With the TG-900P or TG-920P CO2 sensor kit, the
measured value may be incorrect when the
operating temperature changes greatly or there is
excess condensation in the airway adapter or
CAUTION nasal adapter.
may be inaccurate.
CO2 Monitoring (with YG-122T/YG-121T Nasal Adapter)
WARNING WARNING
The only oxygen cannula that can be used with • When you use YG-122T together with an oxygen
YG-122T is manufactured by HUDSON RCI®. Do cannula, check that the oxygen cannula is
not use any other oxygen cannula. Other oxygen correctly attached on the patient by referring to
cannulas cannot be attached and oxygen cannot other parameters and by observing the patient
be delivered to the patient through the nostrils. periodically.
• If arterial oxygen saturation does not increase,
immediately stop using the oxygen cannula with
WARNING the CO2 sensor kit and select another way to
supply oxygen.
Check that the oxygen cannula tube is not bent,
broken, or blocked by the nasal tube. If the ends of
the oxygen cannula tube turn too far up or down, it
causes insufficient O2 supply or the CO2 value may
be incorrect.
CAUTION
When using the YG-121T or YG-122T nasal
adapter on a patient with bleeding disorder, poor
general medical condition or malnutrition, observe
the patient condition all the time. The mouth guide
touches the mouth and may cause pressure sores.
XII Operator’s Manual TEC-5600 series

SpO2 Monitoring
WARNING WARNING
• When using the TL-201T finger probe, do not SpO2 measurement may be incorrect in the
fasten the probe and cable to the finger by following cases.
wrapping with tape. This may cause burn, • When the patient’s carboxyhemoglobin or
congestion or pressure necrosis from poor blood methemoglobin increases abnormally.
circulation. • When dye is injected in the blood.
• When using probes other than the TL-201T finger • When using an electrosurgical unit.
probe, to avoid poor circulation, do not wrap the • During CPR.
tape too tight. Check the blood circulation • When measuring at a site with venous pulse.
condition by observing the skin color and • When there is body movement.
congestion at the skin peripheral to the probe • When the pulse wave is small (insufficient
attachment site. Even for short-term monitoring, peripheral circulation).
there may be burn or pressure necrosis from
poor blood circulation, especially on neonates or
low birth weight infants whose skin is delicate. WARNING
Accurate measurement cannot be performed on
When not monitoring SpO2, disconnect the SpO2
a site with poor peripheral circulation.
connection cord from the input unit. Otherwise,
noise from the probe sensor may interfere and
incorrect data is displayed on the screen.
WARNING
Check the circulation condition by observing the
skin color at the measurement site and pulse WARNING
waveform. Change the measurement site every 8
When monitoring SpO2 of a patient who is
hours for disposable probes and every 4 hours for
receiving photodynamic therapy, the light from the
reusable probes (every 8 hours for TL-630T3 or
finger probe sensor may cause a burn.
TL-631T3 probe). The skin temperature may
Photodynamic therapy uses a photosensitizing
increase at the attached site by 2 or 3°C (4 or 5°F)
agent that has a side effect of photosensitivity.
and cause a burn or pressure necrosis. When
using the probe on the following patients, take
The SpO2 probe has two wavelengths with peaks in the range of 650 nm
extreme care and change the measurement site
and 950 nm. The maximum light intensity is less than 5.5 mW/sr.
more frequently according to symptoms and
degree.
• Patient with a fever
• Patient with peripheral circulation insufficiency
• Neonate or low birth weight infant with delicate
skin
CAUTION CAUTION
While a patient is on medication which causes If the attachment site is dirty with blood or bodily
vasodilation, the pulse waveform may change and fluids, clean the attachment site before attaching
in rare cases the SpO2 value might not be the probe. If there is nail polish on the attachment
displayed. site, remove the polish. Otherwise, the amount of
transmitted light decreases, and measured value
may be incorrect or measurement cannot be
CAUTION performed.
Normal external light does not affect monitoring but
strong light such as a surgical light or sunlight may
affect monitoring. If affected, cover the measuring CAUTION
site with a blanket. When the probe is attached on an appropriate site
with sufficient circulation and an error message
about probe attachment repeatedly appears, the
CAUTION probe may be deteriorated. Replace it with a new
When a message indicates a faulty probe or faulty one.
SpO2 connection cord, stop monitoring and replace
the probe or SpO2 connection cord with a new one.
Operator’s Manual TEC-5600 series XIII

Battery Pack
WARNING WARNING
Do not do the following to the battery pack. It may Do not expose the battery pack to direct sunlight or
cause leakage, overheating, explosion, and fire. leave it in a place with high temperature, such as in
• Do not short-circuit the + and – terminals of the a car parked in direct sunlight or in front of a stove.
battery pack. This may cause leakage, overheating, explosion,
• Do not put the battery pack into fire or heat the and fire. Also, the performance and lifetime of the
battery pack. battery pack may become deteriorated.
• Do not disassemble or modify the battery pack.
• Do not give a strong impact to or deform the
battery pack.
WARNING
• Do not use the battery pack with an unspecified
device. If the liquid leaked from the battery pack contacts the
• Do not charge the battery pack with an eyes, mouth, or skin, do not rub. Flush with plenty of
unspecified device. clean water and see a physician immediately.
• Do not charge the battery pack with the wrong
polarity.
• Do not immerse or soak the battery pack in water. WARNING
The following may cause overheating and leakage
of the battery pack.
WARNING • Leaving the battery pack unused for a long
period (about one year)
• Test the battery pack once a month.
• When you start using a new battery pack, write
the date of first use on the attached date label.
• Replace the battery pack with a new one every
two years.
• Defibrillation cannot be performed on battery
power during a battery test. Perform defibrillation
on AC power or use another defibrillator. The
defibrillator may not be able to discharge if the
battery pack is deteriorated or insufficiently
charged.
CAUTION
To keep the battery fully charged, always keep the
power cord connected to the AC outlet even when
the defibrillator is not used. Otherwise, the battery
may discharge and become unusable.
SD Card
WARNING
Do not leave the SD card near the patient or in
reach of children. This may lead to an accident
such as the patient or child swallowing the SD
card.
CAUTION
Before removing an SD card, turn the defibrillator
off. If the SD is removed while the power is on,
data in the SD card may be lost or static electricity
may make it impossible to write data to the card.
XIV Operator’s Manual TEC-5600 series

Recorder Unit
CAUTION
Do not touch the thermal head inside the recorder
unit. The thermal head may be damaged by static
electricity or become dirty and cause printing
failure.
Maintenance
WARNING WARNING
Never perform defibrillation to a person or object When performing a basic check, make sure that
other than the patient or discharge test equipment the disposable pads are not attached to the
(test electrode plate or energy checker). When patient. Failure to follow this warning may lead to
performing the defibrillation check using the unintended electrical shock to the patient.
CAUTION CAUTION
Before maintenance, cleaning or disinfection, turn Dispose of Nihon Kohden products according to
the defibrillator power off and disconnect the power your local laws and your facility’s guidelines for
cord from the AC socket. Failure to follow this waste disposal. Otherwise, it may affect the
instruction may result in electrical shock and environment. If there is a possibility that the
defibrillator malfunction. product may have been contaminated with
infection, dispose of it as medical waste according
to your local laws and your facility’s guidelines for
CAUTION medical waste. Otherwise, it may cause infection.
Never disassemble or repair the defibrillator. If
there is any problem with the defibrillator, contact
your Nihon Kohden representative. CAUTION
When inserting or removing the battery, disconnect
the power cord from the defibrillator. Otherwise, the
operator may receive electrical shock.
Operator’s Manual TEC-5600 series XV

GENERAL HANDLING PRECAUTIONS
This device is intended for use only by qualified medical personnel.
Use only Nihon Kohden approved products with this device. Use of non-approved products
or in a non-approved manner may affect the performance specifications of the device. This
includes, but is not limited to, batteries, recording paper, pens, extension cables, electrode
leads, input boxes and AC power.
Please read these precautions thoroughly before attempting to operate the instrument.
1. To safely and effectively use the instrument, its operation must be fully understood.
2. When installing or storing the instrument, take the following precautions:

(1) Avoid moisture or contact with water, extreme atmospheric pressure, excessive humidity and temperatures, poorly
ventilated areas, and dust, saline or sulphuric air.
(2) Place the instrument on an even, level floor. Avoid vibration and mechanical shock, even during transport.
(3) Avoid placing in an area where chemicals are stored or where there is danger of gas leakage.
(4) The power line source to be applied to the instrument must correspond in frequency and voltage to product
specifications, and have sufficient current capacity.
(5) Choose a room where a proper grounding facility is available.
3. Before Operation
(1) Check that the instrument is in perfect operating order.
(2) Check that the instrument is grounded properly.
(3) Check that all cords are connected properly.
(4) Pay extra attention when the instrument is combined with other instruments to avoid misdiagnosis or other
problems.
(5) All circuitry used for direct patient connection must be doubly checked.
(6) Check that battery level is acceptable and battery condition is good when using battery-operated models.
4. During Operation
(1) Both the instrument and the patient must receive continual, careful attention.
(2) Turn power off or remove electrodes and/or transducers when necessary to assure the patient's safety.
(3) Avoid direct contact between the instrument housing and the patient.
5. To Shutdown After Use

(1) Turn power off with all controls returned to their original positions.
(2) Remove the cords gently; do not use force to remove them.
(3) Clean the instrument together with all accessories for their next use.
6. The instrument must receive expert, professional attention for maintenance and repairs. When the instrument is
not functioning properly, it should be clearly marked to avoid operation while it is out of order.
7. The instrument must not be altered or modified in any way.
8. Maintenance and Inspection

(1) The instrument and parts must undergo regular maintenance inspection at least every one year.
(2) If stored for extended periods without being used, make sure prior to operation that the instrument is in perfect
operating condition.
XVI Operator’s Manual TEC-5600 series

(3) Technical information such as parts list, descriptions, calibration instructions or other information is available for
qualified user technical personnel upon request from your Nihon Kohden representative.
9. When the instrument is used with an electrosurgical instrument, pay careful attention to the application and/or
location of electrodes and/or transducers to avoid possible burn to the patient.
WARRANTY POLICY
Nihon Kohden Corporation (NKC) shall warrant its products against all defects in materials and workmanship for one year
from the date of delivery. However, consumable materials such as recording paper, ink, stylus and battery are excluded
from the warranty.
NKC or its authorized agents will repair or replace any products which prove to be defective during the warranty period,
provided these products are used as prescribed by the operating instructions given in the operator's and service manuals.
No other party is authorized to make any warranty or assume liability for NKC's products. NKC will not recognize any
other warranty, either implied or in writing. In addition, service, technical modification or any other product change
performed by someone other than NKC or its authorized agents without prior consent of NKC may be cause for voiding
this warranty.
Defective products or parts must be returned to NKC or its authorized agents, along with an explanation of the failure.
Shipping costs must be pre-paid.
This warranty does not apply to products that have been modified, disassembled, reinstalled or repaired without Nihon
Kohden approval or which have been subjected to neglect or accident, damage due to accident, fire, lightning, vandalism,
water or other casualty, improper installation or application, or on which the original identification marks have been
removed.
In the USA and Canada other warranty policies may apply.
CAUTION
United States law restricts this product to sale by or on the order of a physician.
Operator’s Manual TEC-5600 series XVII

EMC RELATED CAUTION
This equipment and/or system complies with IEC 60601-1-2 International Standard for electromagnetic
compatibility for medical electrical equipment and/or system. However, an electromagnetic environment
that exceeds the limits or levels stipulated in IEC 60601-1-2, can cause harmful interference to the
equipment and/or system or cause the equipment and/or system to fail to perform its intended function or
degrade its intended performance. Therefore, during the operation of the equipment and/or system, if there
is any undesired deviation from its intended operational performance, you must avoid, identify and resolve
the adverse electromagnetic effect before continuing to use the equipment and/or system.
The following describes some common interference sources and remedial actions:
1. Strong electromagnetic interference from a nearby emitter source such as an authorized radio station
or cellular phone:
Install the equipment and/or system at another location. Keep the emitter source such as cellular
phone away from the equipment and/or system, or turn off the cellular phone.
2. Radio-frequency interference from other equipment through the AC power supply of the equipment
and/or system:
Identify the cause of this interference and if possible remove this interference source. If this is not
possible, use a different power supply.
3. Effect of direct or indirect electrostatic discharge:
Make sure all users and patients in contact with the equipment and/or system are free from direct or
indirect electrostatic energy before using it. A humid room can help lessen this problem.
4. Electromagnetic interference with any radio wave receiver such as radio or television:
If the equipment and/or system interferes with any radio wave receiver, locate the equipment and/or
system as far as possible from the radio wave receiver.
5. Interference of lightning:
When lightning occurs near the location where the equipment and/or system is installed, it may induce
an excessive voltage in the equipment and/or system. In such a case, disconnect the AC power cord
from the equipment and/or system and operate the equipment and/or system by battery power, or use
an uninterruptible power supply.
6. Use with other equipment:
When the equipment and/or system is adjacent to or stacked with other equipment, the equipment
and/or system may affect the other equipment. Before use, check that the equipment and/or system
operates normally with the other equipment.
7. Use of unspecified accessory, transducer and/or cable:
When an unspecified accessory, transducer and/or cable is connected to this equipment and/or
system, it may cause increased electromagnetic emission or decreased electromagnetic immunity.
The specified configuration of this equipment and/or system complies with the electromagnetic
requirements with the specified configuration. Only use this equipment and/or system with the specified
configuration.
XVIII Operator’s Manual TEC-5600 series

Caution - continued
8. Use of unspecified configuration:
When the equipment and/or system is used with the unspecified system configuration different than
the configuration of EMC testing, it may cause increased electromagnetic emission or decreased
electromagnetic immunity. Only use this equipment and/or system with the specified configuration.
9. Measurement with excessive sensitivity:
The equipment and/or system is designed to measure bioelectrical signals with a specified sensitivity. If
the equipment and/or system is used with excessive sensitivity, artifact may appear by electromagnetic
interference and this may cause mis-diagnosis. When unexpected artifact appears, inspect the
surrounding electromagnetic conditions and remove this artifact source.
If the above suggested remedial actions do not solve the problem, consult your Nihon Kohden
representative for additional suggestions.
For EMC compliance, refer to “Specifications - EMC Application Standards” in the Technical Resources section.
The CE mark is a protected conformity mark of the European Community. Products with the CE mark comply
with the requirements of the Medical Device Directive 93/42/EEC.
NOTE about Waste Electrical and Electronic Equipment (WEEE) Directive 2002/96/EC
For the member states of the European Union only:
The purpose of WEEE directive 2002/96/EC is, as a first priority, the prevention of waste electrical and
electronic equipment (WEEE), and in addition, the reuse, recycling and other forms of recovery of such
wastes so as to reduce the disposal of waste.
Contact your Nihon Kohden representative for disposal.
Operator’s Manual TEC-5600 series XIX

Contents
1
1 General 6 Defibrillation, Synchronized
Cardioversion and AED
2
Introduction............................................................... 1-2 3
Composition............................................................. 1-5 Introduction............................................................6-0-2
Symbols.................................................................... 1-6
4
6-1 Preparation before Defibrillation, 5
2
Synchronized Cardioversion and AED
Panel Description 6
Flow of Preparation...............................................6-1-2
Defibrillator............................................................... 2-2 Connecting Paddles/Pads.....................................6-1-3 6-1
Internal Paddles (Option)......................................... 2-8 Measuring an ECG for Synchronized
6-2
Cardioversion.................................................... 6-1-11
3 Safety Information Using an ECG from an External Monitor as a

Synchronizing Signal.........................................6-1-14
6-3
Caution Labels and Caution Marks.......................... 3-2 6-4

Contact Impedance between Skin and the
Warnings and Cautions............................................ 3-4
External Paddles’ Electrodes.............................6-1-21 7
Installation and Connection...................................... 3-9
8
General Requirements for Connecting Medical 6-2 Defibrillation
Electrical Systems................................................ 3-10 8-1
Introduction............................................................6-2-2
Defibrillation Using the External Paddles..............6-2-5 8-2
4 Preparation Defibrillation Using the Disposable Pads............ 6-2-11
Defibrillation Using the Internal Paddles.............6-2-16
8-3
Power....................................................................... 4-2
9
Using AC Power....................................................... 4-3
6-3 Synchronized Cardioversion
Using the Battery...................................................... 4-4 10
Introduction............................................................6-3-2
Loading the Recording Paper (TEC-5611, 10-1
Synchronized Cardioversion Using the External
TEC-5621, TEC-5631)............................................ 4-9
Paddles...............................................................6-3-5 10-2
Inserting an SD Card.............................................. 4-10
Synchronized Cardioversion Using the
Accuracy of the Built-in Clock................................. 4-10 10-3
Disposable Pads...............................................6-3-12
Changing Settings.................................................. 4-10
Synchronized Cardioversion Using the Internal 11
Paddles.............................................................6-3-19
5 Setup Windows Using Paddle/Pad-Lead ECG as the
12
Introduction............................................................... 5-2 Synchronizing Signal.........................................6-3-25 13
GUIDE...................................................................... 5-6
6-4 AED 14
PADDLE SETUP...................................................... 5-7
Introduction............................................................6-4-2 15
DEVICE SETUP....................................................... 5-9
AED Procedure.....................................................6-4-4
Automatic Energy Charging Standard.................6-4-14
Various Operations..............................................6-4-15
Operator’s Manual TEC-5600 series Contents 1

8-3
7 Pacing (TEC-5631 only) SpO2 Monitoring
Introduction............................................................8-3-2
Introduction............................................................... 7-2 Selecting a Probe..................................................8-3-4
Preparation............................................................... 7-4 Connecting the Probe to the Defibrillator..............8-3-6
Pacing in FIXED Mode........................................... 7-10 Attaching the Probe to the Patient.........................8-3-6
Pacing in DEMAND Mode...................................... 7-13 Starting Measurement (Start of Monitoring)..........8-3-7
Changing SpO2 Settings........................................8-3-8
8 Monitoring Changing Alarm Settings.....................................8-3-10

Changing Settings for Monitoring........................8-3-12
Introduction............................................................8-0-2
GUIDE Window.....................................................8-0-5
8-1 ECG Monitoring

9 Alarm Function
Introduction............................................................... 9-2
Introduction............................................................8-1-2
List of Alarms –Operation of the Defibrillator and
Number of Electrodes and Measuring Leads........8-1-3
Screen Examples–................................................. 9-6
Selecting the Electrode Lead, ECG Connection
Silencing or Suspending Alarms............................. 9-10
Cord and Disposable Electrodes.........................8-1-5
Changing Alarm Settings........................................ 9-12
Connecting the Electrode Lead to the
Setting the Alarm Volume....................................... 9-17
Defibrillator..........................................................8-1-6
Alarm Recording..................................................... 9-17
Attaching the Disposable Electrodes.....................8-1-7
Monitoring ECG with the Disposable Pads...........8-1-7
Starting Measurement (Start of Monitoring)..........8-1-8 10 Recording and Data Storing
Relearning ECG (LEARN ECG)..........................8-1-12 Introduction..........................................................10-0-2
Setting the Monitoring Leads...............................8-1-14
Setting the ECG Sensitivity.................................8-1-16 10-1 Recording and Reports
Changing ECG SETUP and QRS SETUP Introduction..........................................................10-1-2
Settings ............................................................8-1-17 Recording Setting................................................10-1-4
Changing Alarm Settings ....................................8-1-19 Manual Recording...............................................10-1-7
Setting Filter and Display....................................8-1-21 Automatic Recording...........................................10-1-9
Setting Chest Leads............................................8-1-23 Report Settings..................................................10-1-12
Setting Pacing and QRS.....................................8-1-24 Report Recording..............................................10-1-14
Arrhythmia Analysis.............................................8-1-27 Printed Characters and Marks...........................10-1-21
8-2 CO2 Monitoring 10-2 Saving and Sending Data

Introduction............................................................8-2-2 Introduction..........................................................10-2-2
Using the CO2 Sensor Kit (Mainstream Method)...8-2-3 SD Cards.............................................................10-2-2
Performing Zero Calibration (When TG-970P is Saving and Displaying Data................................10-2-4
Used).................................................................8-2-10 Sending Data.......................................................10-2-7
Starting Measurement (Start of Monitoring)........8-2-13
Changing CO2 Settings........................................8-2-15 10-3 Transport Function
Changing Alarm Settings.....................................8-2-17 Introduction..........................................................10-3-2

Setting CALIBRATION METHOD and SCALE....8-2-19 Data Which Can Be Transferred.........................10-3-3
Inspection of Measurement Accuracy.................8-2-21 Transferring Data.................................................10-3-4
Measurement Method.........................................8-2-22
2 Contents Operator’s Manual TEC-5600 series

11 Messages and Troubleshooting
Screen Messages................................................... 11-2
Voice Messages................................................... 11-18 1
Troubleshooting.................................................... 11-20
2
3
12 Maintenance 4
Daily Check............................................................ 12-2
Basic Checks.......................................................... 12-5 5
Self Tests.............................................................. 12-23
6
Expiration Date, Replacement and Disposal........ 12-25
Cleaning, Disinfecting and Storage...................... 12-29 6-1
Periodic Inspection............................................... 12-33 6-2

Repair Parts Availability Policy............................. 12-33
6-3
13 and
Standard Accessories, Options
Consumables
6-4
7
Standard Accessories............................................. 13-2 8
Options and Consumables..................................... 13-3
8-1
14 Setting
Settings
Items and Default 8-2
8-3
Setting Items, Setting Content and Default 9

Settings................................................................ 14-2 10
10-1
15 Technical Resources
10-2
Specifications......................................................... 15-2
Reference............................................................. 15-32 10-3
11
INDEX 12
13
14
15
Operator’s Manual TEC-5600 series Contents 3

Unpacking
Check that all the items are included in the package. If there are any missing
items, contact your Nihon Kohden representative.
The name and quantity are described under the illustration.
Some accessories of this product may differ depending on the destination country
or region.
TEC-5601
Certification
Defibrillator (1) Manuals Certification (1)
TEC-5611, TEC-5621, TEC-5631
Defibrillator (1) ECG connection cord JC-906P (1) Thermal head cleaner pen (1) Recording paper RQS50-3 (1)
Certification
Manuals Certification (1)
For the standard accessories and for consumables such as recording paper,
only use Nihon Kohden specified parts and accessories to satisfy the safety and
performance.
For the model, code number and supply code of the standard accessories, refer
to the “Options and Consumables” page of Section 13 “Standard Accessories,
Options and Consumables” in this manual.
Operator’s Manual TEC-5600 series i

Conventions Used in this Manual and Instrument
Warnings and Cautions
Level Description
A warning alerts the user to the possible injury or death associated with the
WARNING use or misuse of the instrument.
A caution alerts the user to possible injury or problems with the instrument
CAUTION associated with its use or misuse such as instrument malfunction, instrument
failure, damage to the instrument, or damage to other property.
Icons in this Manual
Icon Description
Indicates the important points and other operation methods.
Indicates related pages in this manual which give more detailed

explanations.
ii Operator’s Manual TEC-5600 series

Text Conventions in this Manual
Style Description
Defibrillator TEC-5600 series

Key or button on the front panel or the operation panel below the LCD
XXXXX key/XXXXX button
display.
XXXXX position Selected position of the control dial
[XXXXX] key Key displayed in the window
Press the function key 1 to 5 that corresponds to the key name displayed in
Use/Press the [XXXXX] key.
the window.
“XXXXX” Message, item, or parameter displayed in the window
“XXXXX”
Example: 200J position
[XXX] keys
XXXXX keys or
buttons
Example: Use/Press the [NEXT] key.
Operator’s Manual TEC-5600 series iii

Safety Standards
Safety Standard Classification of the Defibrillator
Type of protection against electrical shock

• When connecting to an AC power (commercial use): Class I ME equipment
• When not connecting to an AC power (commercial use): Internally powered ME equipment
Degree of protection against electrical shock
• Type BF applied parts: External paddles, disposable pads
• Type CF applied parts: Internal paddles, internal paddles (with switch)
• Defibrillation-proof type CF applied parts: ECG connection cable, electrode leads, SpO2 probes, CO2 sensor kit
Protection against harmful ingress of water or fine particulates
• IP44: TEC-5621 and TEC-5631 with a pad adapter or internal paddles, TEC-5611
• IP41: TEC-5621 and TEC-5631 with external paddles, TEC-5601
Applicable when connecting all patient cables (except the recorder)
Sterilization or disinfection methods specified by manufacturers
• Internal paddles, internal paddles with switch: High-pressure steam sterilization (autoclave sterilization),
plasma gas sterilization, ethylene oxide gas sterilization (EOG
sterilization)
• Except internal paddles and internal paddles (with switch): Not for sterilization
Qualifications for use in a high-oxygen atmosphere
Not qualified
Safety level for use in air and flammable anesthetic gas or oxygen/nitrous oxide and flammable anesthetic gas
Not applicable
Mode of operation
Continuous operation
Installation conditions
Indoor and in-vehicle uses
Frequency of use (class by IEC 60601-2-4: 2010)
High frequent use
iv Operator’s Manual TEC-5600 series

1 General
Introduction......................................................................1-2
1
Models and Functions....................................................................1-3

Measurement Parameters..........................................................1-3
Features.........................................................................................1-3
Composition....................................................................1-5
TEC-5601.......................................................................................1-5
TEC-5611, TEC-5621, TEC-5631...................................................1-5
Symbols...........................................................................1-6
On Defibrillator...............................................................................1-6
Transport Package.................................................................... 1-6
On Screen......................................................................................1-7
JC-865V Pad Adapter.....................................................................1-8
Optional ND-860V Series and ND-890V Series Internal
Paddles..........................................................................................1-8
1. General
Introduction
This defibrillator delivers short-duration high-current electrical shock to
patients to treat ventricular fibrillation and ventricular tachycardia. 1
1
Essential performance in EMC standard
The defibrillator has an ECG input function which allows synchronized
cardioversion and asynchronous defibrillation. TEC-5631 has transcutaneous-
pacing which is useful for treating temporary bradycardia.
The defibrillator is designed so that the operator can directly press the keys and
buttons from the operator position (30 cm from the defibrillator).
The defibrillator operates on either AC power or an optional battery pack for
emergency use.
In addition to manual defibrillation mode, the defibrillator provides easy to use
semiautomatic defibrillation in AED mode.
The defibrillator can also monitor the patient’s condition after defibrillation.
TEC-5611, TEC-5621 and TEC-5631 have ECG measurement. SpO2 monitoring
and CO2 monitoring are available with an optional multi parameter/SpO2 unit.
Examples and explanations in this operator’s manual show TEC-5631 (when
the optional external paddle holder is installed) and the default settings.
WARNING
This defibrillator is for one patient at a time. Do not
monitor multiple patients with different sensors
attached.
WARNING
instruments.
Some options and accessories of this product may differ depending on the
destination country or region.
1-2 Operator’s Manual TEC-5600 series

1. General
Models and Functions

The available functions of the TEC-5600-series models vary, as shown in the
table below. 1
• Yes: Included as standard
• Option: Included when optional equipment is connected
• No: Not included
Model
TEC-5601 TEC-5611 TEC-5621 TEC-5631
Function
External
Yes No Yes Yes
paddles
Defibrillation Disposable
No Yes Yes Yes
pads 1
Internal paddles No No Option Option
Transcutaneous pacing 1
No No No Yes
ECG measurement
No Yes Yes Yes
(ECG connector)
Synchronized cardioversion No Yes Yes Yes
AED No Yes Yes Yes
Recorder No Yes Yes Yes
SpO2 measurement Option Option Option Option
CO2 measurement Option Option Option Option
External memory (SD card) Option Option Option Option
Bluetooth communication
®
Option Option Option Option
Audio output Yes Yes Yes Yes
Voice recorder Yes Yes Yes Yes
External ECG input Option Option Option Option
Battery Option Option Option Option
1
Disposable pads are sold separately.
Measurement Parameters
TEC-5611, TEC-5621 and TEC-5631 can monitor ECG leads I, II, III, aVR,
aVL, aVF, Ca, and Cb.
The optional QI-564V multi-parameter/SpO2 unit allows monitoring of SpO2 and
CO2.
Features
BIPHASIC waveform defibrillation
This defibrillator provides biphasic waveform defibrillation with Nihon Kohden’s
unique ActiBiphasic technology.
Crisp, clear LCD display

ECG waveforms and messages are highly visible on the 6.5-inch LCD screen.
AC or battery operation
An optional battery allow portable use.
Operator’s Manual TEC-5600 series 1-3

1. General
Fast charging
The defibrillator charges from 0 to 200 J less than 4 seconds, and from 0 to 270 J
less than 5 seconds. This enables timely defibrillation and cardioversion.
Quick ECG waveform recovery

After defibrillation or cardioversion, the ECG waveform returns within 3 seconds
so that you can immediately check the result of defibrillation or cardioversion.
AED function (TEC-5611, TEC-5621, TEC-5631)

• If a shockable rhythm is detected during ECG analysis, the defibrillator
automatically charges to prepare for defibrillation.
• The AED mode also provides voice instructions.
• If a shockable rhythm is detected during monitor mode, an alarm sounds.
• You can change to the child mode with a single-button operation.
Transcutaneous pacing (TEC-5631)

Transcutaneous pacing can provide emergency treatment for bradycardia which
may occur after defibrillation.
Parameter signal input connectors compatible with

Nihon Kohden bedside monitors (ECG, SpO2, CO2)
While monitoring a patient with this defibrillator, it’s easy to switch to
monitoring with a Nihon Kohden bedside monitor.
Self-check
• Semiautomatic self-check functions, such as defibrillation check, pacing check,
and recorder check, are provided for brief inspection of the defibrillator before
use.
• The self-test function is provided. The condition of the defibrillator is indicated
by the status indicator. To assure readiness for use, the defibrillator performs a
self-test.
• The user can also check individual functions such as defibrillation, pacing and
recorder.
Built-in voice recorder

With the built-in voice recorder, this defibrillator can record ambient sound
during operation, and save the sound data into an SD card with patient’s vital-
sign data. The saved data can be reviewed on a PC with the optional defibrillator
report viewer software.
Built-in recorder (TEC-5611, TEC-5621, TEC-5631)

The built-in recorder provides continuous recording, automatic recording,
report recording, and operation history recording. The recorder uses roll paper
which isn’t affected by vibration or movement such as in an ambulance or other
emergency situation.
Bluetooth® module
An optional QI-832V Bluetooth® module can send data from the defibrillator to a
PC or other device.
Onscreen operation guide

When a technical alarm occurs, the defibrillator can show corrective actions on
the GUIDE window.

1. General
Composition
1
TEC-5601
Software Other Items
Defibrillator
• QP-551VK defibrillator report • Power cord
viewer software • GELAID
• QS-009V software kit • Cart
• Wall mount
• Basket
• Paste holder kit
• Bed rail hook
TEC-5601
Battery Pack SD Memory Card Bluetooth® Module Multi Parameter/SpO2 Unit
DANG
ER
NKB-301V (YZ-024H9) QM-001D, QM-002D QI-832V QI-564V
TEC-5611, TEC-5621, TEC-5631

Defibrillator Accessories
The illustration below is for the
TEC-5631 model.
JC-906P ECG RQS50-3 Y-011 thermal

connection cord recording paper head cleaner pen
TEC-5611, TEC-5621, TEC-5631
Internal Paddles 1 Disposable Pads Battery Pack SD Memory Card

1
Only for TEC-5621 and
TEC-5631
DANG
ER
ND-860V series, P-511, P-513, P-532, P-530, NKB-301V (YZ-024H9) QM-001D, QM-002D
ND-890V series (with switch) P-700 series
Bluetooth® Module Multi Parameter/SpO2 Unit Other Items
• Power cord
• GELAID 1
• JC-865V pad adapter 1
• BR-903P electrode lead
QI-832V QI-564V • Cart
• Wall mount
Software • Basket
• Paste holder kit
• QP-551VK defibrillator report viewer software • Bed rail hook
• QS-831V upgrade kit (For arrhythmia analysis)
• QS-009V software kit 1
Only for TEC-5621 and TEC-5631

1. General
Symbols
The following symbols are used with the defibrillator. The names and
descriptions of each symbol are as shown in the table below.
On Defibrillator
Symbol Description Symbol Description
Alternating current Pacing start
Charging Pacing stop
Charged (Battery charging is finished) Paddle connector locked
Silence alarms Paddle connector unlocked
Recording
Background color: Follow instructions for use
SD card slot Blue
Input/Output The CE mark is a protected conformity

(SD card slot) mark of the European Community.
Products marked with this symbol
Defibrillation-proof type CF applied comply with the requirements of the
part Medical Device Directive 93/42/EEC.
Products marked with this symbol

Type BF applied part comply with the European WEEE
directive 2002/96/EC and require
separate waste collection. For Nihon
Kohden products marked with this
Caution
symbol, contact your Nihon Kohden
representative for disposal.
• Protects against access to hazardous • Protects against access to hazardous
parts with a wire 1.0 mm in diameter. parts with a wire 1.0 mm in diameter.
• Protected against solid foreign objects • Protected against solid foreign objects
IP41 1.0 mm or greater in diameter. IP44 1.0 mm or greater in diameter.
• Protected against harmful effects of • Protected against harmful effects of
vertically falling water drops. splashes of water.
Transport Package
This way up Keep away from rain
Fragile Stacking limit by number

1. General
On Screen
1
Alternating current Infinite pause duration
Battery fully charged During CPR
More than 2/3 battery charge remains Number of electrical shocks
More than 1/3 battery charge remains Out of paper
Remaining battery power is less than

1～3 Recording
three 270 J discharges
0 Battery operation not available Report recording
Standby. (There is no unsaved data in

Remaining battery power unknown
the defibrillator.)
Standby. (There is still unsaved data in

Audio off the defibrillator to be written to the SD
card.) Do not remove the SD card.
Audio pause Writing to the SD card. Do not remove

the SD card.
Alarm off Cannot write to the SD card. SD card or

defibrillator is faulty.
QRS sync mark Free space of the SD card is low.
Standby. (There is still unsaved data to

ECG cascaded display
be written but the SD card is full and
the oldest data will be overwritten.) Do
not remove the SD card.
Pacing mark
Storing waveform report

Pacing reject OFF
Bluetooth connected
The point of implanted pacemaker
pulse output
Bluetooth connected (device type: PC)
Arrhythmia alarm off (other than VF/
VT)
Bluetooth connected (device type:
mobile phone)
VF/VT alarm off
Bluetooth connected (device type:
unknown)
SpO2 pulse wave unstable
Follow instructions for use

AED analysis paused Background
color: Blue

1. General
JC-865V Pad Adapter

Type BF applied part Caution
Optional ND-860V Series and ND-890V Series Internal Paddles

Type CF applied part Caution

2 Panel Description
Defibrillator......................................................................2-2
2
TEC-5601.......................................................................................2-2
Front Panel.................................................................................2-2
Right Side Panel........................................................................2-3
Left Side Panel...........................................................................2-3
Rear Panel.................................................................................2-3
TEC-5611, TEC-5621, TEC-5631...................................................2-4
Front Panel................................................................................ 2-4
Operation Panel (on the Front Panel)....................................... 2-5
Right Side Panel....................................................................... 2-6
Left Side Panel.......................................................................... 2-6
Rear Panel................................................................................ 2-6
External Paddles............................................................................2-7
Internal Paddles (Option)................................................2-8

2. Panel Description
Defibrillator
When a function key or a button on the front panel of the defibrillator is pressed,
a pip sounds. There is no pip sound if the KEY SOUND setting of VOLUME in
the SETUP window is set to “0”.
Section 5 “VOLUME” (p. 5-11)
TEC-5601
Front Panel
2 LCD display 3 Alarm indicator 4 Status indicator
1 Handle
5 Control dial
6 Microphone
7 CHARGE button
8 Battery case
14 Speaker
12 Function keys
9 AC power lamp
10 Battery
charging lamp
11 Battery charging completion lamp 13 Silence alarms key
1 Handle 5 Control dial 10 Battery charging lamp

For carrying the defibrillator Selects the operation mode Lights while the battery is being
2 LCD display (MONITOR, SETUP, BASIC charged.
Displays waveforms, alarms and CHECK), selects the output energy 11 Battery charging completion
other information and settings. in manual defibrillation mode, and lamp
turns the defibrillator ON/OFF. Lights when the battery charging is
3 Alarm indicator
Lights or blinks if an alarm is 6 Microphone completed.
generated. Records the ambient sound. 12 Function keys
4 Status indicator 7 CHARGE button The function depends on the
Indicates the defibrillator condition Starts charging in manual operation screen.
based on the daily self check. defibrillation mode. 13 Silence alarms key
Green: OK 8 Battery case Temporarily mutes or suspends an
Red: Refer to Section 11 Holds the optional NKB-301V alarm.
“Troubleshooting” (p. 11-20). battery pack. 14 Speaker
9 AC power lamp Outputs sound and alarms.
Lights when the defibrillator is
operating on AC power.

Right Side Panel
1 SD card slot
1 SD card slot 2
Insert an SD memory card.
Left Side Panel
1 SpO2 socket (when the QI-564V

is incorporated)
Connect the SpO2 connection cord.
2 CO2 socket (when the QI-564V is
incorporated)
Connect the CO2 sensor kit.
1 SpO2 socket
2 CO2 socket
Rear Panel
1 AC inlet
Connect the supplied power cord.
1 AC inlet

TEC-5611, TEC-5621, TEC-5631
Front Panel
2 LCD display 3 Alarm indicator
1 Handle
TEC-5611
4 Pad connector
4 Paddle connector
6 Battery case 5 Speaker (TEC-5621, TEC-5631)
1 Handle 5 Speaker
For carrying the defibrillator Outputs sound, alarms and CPR sound.
2 LCD display 6 Battery case
Displays waveforms, alarms and other information and Holds the optional NKB-301V battery pack.
settings.
3 Alarm indicator
Lights or blinks if an alarm is generated.
4 Paddle connector (TEC-5621, TEC-5631)
Connect the optional external paddles, internal paddles,
or pad adapter.
Pad connector (TEC-5611)

Connect disposable pads.

Operation Panel (on the Front Panel)

TEC-5631 1 Status indicator
2 SYNC button
14 PULSE lamp
3 Control dial 2
15 START/STOP
key 4 CHILD MODE
button
16 PACING RATE
up/down keys 5 Microphone
17 PACING 6 CHARGE/AED
OUTPUT up/ button
down keys 7 SHOCK button
11 Function keys
8 AC power lamp
9 Battery charging
lamp
12 Record/stop key
10 Battery charging completion lamp 13 Silence alarms key
1 Status indicator 6 CHARGE/AED button 12 Record/stop key

Indicates the defibrillator condition In manual defibrillation mode: starts Starts and stops continuous
based on the daily self check. charging. recording with the recorder. In the
Green: OK In AED mode: starts ECG analysis. SETUP mode, this key outputs the
Red: Refer to Section 11 If the defibrillator judges that selected report.
“Troubleshooting” (p. 11-20). defibrillation is required after
13 Silence alarms key
analyzing an ECG, it automatically
2 SYNC button Temporarily mutes or suspends an
starts charging.
Toggles between the synchronized alarm.
cardioversion and the defibrillation 7 SHOCK button
14 PULSE lamp
(asynchronous) modes. Discharges the energy in the manual
defibrillation and AED modes if Blinks in synchronization with the
3 Control dial pacing pulses in transcutaneous
disposal pads or internal paddles are
Selects the operation mode (AED, connected. pacing.
MONITOR, SETUP, BASIC
8 AC power lamp 15 START/STOP key
CHECK, FIXED PACING,
DEMAND PACING), selects Lights when the defibrillator is Starts and stops transcutaneous
the output energy in manual operating on AC power. pacing.
defibrillation mode, and turns the 16 PACING RATE up/down keys
9 Battery charging lamp
defibrillator ON/OFF. Sets the pacing rate.
Lights while the battery is being
4 CHILD MODE button charged. 17 PACING OUTPUT up/down keys
To enter child mode for AED, Sets the pacing current intensity.
10 Battery charging completion
set the control dial to AED while
lamp
pressing and holding this button.
Lights when the battery charging is
5 Microphone completed.
Records the ambient sound.
11 Function keys
The function depends on the
operation screen.

Right Side Panel
1 SD card slot
1 SD card slot Insert an SD memory card.
2 Door release lever
Pull the lever up to open the paper
2 Door release container door.
lever
3 Recorder
3 Recorder This is a thermal array recorder of 50 mm

width.
Load the consumable recording paper
(RQS50-3) specified by Nihon Kohden.
Left Side Panel
1 ECG socket
Connect the ECG connection cord.
2 SpO2 socket (when the QI-564V is
incorporated)
Connect the SpO2 connection cord.
1 ECG socket
3 CO2 socket (when the QI-564V is
incorporated)
2 SpO2 socket Connect the CO2 sensor kit.
3 CO2 socket
Rear Panel
1 AC inlet
Connect the supplied power cord.
1 AC inlet

External Paddles
1 Shock button 1 Shock button

2 Paddle contact lamp Simultaneously press both buttons to discharge the 2
charged energy. In synchronized cardioversion, the
3 Charge button
defibrillator discharges energy at the appropriate timing
after these buttons are pressed. When the defibrillator is
charged, these buttons start blinking.
1 Shock button
2 Paddle contact lamp
Indicates the quality of contact between the paddles and
patient.
• 0 to 100 ohms : Lights in green (good contact).
• 100 to 200 ohms : Lights in yellow.
• 200 ohms or higher : Lights in orange.
3 Charge button (on paddles)
Charges the defibrillator.
4 Paddle connector (TEC-5621, TEC-5631)
Connect to the paddle connector of the defibrillator.
STERNUM paddle APEX paddle
4 Paddle connector
(TEC-5621, TEC-5631)

Internal Paddles (Option)
ND-860V series (without switch) ND-890V series (with switch)
1 Paddle connector 2 Electrodes 1 Paddle connector 2 Electrodes
3 Handles 3 Handles
4 Shock button
1 Paddle connector
Connect to the paddle connector of the defibrillator.
2 Electrodes
These electrodes deliver energy in direct contact with the
heart.
3 Handles
Keep the handles firmly gripped during charge and
discharge.
Be sure to grip the paddles between the cable and the
guard.
4 Shock button (ND-890V series)
Press to discharge energy. In synchronized cardioversion,
the defibrillator discharges energy at the appropriate
timing after this button is pressed.

3 Safety Information
Caution Labels and Caution Marks.................................3-2

3
On the Defibrillator.........................................................................3-2
Front Panel................................................................................ 3-2
Right Side Panel....................................................................... 3-2
Left Side Panel.......................................................................... 3-2
Rear Panel................................................................................ 3-3
On the External Paddles................................................................3-3
On the JC-865V Pad Adapter.........................................................3-3
On the Internal Paddles (Option)....................................................3-3
Warnings and Cautions...................................................3-4

Battery Pack...................................................................................3-4
Recording Paper............................................................................3-5
SD Cards........................................................................................3-6
Use with an Electrosurgical Unit.....................................................3-7
General Notes on Defibrillation......................................................3-8
Installation and Connection.............................................3-9

Cutting Off the Power Supply to the Defibrillator............................3-9
Installing the Optional Units to the Defibrillator and
Connecting External Instruments...................................................3-9
General Requirements for Connecting Medical

Electrical Systems.........................................................3-10
Examples of Combinations of MEDICAL ELECTRICAL
EQUIPMENT and Non-medical Electrical Equipment.............3-10
3. Safety Information
Caution Labels and Caution Marks

This section provides information on caution labels and caution marks on the
defibrillator.
Refer to the page of each description and be sure to fully understand the content.
Use the defibrillator safely and correctly.
On the Defibrillator Right Side Panel

“SD Cards” (p. 3-6)
Front Panel
Section 12 “Daily Check” (p. 12-2)
TEC-5611, TEC-5621, TEC-5631

Section 4 “Loading the Recording Paper (TEC-5611,
TEC-5621, TEC-5631)” (p. 4-9)
Left Side Panel

TEC-5611, TEC-5621, TEC-5631
Section 6-1 “Connecting Paddles/Pads” (p. 6-1-3)
• Notes on monitoring at the beginning of this manual

• Section 8 “Monitoring”

Rear Panel On the JC-865V Pad Adapter

For replacement of the battery pack
TEC-5621, TEC-5631
Section 12 “Replacement” (p. 12-26)
Section 6 “Defibrillation,
and AED”
On the Internal Paddles (Option)
TEC-5621, TEC-5631
On the External Paddles
ND-860V series (Without switch)
Section 6 “Defibrillation, Synchronized
Cardioversion and AED”
ND-890V series (With switch)
TEC-5621, TEC-5631

Warnings and Cautions

NOTE: Refer to the warnings and cautions described at the beginning of
this manual, as well.
Battery Pack WARNING

The following may cause overheating and leakage
Use of the Battery Pack of the battery pack.
• Leaving the battery pack unused for a long
WARNING period (about one year)
Do not do the following to the battery pack. It may
cause leakage, overheating, explosion, and fire.
• Be sure to perform a battery test before using a new
• Do not short-circuit the + and – terminals of the
battery pack.
battery pack.
• Do not put the battery pack into fire or heat the Administrator’s Guide: “Battery Test Procedure”
battery pack.
• Do not disassemble or modify the battery pack. • The battery life is 2 years. When you start using a new
• Do not give a strong impact to or deform the battery pack, write down the starting date of use in the
battery pack. corresponding space on the label of the battery pack, as
• Do not use the battery pack with an unspecified well as on the label supplied with the battery pack for
device. that purpose. Attach the completed label on the side panel
• Do not charge the battery pack with an
of the defibrillator. Before operating the defibrillator
unspecified device.
on battery power, be sure to check the starting date of
• Do not charge the battery pack with the wrong
use of the battery written on the label attached on the
polarity.
defibrillator.
• Do not immerse or soak the battery pack in water.
• The warranty period of battery life is 1 year. If the available
number of times of discharge has decreased or the battery
WARNING pack becomes unusable, do not leave the battery pack in
Do not expose the battery pack to direct sunlight or the defibrillator. The substance inside the battery may
leave it in a place with high temperature, such as in leak, causing instrument corrosion and fire. Immediately
a car parked in direct sunlight or in front of a stove. replace such a battery pack with a new one.
This may cause leakage, overheating, explosion, • Do not leave a discharged battery pack in the defibrillator
and fire. Also, the performance and lifetime of the without the AC power cord connected between the
battery pack may become deteriorated. defibrillator and AC outlet. The battery pack may be
overdischarged and become unusable. Do not leave
the battery pack, even if it is charged, in the defibrillator
WARNING without AC power supply for one month or longer.
• Test the battery pack once a month. The battery pack will gradually discharge and may
• When you start using a new battery pack, write become unusable because of excessive discharge.
the date of first use on the attached date label.
• Replace the battery pack with a new one every • If the battery charging lamp and battery charging
two years. completion lamp do not light even though AC power
• Defibrillation cannot be performed on battery is supplied to the defibrillator, the battery pack or the
power during a battery test. Perform defibrillation defibrillator may be in failure. Contact your Nihon
on AC power or use another defibrillator. The Kohden representative. Always have a spare battery pack
defibrillator may not be able to discharge if the ready.
battery pack is deteriorated or insufficiently
• Perform a battery test once a month and check the battery
charged.
capacity.
Charging of the Battery Pack

WARNING
If the liquid leaked from the battery pack contacts the • Only charge the battery pack when the ambient
eyes, mouth, or skin, do not rub. Flush with plenty of temperature is between 0 and 40°C (32 and 104°F).
clean water and see a physician immediately. Otherwise, charging may stop. Charging at high
temperature over 40°C (104°F) may accelerate
deterioration of the battery.

• If the battery pack temperature becomes too high because Disposal of Batteries
of long charging time, etc., the battery charging lamp
The batteries usable in this defibrillator are nickel-metal
and battery charging completion lamp will start blinking.
hydride (Ni-MH) batteries.
Immediately stop charging, move the defibrillator to a
Before disposing of a battery pack, contact your Nihon
cooler place, then resume charging. The defibrillator
Kohden representative, because the proper means of
automatically starts charging when the battery pack
disposal differs depending on your local laws. The battery
temperature drops.
pack will be recycled for environmental protection.
• After using the battery pack, charge the battery pack 3
Before disposing of the defibrillator, make sure that the
immediately. Leaving the battery pack uncharged
battery pack is removed from it.
causes excessive discharge and the battery pack might
become unusable.
• Always charge the battery pack using this defibrillator. If
another device is used for charging, it may cause battery Recording Paper
pack malfunction.
NOTE: Always use the specified genuine products for
Checking the Battery Pack the recording paper.
• Replace the battery pack every 2 years. In order to ensure Model name of the specified recording paper:
emergency use of the defibrillator on battery power, RQS50-3
perform a battery test once a month.
• Check the battery pack’s appearance every 6 months for
prevention of accidents with the battery pack. If there is
any damage such as crack, deformation, or wire breakage
on the battery pack or if the battery pack leaks, replace
the battery pack with a new one. If the battery pack is
dirty with dust, clean it. RQS50-3
Storage of the Battery Pack When handling the recording paper, be careful of the
following:
• If the defibrillator will be stored with the battery pack
inside it, leave the defibrillator connected to an AC power • Organic solvents and plastics may develop color on the
source. If the defibrillator will be stored not connected white surface or cause the recording paper to fade.
to an AC power source, remove the battery pack before Examples of color-developing materials containing
storage. organic solvents:
• If the defibrillator will not be used for more than 6 Adhesives, paste, felt-tip pens, and semi-dry diazo paper.
months, remove the battery pack to prevent leakage Examples of color-fading materials made of soft vinyl
or corrosion. Store the battery pack at an ambient chloride:
temperature between −20°C (−4°F) and +35°C (+95°F) Document cases, albums, and desk pads.
and low humidity.
Examples of color-fading materials containing
• When a battery pack will not be used for over one month, plastics:
fully charge it before use. Even if the battery pack was Erasers, adhesive tapes, and some fluorescent pens.
fully charged before short-term storage, the batteries self-
discharge and operation time decreases during storage. • When pasting the recording paper, use paste with a
starch base, PVA base, arabic gum base paste, CMC base
• To ensure full performance of the defibrillator, replace the synthetic paste, or paper bond.
battery pack every 2 years.
• Do not apply high pressure to the recording paper.
• When a battery pack is stored for a long time, charge it Rubbing or scratching the surface with a hard object
every 6 months. discolors it.
• If the battery pack is stored for a long time, it may
discharge and lose its ability to be charged to its full
capacity. If this happens, you can restore its full capacity
by repeating several cycles of discharging the battery to
its rated value then fully charging it.

• Insert the SD card in the correct direction.

SD Cards
“Inserting/Removing an SD Card” (p. 10-2-3)
Compatible SD Cards
Handling during Reading/Writing of Data
Use only an SD card manufactured by Nihon Kohden
(QM-001D or QM-002D). • Only format the SD card and write data to the SD card
with a Nihon Kohden specified device. Otherwise the SD
NOTE: Do not use an SD card other than the card might become unusable.
specified ones. If you do, data may not be
stored or the defibrillator may be damaged. • Never remove the SD card from the device while data is
If you use an SD card that was used with a being written to or read from the card. Otherwise the card
device other than this defibrillator, the data may become damaged.
capacity available with the defibrillator may
decrease.
Use of SD Cards
Be careful of the following when you use an SD card:
WARNING
Do not leave the SD card near the patient or in
reach of children. This may lead to an accident
such as the patient or child swallowing the SD
card.
Handling and Storage

• Never disassemble or modify the SD card.
• Do not impart strong shock to the SD card by dropping or
bending it.
• Do not handle the SD card while eating or drinking. Do
not get an SD card wet.
• Do not touch the terminal of the SD card.
• Do not peel off the label of the SD card or attach another
label.
• Never use the SD card in an unspecified device.
• Keep the SD card slot clean. If dust gets into the slot, the
SD card may malfunction.
• During storage, observe the following items:
• When the SD card is removed from the defibrillator, be
careful not to lose the SD card. Keep the SD card out
of reach of a patient so that he/she will not accidentally
swallow the SD card.
• Do not expose the SD card to direct sunlight or leave it in
a high-temperature or -humidity place.
Recommended environmental conditions
Storage environment: Same as the defibrillator
Operating environment: Same as the defibrillator
• Do not store the SD card where corrosive gas is
generated.

• Install the defibrillator as far as possible from the ESU. If

Use with an Electrosurgical possible, locate them on opposite sides of the operating
table.
Unit
• Use different outlets to supply power.
For use with an electrosurgical unit (ESU), this defibrillator Supply power to the defibrillator and ESU from different
includes measures to protect the patient from skin burn on outlets located as far as possible from each other. This
the electrode attachment site and to reduce interference on prevents noise from the ESU may interfere through
the ECG waveform. However, the effectiveness depends on the AC power line. Do equipotential grounding of the 3
the electrode attachment site and ESU location. defibrillator.
When using an ESU with the defibrillator, pay attention to • Measure with 3-electrode lead.
the following points. Use the minimum number of electrodes.
Use new disposable electrodes which gel are not dried.
WARNING • Position the disposable electrode as far as possible from
When using an ESU, use the ECG electrodes for the incision
monitoring. Do not monitor ECG with disposable Attach disposable electrodes as far as possible from the
pads, external paddles or internal paddles. If ECG incision.
is monitored with pads or paddles, high-frequency
energy from the ESU causes abnormal current to • Position the + and – disposable electrodes as close as
flow in the patient and unexpected discharge. This possible so that the angle (θ) between the disposable
may damage the defibrillator. electrodes and the incision is as small as possible.
• Attach the ESU return plate as near as possible to the
incision and as far as possible from the disposable
WARNING electrode where has enough space for the return plate and
When the defibrillator is used with an less hair.
electrosurgical unit (ESU), firmly attach the entire
As near as possible to incision and
area of the ESU return plate. Otherwise, the
as far as possible from electrode.
current from the ESU flows into the electrodes of
the defibrillator, causing electrical burn where the
electrodes are attached. For details, refer to the Return plate Incision
ESU manual.
θ
CAUTION
When using the defibrillator with an ESU, locate Make small
the defibrillator and ESU appropriately and ground
instruments properly. Otherwise noise from the • Set the sync source to “SpO2”
ESU may interfere with the ECG and the heart rate The heart rate may be unstable because of an ESU. Set
and arrhythmia analysis may be incorrect.
the sync source to SpO2 for the stable monitoring.
“Setting the Sync Source to SpO2” (p. 8-3-13)

TEC-5600 series
• Set the hum filter to “ON”
3-electrode lead
“Setting the Hum Filter On or Off” (p. 8-1-22)
ESU
• Set the filter to “MAXIMUM”
“Setting the Filter” (p. 8-1-22)
Power supply Operating table

Power supply
and grounding for and grounding
defibrillator for ESU

General Notes on Defibrillation WARNING

Perform defibrillation in an ambulance only with the
WARNING vehicle stopped.
Before defibrillation, remove the electrodes for any
other instruments and patches from the positions
where the paddles will be placed. If a defibrillator WARNING
paddle contacts such an object, the delivery of Before defibrillation and cardioversion, remove
shock may be insufficient and cause a skin burn. from the patient all electrodes, probes and trans-
ducers from connectors that do not have a “ ” or
“ ” mark. Otherwise, the operator may receive
WARNING electrical shock and the connected instrument may
be damaged.
performing the defibrillation check using the WARNING
external paddles, keep the paddles in the paddle Before defibrillation, make sure that no one is in
holders. Failure to follow this instruction may result contact with either the patient or any metal part of
in electrical shock. any equipment or cables which supports or is
connected to the patient. Failure to follow this
warning causes serious electrical shock or injury.
WARNING
When using an ESU, use the ECG electrodes for
monitoring. Do not monitor ECG with disposable WARNING
pads, external paddles or internal paddles. If ECG When switching to another defibrillator because of
is monitored with pads or paddles, high-frequency trouble with this defibrillator, remove the disposable
energy from the ESU causes abnormal current to pads and electrodes from the patient. If the
flow in the patient and unexpected discharge. This paddles of the defibrillator in use contact an object
may damage the defibrillator. on the patient, delivery of shock may be
insufficient. In addition, it may cause skin burn or
may damage the defibrillator.
WARNING
Before defibrillation and cardioversion, check that
the cords and cables of the electrodes and trans- CAUTION
ducers attached to the patient are properly If the patient has a pacemaker or ICD:
connected to the defibrillator. Touching the metal • Do not attach the disposable pads directly over
parts of the disconnected cords and cables may the pacemaker or ICD. Doing so may affect the
cause electrical shock or injury by discharged function of the implanted pacemaker or ICD.
energy. Attach the disposable pads at least 8 cm away
from the implanted position (bulging area) of the
pacemaker or ICD. (Do not take time selecting
WARNING the attachment position of the pads at the cost of
delaying emergency treatment.)
The defibrillator generates high voltage. The
• If defibrillation is performed on a patient with an
defibrillator must only be operated by trained and
implanted ICD or pacemaker, the ICD or
qualified medical personnel.
pacemaker function should be checked after
defibrillation.
• If the patient has an ICD that is delivering
WARNING shocks, wait 30 to 60 seconds for the ICD to
Do not move or transport the defibrillator when any complete its treatment cycle before attaching the
residual charge remains in the defibrillator. If the disposable pads. The analysis and shock cycles
defibrillator receives any impact, such as from of the ICD and the defibrillator may conflict.
falling, it may discharge and can cause electrical • Analysis results may be inaccurate if the ECG
shock. includes a wide pacemaker pulse.

CAUTION CAUTION
Have another defibrillator ready in case of trouble Before defibrillation, make sure that the patient is
or accident. not in electrical contact with any metal part of a
bed, stretcher, or other equipment via blood or
chemical solution on the patient. Such contact may
cause unwanted pathways for the defibrillator
current and cause insufficient delivery of electrical
shock.
3
NOTE: Even when a proper electrical shock is

delivered to a patient, the patient may get
burned.
Installation and Connection
Additional Safety Measures for Connecting

Cutting Off the Power Supply External Instruments
to the Defibrillator
When more than one electrical instrument is used,
To cut off the power supply to the defibrillator, disconnect there may be electrical potential difference between the
the power cord of the defibrillator from the wall AC outlet. instruments. Potential difference between instruments
When installing the defibrillator, position the defibrillator may cause current to flow to the patient connected to the
so that it is easy to disconnect the power cord from the wall instruments, resulting in electrical shock. Never use any
AC outlet. medical equipment in patient treatment without proper
grounding.
Always perform equipotential grounding as specified in
Installing the Optional IEC 60601-1: 2005 + Amendment 1: 2012 when required.
It is often required in the operating room, ICU room,
Units to the Defibrillator CCU room, cardiac catheterization room and X-ray room.
and Connecting External Consult with a biomedical engineer to determine if it is
required.
Instruments
“General Requirements for Connecting Medical
Electrical Systems” (p. 3-10)
WARNING
Connect only the specified instrument to the
NOTE • For details on connecting an external
defibrillator and follow the specified procedure.
instrument to the defibrillator, contact your
Failure to follow this warning may result in
Nihon Kohden representative.
electrical shock or injury to the patient and
operator, and cause fire or instrument malfunction. • Leakage current may increase when
interconnecting many medical instruments to
the defibrillator.
CAUTION
Before connecting or disconnecting instruments,
make sure that each instrument is turned off and
the power cord is disconnected from the AC
socket. Then remove the battery pack. Otherwise,
the patient or operator may receive electrical shock
or injury.

General Requirements for Connecting Medical

Electrical Systems
When more than one electrical instrument is used, there may be electrical
potential difference between the instruments. Potential difference between
instruments may cause current to flow to the patient connected to the
instruments, resulting in electrical shock. Therefore, electrical instruments must
be appropriately installed as specified in IEC 60601-1: 2005 + Amendment 1:
2012.
The following is an extract from IEC 60601-1: 2005 + Amendment 1: 2012
“Medical electrical equipment - Part 1: General requirements for basic safety and
essential performance”. For details, refer to IEC 60601-1: 2005 + Amendment 1:
2012 and consult a biomedical engineer.
Examples of Combinations of MEDICAL ELECTRICAL EQUIPMENT and

Non-medical Electrical Equipment
Medically used room
Examples of possible Practical means of
Non-
Outside the causes for exceeding compliance
Situation No. Inside the medically
PATIENT LEAKAGE CURRENT Apply 16.5 in all
PATIENT ENVIRONMENT used room
ENVIRONMENT limits situations
1a Items A and B are Multiplied APPLIED – Verify total PATIENT

ME EQUIPMENT Mains Mains PARTS of the same type can LEAKAGE CURRENT
Plug Plug cause the total PATIENT
A B
IEC 60601 IEC 60601 LEAKAGE CURRENT to
exceed limits
See Note 1.
1b Items A and B are Earth conductor of the – Additional
A B
ME EQUIPMENT MULTIPLE SOCKET- PROTECTIVE EARTH
IEC 60601 IEC 60601
powered via OUTLET is broken CONNECTION
a MULTIPLE (for A or B) or,
See also 1a.
SOCKET-OUTLET
MULTIPLE SOCKET-OUTLET – Separating transformer
1c Item A is ME Due to high TOUCH – Additional
EQUIPMENT CURRENT of B PROTECTIVE EARTH
and B is Non-ME Mains Mains CONNECTION
Plug A Plug
EQUIPMENT B (for B) or,
IEC 60601 IEC xxxxx
– Separating transformer
(for B)
1
1d Item A is ME The earth conductor of – Additional
EQUIPMENT A B the MULTIPLE SOCKET PROTECTIVE EARTH
and B is non-ME IEC 60601 IEC xxxxx OUTLET is broken or, CONNECTION
EQUIPMENT (for A or B) or,
Due to high TOUCH
powered via
CURRENT of B – Separating transformer
a MULTIPLE MULTIPLE SOCKET-OUTLET
SOCKET-OUTLET
1e Item A is ME Mains Due to high TOUCH – Additional
EQUIPMENT A Plug CURRENT of B PROTECTIVE EARTH
powered from IEC 60601 CONNECTION
specified power B (for B) or,
supply in item B IEC xxxxx
1f Item A is ME (for B)
EQUIPMENT Mains
powered from B Plug
A
NON-ME IEC xxxxx
IEC 60601 DC/AC
EQUIPMENT
power supply in B

Medically used room

Examples of possible Practical means of
Outside the Non-medically used causes for exceeding compliance
Situation No. Inside the
PATIENT room LEAKAGE CURRENT Apply 16.5 in all
PATIENT ENVIRONMENT limits situations
ENVIRONMENT
2a Items A and B are

ME EQUIPMENT
Mains
Plug
Mains
Plug
No causes of exceeding
LEAKAGE CURRENT
– No further measures are
necessary
3
A B
IEC 60601 IEC 60601
2b Items A and Earth conductor of the – Additional

item B are ME A B MULTIPLE SOCKET- PROTECTIVE EARTH
EQUIPMENT IEC 60601 IEC 60601 OUTLET is broken CONNECTION (for A
powered via or B) or,
a MULTIPLE
SOCKET- MULTIPLE SOCKET-OUTLET
OUTLET
2 2c Item A is ME Due to high TOUCH – Do not use metal
Mains Mains
EQUIPMENT and Plug Plug CURRENT of B connector housing or,
item B is non-ME A B
IEC 60601 IEC xxxxx See rationale for 16.5. – SEPARATION
EQUIPMENT
DEVICE
2d Item A is ME The earth conductor of the – Additional
EQUIPMENT and MULTIPLE SOCKET- PROTECTIVE EARTH
A B
item B is non-ME OUTLET is broken CONNECTION (for A
IEC 60601 IEC xxxxx
EQUIPMENT or B) or,
powered via
a MULTIPLE
SOCKET- MULTIPLE SOCKET-OUTLET
OUTLET
3a Items A and B are Mains Mains No causes of exceeding – No further measures are
ME EQUIPMENT Plug Plug LEAKAGE CURRENT necessary
A B
IEC 60601 IEC 60601
Common protective earth

3b Item A is ME Due to high TOUCH – Do not use metal
EQUIPMENT and Mains Mains CURRENT of B connector housing
Plug Plug
item B is non-ME A B for SIGNAL INPUT/
IEC 60601 IEC xxxxx See rationale for 16.5.
EQUIPMENT OUTPUT PART or,
Common protective earth – SEPARATION

3 DEVICE
3c Item A is ME a) Potential – Additional
EQUIPMENT difference between PROTECTIVE EARTH
Mains Mains
and item B is ME B PROTECTIVE EARTH CONNECTION for (A),
Plug Plug
EQUIPMENT A IEC 60601 CONNECTIONs of A or
or non-ME IEC 60601 or and B
IEC xxxxx – SEPARATION
EQUIPMENT
b) Due to high TOUCH DEVICE, or
Common protective earth Protective earth CURRENT of B
with potential – Do not use metal
difference See rationale for 16.5. connector housing
in the PATIENT
ENVIRONMENT
NOTE 1 N o causes of TOUCH CURRENT or EARTH LEAKAGE CURRENT

exceeding limits.
NOTE 2 IEC 60601: MEDICAL ELECTRICAL EQUIPMENT in compliance
with IEC 60601.
NOTE 3 IEC xxxxx: Non-medical equipment in compliance with relevant IEC
safety standards.
NOTE 4 Separating transformer: see 16.9.2.1.
NOTE 5 If equipment “B” is outside the PATIENT ENVIRONMENT and if
equipment “A” is a CLASS II equipment and has accessible conductive
parts connected to the PROTECTIVE EARTH CONNECTION of
equipment “B” then additional safety measures could be necessary, for
example: additional protective earth for “B” or separating transformer
or SEPARATION DEVICE.

4 Preparation
Power..............................................................................4-2
4
Types of Power...............................................................................4-2
AC Operation............................................................................ 4-2
Battery Operation...................................................................... 4-2
Using AC Power..............................................................4-3
Connecting the Power Cord...........................................................4-3
Using the Battery.............................................................4-4

Approximate Battery Operation Time.............................................4-4
Installing a Battery Pack.................................................................4-5
Charging the Battery Pack.............................................................4-5
Charging in the Defibrillator....................................................... 4-5
Approximate Charging Time...........................................................4-7
Trickle Charging.............................................................................4-7
Remaining Battery Power Display..................................................4-8
Checking the Remaining Battery Power Mark.......................... 4-8
Loading the Recording Paper

(TEC-5611, TEC-5621, TEC-5631).................................4-9
Inserting an SD Card.....................................................4-10
Accuracy of the Built-in Clock........................................4-10
Changing Settings.........................................................4-10
Administrator Settings..................................................................4-10
4. Preparation
Power
Types of Power
The defibrillator can operate on either battery or AC power.
You can select either AC or an optional battery pack (NKB-301V), according to
where the defibrillator is used.
Combined use of AC power and battery is also possible.
“Using AC Power” (p. 4-3)
AC Operation
AC power lamp To supply AC power to the defibrillator, use the supplied power cord.
While AC power is being supplied, the AC power lamp is lit. When the
defibrillator is turned ON, a mark “ ” is displayed in an upper right position of
the screen.
Either of the battery charging
or battery operation mark
lights.
WARNING
Only use the specified power cord. When the
specified power cord cannot be used or when
equipotential grounding is doubtful (such as in poor
grounding facility), operate the defibrillator on
AC power is supplied. battery power. Otherwise, the patient and operator
Battery Operation
Install the optional battery (NKB-301V battery pack) into the defibrillator and
supply power from the battery pack.
If AC power supply is interrupted and a battery pack is installed, the defibrillator
危険
automatically switches to battery power and a mark indicating remaining battery
DAN
GER
power is displayed on the screen.
使用
開始
年月
“Using the Battery” (p. 4-4)

日
Remaining battery power mark

NKB-301V battery pack
The battery can be charged inside the defibrillator.

The battery inside the defibrillator is continuously charged whenever the
defibrillator is connected to AC power. The battery is charged even during
operation.

4. Preparation
Using AC Power
NOTE • Connect the defibrillator to the power source corresponds in
frequency and voltage to product specifications, and have
sufficient current capacity.
• Always install the battery pack in case of sudden loss of power
supply, such as a power failure or temporary blackout, in a
hospital even when operating the defibrillator on AC power. This 4
enables continuous operation of the defibrillator.
• If a battery pack is not used in case of sudden loss of power
supply, such as a power failure or temporary blackout, the data
in the defibrillator may be damaged.
In the event of a power failure or temporary blackout in a hospital,
secure power supply by connecting to an emergency power system
while the defibrillator is operating on battery power.
Connecting the Power Cord

1 Connect the connector of the power cord into the AC inlet on the rear panel
of the defibrillator and the opposite plug into an AC wall outlet. When the
3-pronged power cord is plugged into a 3-pronged grounded AC outlet, the
defibrillator is automatically grounded.
WARNING
Only use the specified power cord. When the
specified power cord cannot be used or when
equipotential grounding is doubtful (such as in poor
grounding facility), operate the defibrillator on
battery power. Otherwise, the patient and operator
2 Check that the AC power lamp on the front panel of the defibrillator lights
when AC power is supplied.
Either the battery charging lamp “ ” or battery charging completion
lamp “ ” lights, depending on the status of the battery.
AC power lamp

lights.
NOTE: If the AC power lamp does not light when the power cord is
connected, check if the power cord is securely connected.
When the defibrillator is turned on, the “ ” mark is displayed at the upper
right of the screen.
If no battery pack is installed in the defibrillator, the “INSERT

BATTERY PACK” message is displayed.

4. Preparation
Using the Battery

Install the optional battery (NKB-301V battery pack) into the defibrillator and
supply power from the battery pack. The defibrillator normally operates on AC
power. If the AC power is disconnected, the defibrillator switches to battery
operation.
• If the power cord is plugged again, the defibrillator automatically
switches to AC power.
• In the event of a power failure or temporary blackout in a hospital,
secure an AC power supply by connecting the defibrillator to an
emergency power system while the defibrillator is operating on
Battery battery power.
NOTE: Normal battery life is 2 years. Before operating the defibrillator

on battery power, be sure to check the starting date of use of the
battery written on the label attached on the defibrillator.
Before operating the defibrillator on battery power, be sure to read “Notes on the
Battery Pack”.
Approximate Battery Operation Time

Note that operating time varies depending on usage conditions.
With a fully charged new battery at 20°C (68°F), approximate battery operation
time is as shown below.
Defibrillation
At least 100 discharges at 270 J
(At a frequency of 3 times of charging/discharging per minute then 1-minute
pause)
Monitoring
At least 180 minutes continuous monitoring
Transcutaneous Pacing (TEC-5631)

At least 120 minutes pacing in fixed mode at 180 ppm and 200 mA
With a fully charged new battery at 0°C (32°F), approximate battery operation
time is as shown below.
Defibrillation
At least 50 discharges at 270 J
(At a frequency of 3 times of charging/discharging per minute then 1-minute
pause)

4. Preparation
Installing a Battery Pack

Install a battery pack specified by Nihon Kohden (NKB-301V Battery Pack) in
the defibrillator.
Before installing a new battery, write down the starting date of use in the
corresponding space on the label of the battery pack. Be sure to attach the
“inspected battery” label supplied with the defibrillator and the label for writing
down the starting date of use of the battery pack supplied with the battery pack to
the defibrillator. Inspect the battery pack every 6 months and replace the battery 4
pack every 2 years. After installing the battery pack in the defibrillator, be sure to
charge it.
How to Install the Battery Pack: “Replacement” (p. 12-26)

Battery Test: Administrator’s Guide: “Battery Test Procedure”
NOTE • Only use NKB-301V battery pack.

• Replace the battery pack with a new one every 2 years. In order
to ensure emergency use of the defibrillator on battery power,
periodically inspect the battery pack.
• After replacement with a new battery pack, press the [RESET]
key with the BATTERY TEST screen displayed.
• Installation of a battery pack must be performed by your Nihon
Kohden representative or trained personnel.
Charging the Battery Pack

Charge the battery pack with the defibrillator.
NOTE • The battery pack is not fully charged at the factory. Before using
a new battery, be sure to fully charge the battery.
• Charge the battery pack only in the defibrillator. If another
device is used for charging, it may cause malfunction of the
battery pack.
• Only charge the battery pack when the ambient temperature
is between 0 and 40°C (32 and 104°F). Otherwise, charging
may stop. Charging at high temperature over 40°C (104°F) may
accelerate deterioration of the battery.
Charging in the Defibrillator

To charge the battery inside the defibrillator, operate it on AC power.
1 Turn the control dial to the OFF position.

NOTE: Never disconnect the power cord while the “Saving data and
shutting down. Do not touch the AC power cord” message
is displayed. Otherwise, the data in the defibrillator may be
damaged.

4. Preparation
2 Connect the power cord to the defibrillator and set it to the AC operation
mode.
The AC power lamp and battery charging lamp on the front panel of the
defibrillator light, and charging of the battery starts.
NOTE • Never disconnect the power cord before charging is
completed.
• If the temperature of the battery pack or inside the
defibrillator becomes too high because of long charging
time, etc., the battery charging lamp and battery charging
completion lamp start blinking. In such a case, immediately
stop charging, move the defibrillator to a cooler place,
then resume charging. The defibrillator automatically starts
charging when the temperature of the battery pack or inside
the defibrillator drops.
• During charging, check that the AC power lamp is lit
and that either the battery charging or battery charging
completion lamp is lit.
AC power lamp
Battery charging lamp
3 After charging is completed, the battery charging completion lamp is lit.
AC power lamp
Battery charging completion

lamp

4. Preparation
Approximate Charging Time

The approximate charging time for a new battery at 20°C (68°F) is within
3 hours.
NOTE: If charging is not finished after 5 hours or more has elapsed, the
battery is in failure.
4
Trickle Charging
After charging is completed (the battery charging completion lamp is lit), keep
the power cord connected to the AC outlet regardless of whether the defibrillator
is used or not.
Trickle charge starts in order to keep the battery fully charged.
Trickle Charging
Trickle charge is a method for charging with small current to
compensate for the loss by self-discharge. This prevents the decrease of
battery capacity caused by self-discharge.
CAUTION
To keep the battery fully charged, always keep the
power cord connected to the AC outlet even when
the defibrillator is not used. Otherwise, the battery
may discharge and become unusable.
NOTE • If “ 1～3 ” or “ 0 ” appears on the screen shortly after the full

charge, the battery may be deteriorated.
• Check the capacity with the battery test. If the “REPLACE
BATTERY PACK” message is displayed, replace the battery
pack with a new one.
• Perform the battery test once a month.
Administrator’s Guide: “Battery Test Procedure”

4. Preparation
Remaining Battery Power Display

You can check the remaining battery power by looking at the mark displayed on
the screen.
NOTE: With a battery pack whose charging has been repeatedly stopped
before it is fully charged, the remaining battery power display may
be incorrect.
Checking the Remaining Battery Power Mark

Remaining battery power mark While the defibrillator is operated on battery power, the remaining battery power
mark is displayed in an upper right position of the screen.
NOTE • The values in the following tables are calculated assuming that
the battery pack is handled as specified in this manual. The
values depend on the battery usage and storage conditions.
• The remaining battery power mark may indicate different battery
power from the actual remaining battery power depending
on the battery usage and storage conditions and defibrillator
operation.
Mark
Remaining
Remaining Usable Time
Dischages
battery in MONITOR Alarm Action
(at 270 J and
Indication Color power mode 1
20°C (68°F))
95 discharges or 160 minutes or

Fully charged
more more
None None
40 discharges or 35 minutes or
Green Approx. 2/3
more more
4 discharges or 7 minutes or Replace with a charged battery or
Approx. 1/3
more more operate the defibrillator on AC power
to charge the battery.
The alarm is canceled when charging
1 or more 3 discharges or 6 minutes or starts. In such a case, even if charging
1～3
270 J charge(s) more more is stopped while
“ ” or “ 1～3 ” is displayed, an
alarm is not generated.
The defibrillator cannot be operated
Red on battery power. As the defibrillator
Technical
will shut itself off soon, immediately
alarm
Cannot operate replace the battery pack with a charged
0 on battery Not available None one or operate the defibrillator on AC
power to charge the battery pack.
NOTE: With the “ 0 ” mark
displayed, charging cannot
be performed.
Check the meaning of the alarm
Remaining
message, referring to “Messages
White battery power Not available None
on the Screen” (p. 9-5), then take
unknown
appropriate measures.
1
Usable time for monitoring may be shorter than the above times depending on whether the recorder
is used and which parameters are monitored.

4. Preparation
Loading the Recording Paper (TEC-5611,

TEC-5621, TEC-5631)
Door-release lever
CAUTION
unit. The thermal head may be damaged by static 4
failure.
1 Pull the door-release lever of the recorder up to release

the lock then open the door.
As the door stops halfway open for safety, pull the door
down until it opens completely.
2 Set the recording paper inside the recorder as shown in

the figure on the left.
Tabs
Pull the tabs outward to set the
recording paper.
3 Draw out the end of paper toward you from the upper slit.
Close the door until it clicks.
4 After the recording paper is installed, press the record/

stop key on the front panel to check that the paper is fed
through smoothly.

4. Preparation
Inserting an SD Card
To store the data (ECG waveform data, defibrillation data, event data, sound,
etc.) to be measured with this defibrillator and waveform reports in an SD card,
insert an SD card specified by Nihon Kohden into the SD card slot on the right
side of the defibrillator, referring to “SD Cards” (p. 10-2-2).
SD memory card “SD Cards” (p. 10-2-2)

(QM-001D, QM-002D)
Accuracy of the Built-in Clock

The accuracy of the built-in clock IC used in the defibrillator is as shown below.
• At ambient temperature: ±40 ppm or less
This means that a maximum of ±2-minute clock error per month may be
generated.
• Within the range of storage temperature (–25°C to +70°C (68°F to 158°F)):
±135 ppm or less
This means that a maximum of ±6-minute clock error per month may be
generated.
NOTE: For the TEC-5611, TEC-5621 and TEC-5631, before each use,
perform basic checks then print the recorded results out. Check
that the date and time printed on the recording paper are correct.
The date and time on the recording paper are important parts of
the medical record. Refer to “DATE AND TIME” (p. 5-9) for clock
setting. Note that the stored dates and times of past recording
data may differ from what was previously printed out after you
change the clock setting.
Changing Settings
Various settings can be made using the setup windows.
The details for these settings are described in “DATE AND TIME” (p. 5-9).
Administrator Settings
Some settings on the SYSTEM SETUP screen can only be changed by the
administrator.
The details for these settings are described in the Administrator’s Guide.

5 Setup Windows
Introduction......................................................................5-2
5
Setup Item List...............................................................................5-2

Basic Settings . ..............................................................................5-4
Entering Characters ................................................................. 5-5
GUIDE.............................................................................5-6
Setup Item List...............................................................................5-6
Displaying the GUIDE Window . ....................................................5-6
PADDLE SETUP.............................................................5-7
Setup Item List...............................................................................5-7
SYNC BY PADDLE .......................................................................5-7
HR ALARM.....................................................................................5-8
DEVICE SETUP..............................................................5-9
DATE AND TIME............................................................................5-9
Setup Item List.......................................................................... 5-9
DATE AND TIME....................................................................... 5-9
SELF TEST SETUP.....................................................................5-10
Setup Item List.........................................................................5-10
SELF TEST TIME....................................................................5-10
SELF TEST REPORT AUTO TRANSFER...............................5-10
VOLUME .....................................................................................5-11
Setup Item List.........................................................................5-11
Making Volume Settings for Various Sounds . ........................5-12
MEDICATION SETUP .................................................................5-13
Setup Item List.........................................................................5-13
Naming a Medication Key .......................................................5-13
LARGE NUMERICS SETUP .......................................................5-14
Setup Item List.........................................................................5-14
LARGE NUMERICS ...............................................................5-14
5. Setup Windows
Introduction
Display the SETUP window and make various settings for each operation.
NOTE: The changed settings are immediately applied to the relevant
operations. To return a setting to its previous value, change the
setting again.
For Default Values

“Setting Items and Default Settings” (p. 14-1)”
Setup Item List

Item
Description Page
Setup Menu Submenu
? ECG
Displays the GUIDE window for each
GUIDE ? SpO2 p. 5-6
parameter.
? CO2
ALARM Change settings for the upper/lower limit
All parameters p. 8-1-19
SETUP alarm.
PADDLE
SYNC BY PADDLE, HR ALARM Change settings for the paddle/pad lead. p. 5-7
SETUP
ECG ALARM HR/PR, VPC
ECG SETUP HUM FILTER, FILTER, Ca LEAD, Cb LEAD,
CASCADE
Change settings for monitoring the ECG. p. 8-1-17
ECG LEARNING
QRS SETUP PACING REJECT
DETECTION TYPE
ASYSTOLE, VF/VT, VPC RUN, COUPLET,
ARRHYTHMIA
EARLY VPC, BIGEMINY, ARRHYTHMIA Change settings for the arrhythmia alarm. p. 9-15
SETUP
ANALYSIS
SpO2 ALARM SpO2, HR/PR
SpO2 SETUP SYNC SOURCE, SYNC TONE, SENSITIVITY, Change settings for monitoring SpO2. p. 8-3-8
SENSITIVITY MODE
CALIBRATE (AIR, N2)
CO2 SETUP CO2 ALARM ETCO2, RR, APNEA Change settings for monitoring CO2. p. 8-2-15
CALIBRATION METHOD, SCALE
INTERVAL, DELETE ALL REPORTS Change settings for the reports. p. 10-1-13
SAVE REPORT, SEND REPORT p. 10-1-14
REPORT
TRENDGRAPH p. 10-1-16
SETUP Display the REPORT window.
PERIODIC LIST p. 10-1-17
EVENT LIST p. 10-1-18
RECORDING
INTERVAL, RECORDING WAVES Change settings for recording. p. 10-1-4
SETUP

5. Setup Windows
Item
Description Page
Setup Menu Submenu
DATE AND YEAR, MONTH, DAY, HOUR,
Change settings for the date and time. p. 5-9
TIME MINUTE
SELF TEST HOUR,
p. 5-10
TIME MINUTE
SELF TEST
SELF TEST Change settings for the self-test.
SETUP
REPORT PAIRING p. 10-2-11
AUTO
FILE
BLUETOOTH DESTINATION
FORMAT,
If an optional QI-832V Bluetooth® module is
5
PIN CODE, p. 10-2-7
DEVICE SETUP SETUP installed, set the destination device.
DESTINATION
SETUP
DEVICE
VOICE INSTRUCTION, ALARM
SOUND, CHARGE SOUND,
VOLUME Change volume settings for various sounds. p. 5-11
SYNC SOUND, KEY SOUND,
OPERATION SOUND
MEDICATION Change settings for naming the medication
MEDICATION 1 to 5 p. 5-13
SETUP keys.
LARGE
Set whether numerics on the monitor screen are
NUMERICS LARGE NUMERICS p. 5-14
to be enlarged or not.
SETUP

5. Setup Windows
Basic Settings
Follow the procedures below for changing the settings.
1 Turn the control dial to the SETUP position to display the SETUP window.
2 Display the setting window.

1) Press the [ ] key or [ ] key to select a SETUP menu
item.
2) Press the [ ] key or [ ] key to select an item.
3) Press the [OK] key to display the setting window.
The setting window is displayed with the item selected in step 2)
highlighted.
Whole setup menu
SETUP menu item being displayed
1) Select a SETUP menu item. 2) Select an item. 3) [OK]
3 Change the setting.

1) Press the [BACK] key or [NEXT] key to select an item.
2) Press the [ ↓ ] key or [ ↑ ] key to change the setting.
To return to the SETUP window, press the [MENU] key.
Example: RECORDING SETUP

The cursor moves to the selected setting.
The selected setting is highlighted.
1) Select an item. 2) Change the setting.

5. Setup Windows
4 Repeat steps 2 and 3 to set other items.
5 Press the [MENU] key to return to the SETUP window.
Entering Characters
1) Press the [CHARACTER→] key to select the character position.
2) Press the [↓] key or [↑] key to change the character.
Each time the [ ↓ ] key or [ ↑ ] key is pressed, the next character is 5
selected from 0 to 9, a to z, and A to Z in numerical or alphabetical
order.
If the key is held pressed, the character changes continuously.
Example: For setting MEDICATION in the MEDICATION SETUP window

The selected character is highlighted.
1) Select a character to be set. 2) Set a character.

5. Setup Windows
GUIDE
Display the GUIDE window for each parameter.
The GUIDE window shows the corrective measures for a technical alarm using
instructions and figures.
The GUIDE window can also be displayed by pressing the [GUIDE]

key that is displayed when a technical alarm is generated.
“GUIDE Window” (p. 8-0-5)
Setup Item List

Item Description
?ECG
GUIDE ?SpO2 Displays the GUIDE window for each parameter.
?CO2
Displaying the GUIDE Window

Display the GUIDE window and check the content.
To display the GUIDE window
1) Select GUIDE in the SETUP window.
2) Select an item from among ?ECG to ?CO2, and press the [OK] key.
“Basic Settings” (p. 5-4)
Example: GUIDE window for ?ECG
Press to select an item. Press to switch the displayed

page.

5. Setup Windows
PADDLE SETUP
Display the PADDLE SETUP window and change settings for the paddle/pad
lead.
Setup Item List

Item Description (Default) 5
Set whether to enable synchronized cardioversion with the
SYNC BY PADDLE ON, OFF
paddle/pad lead or not.
PADDLE
SETUP Set whether to generate heart rate alarms when monitoring
HR ALARM ON, OFF
ECG with the paddle/pad lead.
To display the PADDLE SETUP window

1) Select PADDLE SETUP in the SETUP window.
2) Select SYNC BY PADDLE or HR ALARM, and press the [OK] key.
SYNC BY PADDLE
Set whether to enable synchronized cardioversion with the paddle lead or not.
CAUTION
Synchronized cardioversion with the paddle lead
does not provide stable ECG because it is difficult
to hold the paddles steady. Artifact on the ECG
may be misinterpreted as QRS and discharge
might not synchronize with the patient’s QRS.
Settings:
• ON: Enables synchronized cardioversion with the paddle/pad lead.
• OFF (default): Disables synchronized cardioversion with the paddle/
pad lead.

5. Setup Windows
HR ALARM
Set whether to generate heart rate alarms when monitoring ECG with the paddle/
pad lead.
Set to “ON” for monitoring for a long period using disposable pads, or set to
“OFF” for monitoring using the external paddles or internal paddles.
Settings:
• ON: Generates heart rate alarms with the paddle/pad lead.
• OFF (default): Does not generate heart rate alarms with the paddle/
pad lead.

5. Setup Windows
DEVICE SETUP
Change settings for the defibrillator.
DATE AND TIME

Setup Item List
Item Description
5
YEAR 2000 to 2079
MONTH 1 to 12
DEVICE
DATE AND TIME DAY Set the date and time of the built-in clock. 1 to 31
SETUP
HOUR 0 to 23
MINUTE 0 to 59
DATE AND TIME

Display the DATE AND TIME window to set the date and time.
NOTE • After BASIC CHECKS, check that the correct date and time
are printed on the recording paper. The date and time on the
recording paper is an important part of medical records.
“Basic Checks” (p. 12-5)
• If the date and time are changed while the Enable Transport
setting is set to “On”, the following reports are deleted. Before
changing the date and time, record or save these reports.
-- TRENDGRAPH - PERIODIC LIST - EVENT LIST
Section 10-3 “Transport Function”
Setting range: 2000/1/1 00:00 to 2079/12/31 23:59
To display the DATE AND TIME window

1) Select DEVICE SETUP in the SETUP window.
2) Select DATE AND TIME and press the [OK] key.
1 Press the [ITEM] key to select an item.
2 Press the [ ↓ ] key or [ ↑ ] key to change the setting.
3 Set all items, and press the [OK] key to register them.
For MINUTE setting, second is set to “00” when the [OK] key is pressed.
1. Select an item. 2. Change the setting. 3. [OK]

5. Setup Windows
SELF TEST SETUP

Display the SELF TEST SETUP window and change settings for the self-test.
“Self Tests” (p. 12-23)
Setup Item List

Item Description (Default)
0 to 23
HOUR
(Default is 12.)
SELF TEST TIME Set the time to perform the self-test.
SELF
DEVICE MINUTE 0 to 59
TEST
SETUP
SETUP
SELF TEST REPORT AUTO Perform pairing with the destination device to
YES, NO
TRANSFER transfer the self-test report automatically.
SELF TEST TIME

Display the SELF TEST SETUP window, and set the time to perform the self-
test.
Settings: 0 HOUR 0 MINUTE to 23 HOUR 59 MINUTE

(default: 12 HOUR 0 MINUTE)
To display the SELF TEST SETUP window

2) Select SELF TEST SETUP, and press the [OK] key.
1 Press the [ITEM] key to select an item.
2 Press the [ ↑ ] key or [ ↓ ] key to change the setting.
3 Set all items.
1. Select an item. 2. Change the setting.
SELF TEST REPORT AUTO TRANSFER

Perform pairing with the destination device to transfer the self-test report
automatically.
For details, refer to “Setting the Device for Auto-saving the Self-test Report” in
Section 10-2.
“Setting the Device for Auto-saving the Self-test Report” (p. 10-2-11)

5. Setup Windows
VOLUME
Display the VOLUME window and set the volume.
WARNING
Set the alarm sound volume according to the place
where the defibrillator is used. If the alarm sound is
too quiet, keep the patient under close observation
and periodically check the defibrillator. Otherwise,
the alarm sound might not be heard and critical
changes on the patient or problems in the 5
defibrillator may be overlooked.
NOTE: If SYNC SOUND is set to “0”, the sync sound is silenced.
Setup Item List
VOICE
Select the voice instruction volume. 1, 2, 3, 4
INSTRUCTION
ALARM
Select the alarm sound volume. 1, 2, 3, 4
SOUND
Select the sound volume for charging and end of charging.
CHARGE
• Charging: A continuous beep sounds. 1, 2, 3, 4
SOUND
• End of charging: Beeps sounds intermittently.
DEVICE
VOLUME Select the sync sound volume.
SETUP
Volumes of the optional sounds, such as the sound generated for CO2 0, 1, 2,
SYNC SOUND
calibration, are set linked with SYNC SOUND. However, if SYNC 3, 4
SOUND is set to “0”, the volume of the optional sounds is set to “1”.
Select the volume of the clicking sound generated when a key is 0, 1, 2,
KEY SOUND
pressed. 3, 4
OPERATION
Select the operation sound volume. 1, 2, 3, 4
SOUND
Sound other than SYNC SOUND and KEY SOUND cannot be silenced.
Priority has been set for VOICE, ALARM SOUND, and CHARGE SOUND.
(Priority: high) VOICE INSTRUCTION > ALARM SOUND > CHARGE SOUND
> SYNC SOUND, KEY SOUND, OPERATION SOUND (Priority: low)
When different types of sound are output at the same time, the volume for the
lower-priority sound becomes “1” regardless of the volume setting.

5. Setup Windows
Making Volume Settings for Various Sounds

Display the VOLUME window and set the appropriate volumes according to the
environment.
Settings: 0 (silenced)1, 1 to 4 1 SYNC SOUND and KEY SOUND only

(Default: “2” for SYNC SOUND and KEY SOUND, and “4” for
other sounds)
To display the VOLUME window

2) Select VOLUME, and press the [OK] key.

5. Setup Windows
MEDICATION SETUP
Display the MEDICATION SETUP window and change settings for naming the
MEDICATION keys.
The medication keys appear when the Medication setting on the SYSTEM
SETUP screen is “On” and the [EVENT] key is pressed.
• Administrator’s Guide: “System Setup”
• “Event Recording” (p. 10-1-8)
Setup Item List 5

Within 13 alphanumerics
DEVICE MEDICATION MEDICATION Change settings for naming (Default for MEDICATION 1: Adrenalin)
SETUP SETUP 1 to 5 the MEDICATION keys. (Default for MEDICATION 2 to 5: Medication
2 to 5)
Naming a Medication Key

Display the MEDICATION SETUP window, and set the parameter.
Press the [ITEM] key to select an item.
To display the MEDICATION SETUP window
2) Select MEDICATION SETUP, and press the [OK] key.

5. Setup Windows
LARGE NUMERICS SETUP

Display the LARGE NUMERICS SETUP window and change the setting for
whether the numerics on the monitor screen are to be enlarged or not.
Setup Item List
LARGE
DEVICE LARGE Change the setting for whether the numerics on the monitor screen
NUMERICS ON, OFF
SETUP NUMERICS are to be enlarged or not.
SETUP
LARGE NUMERICS
Display the LARGE NUMERICS SETUP window, and change the setting.
Settings:
• ON: Numerics on the monitor screen is displayed large.
• OFF (default): Numerics on the monitor screen is not displayed large.
To display the LARGE NUMERICS SETUP window

2) Select LARAGE NUMERICS SETUP, and press the [OK] key.
If the LARGE NUMERIC SETUP is set to “ON”, the setting

is effective while the defibrillator power is turned on. Once the
defibrillator power is turned off, the setting returns to “OFF”.

6
Defibrillation,
Synchronized
Cardioversion and
AED 6
6-1
6-2
Introduction...................................................................6-0-2
6-3
Preparation Before Defibrillation,
Synchronized Cardioversion and AED...............Section 6-1 6-4
Defibrillation........................................................Section 6-2
Synchronized Cardioversion..............................Section 6-3
AED....................................................................Section 6-4
6. Defibrillation, Synchronized Cardioversion and AED
Introduction
With this defibrillator, defibrillation, synchronized cardioversion, and AED can
be performed.
Defibrillation
Defibrillation is a method for delivering electrical shock regardless of patient’s
heart rate conditions, and used for elimination of ventricular fibrillation.
The operator sets the output energy value, charges the defibrillator, then delivers
an electrical shock at any timing.
Synchronized cardioversion is a method for delivering electrical shock with
appropriate timing after detecting a patient’s QRS wave, and it is used for
elimination of atrial fibrillation, etc.
The operator sets the output energy value, charges the defibrillator for any
timing, then holds the shock buttons pressed. The defibrillator will deliver
electrical shock in synchronization with the QRS wave detected first.
AED
The defibrillator analyzes the patient’s ECG then judges whether electrical shock
is needed. If it judges that electrical shock is required, energy will automatically
be charged to the level set beforehand. Electrical shock will be delivered by the
operator, according to the displayed guidance.
External paddle Defibrillation Methods and Available Paddles/Pads

Yes: Available
Option: Available when optional equipment is connected
No: Not available
Model
Function TEC-5601 TEC-5611 TEC-5621 TEC-5631
Defibrillation Yes Yes Yes Yes

Synchronized
Method No Yes Yes Yes
cardioversion
AED No Yes Yes Yes
Internal paddles (option) Disposable pads 1
No Yes Yes Yes
Paddle/Pad External paddles Yes No Yes Yes
Internal paddles No No Option Option
1
Option
6-0-2 Operator’s Manual TEC-5600 series

In this section, necessary preparations and operation procedures for each method
of defibrillation are described.
Disposable pads (option) Preparation Before Defibrillation,

Synchronized Cardioversion and AED (Section 6-1)
Preparations required before performing defibrillation,
synchronized cardioversion, or AED (such as connection/
disconnection of the paddles/pads to/from the defibrillator and
how to attach disposable pads) are described.
Defibrillation (Section 6-2)

The defibrillation procedures are described separately for the 6
types of paddles/pads used.
6-1
6-2
(TEC-5611, TEC-5621, TEC-5631) (Section 6-3)
6-3
The synchronized cardioversion procedures are described
separately for the types of paddles/pads used. 6-4
Defibrillation in AED Mode

(TEC-5611, TEC-5621, TEC-5631) (Section 6-4)
The defibrillation procedure in AED mode is described.
Operator’s Manual TEC-5600 series 6-0-3

6-1
Preparation before
Defibrillation,
Synchronized
Cardioversion and
AED 6
6-1
Flow of Preparation......................................................6-1-2
Defibrillation................................................................................ 6-1-2
Synchronized Cardioversion (TEC-5611, TEC-5621,
TEC-5631).................................................................................. 6-1-2
When Using an ECG from an External Monitor for a
Synchronizing Signal.............................................................. 6-1-2
AED (TEC-5611, TEC-5621, TEC-5631).................................... 6-1-2
Connecting Paddles/Pads............................................6-1-3
Disconnecting Paddles/Pads (TEC-5621, TEC-5631)............... 6-1-3
Connecting External Paddles (TEC-5621, TEC-5631)............... 6-1-4
Changing to the Pediatric Electrode Plate.................................. 6-1-4
Connecting Disposable Pads..................................................... 6-1-5
Connecting the Pad Adapter (TEC-5621, TEC-5631)............ 6-1-6
Attaching the Disposable Pads to the Patient.........................6-1-7
Connecting the Disposable Pads to the Pad Adapter or
Pad Connector....................................................................... 6-1-9
Connecting Internal Paddles (TEC-5621, TEC-5631).............. 6-1-10
Measuring an ECG for Synchronized

Cardioversion.............................................................6-1-11
Confirming the Number of Electrodes and Type of Leads and
Connecting the Electrode Leads...............................................6-1-11
Attaching Disposable Electrodes.............................................. 6-1-12
Monitoring the ECG.................................................................. 6-1-13
Using an ECG from an External Monitor as a

Synchronizing Signal..................................................6-1-14
Connecting an External Monitor............................................... 6-1-14
Checking the Delay Time for Synchronized Cardioversion...... 6-1-15
TEC-5611..............................................................................6-1-15
TEC-5621, TEC-5631...........................................................6-1-18
Contact Impedance between Skin and the External

Paddles’ Electrodes....................................................6-1-21
Flow of Preparation
After checking the patient’s conditions, perform preparations as shown below,
depending on the defibrillation method.
Defibrillation
1 Connect the paddles/pads. Refer to p.6-1-3.
Deliver electrical shock, referring to Section 6-2 “Defibrillation”.
Synchronized Cardioversion (TEC-5611, TEC-5621, TEC-5631)

1 Connect paddles/pads. Refer to p.6-1-3.
2 Measure the ECG for synchronized

cardioversion.
Refer to p.6-1-11.
Deliver electrical shock, referring to Section 6-3 “Synchronized Cardioversion”.
When Using an ECG from an External Monitor for a Synchronizing Signal

To use an ECG from an external monitor as a synchronizing signal, connect the
external monitor and the defibrillator, using a JC-831V external ECG cable, and
check the delay time for synchronized cardioversion.
1 Connect an external monitor to the

defibrillator.
Refer to p.6-1-14.
2 Check the delay time for synchronized

cardioversion.
Refer to p.6-1-15.
3 Connect the paddles/pads. Refer to p.6-1-3.
Deliver electrical shock, referring to Section 6-3 “Synchronized Cardioversion”.
AED (TEC-5611, TEC-5621, TEC-5631)

1 Connect disposable pads. Refer to p.6-1-5.
Administer CPR and electrical shock, referring to Section 6-4 “AED”.

6-1. Preparation before Defibrillation, Synchronized Cardioversion and AED
Connecting Paddles/Pads
Connect paddles/pads to be used, according to the defibrillation method.
Synchronized
Defibrillation AED
Cardioversion
External paddles Yes Yes No

Internal paddles Yes Yes No
Disposable pads Yes Yes Yes
6
External paddles Internal paddles (option) Disposable pads (option)
6-1
Disconnecting Paddles/Pads (TEC-5621, TEC-5631)

If other paddles/pads are already connected, disconnect them, following the
procedure below.
Paddle connector 2 By turning the lock of the paddle connector to the unlock position, pull
out the connector toward you while holding the connector, as shown in the
figure.
NOTE: Always hold the connector when pulling it out. Otherwise, the
connector or the cable may be damaged.
Paddle connector
Unlocked position
Paddle
connector
lock

Connecting External Paddles (TEC-5621, TEC-5631)

Paddle connector
1 Connect the paddle connector of the external paddles
to the paddle connector on the front panel of the
defibrillator, as shown in the figure. Check that the paddle
connector lock is in the locked position.
WARNING
Paddle connector When connecting the paddles or pad adapter, firmly
insert the connector into the paddle connector on
Paddle Locked position the defibrillator. Check the connection and confirm
connector that the tab of the paddle connector lock is in the
lock
locked position.
operates normally.
Push the paddle Check that the paddle such as failure to display “CONNECT
connector in. connector lock is in the PADDLES/PAD” message, accidental removal of
locked position.
2 Turn the control dial to the DISARM position. Check that

the error message “CONNECT PADDLES/PADS” is not
displayed on the screen.
If the paddle contact lamp is lit in orange or yellow,
clean the external paddles and test-discharge electrodes,
referring to “External Paddles” in Section 12
“Maintenance”. (Even if the paddle contact lamp is lit in
Paddle contact lamp orange or yellow, electrical shock can be delivered.)
Changing to the Pediatric Electrode Plate

You can detach the adult electrode plate to change to the pediatric electrode
plate, as required.
WARNING
Pay careful attention to the energy setting when
using the pediatric electrode plates. Applying high
energy with the pediatric electrode plates can
cause skin burn, because the electrode plates are
small.
The current density on the pediatric electrode plates is higher than the current
density on the adult electrode plates, because the pediatric electrode plates
are smaller than the adult electrode plates 1. This increases the possibility of
electric burn on the electrode plate placement area. Be careful that the minimum
effective energy should be set.
1
he pediatric electrode plates have about 1/3 the surface area of the adult
T
electrode plates.

Adult electrode plate 2 Press the tab of the adult electrode plate to unlock the adult electrode plate.
3 Slide the adult electrode plate forward and off, as shown in the figure.
6
6-1
Connecting Disposable Pads

Connect the disposable pads to the defibrillator, as shown in Steps 1 to 3 below.
1 Connect the pad adapter (TEC-5621, TEC-5631). (Refer to p.6-1-6.)
2 Attach the disposable pads to the patient. (Refer to p.6-1-7.)
3 Connect the disposable pads to the pad adapter or pad connector.

(Refer to p.6-1-9.)
WARNING WARNING
If the bag containing disposable pads is torn, do • Do not use the disposable pads if the gel has
not use the pads. Dispose of the pads. Failure to become dry.
follow this warning may lead to skin burns or • Do not use the disposable pads if the gel has
insufficient delivery of shock. become abnormal (the gel has become liquified
or is coming out of the edges of the pad, etc.).
WARNING burn or insufficient delivery of shock.
Do not use the disposable pads if the gel is dark
brown or dark-brown gel is on the protective sheet.
Use of such pads may cause insufficient delivery of WARNING
shock or skin burn where the pads are attached. Do not use the disposable pads if they are past the
expiration date on the package. Failure to follow
this warning may lead to skin burn or insufficient
delivery of shock.
WARNING
Use disposal pads as soon as possible after
opening the package. Failure to follow this warning
WARNING
may lead to skin burn or insufficient delivery of
shock. Do not reuse disposable pads. Failure to follow this
warning may lead to skin burn or insufficient
delivery of shock.
CAUTION CAUTION
When disposable pads are attached to a patient, Do not place heavy objects on the disposable pads
replace them every 24 hours. After 24 hours, the or bend the pads. The pads may become damaged
gel becomes dry and this may reduce performance and deteriorated, resulting in skin burn on the
of the pads. patient.

NOTE: Always have spare disposable pads. Use the spare pads if the gel
of the pads becomes dry, deteriorated or discolored.
Deteriorated means:
• The gel has become liquefied.
• The gel is coming out of the edges of the pad.
Discolored means:
• The color of the gel changes to brownish-red, and brownish gel
is attached to the protection sheet.
Refer to the manual of the disposable pads to be used, as well.
Connecting the Pad Adapter (TEC-5621, TEC-5631)
Paddle connector 1 Connect the paddle connector of the pad adapter to the
paddle connector on the front panel of the defibrillator as
shown in the figure. Check that the paddle connector lock
is in the locked position.
WARNING
Paddle connector
When connecting the paddles or pad adapter, firmly
the defibrillator. Check the connection and confirm
Paddle Locked position that the tab of the paddle connector lock is in the
connector locked position.
lock After the paddles or pad adapter is replaced, do a
operates normally.
Push the paddle Check that the paddle
connector in. connector lock is in the
locked position.


Attaching the Disposable Pads to the Patient

Take the disposable pads out of the package, remove the protection sheets, then
attach them to the patient’s body.
Protection
sheet Refer to the manual of the disposable pads to be used, as well.
WARNING
Before defibrillation, remove everything including
electrodes and patches from the patient’s chest. If
the defibrillator paddle/pad contacts an object on
the patient’s chest, the discharged energy may be
6
insufficient and cause skin burn.
6-1
CAUTION
Do not attach a disposable pad over another pad.
It may cause skin burn on the patient.
CAUTION
If the patient’s body is wet, thoroughly wipe the
moisture off the skin so that the paddles or pads
will not short-circuit each other. Otherwise, delivery
of shock may be insufficient.
CAUTION
When monitoring ECG with disposable pads,
check the polarity of the pads before attaching
delay of treatment.
NOTE • To remove the protection sheet, hold the tab at the cable end
and carefully remove it. If gel is accidentally removed together
with the sheet or a metal part becomes exposed, be sure to use
a new disposal pad.
• To attach the disposable pads to the patient, clean the skin, and
if the patient’s body is wet, thoroughly wipe the moisture off the
skin.
• To attach the disposable pads to the patient, thoroughly wipe
the moisture, oil, and dirt off the skin. Also remove any excess
body hair.
• Do not apply any gel or paste when using the disposable pads.
• Firmly attach the disposable pads to the patient’s body. If they
are loosely attached, electrical shock cannot be delivered.

There are 3 methods for attaching the disposable pads.
Apex-Anterior Placement
This is a basic attachment method.
Front side
Apex-Posterior Placement
This attachment method is not suitable for monitoring or AED analysis.
Front side Back side
Anterior-Posterior Placement
This attachment method is not suitable for AED analysis or monitoring.
To attach the disposable pads to a child’s body, normally attach them by the
apex-anterior placement method, as with an adult patient.
When the patient is a small child and the pads touch each other, attach one pad
on the center of the patient’s chest and the other on the back.
When the Patient is a Small Child

Connecting the Disposable Pads to the Pad Adapter or Pad Connector
1 Securely connect the connector of the disposable pads attached to the

patient’s body to the pad adapter or pad connector.
NOTE: Securely connect the connector of the disposable pads until it
locks.
TEC-5621, TEC-5631 TEC-5611
Pad adapter Pad connector
Disposable
pads Disposable pads
6
6-1
2 Turn the control dial to the DISARM position. Check that the error message
“CHECK PADS” or “CHANGE PADS” is not displayed on the screen.
For defibrillation in AED mode, turn the control dial to the AED position
then check that neither of the error messages is displayed on the screen.
Section 6-4 “AED” (p.6-4-1)

Connecting Internal Paddles (TEC-5621, TEC-5631)

Connect the optional internal paddles to the defibrillator.
CAUTION
Sterilize the internal paddles before use. Failure to
sterilize the paddles may cause serious infection.
NOTE: As the internal paddles are not sterilized at the

factory, be sure to sterilize them before each use.
• Refer to the manual of the internal paddles together
with this operator’s manual.
• Section 12 “To clean, disinfect, and sterilize the
internal paddles” (p.12-32)
Paddle Locked position 1 Connect the paddle connector of the internal paddles to the
connector paddle connector on the front panel of the defibrillator, as
lock shown in the figure. Check that the paddle connector lock
is in the locked position.
WARNING
Push the paddle Check that the paddle insert the connector into the paddle connector on
connector in. connector lock is in the the defibrillator. Check the connection and confirm
locked position.
that the tab of the paddle connector lock is in the
Paddle connector locked position.
operates normally.
Paddle connector
The internal paddles in the

figure above are the
ND-890V series.


Measuring an ECG for Synchronized

Cardioversion
Measure the ECG to be used as a synchronizing signal for synchronized
cardioversion with the defibrillator, following Steps 1 to 3 below.
According to the number of electrodes (leads), select the appropriate electrode
leads, ECG connection cord, and disposable electrodes then connect them.
The ECG being measured by another monitor can be used as a
synchronizing signal.
Refer to “Using an ECG from an External Monitor as a Synchronizing 6
Signal” (p.6-1-14).
6-1
1 Confirm the number of electrodes and type of leads then connect the
electrode leads. (Refer to p.6-1-11.)
2 Attach the disposable electrodes. (Refer to p.6-1-12.)
3 Check the ECG. (Refer to p.6-1-13.)
In a case of emergency defibrillation, the paddle/pad-lead ECG can be used as a

synchronizing signal. In such a case, the above steps are not required.
Section 6-3 “Using Paddle/Pad-Lead ECG as the Synchronizing
Signal” (p.6-3-25)
Confirming the Number of Electrodes and Type of Leads and

Connecting the Electrode Leads
Confirm the number of electrodes and type of leads, referring to Section 8-1
“ECG Monitoring”, then connect the electrode leads.
Section 8-1
• “Checking the Number of Electrodes and Measuring Leads” (p.8-1-3)
• “Connecting the Electrode Lead to the Defibrillator” (p.8-1-6)
When connecting a BR-903P 3-electrode lead
BR-903P
JC-906P

Attaching Disposable Electrodes

Attach the disposable electrodes to the patient’s body.
The placement and lead depend on the number of electrodes (leads).
NOTE • When attaching the ECG electrodes for synchronized
cardioversion, be careful not to attach them to the places where
the paddles are to be placed.
• If the electrodes cannot be attached to the specified places
because the patient has undergone chest incision, for example,
to obtain a relatively stable ECG, place the electrodes under the
armpit.
For details on attachment of disposable electrodes, refer to the manual

of the disposable electrodes to be used, as well.
1 Clean the probe sites with absorbent cotton moistened with alcohol.
To dry alcohol completely, rub the probe sites with dry, clean absorbent
cotton.
To obtain a more stable ECG, rub the probe sites with Nihon Kohden
SkinPure.
2 Open the package of the ECG electrodes to take them out.

Remove the cover, paying attention not to touch the attachment surface of
the electrode.
Attachment of a
When using a snap-type electrode lead, attach the snap-type lead
electrode lead to the electrode before removing the
cover.
3 Paste and closely attach the electrode to a probe site. Avoid attaching to an
uneven place or one with many wrinkles.
NOTE: Although an ECG electrode that is in good contact with the
patient skin can be continuously used for about 24 hours,
if the contact becomes poor because the patient sweats or
moves, replace it with a new one.
When using a clip-type electrode lead, attach the Attachment of a
Lightly press the label on the surface electrode to a probe site first then connect the electrode clip-type lead
of the electrode with your finger to
closely attach the electrode to the skin.
lead to the electrode.
NOTE: When connecting a clip-type electrode
lead to an electrode, do not push down
on the clip. The contact terminal of the
electrode lead may become deformed and
prone to be disconnected. Widely open
the clip at the end of the electrode lead
then pinch the electrode element with it.
Surgical tape
4 Fix the electrode lead to the patient’s body with a piece of surgical tape, etc.
Fixing the electrode lead in place reduces the movement of the lead caused
by body motion, which enables more stable ECG measurement.
NOTE: If the electrode lead is kept taut, it may be broken or the
electrode may be peeled off. When connecting the lead to a
monitoring device, keep the lead slack.

Monitoring the ECG

Turn the control dial to the DISARM position then press the [LEAD] key. Check
that the waveform of each lead is displayed on the screen.
NOTE: It may take several seconds for the waveforms to appear after the
control dial is set to the DISARM position.
Each time the [LEAD] key is pressed, the signal of a lead to be displayed
changes according to the number of electrodes, as shown below.
Number of
Leads to be displayed
electrodes
3 PADDLE or PAD, I, II, III, AUX, in that order 6
PADDLE or PAD, I, II, III, aVR, aVL, aVF, Ca,1 Cb,1 AUX, in that
6 6-1
order
1
Ca or Cb electrode lead can be set in Ca LEAD or Cb LEAD in ECG SETUP in the
SETUP window.
Section 8-1 “Setting Chest Leads” (p.8-1-23)
ECG Lead
For changing leads


Synchronizing Signal
With an external monitor having an analog ECG output function, the analog
ECG output signal can be used as a synchronizing signal for synchronized
cardioversion.
To use an ECG from the external monitor as a synchronizing signal, input an
analog ECG signal from the external monitor, using the JC-831V external ECG
cable.
Before use, check the delay time for synchronized cardioversion.
WARNING
Before using the defibrillator, check that
synchronized cardioversion occurs within 60 ms of
the peak of the ECG’s R wave with the defibrillator
and an external monitor connected.
NOTE: Check that the external monitor to be used is “in compliance with
the IEC 60601-1 safety standards”.
Connecting an External Monitor

Connect an external monitor with the defibrillator, as shown in the figure below.
The figure below shows a connection example using a Nihon Kohden BSM-6000
series bedside monitor.
External monitor
Nihon Kohden monitor
Example: BSM-6000 series ECG socket
Analog ECG output socket

on the BSM-6000 series:
JC-831V external
ECG/BP OUT socket
ECG cable
TEC-5600 series

Checking the Delay Time for Synchronized Cardioversion

When an ECG from the external monitor is used as a synchronizing signal, check
that synchronized discharge can be delivered within 60 ms from a peak of an R
wave.
For this check, a Nihon Kohden AX-103VK defibrillator analyzer is required.
Refer to the operator’s manuals of the AX-103VK defibrillator analyzer
and the external monitor to be used, as well.
TEC-5611
6
1 Connect the defibrillator and an external monitor to the AX-103VK
6-1
defibrillator analyzer, as shown in the figure below.
The JJ-202V analyzer connection cable is provided with the AX-103VK
defibrillator analyzer.
External monitor
Example: BSM-6000
series
TEC-5611
AX-103VK defibrillator
analyzer
Output a simulated ECG signal

for testing from the color-coded
terminals of the defibrillator JJ-202V analyzer
analyzer to the external monitor. connection cable
• C: Chest
• F: Foot
• L: Left hand
• R: Right hand JJ-202V
• RF: Right foot analyzer
connection
Connect the cable
electrode leads
from the
external Holder
monitor.
DELAY button 2 Turn the defibrillator analyzer on then press the DELAY button.
The simulated ECG signal for testing is output from the color-coded
terminals of the defibrillator analyzer to the external monitor.
3 Turn the external monitor on then output a lead I or lead II analog ECG
signal to the defibrillator.

4 Display an ECG waveform from the external monitor.

1) Turn the control dial of the defibrillator to the MONITOR position.
NOTE: It may take several seconds for the waveforms to appear
after the control dial is set to the MONITOR position.
2) Press the [LEAD] key several times until “AUX” is displayed and check
that the ECG waveform from the external monitor is displayed.
Section 8-1 “Setting the Monitoring Leads” (p.8-1-14)
ECG from the external monitor Lead: AUX
5 Turn the control dial of the defibrillator to the 50 J position to set the energy
value of electrical shock to 50 J.
6 Press the SYNC button then check the mode indication and synchronization
points.
• Check that “SYNC MODE” is displayed on the screen.
• Check that the “ ” lines indicating the synchronization positions
are displayed at the rising part (Q–R) of each QRS wave of the ECG
waveform being displayed.
Synchronization positions “ ”
Check that the “ ” lines are indicated at the rising part
of each QRS wave.
Synchronized discharge mode
7 Press the CHARGE/AED button on the front panel to charge the

defibrillator.
During charging, “CHARGING” is displayed on the screen and beeps sound
intermittently.
CHARGING
The energy value increases.

The SHOCK When charging is completed, the message “CHARGED” and some guidance
button is displayed on the screen, and a continuous beep sounds. The SHOCK
flashes. button starts flashing at the same time.
CHARGED Energy value for
electrical shock
6
6-1
WARNING
When charging or discharging, do not touch the
pads or connector. If you touch any other part of
the defibrillator during charging or discharging, you
will receive an electrical shock.
WARNING
shock.
8 Press the flashing SHOCK button to deliver electrical shock. Hold the
SHOCK button pressed until electrical shock is delivered, because discharge
is performed when the first synchronization point is detected after the
SHOCK button is pressed.
Delay time (ms) 9 Check that the delay time displayed on the display of the defibrillator
Check that the delay time is 60 ms or analyzer is 60 ms or less.
less.
NOTE: If the delay time displayed on the defibrillator analyzer
exceeds 60 ms, the ECG from the connected external monitor
cannot be used as a synchronizing signal.
10 To shut the defibrillator off, turn the control dial to the OFF position.
damaged.

TEC-5621, TEC-5631
1 Connect the defibrillator and an external monitor to the AX-103VK

defibrillator analyzer, as shown in the figure below.
External monitor
Example: BSM-6000
series
TEC-5621, TEC-5631
JC-831V external
ECG cable
Output a simulated ECG signal for testing from

the color-coded terminals of the defibrillator
analyzer to the external monitor.
• C: Chest
• F: Foot
• L: Left hand
• R: Right hand
• RF: Right foot AX-103VK defibrillator analyzer
Connect the
electrode leads
from the external
monitor.
DELAY button 2 Turn the defibrillator analyzer on then press the DELAY button.
The simulated ECG signal for testing is output from the color-coded
terminals of the defibrillator analyzer to the external monitor.
3 Turn the external monitor on then output a lead I or lead II analog ECG
signal to the defibrillator.
4 Display an ECG waveform from the external monitor.

1) Turn the control dial of the defibrillator to the MONITOR position.
NOTE: It may take several seconds for the waveforms to appear
after the control dial is set to the MONITOR position.
2) Press the [LEAD] key several times until “AUX” is displayed and check
that the ECG waveform from the external monitor is displayed.
Section 8-1 “Setting the Monitoring Leads” (p.8-1-14)
ECG from the external monitor Lead: AUX
5 Turn the control dial of the defibrillator to the 50 J position to set the energy
value of electrical shock to 50 J.

points.
• Check that the “ ” lines indicating the synchronization positions are
displayed at the rising part (Q–R) of each QRS wave of the ECG
Check that the “ ” lines are indicated at the
rising part of each QRS wave.
6
6-1
7 Press either the charge button on the external APEX paddle or the CHARGE/
AED button on the front panel of the defibrillator to start charging.
intermittently.
CHARGING
The shock buttons flash. When charging is completed, the message “CHARGED” and some guidance
are displayed on the screen, and a continuous beep sounds. At the same time,
the shock buttons on the external paddles start flashing.
electrical shock
Example: Wrong way of holding the

external paddle
WARNING
When charging or discharging, do not touch
anything other than the handles of the paddles. If
any other part of the defibrillator is touched during
charging or discharging, the operator receives an
electrical shock.

WARNING
shock.
Simultaneously and firmly press 8 With the external paddles connected to the defibrillator analyzer,
the shock buttons on both external simultaneously and firmly press the shock buttons on the external paddles to
paddles.
deliver electrical shock.
Hold the shock buttons pressed until electrical shock is delivered, because
discharge is performed when the first synchronization point is detected after
the shock buttons are pressed.
NOTE: Never deliver electrical shock while the electrodes of the
paddles are in contact with each other. The defibrillator may
be damaged.
Delay time (ms)

Check that the delay time is 60 ms or
9 Check that the delay time displayed on the display of the defibrillator
analyzer is 60 ms or less.
less.
NOTE: If the delay time displayed on the defibrillator analyzer
exceeds 60 ms, the ECG from the connected external monitor
cannot be used as a synchronizing signal.
damaged.


External Paddles’ Electrodes
Paddle contact To perform effective defibrillation or cardioversion using the external paddles, it
lamp is important to make the skin-paddle contact impedance as low as possible.
Recommended applied pressure on a paddle is about 100 N (10 kg) per paddle.
NOTE: Note that if you press the paddles on the precordial region of the
patient by leaning on patient, the paddles may slip off.
The defibrillator measures the transthoracic electric resistance when the paddle
electrodes are pressed on the patient’s body and indicates the skin-paddle contact
6
impedance with the paddle contact lamp. 6-1
• 0 to 100 Ω: Lit in green
• 100 to 200 Ω: Lit in yellow
• 200 Ω or higher: Lit in orange
Before delivering electrical shock, place the paddles so that the paddle contact
lamp lights in green. If it does not, take the measures described below. The
paddle contact lamp might not light in green for some patients. (Even if the
paddle contact lamp is lit in orange or yellow, electrical shock can be delivered.)
• Press the paddles against the patient and gradually increase the pressure.
• Check that the contact gel (GELAID) is applied uniformly on the paddles.
• Shave off hair on the skin where paddles are to be placed.

6-2 Defibrillation
6-2
Introduction...................................................................6-2-2
Flow of Operation....................................................................... 6-2-2
Screen Example......................................................................... 6-2-3
Recording Waveforms................................................................ 6-2-4
Defibrillation Using the External Paddles.....................6-2-5
Defibrillation Using the Disposable Pads................... 6-2-11
Defibrillation Using the Internal Paddles....................6-2-16

Introduction
Defibrillation is a method for delivering electrical shock regardless of a patient’s heart
rate condition and is used for elimination of ventricular fibrillation.
The operator sets the output energy value, charges the defibrillator, then delivers an
electrical shock at any timing.
External paddles, internal paddles, or disposable pads can be used with the defibrillator.
Flow of Operation
Preparation (Refer to Section 6-1.) Defibrillation
Check the patient’s conditions. Check the indications on the screen.

Check that the lead is “PADDLE” or “PAD” and that the mode indication
Connect the paddles/pads. is “MANUAL MODE” on the screen.
Connect the paddles/pads to be used.
Disposable pads: Check the ECG.
External paddles Confirm that the patient’s ECG has a shockable rhythm, such as
ventricular fibrillation, for defibrillation.
External paddles: Apply contact gel to the electrode plate

If the patient is a small child, change the surface of each paddle.
adult electrode plates to the pediatric
electrode plates. Select the energy level.
Disposable pads For internal paddles, the selectable energy
Connect in the level is 50 J or less.
following steps:
1) Connect the pad
adapter (TEC-5621,
TEC-5631). External paddles: Press the paddles on the patient then check
2) Attach the disposable pads to the patient. the ECG.
Confirm that the patient’s ECG has a shockable rhythm, such as
3) Connect the disposable pads to the pad ventricular fibrillation, for defibrillation.
adapter or pad connector.
Internal paddles Press the CHARGE/AED button.
Charging starts and beeps sound intermittently.
or
Set the control dial to DISARM.
Check that no error message is displayed External paddles
on the screen.
The message “CHARGED” and some guidance are displayed
on the screen.
When charging is completed, a continuous beep sounds.
Internal paddles: Position the internal paddles against the

heart then check the ECG.
Check the patient’s conditions again, then firmly press the

SHOCK button(s).
External paddles • Disposable pads

• ND-860V series ND-890V series
Check the effect of the electrical shock then deliver another

electrical shock, if required.

6-2. Defibrillation
Screen Example
The figure below is a screen example for when the external paddles are used.
Arrhythmia alarm and VF/VT alarm

The arrhythmia alarm does not sound during defibrillation, regardless of the
alarm setting.
ARRHYTHMIA ANALYSIS OFF • When the external paddles or internal paddles are used, no arrhythmia
• When the external paddles or internal alarm sounds.
paddles are used, the arrhythmia analysis • When disposable pads are used, only the VF/VT alarm can be set to “ON”.
is always set to “OFF”. • The arrhythmia mark “ ” is displayed only when the optional QS-831V
• When the disposable pads are used, the is installed.
arrhythmia analysis is “OFF” if the VF/VT
Remaining battery power
alarm is set to “OFF”.
ECG mark and AC power mark 6
QRS sync mark Scale 6-2

Alarm off mark Sensitivity
Lead of displayed
waveform: PADDLE/
Heart rate PAD
Guidance
To be displayed upon
completion of charging
Function keys
• [LEAD]
For selecting the ECG lead being
displayed
For defibrillation, select “PADDLE”
or “PAD”.
Mode indication: MANUAL MODE CHARGING or CHARGED
• [SENSITIVITY]
For selecting the ECG sensitivity
being displayed
• [EVENT]
For event recording, refer to “Event
Recording” (p. 10-1-8).
• [OP SOUND]
Number of discharges Charged energy
For turning the operation (OP) sound
on or off
The number of times of the operation
sound to be generated per minute
can be set in the Operation Sound
(times/min) for adult setting on the
SYSTEM SETUP screen. If it is
set to “Off”, the operation sound is
generated 100 times per minute.
(Administrator’s Guide: “AED
Setup”)

Recording Waveforms
The waveforms indicated below are stored in the internal memory as a waveform
report when electrical shock is delivered and can be recorded, as required.
“Report Recording” (p. 10-1-14)
A maximum of 2,000 seconds worth of various waveform reports

in total can be stored in the internal memory of the defibrillator. If
the total duration of data exceeds 2,000 seconds, the oldest record is
automatically deleted and a new record is stored.
ECG from 10 Seconds Before to 12 Seconds After an

Electrical Shock
Along with the discharge information, the ECG from 10 seconds before to 12
seconds after an electrical shock is automatically stored in the internal memory
of the defibrillator as a defibrillation report.
When the Record “Charging Start” After Discharge setting on the SYSTEM
SETUP screen is set to “On”, the ECG from the beginning of charging after a
discharge is automatically recorded.
Administrator’s Guide: “System Setup”
If the defibrillator is turned off before 22 seconds have passed after a discharge,
the corresponding defibrillation report is not stored.
To record waveforms other than those described above, press the record/stop key
to perform continuous recording.

6-2. Defibrillation
Defibrillation Using the External Paddles

How to perform defibrillation using the external paddles is described below.
WARNING WARNING
Before defibrillation, make sure that no one is in When using an ESU, use this defibrillator only in
contact with either the patient or any metal part of MONITOR mode and use the ECG electrodes for
any equipment or cables which supports or is monitoring. Do not monitor ECG with external
connected to the patient. Failure to follow this paddles or internal paddles. If ECG is monitored
warning causes serious electrical shock or injury. with paddles, high-frequency energy from the ESU
causes abnormal current to flow in the patient and
unexpected discharge. This may damage the
6
WARNING defibrillator.
other instruments and patches from the positions 6-2
paddle contacts such an object, the delivery of When performing defibrillation on a child, be
shock may be insufficient and cause a skin burn. careful of the selected energy. High energy may
NOTE: Select the appropriate energy and appropriate size of the external
paddles according to the patient. Only use the external paddles
specified by Nihon Kohden.
1 Follow the steps below for preparation of defibrillation.

Section 6-1 “Preparation before Defibrillation, Synchronized
1) Check the patient’s conditions.

2) Connect the external paddles.
If the patient is a small child, change the adult electrode plate to the
pediatric electrode plate, as required.
3) Turn the control dial to the DISARM position. Check that no error
message is displayed on the screen.
Even if the paddle contact lamp is lit in orange or yellow, electrical shock
Paddle contact lamp can be delivered. In such a case, clean the external paddles and the test-
discharge electrodes after use.
“External Paddles” (p. 12-32)
To use the defibrillator on AC power, check that the AC power lamp is lit.
AC power lamp

lights.
To use the defibrillator on battery power, check that there is enough

remaining power in the battery pack.
“Remaining Battery Power Display” (p. 4-8)

2 Check the mode indication and the ECG lead on the screen.
• Check that “MANUAL MODE” is displayed on the screen.
If “SYNC MODE” is displayed, press If “SYNC MODE” is displayed
the SYNC button to change the mode
indication to “MANUAL MODE”.
• Check that “PADDLE” is displayed as the ECG lead on the screen.

If “PAD” is displayed, connect the external paddles.
Lead: PADDLE
Mode indication: MANUAL MODE
3 Pick up the external paddles from the paddle holders then uniformly apply
contact gel (GELAID) to the electrode plate surface of each paddle.
WARNING
Apply contact gel only to the electrode plates of the
external paddles. Otherwise, it may cause electrical
shock to the operator.
WARNING
Do not hold the paddle handles if your hands are
wet or have contact gel on them. This may cause
electrical shock to the operator.
CAUTION
To prevent skin burn on the patient, apply contact
gel evenly to the electrode plates of the external
paddles.

6-2. Defibrillation
4 Turn the control dial to the desired energy position.
WARNING
small.
STERNUM
paddle 5 Press the paddles on the patient.
1) Place the paddles on the chest of the patient. 6
Place the left (STERNUM) paddle on the right side of the sternum and
below the clavicle, and the right (APEX) paddle at the level of fifth
intercostal space and midaxillary line. 6-2
CAUTION
APEX paddle moisture off the skin so that the paddles or pads
will not short-circuit each other. Otherwise, delivery
Placement of the external paddles
NOTE: Do not lean against the paddles when pressing them on the
patient. A paddle may slip and cause injury.
2) Confirm that the patient’s ECG being displayed on the screen has a
shockable rhythm, such as ventricular fibrillation, for defibrillation.
ECG
NOTE: If the patient’s ECG indicates need for synchronized

cardioversion, follow the procedure for synchronized
cardioversion.
“Synchronized Cardioversion Using the External Paddles”

(p. 6-3-5)

intermittently.
CHARGING
When charging is completed, the message “CHARGED” and some guidance

The shock buttons flash. the shock buttons on the external paddles start flashing.
electrical shock
Example: Wrong way of

holding the external paddle For safety, the defibrillator automatically internally discharges charged
energy when the charge holding time passes.
The charge holding time can be set in the Charge Holding Time setting
on the SYSTEM SETUP screen. (Default value: 40 seconds)
Refer to the Administrator’s Guide “System Setup”.
WARNING
electrical shock.
WARNING
shock.
To change the energy level after charging is completed

Turn the control dial to the desired energy position.
The defibrillator starts adjusting the energy one second after the new energy
value is selected.

6-2. Defibrillation
When defibrillation becomes unnecessary after charging is completed

Turn the control dial to the DISARM
or OFF position..
Paddle contact lamp

7 Press the paddles against the paddle placement areas so that the paddle
contact lamp on the STERNUM paddle lights in green.
The paddle contact lamp indicates the status of the transthoracic resistance of
the patient via the external paddle.
The paddle contact lamp might not light in green for some patients, but even
if the lamp is lit in yellow or orange, electrical shock can be delivered. 6
“Contact Impedance between Skin and the External Paddles’
Electrodes” (p. 6-1-21)”
6-2
8 Deliver an electrical shock.

STERNUM 1) Check the patient’s conditions and the charged energy level again.
paddle
NOTE: Before discharge, be sure to check the charged energy
level again.
electrical shock
2) Simultaneously and firmly press the shock buttons on the external paddles
APEX paddle to deliver an electrical shock.
If another defibrillation is required, perform necessary medical treatment
then repeat steps 3 to 8.
Simultaneously and firmly press
the shock buttons on both external
paddles. WARNING
Before discharging, confirm that the paddles or
pads are firmly pressed against the chest wall.
Failure to follow this warning may cause skin burn
or insufficient delivery of shock.
CAUTION
Do not discharge the energy if the electrodes of
paddles are short-circuited to each other by
the heart.
NOTE • Never deliver electrical shock while the electrodes of the

be damaged.
• When the external paddles or internal paddles (with switch)
Contact gel (GELAID) are used, a discharge is not executed when the SHOCK
button on the front panel of the defibrillator is pressed.

Quick Holders
You can temporarily place the external paddles on the edges (quick holders)
of the paddle holders of the defibrillator while you are performing other CPR
treatments.
Use the gap between the electrode plate and the guard of an external paddle
to put it on the edge of a paddle holder, as shown in the figure below.
With the use of the quick holders, cleanliness is facilitated, because contact
gel (GELAID) on the external paddles does not get on the test-discharge
electrodes of the defibrillator.
NOTE: The quick holders cannot be used when the pediatric
electrode plates are used (when the adult electrode plates are
not attached to the external paddles).
NOTE • Never disconnect the power cord while the “Saving data and
damaged.
• If the defibrillator is turned off before 22 seconds have
passed after a discharge, the corresponding defibrillation
report is not stored.
10 Thoroughly wipe off the contact gel (GELAID) from the electrode plates of
the external paddles then return and gently press the external paddles into the
paddle holders.
Return the paddles to the paddle

holders.

6-2. Defibrillation
Defibrillation Using the Disposable Pads

How to perform defibrillation using the disposable pads is described below.
WARNING WARNING
any equipment or cables which supports or is monitoring. Do not monitor ECG with disposable
connected to the patient. Failure to follow this pads. If ECG is monitored with pads, high- 6
warning causes serious electrical shock or injury. frequency energy from the ESU causes abnormal
current to flow in the patient and unexpected
discharge. This may damage the defibrillator.
WARNING 6-2
If the bag containing disposable pads is torn, do
not use the pads. Dispose of the pads. Failure to WARNING
follow this warning may lead to skin burns or
• Do not use the disposable pads if the gel has
insufficient delivery of shock.
become dry.
become abnormal (the gel has become liquified
WARNING or is coming out of the edges of the pad, etc.).
Do not use the disposable pads if they are past the Failure to follow these warnings may cause skin
expiration date on the package. Failure to follow burn or insufficient delivery of shock.
delivery of shock.
WARNING
WARNING brown or dark-brown gel is on the protective sheet.
Use disposal pads as soon as possible after Use of such pads may cause insufficient delivery of
opening the package. Failure to follow this warning shock or skin burn where the pads are attached.
shock.
WARNING
WARNING careful of the selected energy. High energy may
Do not reuse disposable pads. Failure to follow this cause critical damage to the cardiac muscle.
delivery of shock.
CAUTION CAUTION
Do not place heavy objects on the disposable pads When disposable pads are attached to a patient,
or bend the pads. The pads may become damaged replace them every 24 hours. After 24 hours, the
and deteriorated, resulting in skin burn on the gel becomes dry and this may reduce performance
patient. of the pads.
CAUTION

NOTE • Always have spare disposable pads. Use the spare pads if the
gel of the pads becomes dry, deteriorated, or discolored.
Deteriorated means:
- The gel has become liquefied.
- The gel is coming out of the edges of the pad.
Discolored means:
-T he color of the gel changes to brownish-red, and brownish
gel is attached to the protection sheet.
• If the gel is accidentally removed from the pad together with the
sheet or if a metal part becomes exposed, be sure to use a new
disposal pads.
• Select the appropriate energy and appropriate size of the
disposable pads according to the patient. Only use the
disposable pads specified by Nihon Kohden.

NOTE: Firmly attach the disposable pads to the patient’s body. If they
2) Connect the disposable pads.
• Connect the pad adapter (TEC-5621, TEC-5631).
• Attach the disposable pads to the patient.
• Connect the disposable pads to the pad adapter or pad connector.
AC power lamp

lights.
To use the defibrillator on battery power, check that there is enough remaining
power in the battery pack.

6-2. Defibrillation
2 Check the mode indication, the ECG lead, and the ECG on the screen.
If “SYNC MODE” is displayed, press
the SYNC button to change the mode If “SYNC MODE” is displayed
indication to “MANUAL MODE”.
• Check that “PAD” is displayed as the ECG lead on the screen.

If “PADDLE” is displayed, connect the disposable pads.
• Confirm that the patient’s ECG being displayed on the screen has a
shockable rhythm, such as ventricular fibrillation, for defibrillation.
6
6-2
ECG
Confirm that the patient’s ECG has a
shockable rhythm, such as ventricular
fibrillation, for defibrillation. Lead: PAD

cardioversion.
“Synchronized Cardioversion Using the Disposable Pads” (p. 6-3-12)

defibrillator.
NOTE: If a disposable pad is detached from the patient, charging
does not start even if the CHARGE/AED button is pressed.
If a disposable pad becomes detached after charging starts,
the defibrillator automatically discharges energy internally for
safety.
intermittently.
CHARGING


The SHOCK
button flashes. are displayed on the screen, and a continuous beep sounds. The SHOCK
button starts flashing at the same time.
Energy value
CHARGED for electrical
shock
For safety, the defibrillator automatically internally discharges charged

WARNING
WARNING
shock.

value is selected.
Turn the control dial to the DISARM or OFF position.

6-2. Defibrillation

1) Check the patient’s conditions and the charged energy level again.
level again.
Energy value
shock
2) Firmly press the flashing SHOCK button to deliver electrical shock.

6
6-2
WARNING
CAUTION
the heart.
damaged.
7 Dispose of the disposable pads.

1) Detach the disposable pads from the chest of the patient.
2) Disconnect the disposable pads from the pad adapter or pad connector.
3) Return the disposable pads to their package and dispose of them.
“Disposable Pads (Option)” (p. 12-28)”

Defibrillation Using the Internal Paddles

How to perform defibrillation using the internal paddles (ND-890V series or
ND-860V series) is described below.
By directly applying the internal paddles to the heart, defibrillation at low energy
level is available during open chest surgery.
Refer to the manual of the internal paddles to be used, as well.
ND-890V Series (With Switch) ND-860V Series (Without Switch)
Shock button
WARNING WARNING
CAUTION CAUTION
Sterilize the internal paddles before use. Failure to Pay careful attention to the selected energy when
sterilize the paddles may cause serious infection. using internal paddles. Applying high energy to the
heart may cause cardiac muscle necrosis. Low
energy is recommended.
CAUTION
Do not twist the internal paddle while holding the
electrode or impact strong impact to the paddle.
NOTE: Select the appropriate energy and appropriate size of the internal
paddles according to the patient. Only use the internal paddles

6-2. Defibrillation


2) Connect the internal paddles.
AC power lamp

or battery operation mark 6-2
lights.

2 Check the mode indication and the ECG lead on the screen.
If “SYNC MODE” is displayed, press the SYNC button to change the
mode indication to “MANUAL MODE”.
• Check that “PADDLE” is displayed as the ECG lead on the screen.

If “PAD” is displayed, connect the internal paddles.
Lead: PADDLE

NOTE: For the internal paddles, the selectable energy level is 50 J
or less. If the energy level is set to 70 J or higher, charging
cannot be performed.


defibrillator.
intermittently.
CHARGING

are displayed on the screen, and a continuous beep sounds.
Example: When the ND-890V Series is Used

Energy value
shock
When the ND-860V Series is Used When the ND-860V series internal paddles are used, the SHOCK button
The SHOCK starts flashing at the same time.
button flashes.
WARNING
When charging or discharging, grip the internal
paddles between the cable and the guard at the
top of the handle. If the internal paddles are
WARNING
shock.

6-2. Defibrillation

value is selected.
If the energy level is changed to 70 J or higher, the defibrillator automatically
internally discharges charged energy.
Turn the control dial to the DISARM or
OFF position.
Handles 5 Place the electrodes of the internal paddles on both auricles of the patient’s 6-2
heart as if holding the heart with the paddles. Confirm that the patient’s ECG
has a shockable rhythm, such as ventricular fibrillation, for defibrillation.
For better contact between the electrodes of the internal paddles and heart,
place sterilized gauze moistened with physiological saline solution between
Guard each electrode and the area of the heart.
ECG
Grip each internal paddle between the cable Confirm that the patient’s ECG has a shockable rhythm, such
and the guard at the top of the handle. as ventricular fibrillation, for defibrillation.

cardioversion.
“Synchronized Cardioversion Using the Internal Paddles”
(p. 6-3-19)

level again.
electrical shock

When the ND-860V Series is Used 2) Deliver an electrical shock.

Firmly hold the paddle handles until discharge is completed.
When the ND-860V series internal paddles are used
Firmly press the flashing SHOCK button on the defibrillator to deliver
electrical shock.
When the ND-890V series internal paddles (with switch) are used
Firmly press the shock button on the handle of an internal paddle to deliver
electrical shock.
When the ND-890V Series is Used
NOTE • The shock button on the handle of an internal paddle does
Shock button
not flash.
are used, a discharge is not executed when the SHOCK
WARNING
paddles are firmly positioned against the heart.
WARNING
Do not discharge with the paddles in the air. This
may cause electrical shock or damage the
defibrillator.

be damaged.
damaged.
8 Disconnect the internal paddles from the defibrillator. Wash off any blood
from the internal paddles and sterilize them.
• “Disconnecting Paddles/Pads (TEC-5621, TEC-5631)” (p. 6-1-3)
• “Internal Paddles” (p. 12-32)
• Manual of the internal paddles to be used

6-3 Synchronized
Cardioversion
6
Introduction...................................................................6-3-2
Flow of Operation....................................................................... 6-3-2 6-3
Screen Example......................................................................... 6-3-3
Recording Waveforms................................................................ 6-3-4

Paddles........................................................................6-3-5
Synchronized Cardioversion Using the Disposable

Pads...........................................................................6-3-12
Synchronized Cardioversion Using the Internal

Paddles......................................................................6-3-19
Using Paddle/Pad-Lead ECG as the Synchronizing

Signal.........................................................................6-3-25
Introduction
Synchronized cardioversion is a method for delivering electrical shock with appropriate
timing after detecting a patient’s QRS wave, and it is used for elimination of atrial
fibrillation, etc.
The operator sets the output energy value, charges the defibrillator for any timing,
then holds the SHOCK button pressed. The defibrillator will deliver electrical shock in
synchronization with the QRS wave detected first.
External paddles, internal paddles, or disposable pads can be used with the defibrillator.
Flow of Operation
Preparation (Refer to Section 6-1.) Cardioversion
Check the patient’s conditions. Select the ECG lead then press the SYNC button.
Connect the paddles/pads. • Check that “SYNC MODE” is displayed on the screen.
Connect the paddles/pads to be used. • Check that the “ ” lines indicating the
External paddles synchronization position are displayed at the
rising part of each QRS wave of the ECG
If the patient is a small child, change
the adult electrode plates to the External paddles: Apply contact gel to the electrode
pediatric electrode plates. plate surface of each paddle.
Disposable pads
Select the energy level.
Connect in the For internal paddles, the selectable energy
following steps: level is 50 J or less.
1) Connect the pad
adapter (TEC-5621, TEC-5631).
2) Attach the disposable pads to the
patient.
3) Connect the disposable pads to the External paddles: Press the paddles on the patient.
pad adapter or pad connector.
Press the CHARGE/AED button.
Internal paddles
Charging starts and beeps will sound intermittently.
or
Set the control dial to DISARM.
Check that no External paddles
error message is
displayed on the The message “CHARGED” and some guidance are
screen. displayed on the screen.
When charging is completed, a continuous beep sounds.
Internal paddles: Position the internal paddles against

Measure the ECG to be used for the heart then check the ECG.
synchronization.
Measure the ECG to be used as Check patient’s conditions again, then hold the SHOCK
the synchronizing signal with the button(s) pressed firmly.
defibrillator.
• To use an ECG from an external
monitor as a synchronizing signal,
connect the external monitor and
the defibrillator and check the delay External paddles • Disposable pads
time for synchronized cardioversion ND-890V series
• ND-860V series
beforehand.
• In a case of emergency defibrillation,
the paddle/pad-lead ECG can be used
as a synchronizing signal. Check the effect of the electrical shock then deliver another
electrical shock, if required.

6-3. Synchronized Cardioversion
Screen Example
The figure below is a screen example for when the external paddles are used.
ARRHYTHMIA ANALYSIS OFF
When PADDLE is selected as the lead (the external paddles or internal
paddles are used), arrhythmia analysis is always set to “OFF”. For other
leads, arrhythmia analysis is set to “OFF” when the VF/VT alarm is set to
“OFF”.
When the arrhythmia analysis is set to “OFF”, the message
“ARRHYTHMIA ANALYSIS OFF” is displayed on the screen.

The arrhythmia alarm does not sound during cardioversion, regardless of
the alarm setting.
6
When PADDLE is selected as the lead (the external paddles or internal
paddles are used), no arrhythmia alarm sounds. For other leads, only the
VF/VT alarm can be set to “ON”.
The arrhythmia mark “ ” is displayed only when the optional QS-831V
is installed. 6-3
Synchronization position “ ”
To be displayed at the rising
part of each QRS wave
ECG mark and AC power mark
QRS sync mark Scale

Lead of
displayed
Heart rate waveform
Guidance
To be displayed upon
completion of charging
Function keys
• [LEAD]
displayed
• [SENSITIVITY]
being displayed Mode indication: SYNC MODE CHARGING or CHARGED
• [EVENT]
Recording” on p. 10-1-8.
• [OP SOUND]
For turning the operation (OP) sound
on or off
Number of discharges Charged energy
The number of times of the operation
sound to be generated per minute
can be set in the Operation Sound
(times/min) for adult setting on the
SYSTEM SETUP screen. If it is
set to “Off”, the operation sound is
generated 100 times per minute.
(Administrator’s Guide: “AED
Setup”)

Recording Waveforms
The waveforms indicated below are stored in the internal memory as a waveform
report when electrical shock is delivered and can be recorded, as required.
Section 10-1 “Report Recording” (p. 10-1-14)


Electrical Shock
Along with the discharge information, the ECG from 10 seconds before to
12 seconds after an electrical shock is automatically stored in the internal
memory of the defibrillator as a defibrillation report.
If the defibrillator is turned off before 22 seconds have passed after a discharge,
the corresponding defibrillation report is not stored.
To record waveforms other than those described above, press the record/stop key
to perform continuous recording.


Paddles
How to perform synchronized cardioversion using the external paddles is
described below.
WARNING WARNING
6
6-3
other instruments and patches from the positions
paddle contacts such an object, the delivery of Check that the vertical dotted line indicating
shock may be insufficient and cause a skin burn. synchronization position is displayed on the rising
slope of every QRS wave (between the Q and R
points). If the position of the vertical dotted line is
WARNING incorrect, adjust the position as follows:
Confirm that there is no artifact on the ECG.
with the [SENSITIVITY] function key.
Artifact may be misinterpreted as QRS and
discharge might not synchronize with the patient’s
key.
QRS.
WARNING properly and may cause ventricular fibrillation to
When performing defibrillation on a child, be the patient.
CAUTION
When performing synchronized cardioversion,
confirm that SYNC MODE is displayed on the
defibrillator screen before every discharge.
Depending on the setting made on the SYSTEM
SETUP screen, the defibrillator automatically
NOTE • Select the appropriate energy and appropriate size of the

external paddles according to the patient. Only use the external
paddles specified by Nihon Kohden.
• After SYNC mode is selected, if the control dial setting is
changed to MONITOR, PACING, AED, SETUP, or BASIC
CHECK, the defibrillator exits SYNC mode.
1 Follow the steps below for preparation of synchronized cardioversion.



2) Connect the external paddles.
If the patient is a small child, change the adult electrode plate to the
pediatric electrode plate, as required.
Paddle contact lamp 3) Turn the control dial to the DISARM position. Check that no error
Even if the paddle contact lamp is lit in orange or yellow, electrical shock
can be delivered. In such a case, clean the external paddles and the test-
discharge electrodes after use.
Section 12 “External Paddles” (p. 12-32)
4) Measure the ECG to be used as synchronizing signal with the defibrillator.

• The ECG being measured by another monitor can be used as a
Refer to Section 6-1 “Using an ECG from an External Monitor as a
Synchronizing Signal” (p. 6-1-14).
• In a case of emergency synchronized cardioversion, the paddle-lead
ECG can be used as a synchronizing signal.
Refer to “Using Paddle/Pad-Lead ECG as the Synchronizing Signal”
(p. 6-3-25).
AC power lamp
Either of the battery

charging or battery
operation mark lights.

Section 4 “Remaining Battery Power Display” (p. 4-8)
2 Press the [LEAD] key to select the lead of the ECG to be used as the
When the ECG to be used as a synchronizing signal is measured with the
defibrillator, a Lead II signal is usually used so that the highest-amplitude
QRS wave can be obtained.
Section 8-1 “Setting the Monitoring Leads” (p. 8-1-14)
When an ECG from an external monitor is to be used as the synchronizing

signal, select “AUX” as the ECG lead.
When the paddle-lead ECG is to be used as a synchronizing signal, select
“PADDLE” as the lead.
Lead

NOTE • Select a lead so that the whole waveform is displayed on the

screen and the T waveform is not much larger than the QRS
waveform. Otherwise, QRS cannot be recognized correctly.
• If the defibrillator miscounts a narrow-width QRS, set the
PACING REJECT setting in ECG SETUP in the SETUP window
to "OFF" and confirm that the QRS is correctly recognized.
positions.
6
WARNING
Check that the vertical dotted line indicating
synchronization position is displayed on the rising 6-3
key.
the patient.
Check that the “ ” lines are indicated at the rising part of each QRS
wave.
NOTE • SYNC mode cannot be selected when the control dial is set to
the MONITOR, PACING, or AED position.

4 Pick up the external paddles from the paddle holders then uniformly apply
contact gel (GELAID) to the electrode plate surface of each paddle.
WARNING
Apply contact gel only to the electrode plates of the
external paddles. Otherwise, it may cause electrical
shock to the operator.
WARNING
Do not hold the paddle handles if your hands are
wet or have contact gel on them. This may cause
electrical shock to the operator.
CAUTION
To prevent skin burn on the patient, apply contact
gel evenly to the electrode plates of the external
paddles.
WARNING
small.
STERNUM
paddle
6 Place the paddles on the chest of the patient.
Place the left (STERNUM) paddle on the right side of the sternum and
below the clavicle, and the right (APEX) paddle at the level of fifth
intercostal space and midaxillary line.
CAUTION
moisture off the skin so that the paddles or pads
APEX paddle will not short-circuit each other. Otherwise, delivery
Placement of the external paddles

NOTE: Do not lean against the paddles when pressing them on the
patient. A paddle may slip and cause injury.

Paddle contact
lamp 7 Press the paddles against the paddle placement areas so that the paddle
contact lamp on the STERNUM paddle lights in green.
The paddle contact lamp indicates the status of the transthoracic resistance of
the patient via the external paddle.
The paddle contact lamp might not light in green for some patients, but even
if the lamp is lit in yellow or orange, electrical shock can be delivered.
Section 6-1 “Contact Impedance between Skin and the External
Paddles’ Electrodes” (p. 6-1-21)
6
intermittently.
CHARGING
6-3
The energy value increases

the shock buttons on the external paddles start flashing.
The shock buttons flash.
Energy value
shock
Example: Wrong way of holding the

external paddle WARNING
electrical shock.
WARNING
shock.


value is selected.
OFF position.
STERNUM 1) Check the patient’s conditions and the charged energy level again.
paddle
level again.
Energy value for
electrical shock
2) Simultaneously and firmly press the shock buttons on the external paddles
to deliver an electrical shock.
Hold the shock buttons pressed with the external paddles pressed against
the patient’s chest until electrical shock is delivered, because discharge is
APEX paddle performed when the first synchronization point is detected after the shock
buttons are pressed.
If another cardioversion is required, perform necessary medical treatment
Simultaneously and firmly press then repeat steps 5 to 9.
the shock buttons on both external
paddles. If the Sync Mode after CV setting on the SYSTEM SETUP screen is
set to “Defib”, the defibrillation mode changes to “MANUAL MODE”
after an electrical shock is delivered.
WARNING
CAUTION
the heart.
NOTE • Never deliver electrical shock while the electrodes of the

be damaged.
Contact gel (GELAID)

Quick Holders
You can temporarily place the external paddles on the edges (quick holders)
of the paddle holders of the defibrillator while you are performing other CPR
treatments.
Use the gap between the electrode plate and the guard of an external paddle
to put it on the edge of a paddle holder, as shown in the figure below.
With the use of the quick holders, cleanliness is facilitated, because contact
gel (GELAID) on the external paddles does not get on the test-discharge
electrodes of the defibrillator.
NOTE: The quick holders cannot be used when the pediatric
electrode plates are used (when the adult electrode plates are
not attached to the external paddles). 6
is displayed. Otherwise, the data in the defibrillator may be 6-3
damaged.
11 Thoroughly wipe off the contact gel (GELAID) from the electrode plates of
the external paddles then return and gently press the external paddles into the
paddle holders.
Dispose of the ECG electrodes used in synchronized cardioversion, referring
to the provided manuals for each item.
Return the paddles to the
paddle holders.


Disposable Pads
How to perform synchronized cardioversion using the disposable pads is
described below.
WARNING WARNING
connected to the patient. Failure to follow this pads. If ECG is monitored with pads, high-
WARNING
follow this warning may lead to skin burns or
insufficient delivery of shock.
become dry.
become abnormal (the gel has become liquified
WARNING or is coming out of the edges of the pad, etc.).
Do not use the disposable pads if they are past the Failure to follow these warnings may cause skin
expiration date on the package. Failure to follow burn or insufficient delivery of shock.
delivery of shock.
WARNING
WARNING brown or dark-brown gel is on the protective sheet.
Use disposal pads as soon as possible after Use of such pads may cause insufficient delivery of
opening the package. Failure to follow this warning shock or skin burn where the pads are attached.
shock.
WARNING
WARNING careful of the selected energy. High energy may
Do not reuse disposable pads. Failure to follow this cause critical damage to the cardiac muscle.
delivery of shock.
WARNING
Artifact may be misinterpreted as QRS and
discharge might not synchronize with the patient’s
QRS.

WARNING
synchronization position is displayed on the rising
key.
synchronized cardioversion may not be performed 6
the patient.
CAUTION CAUTION 6-3

When performing synchronized cardioversion, When disposable pads are attached to a patient,
confirm that SYNC MODE is displayed on the replace them every 24 hours. After 24 hours, the
defibrillator screen before every discharge. gel becomes dry and this may reduce performance
Depending on the setting made on the SYSTEM of the pads.
CAUTION
Do not place heavy objects on the disposable pads
or bend the pads. The pads may become damaged
CAUTION and deteriorated, resulting in skin burn on the
Do not attach a disposable pad over another pad. patient.
NOTE • Always have spare disposable pads. Use the spare pads if
the gel of the pads becomes dry, deteriorated, or discolored.
Deteriorated means:
Discolored means:
- The color of the gel changes to brownish-red, and
brownish gel is attached to the protection sheet.
• If the gel is accidentally removed from the pad together with
the sheet or if a metal part becomes exposed, be sure to
use a new disposal pads.
• Select the appropriate energy and appropriate size of the
disposable pads according to the patient. Only use the
disposable pads specified by Nihon Kohden.



• In a case of emergency synchronized cardioversion, the pad-lead ECG
can be used as a synchronizing signal.
(p. 6-3-25).
AC power lamp

lights.


When the pad-lead ECG is to be used as a synchronizing signal, select
“PAD”.
Lead

PACING REJECT setting in ECG SETUP in the SETUP
window to “OFF” and confirm that the QRS is correctly
recognized.
positions.
WARNING
points). If the position of the vertical dotted line is 6
key. 6-3
the patient.
Check that the “ ” lines are indicated at the rising part of
each QRS wave.
NOTE • SYNC mode cannot be selected when the control dial is set
to the MONITOR, PACING, or AED position.


defibrillator.
NOTE: If a disposable pad is detached from the patient, charging
does not start even if the CHARGE/AED button is pressed.
If a disposable pad becomes detached after charging starts,
the defibrillator automatically discharges energy internally for
safety.
intermittently.
CHARGING
The SHOCK When charging is completed, the message “CHARGED” and some guidance
button flashes. are displayed on the screen, and a continuous beep sounds. The SHOCK
button starts flashing at the same time.
Energy value
shock
WARNING
WARNING
shock.


value is selected.
OFF position.

6
level again.
Energy value
CHARGED for electrical 6-3
shock
2) Firmly press the flashing SHOCK button to deliver electrical shock.

Hold the SHOCK button pressed until electrical shock is delivered,
because discharge is performed when the first synchronization point is
detected after the SHOCK button is pressed.
If the Sync Mode after CV setting on the SYSTEM SETUP screen is

WARNING
CAUTION
the heart.

damaged.

2) Disconnect the disposable pads from the pad adapter or pad connector.
Dispose of the ECG electrodes used for synchronized cardioversion,
referring to the provided manuals for each item.
Section 12 “Disposable Pads (Option)” (p. 12-28)


Paddles
How to perform synchronized cardioversion using the internal paddles (the ND-
890V series or ND-860V series) is described below.
By directly applying the internal paddles to the heart, defibrillation at low energy
level is available during open chest surgery.
Refer to the manual of the internal paddles to be used, as well.
ND-890V Series (With Switch) ND-860V Series (Without Switch) 6
6-3
Shock button
WARNING WARNING
When using an ESU, use this defibrillator only in Before defibrillation, make sure that no one is in
MONITOR mode and use the ECG electrodes for contact with either the patient or any metal part of
monitoring. Do not monitor ECG with external any equipment or cables which supports or is
paddles or internal paddles. If ECG is monitored connected to the patient. Failure to follow this
with paddles, high-frequency energy from the ESU warning causes serious electrical shock or injury.
defibrillator. WARNING
WARNING slope of every QRS wave (between the Q and R
Confirm that there is no artifact on the ECG. points). If the position of the vertical dotted line is
Artifact may be misinterpreted as QRS and incorrect, adjust the position as follows:
discharge might not synchronize with the patient’s • Change the amplitude of the ECG waveforms
QRS. with the [SENSITIVITY] function key.
key.
WARNING • Change the electrode position.
When performing defibrillation on a child, be If the position of the vertical dotted line is incorrect,
careful of the selected energy. High energy may synchronized cardioversion may not be performed
cause critical damage to the cardiac muscle. properly and may cause ventricular fibrillation to
the patient.
CAUTION CAUTION
When performing synchronized cardioversion, Pay careful attention to the selected energy when
confirm that SYNC MODE is displayed on the using internal paddles. Applying high energy to the
defibrillator screen before every discharge. heart may cause cardiac muscle necrosis. Low
Depending on the setting made on the SYSTEM energy is recommended.

CAUTION CAUTION
Sterilize the internal paddles before use. Failure to Do not twist the internal paddle while holding the
sterilize the paddles may cause serious infection. electrode or impact strong impact to the paddle.
NOTE: Select the appropriate energy and appropriate size of the internal
paddles according to the patient. Only use the internal paddles


2) Connect the internal paddles.
• In a case of emergency synchronized cardioversion, the paddle-lead
ECG can be used as a synchronizing signal.
(p. 6-3-25).
AC power lamp
Either of the battery

charging or battery
operation mark lights.


When the paddle-lead ECG is to be used as a synchronizing signal, select
“PADDLE” as the lead.

Lead
NOTE • Select a lead so that the whole waveform is displayed on

the screen and the T waveform is not much larger than the
QRS waveform. Otherwise, QRS cannot be recognized
correctly.
PACING REJECT setting in ECG SETUP in the SETUP
window to “OFF” and confirm that the QRS is correctly 6
recognized.
positions.
• Check that “SYNC MODE” is displayed on the screen. 6-3
WARNING
key.
the patient.
Check that the “ ” lines are indicated at the rising part of
each QRS wave.

NOTE • SYNC mode cannot be selected when the control dial is set
to the MONITOR, PACING, or AED position.



defibrillator.
intermittently.
CHARGING

are displayed on the screen, and a continuous beep sounds.
Example: When the ND-890V Series is Used
Energy value
shock
When the ND-860V Series is Used When the ND-860V series internal paddles are used, the SHOCK button starts
The SHOCK flashing at the same time.
button flashes.
WARNING
When charging or discharging, grip the internal
paddles between the cable and the guard at the
top of the handle. If the internal paddles are
WARNING
shock.


value is selected.
If the energy level is changed to 70 J or higher, the defibrillator automatically
internally discharges charged energy.
Turn the control dial to the DISARM or OFF position.
Handles
6 Place the electrodes of the internal paddles on both auricles of the patient’s
6-3
heart as if holding the heart with the paddles.
For better contact between the electrodes of the internal paddles and heart,
place sterilized gauze moistened with physiological saline solution between
each electrode and the area of the heart.
Guard

Grip each internal paddle between the
cable and the guard at the top of the 1) Check the patient’s conditions and the charged energy level again.
handle.
level again.
When the ND-860V series is Used
Energy value for
electrical shock
2) Deliver an electrical shock.

Firmly hold the paddle handles until discharge is completed.
Hold the shock button pressed until electrical shock is delivered, because
discharge is performed when the first synchronization point is detected
after the shock button is pressed.
When the ND-890V series is Used When the ND-860V series internal paddles are used
Shock button Firmly press the flashing SHOCK button on the defibrillator to deliver electrical
shock.
When the ND-890V series internal paddles (with switch) are Used
Firmly press the shock button on the handle of an internal paddle to deliver
electrical shock.
NOTE • The shock button on the handle of an internal paddle does
not flash.
If the Sync Mode after CV setting on the SYSTEM SETUP screen is

WARNING
paddles are firmly positioned against the heart.
WARNING
Do not discharge with the paddles in the air. This
may cause electrical shock or damage the
defibrillator.

be damaged.
damaged.
9 Disconnect the internal paddles from the defibrillator. Wash off any blood
from the internal paddles and sterilize them.
Dispose of the ECG electrodes used for synchronized cardioversion,
referring to the provided manuals for each item.
• Section 6-1 “Disconnecting Paddles/Pads (TEC-5621, TEC-5631)” (p. 6-1-3)

• Section 12 “Internal Paddles” (p. 12-32)
• Manual of the internal paddles to be used

Using Paddle/Pad-Lead ECG as the

Synchronizing Signal
In a case of emergency cardioversion, the paddle/pad-lead ECG can be used as a
The SYNC BY PADDLE setting in PADDLE SETUP in the SETUP window
must be set to “ON” beforehand.
Select “PADDLE” or “PAD” as the lead.
CAUTION 6
Synchronized cardioversion with the paddle lead
does not provide stable ECG because it is difficult
to hold the paddles steady. Artifact on the ECG
may be misinterpreted as QRS and discharge
might not synchronize with the patient’s QRS. 6-3

PACING REJECT setting in ECG SETUP in the SETUP window
to “OFF” and confirm that the QRS is correctly recognized.

6-4 AED
Introduction...................................................................6-4-2
Screen Example......................................................................... 6-4-2
AED Flowchart........................................................................... 6-4-3 6-4
AED Procedure............................................................6-4-4
Automatic Energy Charging Standard........................6-4-14
Various Operations.....................................................6-4-15
Pause Function........................................................................ 6-4-15
Timer Operation........................................................................ 6-4-16
Recording Waveforms.............................................................. 6-4-16
Introduction
With the TEC-5611, TEC-5621, TEC-5631, defibrillation in AED mode is
possible.
In AED mode, the defibrillator analyzes the patient’s ECG then judges whether
electrical shock is needed. If it judges that electrical shock is required, energy is
automatically charged to the level set beforehand. Electrical shock is delivered
by the operator, according to the displayed guidance.
In AED mode, only the disposable pads can be used.
NOTE • In AED mode, some alarms may be set to off. Do not monitor
the patient in AED mode for a long time.
• If the attached disposable pads are detached then reattached
3 times or more, AED operation is canceled and the CPR cycle
starts.
Screen Example
The screen example below is for AED for ADULT mode.
In AED mode, the arrhythmia alarms, except for the VF/VT alarm, are not
generated, regardless of the alarm setting.
The arrhythmia mark “ ” is displayed only when the optional QS-831V
is installed.
ECG mark and AC power mark
QRS sync mark Scale

Lead of displayed
waveform: PAD
Heart rate
Guidance
The operator follows
the guidance to be
displayed.
Function keys Timer
• [STOP TIMER],
[LAP MEASUREMENT]
For operation of the timer displayed
in the guidance area, refer to p. 6-4-16.
During pause During CPR
• [EVENT]
Recording” on p. 10-1-8.
Remaining time Remaining time CHARGING or
• [PAUSE START/STOP] for pause for CPR CHARGED
Press to enter pause mode during the
periods indicated below. The VF/VT
alarm is suspended during pause
mode.
• From the start of AED operation
until the CHARGE/AED button is
pressed (whether or not pause is
Mode indication: ADULT MODE or Number of Charged
available depends on the setting in
CHILD MODE discharges energy
AED Setup).
• During CPR
To release pause mode, press the key
again. (Refer to p. 6-4-15.)

6-4. AED
AED Flowchart
Automatic operation by the defibrillator
The messages shown in quotation marks
(“ ”) are guidance instructions.
Operation by the operator
Check the patient’s conditions then connect the
disposable pads. (Refer to Section 6-1.) Parameters in AED Setup in SYSTEM
SETUP
If the patient is a small child, set the control dial

Set the control dial to AED. to AED while holding the CHILD MODE button
pressed.
1
For details on the AED settings, refer to the Administrator’s
Off Guide. 6
Manual Analysis for 1st Discharge in AED Mode 1
2
Each parameter for AED can be set in AED Setup.
• Discharged Energy for Adult (J) or Discharged Energy for
On Child (J)
• Number of Discharges per Sequence
3
Each parameter for CPR can be set in AED Setup.
• CPR Cycles per Sequence (for adults/children)
Check the patient’s • Operation Sound (times/min) (for adults/children)
conditions then press the • Number of Chest Compressions (for adults/children)
AED operation 2
• Number of Rescue Breaths (for adults/children) 6-4

CHARGE/AED button.4 4
If a shockable rhythm is detected before the CHARGE/AED
button is pressed, a VF/VT alarm is generated and the message
“Press AED button” is displayed in the guidance area.
“Do not touch patient.”

Nonshockable rhythm
detected
AED analysis (VF/VT analysis) starts.
“Analyzing heart rhythm. Do not
touch patient.”
Shockable rhythm
detected “No shock advised.”
On
Shock canceled.”
“Heart rhythm changed.
VF/VT Analysis when Heart Rhythm Changes 1
Charging starts.
“Shock advised. Charging.” Off “It is safe to touch patient. Start
detected
rhythm
Nonshockable
CPR.”
Charging completed Start CPR. CPR3

“Do not touch patient. Press
the flashing SHOCK button.”
“Continue CPR.”
Check the
patient’s condition Continue CPR.
again, then firmly
press the SHOCK Five more chest compressions
button.
“Do 5 more chest compressions.
Do not touch patient.”
“Shock delivered.”
End of
sequence Perform 5 more chest
During a sequence compressions then stop CPR.
Off, Each Sequence

Off
Manual Analysis for 2nd or Later Discharge in AED Mode1 Manual Analysis for 2nd or Later Discharge in AED Mode1
Each Shock Each Shock, Each Sequence

AED Procedure
How to perform defibrillation in AED mode is described below.
WARNING WARNING
connected to the patient. Failure to follow this pads. If ECG is monitored with pads, high-
WARNING
follow this warning may lead to skin burns or Do not use the disposable pads if they are past the
insufficient delivery of shock. expiration date on the package. Failure to follow
delivery of shock.
WARNING
opening the package. Failure to follow this warning WARNING
may lead to skin burn or insufficient delivery of Do not reuse disposable pads. Failure to follow this
shock. warning may lead to skin burn or insufficient
delivery of shock.
WARNING
Do not use the disposable pads if the gel is dark WARNING
brown or dark-brown gel is on the protective sheet. When performing defibrillation on a child, be
Use of such pads may cause insufficient delivery of careful of the selected energy. High energy may
shock or skin burn where the pads are attached. cause critical damage to the cardiac muscle.
WARNING WARNING
• Do not use the disposable pads if the gel has When the patient is a child age 0 to 7, perform
become dry. defibrillation in AED mode (child mode).
• Do not use the disposable pads if the gel has When using the defibrillation pads, make sure that
become abnormal (the gel has become liquified the pads do not touch each other.
burn or insufficient delivery of shock.
CAUTION CAUTION
When disposable pads are attached to a patient, When monitoring ECG with disposable pads,
replace them every 24 hours. After 24 hours, the check the polarity of the pads before attaching
gel becomes dry and this may reduce performance them on the patient. If the pad polarity is incorrect,
of the pads. the waveform appears upside-down and this may
delay of treatment.

6-4. AED
CAUTION CAUTION
Do not place heavy objects on the disposable pads Do not attach a disposable pad over another pad.
or bend the pads. The pads may become damaged It may cause skin burn on the patient.
and deteriorated, resulting in skin burn on the
patient.
CAUTION
The defibrillator may not be able to correctly
CAUTION analyze an ECG of a patient with an implanted
For some ECG waves, the defibrillator may pacemaker. For such a patient, follow a physician’s
incorrectly judge that defibrillation is not necessary. instructions.
When the defibrillator judges that defibrillation is
not necessary, it provides instructions for
performing CPR. In very rare cases, the 6
defibrillator may incorrectly judge that defibrillation
is necessary.
Deteriorated means: 6-4
Discolored means:
- The color of the gel changes to brownish-red, and brownish
disposal pads.
• Select the appropriate size of the disposable pads according
to the patient. Only use disposable pads specified by Nihon
Kohden.
• Although a VF or VT alarm is generated in monitor mode, such
an ECG might not be necessarily judged as a shockable rhythm
in AED mode.
1 Confirm that the patient is unconscious and has no respiration and no pulse.
CAUTION
Before ECG analysis or defibrillation, confirm that
the patient is unconscious and has no respiration
and no pulse.


AC power lamp To use the defibrillator on battery power, check that there is enough

lights.
To enter AED (ADULT MODE) 3 Turn the control dial to the AED position and check that “ADULT MODE”
is displayed in the mode indication area.
If the patient is a small child, turn the control dial to the AED position while
holding the CHILD MODE button pressed.
• Check that the error message “CHECK PADS” or “CHANGE PADS” is
not displayed on the screen.
• Check that displayed mode indication “ADULT MODE” or “CHILD
MODE” is correctly selected.
Set the control dial to AED.
• Check that “PAD” is displayed as the ECG lead on the screen.
To enter AED (CHILD MODE) NOTE: Only “PAD” is selectable as a lead.
Lead: PAD
While holding the CHILD

MODE button pressed, set the
Mode indication: ADULT MODE or CHILD MODE
control dial to AED.
WARNING
When the patient is a child age 0 to 7, perform
defibrillation in AED mode (child mode).
When using the defibrillation pads, make sure that
the pads do not touch each other.
NOTE: It may take several seconds for the waveforms to appear after
the control dial is set to the AED position.
Analysis during AED mode
In AED mode, even while the AED analysis is not performed, whether or not
a shockable rhythm appears in the ECG being measured is always analyzed.
“Automatic Energy Charging Standard” (p. 6-4-14)
If a shockable rhythm is detected before the AED analysis is started, a VF/

VT alarm is generated and the message “Press AED button” is displayed in
the guidance area.

6-4. AED
6
• A VF/VT alarm can be suspended by pressing the [PAUSE START/
STOP] key for entering pause mode. (Refer to p. 6-4-15.)
• If the Manual Analysis for 1st Discharge in AED Mode setting
in AED Setup is set to “Off”, the message “Press AED button” is
displayed and an AED analysis is automatically performed. For the
Manual Analysis for 2nd or Later Discharge in AED Mode setting in
AED Setup, refer to “AED Flowchart” (p. 6-4-3).
6-4
Administrator’s Guide: “AED Setup”
4 Check that the energy level displayed on the screen is appropriate.

The energy value for electrical shock can be set in Discharged Energy for
Adult (J) or Discharged Energy for Child (J) in AED Setup.
Energy value for electrical shock
5 Start an AED analysis.

1) Temporarily stop the lifesaving treatment such as CPR and keep the
patient at rest.
2) Press the CHARGE/AED button to start an AED analysis.
After the AED analysis is started, the message “Analyzing heart rhythm.
Do not touch patient” is displayed in the guidance area of the screen.
WARNING
While the defibrillator is analyzing the patient’s
ECG, stop CPR and do not move or shake the
patient’s body. If the patient is in a car, stop the car.
Otherwise, the defibrillator cannot analyze the
patient’s ECG correctly.

NOTE: Be careful handling the CHARGE/AED button, because

charging is automatically started when the CHARGE/AED
button is pressed.
• If the CHARGE/AED button is pressed during pause mode, pause is

canceled. (Refer to p. 6-4-15.)
• If the Manual Analysis for 1st Discharge in AED Mode setting in
AED Setup is set to “Off”, an AED analysis is automatically started.
For the Manual Analysis for 2nd or Later Discharge in AED Mode
setting in AED Setup, refer to “AED Flowchart” (p. 6-4-3).
The waveforms during an AED (VF/VT) analysis is automatically stored in

the internal memory of the defibrillator as a VF report, along with the result
of the analysis.
A maximum of 2,000 seconds worth of various waveform reports in total can
be stored in the internal memory of the defibrillator. If the total duration of
data exceeds 2,000 seconds, the oldest record is automatically deleted and a
new record is stored.
3) If a shockable rhythm is detected during an AED (VF/VT) analysis, the

message “Shock advised. Charging” is displayed in the guidance area and
beeps sounds intermittently.
If only a nonshockable rhythm is detected, the defibrillator
automatically discharges the charged energy internally, and the
messages indicated below will be displayed in the guidance area. Start
CPR as described in step 7.
• “No shock advised.”
• “It is safe to touch patient. Start CPR.”
CHARGING
WARNING
WARNING
shock.

6-4. AED
CAUTION
Asystole is not judged as a shockable rhythm.
NOTE • If a disposable pad becomes detached after charging starts,

the defibrillator automatically discharges energy internally
for safety.
• If the amplitude of a waveform is very small, the waveform
may be judged as that for asystole, in which case automatic
energy charging might not be performed. (The automatic
energy charging standards are ventricular fibrillation with
average amplitude not less than 0.1 mV or ventricular 6
tachycardia with heart rate not less than 180 bpm.)
• In a case where small-amplitude ventricular fibrillation is not
judged to be a shockable rhythm, with continuing CPR the
amplitude of ventricular fibrillation may become large and
reanalysis may advise defibrillation. Therefore, continue
appropriate treatment, following the physician’s instructions. 6-4
• Be fully careful of any ECG changes right before and after
charging starts.
• If nonshockable rhythm is detected during charging or after
charging is completed, the charged energy is automatically
discharged internally.
• Automatic charging might not be performed if there are
waveforms similar to QRSs in the ventricular fibrillation
waveforms or if there are sharp QRSs in the ventricular
tachycardia waveforms.
• If there is noise similar to VF waveforms due to static
electricity or chest compression, automatic charging may be
performed for a patient with asystole.
• Although a VF or VT alarm is generated in monitor mode,
such an ECG might not be necessarily judged as a
shockable rhythm in AED mode.
The SHOCK 4) When charging is completed, the message “CHARGED” and some
button flashes. guidance are displayed on the screen, and a continuous beep sounds. The
SHOCK button starts flashing at the same time.
Energy value
shock


When defibrillation becomes unnecessary during charging or after

charging is completed
If nonshockable rhythm is detected during charging or after charging is
completed, the defibrillator automatically discharges internally.
“Automatic Energy Charging Standard” (p. 6-4-14)
To stop delivering electrical shock because, for example, the patient’s pulse,
consciousness, and respiration are restored or a sudden change in patient’s
ECG is recognized, turn the control dial to the DISARM or OFF position.

1) Check that the displayed mode indication “ADULT MODE” or “CHILD
MODE” is appropriate.
Mode indication: ADULT MODE or

CHILD MODE
2) Check that the SHOCK button is flashing.

3) Firmly press the SHOCK button to deliver an electrical shock, following
the physician’s instruction.
NOTE: • Firmly press the SHOCK button.
• Never deliver electrical shock while the electrodes of the
pads are in contact with each other. The defibrillator may
be damaged.
WARNING WARNING
Before defibrillation, make sure that no one is in Before defibrillation and cardioversion, remove
contact with either the patient or any metal part of from the patient all electrodes, probes and trans-
any equipment or cables which supports or is ducers from connectors that do not have a “ ” or
connected to the patient. Failure to follow this “ ” mark. Otherwise, the operator may receive
warning causes serious electrical shock or injury. electrical shock and the connected instrument may
be damaged.
WARNING
Before defibrillation, remove everything including WARNING
electrodes and patches from the patient’s chest. If Before defibrillation and cardioversion, check that
the defibrillator paddle/pad contacts an object on the cords and cables of the electrodes and trans-
the patient’s chest, the discharged energy may be ducers attached to the patient are properly
insufficient and cause skin burn. connected to the defibrillator. Touching the metal
parts of the disconnected cords and cables may
cause electrical shock or injury by discharged
energy.

6-4. AED
WARNING WARNING
Before discharging, confirm that the paddles or When charging or discharging, do not touch the
pads are firmly pressed against the chest wall. pads or connector. If you touch any other part of
Failure to follow this warning may cause skin burn the defibrillator during charging or discharging, you
or insufficient delivery of shock. will receive an electrical shock.
CAUTION CAUTION
Do not discharge the energy if the electrodes of If the patient’s body is wet, thoroughly wipe the
paddles are short-circuited to each other by moisture off the skin so that the paddles or pads
contact gel. Failure to follow this warning may will not short-circuit each other. Otherwise, delivery
cause skin burn or insufficient delivery of shock to of shock may be insufficient. 6
the heart.
Along with the discharge information, the ECG from 10 seconds before to
12 seconds after an electrical shock is automatically stored in the internal
memory of the defibrillator as a defibrillation report.
Section 10-1 “Report Recording” (p. 10-1-14) 6-4
When the Record “Charging Start” After Discharge setting on the

SYSTEM SETUP screen is set to “On”, the ECG from the beginning of
charging after a discharge is automatically recorded.
4) The message “Shock delivered” is displayed, and the energy value

changes to that for the next discharge.
The energy values for the first to third discharges can be set in the
Discharged Energy for Adult (J) or Discharged Energy for Child (J)
setting in AED Setup.
The energy value for the fourth or subsequent discharges is the same as
that for the third discharge.
NOTE: If the defibrillator reenters AED mode after it is switched to

another mode, the energy value is reset to that for the first
discharge.
Energy value for the next discharge
5) The message “It is safe to touch patient. Start CPR” is displayed in the
guidance area. Perform CPR, as required.

In a case where the number of discharges per sequence is 2 or more

If the Number of Discharges per Sequence setting in AED Setup is set to
“2” to “4”, repeat step 5 to step 4) of 6 as many times as the set number of
discharges per sequence.
7 Perform CPR.
1) After an electrical shock is delivered or when nonshockable rhythm is
detected, start CPR, following the guidance being displayed.
Each parameter for CPR can be set in AED Setup.
• CPR Cycles per Sequence (for adults/children)
• Operation Sound (times/min) (for adults/children)
• Number of Chest Compressions (for adults/children)
• Number of Rescue Breaths (for adults/children)
During CPR, the message “Continue CPR” and the remaining time for
CPR are displayed.
Remaining time for CPR
If electrical shock becomes necessary during CPR, press the CHARGE/

AED button. Start an AED analysis described in step 5.
• W hen the VF/VT Alarm during CPR setting made in AED Setup is
set to “On”, if VF/VT is detected, a VF/VT alarm is generated.
• If the [PAUSE START/STOP] key is pressed during CPR, the
defibrillator enters pause mode, which enables extension of CPR
duration and suspension of the VF/VT alarm. (Refer to p. 6-4-15.)
2) When the remaining number of chest compression becomes 5, the

message “Do 5 more chest compressions. Do not touch patient” is
displayed in the guidance area. Perform chest compression 5 times in
synchronization with the operation sound, then finish CPR.
8 If electrical shock is required after CPR, repeat step 5 and later steps.

6-4. AED
damaged.

2) Disconnect the disposable pads from the pad adapter or pad connector. 6
NOTE: Follow your local laws for disposing of medical waste.
6-4

Automatic Energy Charging Standard

During AED analysis, electrical shock is considered to be required for the ECGs
indicated below.
• Ventricular fibrillation (VF) with average amplitude not less than 0.1 mV
• Ventricular tachycardia (VT) with heart rate not less than 180 bpm
For ECGs other than those mentioned above and for the cases described below,
the defibrillator judges the following as nonshockable rhythms:
• Asystole
• Ventricular fibrillation (VF) with average amplitude less than 0.1 mV
• Ventricular tachycardia (VT) with heart rate less than 180 bpm
In the above-mentioned cases, automatic charging is not performed.
Perform appropriate treatment according to emergency lifesaving protocol.
If the patient’s condition changes, perform AED analysis again and follow the
physician’s instruction.
CAUTION
Asystole is not judged as a shockable rhythm.
NOTE • If the amplitude of an ECG waveform is very small, the

waveform may be judged as that for asystole and automatic
energy charging might not be performed. (The automatic energy
charging standards are ventricular fibrillation with average
amplitude not less than 0.1 mV or ventricular tachycardia with
heart rate not less than 180 bpm.)
• In a case where small-amplitude ventricular fibrillation is not
judged to be a shockable rhythm, with continuing CPR the
amplitude of ventricular fibrillation may become large and
reanalysis may advise defibrillation. Therefore, continue
appropriate treatment, following the physician’s instructions.
• Be fully careful of any ECG changes right before and after
charging starts.
• Automatic charging might not be performed if there are
waveforms similar to QRSs in the ventricular fibrillation
waveforms or if there are sharp QRSs in the ventricular
tachycardia waveforms.
• If there is noise similar to VF waveforms due to static electricity
or chest compression, automatic charging may be performed for
a patient with asystole.
in AED mode.

6-4. AED
Various Operations
Pause Function
If the [PAUSE START/STOP] key is pressed in the following cases, the
defibrillator enters pause mode and the [ ] mark and the remaining time for
pause is displayed on the screen:
The pause duration can be set in the Pause Time setting in AED Setup.
6
During AED Operation
In a case where pressing the CHARGE/AED button is required for starting
an AED analysis (whether or not the button must be pressed to start an AED
analysis can be set in AED Setup), if the [PAUSE START/STOP] key is pressed
anywhere from the start of AED operation to pressing of the CHARGE/AED
button, the VF/VT alarm is suspended. 6-4
Pause mode is automatically canceled when an AED analysis is started with

pressing of the CHARGE/AED button.
If automatic AED analysis is set (for example, when the Manual
Analysis for 1st Discharge in AED Mode setting or the Manual
Analysis for 2nd or Later Discharge in AED Mode setting in AED
Setup is set to “Off”), the [PAUSE START/STOP] key is disabled.
For details, refer to “AED Flowchart” (p. 6-4-3).
During CPR
If the [PAUSE START/STOP] key is pressed during CPR, the defibrillator enters
pause mode, regardless of the remaining time for CPR.
When the VF/VT Alarm during CPR setting in AED Setup is set to “Off”, a VF/
VT alarm is suspended.
The CPR cycle is finished when pause mode is canceled during CPR or when the
remaining time for pause becomes zero.
Remaining time for pause
The VF/VT alarm is

suspended during pause mode.
[PAUSE START/STOP]
For starting/canceling pause

Timer Operation
The timer that is displayed in the guidance area is automatically activated when
the defibrillator enters AED mode (for ADULT or CHILD) to indicate the
elapsed time in AED mode. You can use this timer for measuring the duration of
medical treatment.
To operate the timer, use the function keys.
Elapsed time in AED mode Lap time

Number of laps and lap time
LAP00 LAP01 LAP02
Elapsed time in AED mode

While the timer is operating
• [STOP TIMER]
For stopping the timer. While
the timer is stopped, the [LAP
MEASUREMENT] key is switched to
[RESET TIMER].
• [LAP MEASUREMENT]
For measuring the lap time.
The number of laps and lap time being
displayed is updated.
While the timer is stopped

• [START TIMER]
For resuming timer operation
• [RESET TIMER]
For resetting the timer
Recording Waveforms
In AED mode, the waveforms indicated below are stored in the internal memory
as waveform reports and can be recorded, as required.
ECG during AED (VF/VT) Analysis

The ECG during AED (VF/VT) analysis is automatically stored in the internal
memory of the defibrillator as a VF analysis report, along with the results of the
analysis.

Electrical Shock
Along with the discharge information, the ECG from 10 seconds before to 12
seconds after an electrical shock is automatically stored in the internal memory
of the defibrillator as a defibrillation report.

6-4. AED
To record waveforms other than those described above in AED mode, press the
record/stop key to perform continuous recording.
6-4

7 Pacing
(TEC-5631 only)
Introduction......................................................................7-2
Pacing Procedure...........................................................................7-3
Preparation......................................................................7-4
Connecting the Pad Adapter .........................................................7-4 7
Setting and Checking the Pacing Rate and Current .....................7-5
Measuring the ECG and Selecting the Lead .................................7-6
Connecting Disposable Pads ........................................................7-7
Attaching the Disposable Pads to the Patient . .........................7-8
Connecting the Disposable Pads to the Pad Adapter . .............7-9
Pacing in FIXED Mode..................................................7-10

Screen Example ..........................................................................7-10
Pacing in FIXED Mode ................................................................7-11
Pacing in DEMAND Mode.............................................7-13

Screen Example ..........................................................................7-13
Pacing in DEMAND Mode ...........................................................7-14
7. Pacing (TEC-5631 only)
Introduction
The TEC-5631 includes a pacing circuit. In cases in which bradycardia is
observed after defibrillation, emergency treatment is enabled with electric
stimulation through the patient’s chest. A single TEC-5631 can cover three roles
of emergency medication: pacing, monitoring and defibrillation.
The disposable pads can be used for pacing so that the ECG waveforms during
pacing can be monitored continuously with the ECG connection cord and
electrodes.
Two pacing modes are provided with the TEC-5631 defibrillators.
• Fixed mode: Pacing current is output at the selected pacing rate, regardless
of spontaneous heart beat.
• Demand mode: When there is no spontaneous heart beat, pacing current
is output at the selected pacing rate. When there is a
spontaneous heart beat and the next heart beat does not occur,
pacing current is output at the selected pacing rate.
WARNING WARNING
Confirm that there is no artifact on the ECG. When using the disposable pads for long term
Artifact may be misinterpreted as QRS and correct pacing, replace them every hour. Failure to follow
pacing cannot be performed. this warning may cause skin burn or insufficient
energy discharge and pacing current to the heart.
WARNING
Do not perform pacing while using an ESU. Before WARNING
using the ESU, turn the defibrillator power off and If any disposable pad or connector gets wet, wipe
remove disposable pads from the patient. Other- off moisture before use. If a wet pad or connector
wise, high frequency energy from the ESU causes is used, it may cause electrical shock.
abnormal current to flow into the patient and
causes electrical burn, shock or other injury. It also
damages the defibrillator.
CAUTION
Deteriorated means:
Discolored means:
-T he color of the gel changes to brownish-red, and brownish
disposal pads.

Pacing Procedure
Preparation (Refer to p. 7-4.) Pacing
Check the patient’s conditions. Start pacing.

In DEMAND mode, check that the mark
Connect the pad adapter. “ ” which indicates the detection point
of the QRS waveform, is displayed at the
rising edge of the QRS waveform of ECG.
Increase the pacing current.

Turn the control dial to the
The pacing current should be the minimum
FIXED or DEMAND position.
value for pacing.
Stop pacing.
Press the START/STOP key or set the pacing
current to “0 mA” to stop pacing.
Set the pacing

rate. 7
Check that the pacing current

is set to “0 mA”.
If it is not, set the
pacing current to
“0 mA”.
Measure the ECG and select

the lead.
1) Check the number of electrodes
and lead.
2) Connect the electrode lead.
3) Attach the disposable electrodes.
4) Select the most appropriate lead.
Connect the disposable pads.

Follow the
procedures below.
1) Attach the disposable pads to the

patient.
2) Connect the disposable pads to
the pad adapter.

Preparation
Check the patient’s conditions, and follow the procedures for preparation
described below.
1 Connect the pad adapter. Refer to p. 7-4.
2 Set and check the pacing rate and current. Refer to p. 7-5.
3 Measure the ECG and select the lead. Refer to p. 7-6.
4 Connect the disposable pads. Refer to p. 7-7.
Start pacing.
Connecting the Pad Adapter

Paddle connector 1 Connect the paddle connector of the pad adapter to the
paddle connector on the defibrillator and check that the
paddle connector lock is in the locked position.
If another paddle/pad is connected, remove it.
Refer to Section 6-1 “Disconnecting Paddles/Pads
(TEC-5621, TEC-5631)” (p. 6-1-3)
Paddle connector WARNING

Locked position
the defibrillator. Check the connection and confirm
Paddle
connector that the tab of the paddle connector lock is in the
lock locked position.
operates normally.
Push the connector in. Check that the paddle
connector lock is in the PADDLES/PAD” message, accidental removal of
locked position. the cable, or insufficient delivery of electrical shock.

2 Turn the control dial to the DISARM position and check that the error
message “CONNECT PADDLES/PADS” is not displayed.
For AC power operation, check that the AC power lamp lights.
AC power lamp

lights.
For battery operation, check that enough battery charge remains.
Setting and Checking the Pacing Rate and Current

For FIXED mode 1 Turn the control dial to the FIXED or DEMAND position and check that the
7
mode indication “FIXED PACING” or “DEMAND PACING” on the screen
is correct.
NOTE: The waveform might not appear for several seconds after
changing the mode by turning the control dial.
For DEMAND mode
Mode: FIXED PACING or DEMAND PACING
2 Press the PACING RATE key to set the pacing rate.

The set pacing rate is displayed on the screen.
Pacing rate
3 Check that the pacing current displayed on the screen is “0 mA”.

If it is not, press the PACING OUTPUT key to set the pacing current to
“0 mA”.
Pacing current: 0 mA

Measuring the ECG and Selecting the Lead

NOTE • Do not attach the ECG monitoring electrodes where the
disposable pads are attached.
• If the disposable pads and ECG monitoring electrodes are
placed near each other, noise from the pacing pulse becomes
large and ECG cannot be observed. If the noise is large,
change the ECG electrode position and ECG lead.
1 Measure the ECG following the procedures below, referring to Sections 8-1
and 6-1.
1) As the measurable lead of ECG depends on the number of electrodes,
check the number of electrodes and the lead.
Section 8-1 “Checking the Number of Electrodes and Measuring
Leads” (p. 8-1-3)
2) Connect the electrode lead to the ECG socket via the ECG connection
cord.
Section 8-1 “Connecting the Electrode Lead to the Defibrillator” (p. 8-1-6)
3) Attach the disposable electrodes to the patient. The placement and lead
depend on the number of electrodes (leads).
Section 6-1 “Attaching Disposable Electrodes” (p. 6-1-12)
2 Press the [LEAD] key to select an appropriate lead.

Usually lead II is selected, because it enables the largest QRS.
Each time the [LEAD] key is pressed, the lead changes as shown below
according to the number of electrodes.
No. of Electrodes Lead

3 І→ІІ→ІІІ
6 І→ІІ→ІІІ→aVR→aVL→aVF→Ca→Cb
(Ca and Cb are 2 leads among V1 to V6.)
ECG lead
NOTE • Select a lead so that the whole waveform is displayed on

the screen. Also select a lead so that the T waveform is not
much larger than the QRS waveform. For some waveforms,
the defibrillator cannot recognize QRS correctly.
• If the defibrillator miscounts the narrow-width QRS, set
PACING REJECT in ECG SETUP to “OFF” and check that
QRS is correctly recognized.

Connecting Disposable Pads

Connect the disposable pads with the procedures below.
1 Attach the disposable pads to the patient. (Refer to p. 7-8.)
2 Connect the disposable pads to the pad adapter. (Refer to p. 7-9.)
WARNING WARNING
If the bag containing disposable pads is torn, do • Do not use the disposable pads if the gel has
not use the pads. Dispose of the pads. Failure to become dry.
follow this warning may lead to skin burns or • Do not use the disposable pads if the gel has
insufficient delivery of shock. become abnormal (the gel has become liquified
WARNING burn or insufficient delivery of shock.
brown or dark-brown gel is on the protective sheet.
Use of such pads may cause insufficient delivery of WARNING
shock or skin burn where the pads are attached. Do not use the disposable pads if they are past the
this warning may lead to skin burn or insufficient 7
delivery of shock.
WARNING
opening the package. Failure to follow this warning
WARNING
shock. Do not reuse disposable pads. Failure to follow this
delivery of shock.
CAUTION CAUTION
When disposable pads are attached to a patient, Do not place heavy objects on the disposable pads
replace them every 24 hours. After 24 hours, the or bend the pads. The pads may become damaged
gel becomes dry and this may reduce performance and deteriorated, resulting in skin burn on the
of the pads. patient.
Deteriorated means:
Discolored means:
- The color of the gel changes to brownish-red, and brownish
protection sheet or if a metal part becomes exposed, be sure to
use a new disposal pads.
Refer to the manual provided with the disposable pads.

Attaching the Disposable Pads to the Patient

Take the disposable pads out of the package, remove the protection sheet, and
attach the pads securely.
Refer to the manual provided with the disposable pads.
Protection
sheet CAUTION
NOTE • To remove the protection sheet, hold the tab at the cable end
and carefully remove it. If gel is accidentally removed together
with the sheet or a metal part becomes exposed, be sure to use
a new disposal pad.
• To attach the disposable pads to the patient, clean the skin, and
if the patient’s body is wet, thoroughly wipe the moisture off the
skin.
• To attach the disposable pads to the patient, thoroughly wipe
the moisture, oil, and dirt off the skin. Also remove any excess
body hair.
• Do not apply any gel or paste when using the disposable pads.
There are 3 methods for attaching the disposable pads.
Apex-Anterior Placement
This is a basic attachment method.
Front side
Apex-Posterior Placement
This attachment method is not suitable for monitoring or AED analysis.

Anterior-Posterior Placement
This attachment method is not suitable for AED analysis or monitoring.
Connecting the Disposable Pads to the Pad Adapter

Connect the disposable pads attached to the patient to the pad adapter securely.
Pad adapter
NOTE: Firmly connect the disposable pads to the pad adapter, pushing
until the connector of the disposable pads clicks.
Disposable
pads

Pacing in FIXED Mode

In FIXED mode, pacing current is output at the selected pacing rate, regardless
of spontaneous heart beat.
Screen Example
This is an example of the pacing screen with pacing current of 100 mA and
pacing rate of 80 ppm.

During pacing, the arrhythmia alarm and VF/VT alarm are not
generated, regardless of the alarm settings.
The arrhythmia mark “ ” is displayed only when an optional
QS-831V is installed.
Remaining battery
ECG power mark and AC
Heart rate waveform power mark
Scale
Pacing mark “ ” Sensitivity
Appears synchronizing with the Lead
pacing pulse output.
Function keys
• [LEAD]
displayed
• [SENSITIVITY]
being displayed
• [EVENT] Pacing duration Pacing
For event recording, refer to
“Event Recording” on p. 10-1-8.
Mode indication : FIXED PACING Pacing current Pacing rate
The pacing duration is reset in the following conditions.

• The defibrillator power is turned off.
• Perform pacing for one hour and replace the disposable pads, then
restart pacing.

Pacing in FIXED Mode

1 Prepare for pacing with the procedures below.
“Preparation” (p. 7-4)

2) Connect the pad adapter.
3) Set and check the pacing rate and current.
Turn the control dial to the FIXED position.
4) Measure the ECG and select the lead.
• Connect the disposable pads to the pad adapter.
2 Start pacing.
1) Press the START/STOP key to start pacing.
“PACING” is displayed on the screen.
NOTE: Pacing is not performed for 3 seconds after the START/
STOP key is pressed.
7
Pacing in progress
2) Press the PACING OUTPUT key, if required, to gradually increase the

Lights synchronizing
with the pacing pulse pacing current.
output. When pacing pulse is output, the PULSE lamp lights and the pacing
marks “ ” appear below the ECG waveform.
Pacing mark “ ”
Pacing current
Pacing rate
• The step size for pacing current can be set with Pacing Current Steps
on the SYSTEM SETUP screen.
• Press the PACING RATE key to change the pacing rate.

WARNING
CAUTION
NOTE • The pacing current should be the minimum value for pacing.
• If the pacing current is set to “0 mA”, the PULSE lamp does
not light.
• If the pacing current is set less than “10 mA”, the error
message “Pacing stopped. (pad disconnected)” might not
be displayed. Always check the pacing effect on the screen.
• When the pad-skin contact impedance is high, pacing
may stop and the error message “Pacing stopped. (pad
disconnected)” may appear. To solve this, refer to “Pacing
stopped. (pad disconnected)” (p. 11-7) or “The message
“Pacing stopped (pad disconnected)” appears and pacing
stops before completion.” (p. 11-22).
3 Stop pacing by either of the methods described below.

• Press the START/STOP key.
• Press the PACING OUTPUT key to set the pacing current to “0 mA”.
NOTE: When the pacing current is set to “0 mA”, the pacing pulse
output stops, and pacing restarts when the pacing current is
set to other than “0 mA”.
4 Turn the control dial to the OFF position to turn the defibrillator off.
damaged.

1) Remove the disposable pads from the chest of the patient.
2) Disconnect the disposable pads from the pad adapter.
Dispose of the ECG electrode, referring to the provided manuals for each
item.

Pacing in DEMAND Mode

If there is no spontaneous heart beat, perform pacing with the same pacing rate
as that set in FIXED mode.
When there is a spontaneous heart beat and the next heart beat does not occur,
pacing current is output at the selected pacing rate.
Screen Example
This is an example of the pacing screen with pacing current of 100 mA and
pacing rate of 80 ppm.
QRS wave detection point “ ”

Displayed at the rising edge of every
QRS wave
ECG waveform
Spontaneous Arrhythmia alarm and VF/VT alarm

ECG During pacing, the arrhythmia alarm and VF/VT alarm are
ECG of not generated, regardless of the alarm settings.
spontaneous The arrhythmia mark “ ” is displayed only when an
circulation optional QS-831V is installed.
Pacing mark “ ” Remaining battery power mark and
Appears synchronizing with the pacing AC power mark
pulse output.
QRS sync mark Scale

Displays synchronizing
with the spontaneous Sensitivity
circulation. Lead
Heart rate
Function keys
• [LEAD]
displayed
• [SENSITIVITY]
being displayed
• [EVENT] Pacing duration Pacing in progress
For event recording, refer to
“Event Recording” on p. 10-1-8.
Mode indication: DEMAND PACING Pacing current Pacing rate
The pacing duration is reset in the following conditions.

• The defibrillator power is turned off.
• Perform pacing for one hour and replace the disposable pads, then
restart pacing.

Pacing in DEMAND Mode

1 Prepare for pacing with the procedures below.
“Preparation” (p. 7-4)

2) Connect the pad adapter.
3) Set and check the pacing rate and current.
Turn the control dial to the DEMAND position.
4) Measure the ECG and select the lead.
• Connect the disposable pads to the pad adapter.
2 Check that the QRS wave of the spontaneous ECG is detected on the screen.
• Check that the “ ” mark, indicating the detection point of the QRS wave,
is displayed at the rising edge of the QRS wave of spontaneous ECG (the
part corresponding to Q-R) displayed on the screen.
If the position of the “ ” mark is not correct, pacing cannot be performed
correctly. Correct the displayed position of the “ ” mark as follows:
-- Change the amplitude of ECG, using the [SENSITIVITY] key.
-- Change the lead, using the [LEAD] key.
-- Change the attachment site of the ECG electrode.
• Check that the “ ♥ ” mark appears on the screen synchronizing with the
detection of the QRS wave of the spontaneous ECG.
QRS wave detection point “ ”
Check that the mark is displayed at the
QRS sync mark rising edge of every QRS wave.
WARNING
Artifact may be misinterpreted as QRS and correct
pacing cannot be performed.

3 Start pacing.
1) Press the START/STOP key to start pacing.
“PACING” is displayed on the screen.
NOTE: Pacing is not performed for 3 seconds after the START/
STOP key is pressed.
Pacing in progress
2) Press the PACING OUTPUT key, if required, to gradually increase the

Lights synchronizing
with the pacing pulse pacing current.
output. When pacing pulse is output, the PULSE lamp lights and the pacing
marks “ ” appear below the ECG waveform.
Pacing mark “ ”
Pacing current
Pacing rate
• The step size for pacing current can be set with Pacing Current Steps
• Press the PACING RATE key to change the pacing rate.
WARNING
WARNING
When performing pacing in a vehicle, such as an
ambulance, confirm that noise due to automobile
vibrations is not misinterpreted as QRS.
CAUTION

NOTE • The pacing current should be the minimum value for pacing.
• If the pacing current is set to “0 mA”, the PULSE lamp does
not light.
• QRS within 350 ms after pacing pulse output might not be
detected.
• Pacing pulse output stops for 3 seconds if lead or sensitivity
is changed during pacing.
• If the pacing current is set less than “10 mA”, the error
message “Pacing stopped. (pad disconnected)” might not
be displayed. Always check the pacing effect on the screen.
• When the pad-skin contact impedance is high, pacing
may stop and the error message “Pacing stopped. (pad
disconnected)” may appear. To solve this, refer to “Pacing
stopped. (pad disconnected)” (p. 11-7) or “The message
“Pacing stopped (pad disconnected)” appears and pacing
stops before completion.” (p. 11-22).
4 Stop pacing by either of the methods described below.

• Press the START/STOP key.
• Press the PACING OUTPUT key to set the pacing current to “0 mA”.
NOTE: When the pacing current is set to “0 mA”, the pacing pulse
output stops, and pacing restarts when the pacing current is
set to other than “0 mA”.
damaged.

1) Remove the disposable pads from the chest of the patient.
2) Disconnect the disposable pads from the pad adapter.
Dispose of the ECG electrode, referring to the provided manuals for each
item.

8 Monitoring
Introduction...................................................................8-0-2
Displaying the Monitor Screen .................................................. 8-0-2
Monitor Screen .......................................................................... 8-0-3
Displaying Values Large .......................................................8-0-4
GUIDE Window............................................................8-0-5
8
Displaying the GUIDE Window . ................................................ 8-0-5
Displaying from the SETUP Window ....................................8-0-5 8-1
Displaying when a Technical Alarm is Generated ................8-0-6
8-2
ECG Monitoring .................................................Section 8-1 8-3
CO2 Monitoring...................................................Section 8-2
SpO2 Monitoring ................................................Section 8-3

8. Monitoring
Introduction
This defibrillator has various monitoring functions to monitor the patient’s
condition after defibrillation. In addition to ECG measurement (TEC-5611,
TEC-5621, TEC-5631), SpO2 monitoring and CO2 monitoring are also available
when an optional Multi parameter/SpO2 unit is mounted.
“Measurement Parameters” (p. 1-3)
Attach the optional ECG electrodes and sensors to the patient, and perform the
ECG monitoring, SpO2 monitoring, CO2 monitoring, and measurements.
When monitoring starts, waveforms and measured values of parameters are
displayed on the monitor screen.
This manual describes measuring procedures and settings for monitoring for each
parameter.
WARNING
instruments.
WARNING
After attaching electrodes, probes and sensors on
the patient and connecting cables to the
defibrillator, check that there are no error
messages and the waveforms and numeric data
are appropriately displayed on the screen. If there
is an error message, or waveform or numeric data
is not appropriate, check the electrodes, probes
and sensor attachment, patient condition and
settings on the defibrillator and remove the cause.
WARNING
A physician must be within the range where he/she
can hear the alarm sound of the defibrillator while
monitoring a patient on the defibrillator. If the
physician cannot hear the alarm sound, critical
Displaying the Monitor Screen

Turn the control dial to the MONITOR position to display the monitor screen.
NOTE: The waveform might not appear for several seconds after
changing the mode by turning the control dial.

8. Monitoring
Monitor Screen
On the monitor screen, waveforms and measured values for parameters are
displayed.
For details on parameters, refer to the corresponding section.
The measured value for VPC is “---” and the VPC alarm is not generated
if ARRHYTHMIA ANALYSIS in ARRHYTHMIA SETUP in the
SETUP window is set to “OFF”.
Refer to Section 9 “Changing the Settings for Arrhythmia Alarms” (p. 9-15).
NOTE: If the parameter has not been measured correctly, the measured
value is invalid and “---” is displayed. For a parameter whose
measured value is “---”, the upper/lower limit alarms is not
generated.
Value Waveforms (ECG, SpO2, CO2)
Measurement values for Waveforms for parameters are displayed
monitoring and measuring during monitoring.
parameters are displayed.
Remaining battery
Parameter power mark and
AC power mark
8
Sensitivity 8-1
Lead of displayed 8-2

Alarm off waveform
mark
8-3
Function keys
• [LEAD]
For selecting the ECG lead being displayed
• [SENSITIVITY]
For selecting the ECG sensitivity being displayed.
• [EVENT]
For event recording (Refer to Section 10-1 “Event Recording” (p. 10-1-8).)
• [FREEZE]
For freezing every waveforms displayed on the monitor screen.
The measured values are not frozen but are updated as usual.
To cancel freezing, perform one of the operations below.
- Press the [UNFREEZE] key.
- Change the lead or sensitivity of the displayed ECG.
- Change the number of traces of the displayed ECG.
- Change the displayed screen.
- Change the parameter to be measured.
• [GUIDE]
The [GUIDE] key is activated if the technical alarm corresponding to
the GUIDE window is generated. Press the [GUIDE] key to display the
GUIDE window. (Refer to p. 8-0-5.)

8. Monitoring
Displaying Values Large

The measured values for parameters is displayed large if LARGE NUMERICS
SETUP in DEVICE SETUP in the SETUP window is set to “ON”.
“LARGE NUMERICS SETUP” (p. 5-14).
When the [WAVEFORMS] key is pressed, the normal monitor screen is restored,
and LARGE NUMERICS SETUP is set to “OFF”.
If the LARGE NUMERIC SETUP is set to “ON”, the setting is effective

while the defibrillator power is turned on. Once the defibrillator power is
turned off, the setting returns to “OFF”.

mark and AC power mark
ECG
ECG during monitoring
is displayed. Sensitivity
Parameter Lead of displayed waveform
Alarm off mark
Value Pulse wave graph

Measured values for Bars are increased and
monitoring and decreased synchronizing with
measuring parameters the pulse wave.
are displayed large.
CO2 partial pressure
graph
Bars are increased and
decreased synchronizing
with the CO2 partial
Function keys pressure.
• [LEAD]
For selecting the ECG lead being displayed
• [SENSITIVITY]
For selecting the ECG sensitivity being displayed
• [EVENT]
For event recording (Refer to Section 10-1 “Event
Recording”.)
• [WAVEFORMS]
For displaying the normal monitor screen

8. Monitoring
GUIDE Window
The GUIDE window shows the corrective measures for a technical alarm using
instructions and figures.
Displaying the GUIDE Window

The GUIDE window is displayed from the SETUP window or when a technical
alarm is generated.
Displaying from the SETUP Window
2 Display the GUIDE window.

item GUIDE.
2) Press the [ ] key or [ ] key to select a parameter
whose GUIDE window is to be displayed. 8
8-1
The GUIDE window for the parameter selected in step 2) is displayed.
8-2
8-3
1) Select a SETUP 2) Select a 3) [OK]

menu item. parameter.
Press to select an item. Press to change the displayed page.

8. Monitoring
Displaying when a Technical Alarm is Generated

If you press the [GUIDE] key that is displayed when the technical alarm is
generated, the corrective measures for the technical alarm is displayed.
Example: When a technical alarm “CONNECTOR OFF” is generated

8-1 ECG Monitoring
Introduction............................................. 8-1-2 Setting the ECG Sensitivity.................. 8-1-16

Measuring Procedures .....................................8-1-2 Setting Range ............................................ 8-1-16
Number of Electrodes and Measuring Setting the Sensitivity .....................................8-1-16
Leads...................................................... 8-1-3 Changing ECG SETUP and QRS
Checking the Number of Electrodes and SETUP Settings .................................. 8-1-17
Measuring Leads . ............................................8-1-3 ECG SETUP Window . ............................... 8-1-17 8
Positions and Leads for 3 Electrodes ..........8-1-3 QRS SETUP Window ................................ 8-1-17 8-1
Positions and Leads for 6 Electrodes .........8-1-4 Setup Item List ...............................................8-1-18
Selecting the Electrode Lead, ECG Displaying the Setting Window . .....................8-1-18
Connection Cord and Disposable Changing Alarm Settings ..................... 8-1-19
Electrodes.............................................. 8-1-5 Setting Range ............................................ 8-1-19
3 Electrodes and 6 Electrodes .....................8-1-5 Arrhythmia Alarm ....................................... 8-1-19
Connecting the Electrode Lead to the Changing Alarm Settings.................................8-1-20
Defibrillator............................................. 8-1-6 Setting Filter and Display..................... 8-1-21

Connecting the Disposable Electrodes Setting Range ............................................ 8-1-21
with DIN-type Leads ....................................8-1-6 Setting Filter and Cascade Display ................8-1-21
Attaching the Disposable Electrodes...... 8-1-7 Setting the Hum Filter On or Off ................ 8-1-22
Setting the Filter ......................................... 8-1-22
For Reducing Artifacts ......................................8-1-7
Setting the Cascade Display On or Off . .... 8-1-22
Monitoring ECG with the Disposable
Setting Chest Leads............................. 8-1-23
Pads....................................................... 8-1-7
Setting Range ............................................ 8-1-23
Starting Measurement Setting the Leads for the Ca and Cb Leads ...8-1-23
(Start of Monitoring)................................ 8-1-8 Setting Pacing and QRS...................... 8-1-24
Screen Example ...............................................8-1-9 Setting Range ............................................ 8-1-24
Arrhythmia Analysis Off ............................. 8-1-10
Setting the Detection Type for Pacing Reject
Detached Electrode and Display ....................8-1-10
and QRS . .......................................................8-1-24
Checking the Dominant QRS .........................8-1-10 Setting the PACING REJECT On or Off .... 8-1-25
QRS Annotation ......................................... 8-1-11 Setting the QRS Detection Type ................ 8-1-26
Relearning ECG (LEARN ECG)........... 8-1-12 Arrhythmia Analysis.............................. 8-1-27
Setting the Monitoring Leads................ 8-1-14 Arrhythmia Analysis and Dominant QRS .......8-1-27
Setting Range ............................................ 8-1-14 Automatic Updating of Dominant QRS
Setting the Leads............................................8-1-15 (Automatic Start of ECG Learning) ............ 8-1-27
Optimum Lead for Monitoring . .......................8-1-15 Criteria for Arrhythmia Alarm ..................... 8-1-28
8. Monitoring
Introduction
To measure and monitor ECG, attach the disposable electrodes to the patient and
connect them to the ECG socket.
On the monitor screen, ECG from any lead can be displayed. Arrhythmia
analysis can also be performed.
Monitoring using disposable pads instead of disposable electrodes is also
available.
When an optional QS-831V is installed in the defibrillator, the types of
arrhythmia to be detected can be increased.
Refer to “Arrhythmia Analysis” (p. 8-1-27).
Measuring Procedures
Select the electrode lead, ECG connection cord and disposable electrodes.
1 Refer to p. 8-1-5.
Connect the electrode lead to the defibrillator.

Connect the electrode lead to the ECG socket via the
ECG connection cord.
Attach the disposable electrodes to the patient.

Attach the disposable electrodes and connect them to
3 the electrode lead. Refer to p. 8-1-7.
Start measurement (start of monitoring).

4 When the procedures above are completed, ECG is set to measuring mode and monitoring
starts.
Refer to p. 8-1-8.
5 Set the leads for monitoring.

Set the leads most adequate for monitoring.
Refer to p. 8-1-14.
6 Check that the QRS detection type is correct.

Check that the QRS detection type displayed on the screen (ADULT or CHILD) is correct.
Refer to p. 8-1-24.
7 Set the ECG sensitivity. Refer to p. 8-1-16.

8-1. ECG Monitoring
8 Check that the dominant QRS is appropriate for the patient. Refer to p. 8-1-10.
9 Make necessary settings.

Change the settings for monitoring.
Refer to p. 8-1-17.
Number of Electrodes and Measuring Leads
Checking the Number of Electrodes and Measuring Leads

The ECG leads that can be measured depend on the number of electrodes.
The number of electrodes can be set in ECG Leads on the SYSTEM SETUP
screen.
If ECG Leads is set to “AUTO”, the number of electrode leads is detected
automatically.

8
8-1
ECG Leads on No. of
Lead
SYSTEM SETUP Electrodes
3 Lead 3 Ι, ΙΙ, ΙΙΙ
Ι, ΙΙ, ΙΙΙ, aVR, aVL, aVF, Ca, Cb
6 Lead 6
(Ca and Cb are 2 leads among V1 to V6.)
Positions and Leads for 3 Electrodes
Electrode Lead
Symbol Electrode Position
Lead Color Clip Color
L/LA R Red Red-beige
R/RA Right infraclavicular fossa
RA White White-beige
L Yellow Yellow-beige
Left infraclavicular fossa
LA Black Black-beige
F Green Green-beige Lowest rib on the left anterior axillary
LL Red Red-beige line
F/LL N is the electrical reference point.
Lead I Lead II Lead III
R/RA L/LA R/RA L/LA R/RA L/LA
F/LL F/LL F/LL

8. Monitoring
Positions and Leads for 6 Electrodes

The 5-electrode method with Lead II and Lead V5 is effective for monitoring
myocardial ischemia. Monitoring accuracy is improved by adding Lead V4 to this
L/LA combination.
R/RA
Ca and Cb can be at any position of the standard 12 leads C1 to C6, but C4 and C5
are most appropriate for myocardial ischemic monitoring.
Cb/Vb
Ca/Va
Electrode Lead
Symbol Electrode Position
Lead Color Clip Color
R Red Red-beige
Right infraclavicular fossa
RA White White-beige
N (RF/RL) F/LL
L Yellow Yellow-beige
Left infraclavicular fossa
LA Black Black-beige
F Green Green-beige Lowest rib on the left anterior
LL Red Red-beige axillary line
N (RF) Black Black-beige Right anterior axillary line at the
N (RL) Green Green-beige same level as F
Ca White Brown-white Fifth intercostal space on the left
midclavicular line (C4 position of
Va Brown Blue-brown standard 12 leads)
Cb White Black-white Left anterior axillary line at the
same level as Ca (C5 position of
Vb Brown Orange-brown standard 12 leads)
Ca and Cb electrode leads can be set using Ca LEAD or Cb LEAD in ECG

SETUP in the SETUP window.
N is the electrical reference point.
“Setting Chest Leads” (p. 8-1-23)
Standard limb leads

Lead I Lead II Lead III
R/RA L/LA R/RA R/RA

L/LA L/LA
F/LL F/LL F/LL
N (RF/RL) N (RF/RL) N (RF/RL)
Monopolar limb leads

aVR lead aVL lead aVF lead
R/RA L/LA R/RA L/LA R/RA

L/LA
F/LL F/LL F/LL
N (RF/RL) N (RF/RL) N (RF/RL)
Monopolar chest leads

V1 to V6 leads
to
R/RA L/LA
F/LL
N (RF/RL)

8-1. ECG Monitoring

Cord and Disposable Electrodes
Select the appropriate electrode lead, ECG connection cord, and disposable
electrodes according to the number of electrodes (leads).
WARNING
Only use Nihon Kohden specified parts and
caused.
NOTE • If electrodes of a type whose element uses material other than

Ag/AgCl are used with the defibrillator, it may take a little time
to restore recording of ECG. Be sure to use electrodes whose
elements use Ag/AgCl when the defibrillator is used.
• Avoid using different types of electrodes together. Monitoring of
stable ECG might not be obtained. 8
3 Electrodes and 6 Electrodes 8-1
Disposable Electrodes 1 Electrode Lead ECG Connection Cord

BR-903P (IEC), BR-903PA (AHA), 0.8 m JC-906P (IEC), 3 m 2
BR-913P (IEC), 0.8 m JC-906PA (AHA), 3 m
JC-916P (IEC), 1.5 m
BR-923P (IEC), 1.5 m
BR-963P (IEC), 0.8 m
3 electrodes
Type
without
Lead The figure shows the The figure shows the
The figure shows BR-903P. BR-963P.
the Vitrode C.
BR-906P (IEC), BR-906PA (AHA), 0.8 m
BR-916P (IEC),
0.8 m
6 electrodes
BR-926P (IEC),
1.5 m The figure shows the
BR-906P.
Disposable electrodes with DIN-type leads
A DIN type lead has a connector on which no metal part is exposed, for safety. (DIN:
Deutsche Industrie Normenausschuss)
Type
with
Leads
The figure shows the The figure shows the

V-090M3. V-060M6.
For the type of disposable electrodes, refer to “Paddles and Disposable Pads” (p. 13-4)”.
1
Accessories for the TEC-5611, TEC-5621 and TEC-5631

2

8. Monitoring
Connecting the Electrode Lead to the Defibrillator
White panels Connect the selected electrode lead to the ECG socket via the
ECG connection cord.
1 Connect the electrode lead and ECG connection cord so

that their white panels face the same way.
When 3 Electrodes (BR-903P) are Connected 2 Connect the ECG connection cord to the ECG socket on
the left side of the defibrillator.
BR-903P
JC-906P
Connecting the Disposable Electrodes with DIN-type Leads

When the JC-906P or JC-916P ECG
Connection Cord is Connected
1 Check the number of electrodes.
“Checking the Number of Electrodes and Measuring
Leads” (p. 8-1-3)
2 Connect the electrode leads directly to the ECG

connection cord, following the indications on the panel of
the cable.
R F N
L Ca Cb
• For 3 electrodes: R, L, F
• For 6 electrodes: R, L, F, N, Ca, Cb
When Disposable Electrodes with DIN-type Leads

(Vitrode V) are Connected
3 Connect the ECG connection cord to the ECG socket on
the left side of the defibrillator.
Vitrode V
JC-906P or JC-916P

8-1. ECG Monitoring
Attaching the Disposable Electrodes

For details on attaching the disposable electrodes, refer to “Attaching Disposable
Electrodes” (p. 6-1-12) and the manual provided with the disposable electrodes.
WARNING
After attaching the electrode to the patient and
connecting the cable to the defibrillator, check that
electrodes are attached to the patient and check
that the cable is connected to the defibrillator
properly. When the electrodes are removed from
the patient, do not touch the metal part of the
electrode with bare hands or let the metal part of
the electrode contact the metal part of the bed or
any other conductive parts. Failure to follow this
warning may cause electrical shock or injury to the
patient by discharged energy.
For Reducing Artifacts

8
To maintain good contact between an electrode and skin for accurate ECG
measurement, skin treatment is recommended before attaching the disposable 8-1
electrodes.
Treatment with gauze is most important in the procedures below.
• Shave excess hair if the electrode cannot be in contact with the skin because of
hair.
• Rub the skin where the electrode is to be attached, using a dry gauze.
• If the skin is dirty, clean with soap and water. Dry completely.
• If an electrode tends to come off or floats because of oil, wipe with a piece of
cotton moistened with alcohol. Dry completely.
Monitoring ECG with the Disposable Pads

ECG monitoring can be performed with the disposable pads instead of ECG
monitoring electrodes.
For ECG monitoring with the disposable pads, set the displayed lead to “PAD”.
For details on connection and attachment of the disposable pads, refer to
“Connecting Disposable Pads” (p. 6-1-5).
“Setting the Monitoring Leads” (p. 8-1-14)
CAUTION
When monitoring ECG with disposable pads,
check the polarity of the pads before attaching
delay of treatment.
NOTE: Arrhythmia analysis other than VF/VT cannot be performed with

pad lead.

8. Monitoring
Starting Measurement (Start of Monitoring)

When preparation is completed, the defibrillator is set to measuring mode.
Heart rate (HR) and ECG monitoring begins.
• The sweep speed of the displayed ECG can be set in ECG Sweep
Speed on the SYSTEM SETUP screen.
Refer to the Administrator’s Guide: “System Setup”
• The maximum heart rate range is 300. If the patient’s heart rate is
above 300, “300” is displayed on the screen.
CAUTION
When the “Check Electrodes” message is
displayed, ECG is not monitored properly and the
ECG alarm does not function. Check the electrode,
electrode leads and connection cord, and if
necessary, replace with new ones.
CAUTION
When the “Noise” or “Cannot Analyze” message is
displayed, ECG data and alarm are not reliable.
Remove the cause by checking the electrodes,
electrode leads, patient’s body movement, EMG
and peripheral instruments grounding. Also make
sure that an electric blanket is not used.
NOTE: Check that the sync sound is generated when monitoring starts.
If there is no sync sound, check the setting of SYNC SOUND in
VOLUME in the SETUP window and that sync sound is silenced
intentionally.
“VOLUME” (p. 5-11)

8-1. ECG Monitoring
Screen Example
On the monitor screen, ECG waveforms and values being measured are
displayed.
The sync sound is heard synchronizing with the QRS sync mark.
• Press the [LEAD] or [SENSITIVITY] key to change the setting of the
ECG lead or sensitivity.
• The [GUIDE] key is activated if the technical alarm corresponding to
the GUIDE window is generated. Press the [GUIDE] key to display
the GUIDE window. (Refer to p. 8-0-5.)
VF/VT alarm
If ARRHYTHMIA ANALYSIS is set
Arrhythmia alarm to “OFF” or VF/VT in ARRHYTHMIA
Alarm off mark
Displayed only when an SETUP in the SETUP window is set to
optional QS-831V is installed. “OFF”, the alarm off mark is displayed.
QRS sync
mark If ARRHYTHMIA ANALYSIS
is set to “OFF”, the alarm off QRS detection type
Heart mark is displayed. ECG waveform
Filter setting
rate
Scale
Sensitivity
8
Number of VPCs
The number of VPCs is displayed according to 8-1
Lead
the settings or conditions as described below.
• I f the ECG lead is set to “PAD”, “PADDLE”, or
“AUX”, the number of VPCs is not displayed.
• I f the electrodes are removed or
ARRHYTHMIA ANALYSIS is set to “OFF”,
the measurement value indicating a VPC is
displayed as “---” and the VPC alarm is not
generated.
Function keys
Refer to “Monitor Screen”
(p. 8-0-3).
If CASCADE in ECG SETUP in the SETUP window is set to “ON”, ECG

waveforms appear in cascade display.
Example: Cascade Display
ECG cascade display mark

8. Monitoring
Arrhythmia Analysis Off

In the cases below, ARRHYTHMIA ANALYSIS is set to “OFF” and the message
“ARRHYTHMIA ANALYSIS OFF” is displayed.
The conditions depend on whether an optional QS-831V is installed or not.
• When a QS-831V is installed:
When ARRHYTHMIA ANALYSIS in ARRHYTHMIA SETUP in the SETUP
window is set to “OFF”
• When no QS-831V is installed:
When VF/VT in ARRHYTHMIA SETUP in the SETUP window is set to
“OFF”
“Changing the Settings for Arrhythmia Alarms” (p. 9-15)
Detached Electrode and Display

The defibrillator detects electrode detachment in the cases listed below.
• Electrode lead is detached from the electrode.
• Electrode lead is detached from the ECG connection cord.
• Electrode lead is broken.
• Electrode lead clip is not properly secured to the electrode.
• Electrode is detached from the patient.
When an electrode detachment is detected, the message “CHECK
ELECTRODE” is displayed.
When electrodes are detached, the ECG waveforms become dotted lines. (See
the figure below.) When a dotted line appears, check the electrode, electrode lead
and ECG connection cord.
Checking the Dominant QRS

Check whether the dominant QRS obtained with the ECG learning is appropriate
for the patient or not.
At the start of monitoring, noise may accidentally be obtained for the dominant
QRS. As the dominant QRS differs from the stable ECG of the patient,
arrhythmia analysis may be inaccurate.
When monitoring is to be started, it is recommended to check that the dominant
QRS obtained after ECG learning represents the stable ECG of the patient.
ECG learning cannot be performed in the cases listed below.
• PAD, PADDLE, or AUX is displayed as the lead.
• ARRHYTHMIA ANALYSIS is set to “OFF”.
“Arrhythmia Analysis” (p. 8-1-27)

8-1. ECG Monitoring
CAUTION
dominant QRS is appropriate. Otherwise
arrhythmia monitoring may be inaccurate.
Check that the obtained dominant QRS represents the ECG of the patient
appropriately, following the procedures given below.
NOTE: QRS annotation is printed on delayed recording only. Before
checking the dominant QRS, check that Delayed Recording on
the SYSTEM SETUP screen is set to “On (Default)”.
1 Press the record/stop key to start recording.

Pressing the record/stop key during recording stops recording.
2 Check that the QRS annotation of ECG is printed correctly on the recording 8
paper.
8-1
If the QRS annotation is not correct, perform ECG learning again.
“Relearning ECG (LEARN ECG)” (p. 8-1-12)
QRS Annotation
QRS Annotation
Type of QRS annotation and its meaning are as shown below.
QRS
Description
Annotation
Pulse recognized as normal heart rate and the wave with the
N
same waveform
Deformed waveform of pulse recognized as ventricular
V premature contraction (VPC), including ventricular escaped
beat.
P Pulse generated by pacing
Pulse during ECG learning or whose classification is
?
suspended because of noise interference.
- Detected as QRS but recognized as noise but not pulse

8. Monitoring
Relearning ECG (LEARN ECG)

The defibrillator relearns ECG if there is any doubt on the decision and
classification of arrhythmia analysis (normally 8 pulses). If an ECG setting, such
as lead, is changed, the defibrillator automatically learns the patient’s ECG, and
the dominant QRS is updated.
ECG learning cannot be performed in the cases listed below.
• PAD, PADDLE, or AUX is displayed as the lead.
• ARRHYTHMIA ANALYSIS is set to “OFF”.
CAUTION
If there is any doubt about the arrhythmia analysis,
make the defibrillator relearn the patient’s ECG
and check that the dominant QRS is appropriate.
Otherwise, an important arrhythmia may be
overlooked.
NOTE • If ARRHYTHMIA ANALYSIS is set to “OFF”, ECG learning does

not function. For ECG learning, set ARRHYTHMIA SETUP in
the SETUP window as described below.
The settings depend on installation of an optional QS-831V.
If a QS-831V is installed: Set ARRHYTHMIA ANALYSIS to
“ON”.
If no QS-831V is installed: Set VF/VT to “ON”.
• For ECG learning, keep the patient quiet and check that ECG
with regular rhythm and no noise is observed.
• While the defibrillator is learning an ECG, the message “ECG
LEARNING” is displayed and only the alarms below are
generated.
• ASYSTOLE 1 • VF • BRADYCARDIA 1 • TACHYCARDIA 1
1
Displayed only when an optional QS-831V is installed.
• After ECG learning, check that the obtained dominant QRS is

appropriate for the patient.

8-1. ECG Monitoring
2 Learn ECG.
item QRS SETUP.
2) Press the [ ] key or [ ] key to select LEARN ECG.
The message is displayed during 3) Press the [OK] key.
learning of an ECG and disappears While the defibrillator is learning an ECG, the message “ECG
when the ECG learning ends.
LEARNING” is displayed in the window and the message disappears
when learning ends.

8
3 Check the updated dominant QRS. 8-1
1) Turn the control dial to the MONITOR position to display the monitor
screen.
2) Check that the obtained dominant QRS represents the ECG of the patient
appropriately.
“Checking the Dominant QRS” (p. 8-1-10)

8. Monitoring
Setting the Monitoring Leads

Set the ECG lead indicated on the monitor screen.
The leads that can be measured depend on operation mode of the defibrillator
(monitor mode, defibrillation mode, pacing mode, or AED mode) and the number
of electrodes used.
“Checking the Number of Electrodes and Measuring Leads” (p. 8-1-3)
The monitoring leads setting returns to the default setting 1 minute after the
defibrillator is turned off.
Setting Range
In Monitor Mode
No. of
Lead
Electrodes
3 electrodes Pads or paddles, I, II, III, AUX 1
6 electrodes Pads or Paddles, I, II, III, aVR, aVL, aVF, Ca 2, Cb 2, AUX 1
In Defibrillation Mode
No. of
Lead
Electrodes
3 electrodes Pads or paddles, I, II, III, AUX 1
6 electrodes Pads or Paddles, I, II, III, aVR, aVL, aVF, Ca 2, Cb 2, AUX 1
In Pacing Mode In AED Mode

No. of No. of
Lead Lead
Electrodes Electrodes
3 electrodes I, II, III 3 electrodes
Pads
6 electrodes I, II, III, aVR, aVL, aVF, Ca , Cb
2 2
6 electrodes
1
Select the AUX lead if an external monitor is connected, using a JC-831V external ECG
cable.
2
For Ca and Cb, 2 leads among V1 to V6 can be set.
• “Using an ECG from an External Monitor as a Synchronizing
Signal” (p. 6-1-14)
• “Setting the Leads for the Ca and Cb Leads” (p. 8-1-23)
NOTE • If the defibrillator miscounts the narrow-width QRS, set PACING

REJECT to “OFF” and check that QRS is correctly recognized.
• A patient with an implanted pacemaker might not be correctly
monitored if pads are used as the lead.
• Select a lead so that the whole waveform is displayed on
the screen and the T waveform is not much larger than the
QRS waveform. For some waveforms, the defibrillator cannot
recognize QRS correctly.
• “Setting Filter and Display” (p. 8-1-21)

8-1. ECG Monitoring
Setting the Leads

Press the [LEAD] key to set the ECG lead displayed on the monitor screen.
Lead
Optimum Lead for Monitoring

NOTE: Follow the physician’s instructions for the lead when available.
It is generally considered that Lead II and Lead VI are suitable for arrhythmia
monitoring and that Lead V4 and V5 are suitable for myocardial ischemia
monitoring.
Some types of ECGs are difficult for automatic analysis, and heart rate or
arrhythmia detection level is not accurate for some patients.
8
In these cases, use the following procedures to find the appropriate lead for
automatic analysis, referring to 12 ECG leads: 8-1
Criteria for Selecting the Optimum ECG Lead

1) Select the lead with the higher QRS wave. Also select the lead with least
difference in amplitude compared with the QRS by VPC or pacing.
0.5 < QRS1/QRS2 <2
2) Select the lead with 0.2 mV or less amplitude of the P-wave (amplitude of the
P-wave is 2 mm or less on the screen with sensitivity ×1).
P ≤ 0.2mV
3) Select the lead with a T-wave amplitude less than one-third of the QRS wave.
T1 ≤ 1/3·QRS1
T2 ≤ 1/3·QRS2
QRS1
P T1 T2
QRS2

8. Monitoring
Setting the ECG Sensitivity

Set the sensitivity for the ECG being monitored.
QRS detection sensitivity also changes with the changed sensitivity. For stable
QRS detection, the QRS amplitude should be larger than 1 cm on the screen.
Setting Range
Setting Range (Default)

× 1/4, × 1/2, × 1, × 2, × 4
The ECG sensitivity setting returns to the default setting 1 minute after the
Setting the Sensitivity

Press the [SENSITIVITY] key to set the ECG sensitivity.
The scale changes according to the sensitivity setting.
Sensitivity Scale
× 1/4 4 mV
× 1/2 2 mV
×1 1 mV
×2 0.5 mV
×4 0.25 mV
Sensitivity Scale

8-1. ECG Monitoring
Changing ECG SETUP and QRS SETUP Settings

Change settings for ECG monitoring in ECG SETUP or QRS SETUP in the
SETUP window.
NOTE: After changing settings, check the settings.
ECG SETUP Window

The display of the ECG SETUP window differs depending on the menu items.
8
8-1
QRS SETUP Window

8. Monitoring
Setup Item List

• Upper limit: 35 to 300, OFF

• HR (bpm) Change the upper/lower limit alarms for HR/PR (Default: 140)
ECG (Heart Rate/Pulse Rate). • Lower limit: OFF, 30 to 295
• PR (/min)
ALARM (Default: 40)
VPC (/min) Change the upper limit alarm for VPC. 1 to 99, OFF (Default: 10)
ECG HUM FILTER Set the hum filter. ON, OFF

SETUP DIAGNOSIS, MONITOR,
FILTER Set the filter.
MAXIMUM
Ca LEAD Set the Ca lead if 6 electrodes are attached. V1, V2, V3, V4, V5, V6
Cb LEAD Set the Cb lead if 6 electrodes are attached. V1, V2, V3, V4, V5, V6
Set whether ECG waveforms are to appear as
CASCADE ON, OFF
cascade display or not.
LEARN ECG Relearn ECG. (Refer to p. 8-1-12.) —
QRS Set whether the detected pacing pulse is to be

PACING REJECT ON, OFF
recognized as QRS or not.
SETUP
Set the QRS detection type for the patient for
DETECTION TYPE ADULT, CHILD
monitoring.
Displaying the Setting Window


item ECG SETUP or QRS SETUP.
2) Press the [ ] key or [ ] key to select an item to be
set.
A setting window is displayed in which the parameter selected in step 2)
is highlighted.
3 Change the settings, referring to the corresponding page.
4 Turn the control dial to the MONITOR position to display the monitor
screen.

8-1. ECG Monitoring
Changing Alarm Settings

Change the settings for upper/lower limit alarms for HR/PR (Heart Rate/Pulse
Rate) and the number of VPCs.
As the settings for the upper/lower limit alarms are linked with the settings
in ALARM SETUP in the SETUP window, settings on either of the
windows are reflected to another window.
Refer to “Changing the Settings for Upper/Lower Limit Alarms” (p. 9-13).
Setting Range
Item Setting Range Step

Upper
35 to 300, OFF
HR:bpm limit
HR/PR 1
PR:/min Lower
OFF, 30 to 295
ECG ECG limit
SETUP ALARM Upper
1 to 99, OFF 1
limit
VPC /min
Lower
― ―
limit 8
8-1
The HR/PR alarm can be set in the setting window shown below.
The settings are linked so that the setting changed in one of the
windows is reflected to other windows.
• SpO2 SETUP in the SETUP window
CAUTION
When the alarm limit is set to Off, there will be no
alarm for that limit. Be careful when you set the
alarm limit to Off.
Arrhythmia Alarm
The arrhythmia alarm is set in ARRHYTHMIA SETUP in the SETUP window.
NOTE • Arrhythmia alarms other than VF/VT DETECTED are generated
only when limb leads and chest leads are selected in monitor
mode.
• In pacing mode, the arrhythmia alarm is not generated.
• If VF alarm or VT alarm is generated in monitor mode, it may
not be determined as an ECG that is shockable rhythm in AED
mode.
For details, refer to Section 9 “Alarm Function”.
• “Changing the Settings for Upper/Lower Limit Alarms” (p. 9-13)
• “Changing the Settings for Arrhythmia Alarms” (p. 9-15)

8. Monitoring

To change the settings, activate the ECG SETUP window in the SETUP window.
For Displaying the Window

1) Select ECG SETUP in the SETUP window.
2) Select ECG ALARM then press the [OK] key.
“Displaying the Setting Window” (p. 8-1-18)
1 Change settings for the upper/lower limit alarms.

1) Press the [BACK] key or [NEXT] key to select an item to be set.
2) Press the [↓] key or [↑] key to change the upper or lower limit.
NOTE: If the upper limit is set lower than the lower limit, the lower
limit is automatically decreased. Also if the lower limit is
set higher than the upper limit, the upper limit is increased
automatically. However, they are not set to “OFF”.
To set the upper or lower limit alarm off, press the [↓] or [↑] key to set a
value outside the setting range. Then the upper limit or lower limit setting
changes to “OFF”.
The cursor is placed on the selected item.
Measurement value
The current measured
value is displayed.
Upper limit
Position
of current
measured
value
Lower limit

When the key is held The set value is increased
pressed, the cursor or decreased by 1 step.
moves consecutively. When the key is held
pressed, the setting changes
continuously.

8-1. ECG Monitoring
Setting Filter and Display

Change the settings for the filter and display according to the measurement
conditions.
Setting Range
Item Setting Range

HUM FILTER ON, OFF
ECG SETUP FILTER DIAGNOSIS, MONITOR, MAXIMUM
CADCADE ON, OFF
Setting Filter and Cascade Display

To change the settings for filter and display, display the ECG SETUP window in
the SETUP window.
For Displaying the Window 8
1) Select ECG SETUP in the SETUP window. 8-1
2) Select HUM FILTER, FILTER, or CASCADE then press the [OK] key.
1 Change settings for each item.

2) Press the [↓] key or [↑] key to set the item.
The setting is highlighted.

8. Monitoring
Setting the Hum Filter On or Off

Set the hum filter for the AC power line to ON or OFF.
The hum filter removes only the sine wave of 50 Hz or 60 Hz. Therefore this
does not affect the ECG.
The frequency of the hum filter is set in AC Line Frequency (Hz) on the
SYSTEM SETUP screen.
In defibrillation mode, AED mode, and pacing mode, the setting for the hum
filter is fixed to “ON”.
Settings:
• ON: Set the hum filter to “ON”.
• OFF: Set the hum filter to “OFF”.
Setting the Filter

Set the filter.
NOTE: To deliver electrical shock using another defibrillator during
monitoring with this defibrillator, set FILTER to “MONITOR” or
“MAXIMUM”. If electrical shock is delivered with FILTER set to
“DIAGNOSIS”, recovery of the waveform may be delayed.
In defibrillation mode, AED mode, and pacing mode, the setting for FILTER is
fixed to “MONITOR”.
Filter setting Frequency characteristics for each filter setting:
Refer to Section 15 “Technical Resources”.
Settings:
• MAXIMUM: D
rift-free filter and high-cut filter. Use this setting when
there is hum noise or ESU is to be used.
• MONITOR: Low-cut filter and high-cut filter.
• DIAGNOSIS: F
or monitoring waveforms similar to the real ECG in
such cases as focusing on the QRS change.
Setting the Cascade Display On or Off

Set whether ECG waveforms are to appear as cascade display or not.
“Screen Example” (p. 8-1-9)
Settings:
• ON: Cascade display
• OFF: No cascade display

8-1. ECG Monitoring
Setting Chest Leads

Set the leads for the Ca and Cb leads when 6 electrodes are used.
Setting Range
Item Setting Range

Ca LEAD
ECG SETUP V1, V2, V3, V4, V5, V6
Cb LEAD
Setting the Leads for the Ca and Cb Leads

Display the ECG SETUP window from the SETUP window and set any 2 leads
from V1 to V6 as the Ca and Cb leads if 6 electrodes are used.
The Ca and Cb leads can be set only if 6 electrodes are used.
1) Select ECG SETUP in the SETUP window. 8
2) Select Ca LEAD or Cb LEAD then press the [OK] key.
“Displaying the Setting Window” (p. 8-1-18) 8-1
1 Set the lead.

1) Press the [BACK] key or [NEXT] key to select Ca LEAD or Cb LEAD.
2) Press the [↓] key or [↑] key to set the lead.
Leads set for the Ca and Cb leads are selectable when the lead for monitoring is
to be set.

8. Monitoring
Setting Pacing and QRS

Change the settings for the pacing and QRS according to the measurement
conditions.
Setting Range
Item Setting Range

PACING REJECT ON, OFF
QRS SETUP
DETECTION TYPE ADULT, CHILD
Setting the Detection Type for Pacing Reject and QRS

Display the QRS SETUP window from the SETUP window and change the
settings for pacing and QRS.
1) Select QRS SETUP in the SETUP window.
2) Select PACING REJECT or DETECTION TYPE then press the [OK] key.


8-1. ECG Monitoring
Setting the PACING REJECT On or Off

Set whether the detected pacemaker pulse is to be omitted from the heart rate
counts or not.
For monitoring a pacemaker patient, the pacing pulse may be counted as QRS
and the heart rate may be miscounted. The pacing pulse is a very small wave that
cannot be displayed on the screen of the defibrillator.
When PACING REJECT is set to “ON”, only the pacemaker pulse is detected
and used for detecting QRS correctly.
Pacing reject OFF mark
If PACING REJECT is set to “OFF”, a pacing reject OFF mark appears
at the upper part on the home screen.
Settings:
• ON: P
acemaker pulse is detected and distinguished from QRS wave.
It is removed from the heart rate counts.
• OFF: Pacemaker pulse is not detected.
Note on pacing reject
WARNING
Turn the PACING REJECT to On when monitoring 8
a pacemaker patient. Otherwise the pacemaker 8-1
pulse is not rejected. However, even when the
PACING REJECT is set to On, the pacemaker
pulse might not be rejected. When the pacemaker
pulse is not rejected, the pacemaker pulse is
detected as QRS and false heart rate may be
indicated or critical arrhythmia such as asystole
may be overlooked. Keep pacemaker patients
under close observation.
For rejecting pacemaker pulse, refer to “Pacemaker pulse rejection capability”

(p. 15-26).
Section 15 “Technical Resources”
WARNING
Even when the PACING REJECT is set to On, the
pacemaker pulse can be overlooked or detected
as QRS. You cannot confirm the pacemaker
operation only from the detected pacemaker pulse.
NOTE: If the defibrillator miscounts a narrow-width QRS, set PACING

REJECT to "OFF" and confirm that the QRS is correctly
recognized.

8. Monitoring
Setting the QRS Detection Type

Set the QRS detection type for the patient for monitoring.
CAUTION
correct patient type is set for [DETECTION TYPE]
on the QRS SETUP window.
If an inappropriate patient type is set, heart rate
cannot be counted accurately and noise or P waves
may be counted as QRS and cardiac arrest may be
overlooked.
QRS detection type
The QRS detection type currently set is displayed on the home screen.
Settings:
• ADULT: F
or monitoring an adult.
• CHILD: For monitoring a child.
NOTE • Detection type setting is valid only when the limb/chest lead is
selected in monitor mode. It is not linked with the child mode in
AED mode.
• Even if DETECTION TYPE is set to “CHILD”, a neonate’s QRS
might not be detected correctly.

8-1. ECG Monitoring
Arrhythmia Analysis
Arrhythmia Analysis and Dominant QRS

Arrhythmia analysis is performed by obtaining the stable ECG of the patient
(dominant QRS), comparing the waveform and its pattern of each pulse, and the
information shown below (pattern matching system).
• RR interval
• QRS width
• QRS amplitude
• QRS polarity, etc
The dominant QRS is obtained with the ECG learning. If the obtained dominant
QRS differs from the stable ECG of the patient, arrhythmia analysis may be
inaccurate.
To improve the accuracy of arrhythmia detection of the defibrillator, check the
dominant QRS after the ECG learning then start ECG monitoring.
“Checking the Dominant QRS” (p. 8-1-10)

8
8-1
CAUTION
dominant QRS is appropriate. Otherwise
arrhythmia monitoring may be inaccurate.
Automatic Updating of Dominant QRS (Automatic Start of ECG Learning)

The defibrillator automatically starts ECG learning and updates the dominant
QRS in the cases listed below.
• When turning the power on
• When changing the monitor screen
• When restoring from the electrode check
• When changing the lead
• When changing the pacing reject setting (ON/OFF)
• When changing the arrhythmia analysis setting
• When changing the QRS detection type setting (adult/child)

8. Monitoring
Criteria for Arrhythmia Alarm

The arrhythmia alarm is generated when the result of arrhythmia analysis is
judged as arrhythmia. Arrhythmia alarm messages and standard for arrhythmia
analysis are shown in the table below.
Period for displaying arrhythmia alarm messages differ depending on the
importance of the arrhythmia alarm.
For details on settings for the periods of displaying arrhythmia alarm messages
and arrhythmia alarm, refer to Section 9 “Alarm Function”.
• “Arrhythmia Alarms” (p. 9-7)
• “Changing the Settings for Arrhythmia Alarms” (p. 9-15)
NOTE • Arrhythmia alarms other than VF/VT DETECTED are generated

only when limb leads and chest leads are selected in monitor
mode.
• In pacing mode, the arrhythmia alarm is not generated.
• If VF alarm or VT alarm is generated in monitor mode, it might
not be determined that the ECG is a shockable rhythm in AED
mode.
Detection
Message Importance Description Decision Condition
Condition
3 to 10 Longer than 3 to 10 seconds (selectable) with
ASYSTOLE 1 Asystole
seconds no QRS complex.
VF Ventricular fibrillation — Ventricular fibrillation longer than 4 seconds.

CRISIS
When the following conditions are satisfied:
• Heart rate exceeding the 180 beats/min.
VT Ventricular tachycardia —
• VPC continues for more than the VPC RUN
setting (beats).
3 to 8 VPC continues for the VPC RUN setting
VPC RUN 1 VPC short run
beats (beats).
WARNING
TACHYCARDIA 1 Tachycardia — Heart rate above the upper heart rate limit.
BRADYCARDIA 1 Bradycardia — Heart rate below the lower heart rate limit.
COUPLET 1
VPC couplet (paired PCs) — 2 consecutive VPCs.
VPC with a time interval from the
preceding normal QRS complex of less than
Early VPC including R-on-T
EARLY VPC 1 — approximately one-third of the normal R-R
type
interval, at heart rate dropping below 120
ADVISORY beats/min.
A dominant rhythm of N-V-N-V-N-V (N =
BIGEMINY 1 Ventricular bigeminy —
normal beat, V = ventricular beat)
VPC rate (VPCs/min) reaching or exceeding
FREQ VPC 1 Frequent VPCs — the preset limit of 1 to 99 VPCs/min
(selectable).
When detecting an ECG that is a shockable
Ventricular fibrillation or rhythm under any of the conditions below.
VF/VT
CRISIS ventricular tachycardia that — • Defibrillation mode or AED mode
DETECTED
was a shockable rhythm • Monitoring PAD lead or AUX lead ECG in
monitor mode
1
Only when optional arrhythmia analysis software is installed

8-2 CO2 Monitoring
Introduction............................................. 8-2-2 Changing CO2 Settings......................... 8-2-15

Measuring Procedures .....................................8-2-2 CO2 Setting Window .................................. 8-2-15
Using the CO2 Sensor Kit Setup Item List ...............................................8-2-15
(Mainstream Method)............................. 8-2-3 Displaying the CO2 Setting Window ...............8-2-16
Selecting a CO2 Sensor Kit ..............................8-2-3 Changing Alarm Settings...................... 8-2-17

TG-920P CO2 Sensor Kit .............................8-2-5 Setting Range ............................................ 8-2-17 8
TG-900P CO2 Sensor Kit .............................8-2-7 Changing Alarm Settings.................................8-2-18
TG-970P CO2 Sensor Kit .............................8-2-8 Setting CALIBRATION METHOD and
Connecting the CO2 Sensor Kit to the 8-2
SCALE.................................................. 8-2-19
Defibrillator .......................................................8-2-9
Setting Range ............................................ 8-2-19
Performing Zero Calibration Setting CALIBRATION METHOD and
(When TG-970P is Used)..................... 8-2-10 SCALE . ..........................................................8-2-19
Zero Calibration ......................................... 8-2-10 Setting the Calibration Method ..................8-2-20
Calibrating by Air............................................. 8-2-11 Setting the Scale ........................................8-2-20
Calibrating with N2 Gas ..................................8-2-12 Inspection of Measurement Accuracy.. 8-2-21
Storing the Value of Zero Calibration in Daily Inspection of Measurement Accuracy ...8-2-21
Memory ..........................................................8-2-12 Inspection of Measurement Accuracy
Starting Measurement (Precise Method) ............................................8-2-21
(Start of Monitoring).............................. 8-2-13 Measurement Method.......................... 8-2-22
Notes on Measurement...................................8-2-13 Merits and Limitations ....................................8-2-22
When Measuring by the Inspiration Zero
Principles . ......................................................8-2-22
Balance Adjustment Method Using the
Measurement Error when Measuring with the
TG-900P or TG-920P ................................ 8-2-13
Inspiration Zero Balance Adjustment
When Measuring by the Single Wave
Method ...........................................................8-2-23
Spectroscopic Method Using the
TG-970P .................................................... 8-2-13
Measurement Error when Using Volatile
Anesthetic Agents ...................................... 8-2-14
Screen Example .............................................8-2-14
8. Monitoring
Introduction
This defibrillator performs CO2 measurement and monitoring with the infrared
absorption method.
The defibrillator supports measurements by sensors of the mainstream method.
Measuring CO2 with the Mainstream Method

For measurement, connect the TG-900P, TG-920P or TG-970P CO2 sensor kit
to the patient’s respiration circuit or directly to the patient and connect the CO2
sensor kit to the CO2 socket. When using the CO2 sensor kit, refer to the manual
provided with the CO2 sensor kit.
For details on the measurement method, refer to “Measurement Method”
(p. 8-2-22).
Select a CO2 sensor kit.
Connect the CO2 sensor kit to the defibrillator.
3 Perform zero calibration (single wave spectroscopic method: TG-970P only). Refer to p. 8-2-10.
Connect the CO2 sensor kit to the patient’s respiration circuit or attach it to the patient.
For connecting or attaching the kit, refer to the manual provided with the CO2 sensor kit.
For tracheal cannulation For no tracheal cannulation

5 When the procedures above are completed, CO2 measurement mode is set and monitoring
starts.
Refer to p. 8-2-13.
6 Make necessary settings.

Refer to p. 8-2-15.

8-2. CO2 Monitoring
Using the CO2 Sensor Kit (Mainstream Method)
Selecting a CO2 Sensor Kit

The TG-900 series CO2 sensor kit of mainstream method is combined with a
sensor and measurement circuit.
The CO2 sensor kits that can be used with the defibrillator are introduced on the
next page, depending on the two measurement methods (inspiration zero balance
adjustment method and single wave spectroscopic method), weight of the patient,
dead space volume, etc.
Select an appropriate kit for the purpose.
For details on the measurement method, refer to “Measurement Method”
(p. 8-2-22).
WARNING
When using the airway adapter or nasal adapter
on a patient with low ventilatory volume, the CO2
may mix in the inspiration due to the airway 8
adapter’s dead space, resulting in inaccurate
measured values or difficulty in detecting apnea.
Perform ventilation taking into consideration the 8-2
dead space of the adapters.
CAUTION CAUTION
With the TG-900P or TG-920P CO2 sensor kit, the The CO2 data may be inaccurate when monitoring
measured value may be incorrect when the a patient with an extremely high respiration rate or
operating temperature changes greatly or there is irregular respiration. Read the measured values
excess condensation in the airway adapter or carefully.
nasal adapter.
CAUTION
CAUTION When using an anesthetic instrument with a
Only use Nihon Kohden specified CO2 sensor kit. volatile anesthetic agent, the CO2 measurement
Otherwise, the maximum performance from the may be inaccurate.
defibrillator cannot be guaranteed.
Warning and caution differ depending on the CO2 sensor kit to be used. Refer to
the manual provided with the kit to be used.

8. Monitoring
NOTE • For tracheal cannulation, attach the CO2 sensor so that it does
not touch the patient.
• Use the TG-970P CO2 sensor kit inside a healthcare facility.
Otherwise, the measurement data may be incorrect by strong
electromagnetic interference.
Dead
When the TG-900 Series CO2 Sensor Tracheal Airway Adapter or Patient Reference
Space
Kit is Attached Cannulation Nasal Adapter (Weight) Page
Volume
YG-120T nasal adapter
Inspiration Zero Balance Adjustment Method (Semi-quantitative Method)
YG-121T nasal adapter (For nasal breathing)

10 kg or
Not used (For naso-oral breathing) 1.2 mL
more
(For oxygen cannula
TG-920P adjustment) p. 8-2-5
7 kg or
YG-111T airway adapter 4 mL
more
Measurement Method
Straight type
tracheal tube 10 kg or
TG-900P YG-101T airway adapter 5 mL p. 8-2-7
more
Used
Elbow type
tracheal tube
Method (Quantitative Method)
7 kg or
Single Wave Spectroscopic
YG-211T airway adapter 4 mL

more
YG-213T neonatal/infant
TG-970P 2 to 7 kg 0.5 mL p. 8-2-8
airway adapter
YG-214T neonatal/infant
2.5 to 7 kg 1.8 mL
airway adapter
For purchasing the CO2 sensor kit, refer to “For CO2 Monitoring” (p. 13-6)”.

8-2. CO2 Monitoring
TG-920P CO2 Sensor Kit

The TG-920P CO2 sensor kit measures the partial pressure of the expirated CO2
with the inspiration zero balance adjustment method (semi-quantitative method).
This CO2 sensor kit can be used on both intubated and non-intubated patients by
selecting the adapter to be used appropriately.
• When the patient is intubated: Use with the YG-111T airway adapter.
• When the patient is not intubated: Use with the YG-120T, YG-121T or
YG-122T nasal adapter.
CAUTION CAUTION
the inspiration of every respiration. If the inspired CAUTION
With the TG-900P or TG-920P CO2 sensor kit, the
measured value may be incorrect when the
operating temperature changes greatly or there is
8
excess condensation in the airway adapter or
CAUTION nasal adapter.
The TG-900P and TG-920P CO2 sensor kits do not 8-2
may be inaccurate.
The measurement value drops 0.13 kPa (1 mmHg) for

5.33 kPa (40 mmHg) CO2 gas when an atmospheric pressure
drops 3.3 kPa.
NOTE: If the TG-920P CO2 sensor kit is used in environments with
high concentration of nitrous oxide gas, measurement may be
inaccurate.

8. Monitoring
When the patient is not intubated: Use the nasal adapter.

TG-920P CO 2 Sensor Kit
Three types of adapters are provided for the various requirements.
This kit is combined with a sensor for measuring CO2
YG-120T YG-121T YG-122T
and a measurement circuit.
(For nasal breathing) (For naso-oral (For oxygen cannula
breathing) adjustment)
Sensor
TG-121T CO2 sensor
Dead
Supply
Type Weight Space
Code
Volume
YG-120T V921
10 kg or
YG-121T 1.2mL V922
more
YG-122T V923
JP-920P CO2 adapter When the patient is intubated: Use the airway adapter.
YG-111T
Dead
Supply
Type Weight Space
Code
Volume
7 kg or
YG-111T 4mL R804
more
Notes on Using the YG-122T or YG-121T Nasal Adapter
WARNING WARNING
The only oxygen cannula that can be used with • When you use YG-122T together with an oxygen
YG-122T is manufactured by HUDSON RCI®. Do cannula, check that the oxygen cannula is
not use any other oxygen cannula. Other oxygen correctly attached on the patient by referring to
cannulas cannot be attached and oxygen cannot other parameters and by observing the patient
be delivered to the patient through the nostrils. periodically.
• If arterial oxygen saturation does not increase,
immediately stop using the oxygen cannula with
WARNING the CO2 sensor kit and select another way to
supply oxygen.
Check that the oxygen cannula tube is not bent,
broken, or blocked by the nasal tube. If the ends of
the oxygen cannula tube turn too far up or down, it
causes insufficient O2 supply or the CO2 value may
be incorrect.
CAUTION
When using the YG-121T or YG-122T nasal
adapter on a patient with bleeding disorder, poor
general medical condition or malnutrition, observe
the patient condition all the time. The mouth guide
touches the mouth and may cause pressure sores.

8-2. CO2 Monitoring

The TG-900P CO2 sensor kit measures the partial pressure of the expired CO2 of
an intubated patient by the inspiration zero balance adjustment method (semi-
quantitative method).
It is used with the YG-101T airway adapter.
CAUTION CAUTION
Supply adequate oxygen when measuring CO2 With the TG-900P or TG-920P CO2 sensor kit, the
partial pressure of a patient connected to a measured value may be incorrect when the
Jackson Rees, Mapleson D or any other operating temperature changes greatly or there is
respiration circuit where CO2 gas may be present excess condensation in the airway adapter or
during inspiration. The semi-quantitative method nasal adapter.
measures CO2 partial pressure based on the
CAUTION
8
high altitudes because the measurement value 8-2
may be inaccurate.
The measurement value drops 0.13 kPa (1 mmHg) for

5.33 kPa (40 mmHg) CO2 gas when an atmospheric
pressure drops 3.3 kPa.
NOTE The measurement value may be inaccurate in the cases listed

below.
• When used in an environment with high concentration nitrous
oxide gas.
• When used with a spontaneously respirated patient with
irregular breathing (expiration cannot be detected).
TG-900P CO2 Sensor Kit YG-101T airway adapter

This kit is combined with a sensor for measuring CO2 and a
measurement circuit.
TG-101T CO2 sensor
Dead Space Supply

Type Weight
Volume Code
10 kg or
JG-900P CO2 adapter YG-101T 5 mL R801
more

8. Monitoring

NOTE: Use the TG-970P CO2 sensor kit inside a healthcare facility.
Otherwise, the measurement data may be incorrect by strong
electromagnetic interference.
The TG-970P CO2 sensor kit measures the partial pressure of the expired CO2 of
a patient by the single wave spectroscopic method (quantitative method).
This CO2 sensor kit can be used on both intubated and non-intubated patients by
selecting the adapter or cap-ONE mask to be used appropriately.
When the patient is intubated, use the CO2 sensor kit with the YG-211T,
YG-213T or YG-214T airway adapter.
CAUTION
With the TG-970P CO2 sensor kit, measured value
may be incorrect when the operating temperature
changes greatly. In this case, wait for about 30
minutes to acquire correct measurement.
NOTE: The measurement value may be inaccurate in the cases listed

below.
• When used in an environment with high concentration nitrous
oxide gas.
• When used in an environment with sudden temperature
changes.
• When used in an environment with very high humidity.
TG-970P CO2 Sensor Kit When the patient is intubated: Use the airway adapter.
This kit is combined with a sensor for measuring CO2 and Three types of adapters are provided for the weight and
a measurement circuit. ventilation air volume of the patient.
YG-211T YG-214T
TG-221T CO2 sensor
YG-213T
Dead
Supply
JG-970P CO2 adapter Type Patient Weight Space
Code
Volume
YG-211T ― 7 kg or more 4 mL R805
YG-213T Neonates/ 2 to 7 kg 0.5 mL R806
YG-214T infants 2.5 to 7 kg 1.8 mL R807

8-2. CO2 Monitoring
Connecting the CO2 Sensor Kit to the Defibrillator

When the TG-970P CO2 Sensor Kit is Connected Connect the CO2 sensor kit to the CO2 socket.
YG-211T, YG-213T NOTE: Only one CO2 socket can be used for monitoring
or YG-214T airway CO2.
adapter
TG-221T
CO2 sensor
JG-970P CO2 adapter
8-2

8. Monitoring
Performing Zero Calibration (When TG-970P is

Used)
When using the TG-970P for measuring by the single wave spectroscopic
method, perform zero calibration under the conditions listed below.
• Before use
• Once a day
• When the airway adapter is replaced with a new one.
• When a different type of airway adapter is used.
• When the operating temperature changes.
• When the measurement room is changed.
Perform the calibration under conditions other than above, as required.
NOTE • Calibration cannot be performed in the first 10 seconds after the
TG-970P is connected to the defibrillator.
• If zero calibration is performed when apnea is detected, the
apnea alarm is cleared.
• Alarms do not sound in the first 30 seconds after zero
calibration.
Zero Calibration
Zero calibration can be performed in two ways: calibration with air and
calibration with N2 gas.
Zero calibration is performed in CO2 SETUP in the SETUP window.
Calibration method (AIR or N2) can be set in CO2 SETUP in CALIBRATION
METHOD.
“Measurement Method” (p. 8-2-22)
Calibration with AIR

Expose the airway adapter to air for zero calibration.
Calibrates with about 0.2 mmHg CO2 in the air.
Calibration with N2
Flow N2 gas into the airway adapter for zero calibration.
The method for flowing N2 gas into the airway adapter differs depending on the
type of gas cylinder. Refer to the manual provided with the N2 gas cylinder.

8-2. CO2 Monitoring
Calibrating by Air
Expose the airway adapter to air for zero calibration.
1 Expose the airway adapter mounted to the CO2 sensor kit to air.
3 Perform AIR calibration. (zero calibration)

item CO2 SETUP.
2) Press the [ ] key or [ ] key to select CALIBRATE
(AIR).
If the setting is CALIBRATE (N2), set CALIBRATION METHOD to
AIR.
“Setting the Calibration Method” (p. 8-2-20)
3) Press the [OK] key.

Displayed during calibrating.
During calibrating, “ZERO CALIBRATING” is displayed. When
calibration is completed, the message disappears and there is a “BING
bong” sound.
8
If calibration has failed, there is a “bong BING” sound.
8-2
screen.
After zero calibration, return the airway adapter to the respiration circuit.
The defibrillator is set to the CO2 measurement mode and starts CO2
monitoring.

8. Monitoring
Calibrating with N2 Gas

Flow N2 gas into the airway adapter for zero calibration.
NOTE: For disposal of used N2 gas, follow the instructions of the
distributor.
1 Connect the airway adapter mounted to the CO2 sensor kit to the N2 gas
cylinder.
3 Perform N2 calibration. (zero calibration)

item CO2 SETUP.
2) Press the [ ] key or [ ] key to select CALIBRATE
(N2).
If the setting is CALIBRATE (AIR), set CALIBRATION METHOD to
“N2”.
“Measurement Method” (p. 8-2-22)
3) Flow the N2 gas from the N2 gas cylinder to the airway adapter then press
Displayed during calibrating.
the [OK] key.
During calibrating, “ZERO CALIBRATING” is displayed. When
calibration is completed, the message disappears and there is a “BING
bong” sound.
If calibration has failed, there is a “bong BING” sound.
screen.
After zero calibration, return the airway adapter to the respiration circuit.
The defibrillator is set to the CO2 measurement mode and starts CO2
monitoring.
Storing the Value of Zero Calibration in Memory

The zero value is stored in memory on the connector of the CO2 sensor kit after
zero calibration.
After zero calibration, if the CO2 sensor kit is connected via the connector of
Memory is built-in.
another defibrillator or the sensor kit which is calibrated on another defibrillator
is connected via the connector on this defibrillator, the value is displayed
referring to the zero calibration value stored in memory on the connector. In such
a case, this defibrillator displays “NOT CALIBRATED” for confirmation.

8-2. CO2 Monitoring

When the preparations before measurement are completed, CO2 measurement
mode is set and monitoring starts.
CAUTION
When the “Adapter Failure” or “Sensor Failure”
message is displayed, check the CO2 sensor kit
and replace it if necessary. CO2 cannot be
monitored while the message is displayed.
Notes on Measurement
When Measuring by the Inspiration Zero Balance Adjustment Method

Using the TG-900P or TG-920P
CAUTION 8
different atmospheric pressure. Be careful when 8-2
may be inaccurate.
NOTE • The defibrillator automatically calibrates the sensor at periodic
intervals.
• In the following cases, calibration of the sensor is performed
automatically:
- Upon defibrillation power-on and the patient’s first respiration.
- When the airway adapter is removed and connected again.
- When respiration has stopped for 20 seconds.
- When the signal changed rapidly due to temperature change.
• During calibration, the CO2 waveform appears as a stepwise
calibrated waveform, but the respiration rate and measurement
value are not affected.
When Measuring by the Single Wave Spectroscopic Method Using the

TG-970P
NOTE: Perform calibration of the CO2 sensor under conditions listed
below.
• When the airway adapter is changed with a new one.
• When a different type of airway adapter is used.
• When the operating temperature changes.
• When the measurement room is changed.
• Perform the calibration under conditions other than above, as
required.

8. Monitoring
Measurement Error when Using Volatile Anesthetic Agents

If N2O is mixed into inspiration or high-concentration oxygen is inhaled, it
affects on the infrared absorption sensitivity of CO2, and measurement may be
inaccurate.
CAUTION
When using an anesthetic instrument with a
volatile anesthetic agent, the CO2 measurement
may be inaccurate.
Measurement Error when Using Volatile Anesthetic Agents
Volatile Measurement error [mmHg (kPa)]

Anesthetic Concentration
Agents TG-900P TG-920P TG-970P
Halothane 4% + 0.9 (+ 0.12) + 0.6 (+ 0.08) + 0.3 (+ 0.04)

Enflurane 5% + 1.5 (+ 0.20) + 1.5 (+ 0.20) + 0.9 (+ 0.12)
Isoflurane 5% + 1.8 (+ 0.24) + 1.7 (+ 0.23) + 1.7 (+ 0.22)
Sevoflurane 6% + 2.8 (+ 0.37) + 2.7 (+ 0.36) + 2.1 (+ 0.28)
24% + 7.0 (+ 0.93) + 6.6 (+ 0.88) —
Desflurane
15% + 6.6 (+ 0.88) + 5.4 (+ 0.72) + 2.9 (+ 0.39)
Condition: At 1 atmospheric pressure, 5% (38 mmHg, 5.1 kPa) CO2 and N2
mixture dry gas
Screen Example
On the monitor screen, the measurement value (ETCO2 and respiration rate) and
CO2 waveform are displayed.
• The sweep speed of the displayed CO2 waveform can be set with CO2
Sweep Speed on the SYSTEM SETUP screen.
• The [GUIDE] key is activated if the technical alarm corresponding
to the GUIDE window is generated. To display the GUIDE window,
press the [GUIDE] key. (Refer to p. 8-0-5.)
Ending tidal
CO2 partial
pressure value Alarm off
(ETCO2) mark
Respiration
Rate (RR)
Function keys
Refer to “Monitor Screen”
(p. 8-0-3). CO2 waveform Scale of CO2
waveform

8-2. CO2 Monitoring
Changing CO2 Settings

Change settings for CO2 monitoring in CO2 SETUP in the SETUP window.
CO2 Setting Window

The display of the CO2 SETUP window differs depending on the menu items.
8-2
Setup Item List

Perform zero calibration. (Refer to p. 8-2-10.)
CALIBRATE (AIR, N2) Zero calibration can be performed only when the ―
TG-970P is used.
• Upper limit: 2 to 99, OFF
mmHg (1.0 to 13.5, OFF)
ETCO2 Change the upper limit alarm for ETCO2.
(kPa) 1 • Lower limit: OFF, 1 to 98
CO2 (OFF, 0.5 to 13.0)
CO2 ALARM
Change the upper and lower limit alarms for • Upper limit: 2 to 150, OFF
SETUP RR /min
respiration rate. • Lower limit: OFF, 0 to 148
APNEA s Change the upper limit alarm for APNEA. 5 to 40, OFF
Set the calibration method when the
CALIBRATION METHOD AIR, N2
TG-970P is used.
mmHg 0-20, 0-40, 0-80

SCALE Set the scale for CO2 waveform.
(kPa) 1 (0.0-2.5, 0.0-5.5, 0.0-10.5)
1
The unit can be set in Pressure Units on the SYSTEM SETUP screen.

8. Monitoring
Displaying the CO2 Setting Window


item CO2 SETUP.
set.
A setting window is displayed in which the item selected in step 2) is
highlighted.
screen.

8-2. CO2 Monitoring

Change the upper/lower limit alarms for ETCO2, RR (Respiration Rate), and
APNEA in the CO2 SETUP window.
in ALARM SETUP in the SETUP window, settings on either of the windows
are reflected to another window.
Setting Range
Upper 2 to 99, OFF

limit (1.0 to 13.5, OFF)
mmHg 1
ETCO2
(kPa) 2 (0.5)
Lower OFF, 1 to 98
limit (OFF, 0.5 to 13.0)
CO2 Upper
ALARM RR 2 to 150, OFF
limit
(Respiration /min 2
Rate) Lower
OFF, 0 to 148 8
limit
Upper
APNEA 1 bpm 5 to 40, OFF 5
limit
8-2
1
The apnea alarm is silenced if zero calibration is performed or another alarm,
such as CHANGE ADAPTER, SENSOR ERROR, CHECK SENSOR, is
generated.
2
The units can be set in Pressure Units on the SYSTEM SETUP screen.
CAUTION
alarm limit to Off.

8. Monitoring

Display the CO2 SETUP window to change the settings.

1) Select CO2 SETUP in the SETUP window.
2) Select CO2 ALARM then press the [OK] key.
“Displaying the CO2 Setting Window” (p. 8-2-16)
1 Change the upper/lower limit alarms.

To set the upper/lower limit alarms off, press the [↓] or [↑] key to set a
Measurement value
value is displayed.
Upper limit
Position of current
measured value
Lower limit

When the key is held The set value is increased or
pressed, the cursor moves decreased by 1 step.
consecutively. When the key is held pressed, the
setting changes continuously.

8-2. CO2 Monitoring
Setting CALIBRATION METHOD and SCALE

In the CO2 SETUP window you can set the zero calibration method and scale for
the CO2 waveform.
Setting Range
Item Setting Range
CALIBRATION METHOD AIR, N2
0-20, 0-40, 0-80

SCALE mmHg (kPa) 1
(0.0-2.5, 0.0-5.5, 0.0-10.5)
1
Setting CALIBRATION METHOD and SCALE

Activate the CO2 SETUP window in the SETUP window and set the zero
8
calibration method and scale for the CO2 waveform.
1) Select CO2 SETUP in the SETUP window.
8-2
2) Select CALIBRATION METHOD or SCALE then press the [OK] key.
“Displaying the CO2 Setting Window” (p. 8-2-16)



8. Monitoring
Setting the Calibration Method

Set the calibration method when the TG-970P is used.
“Performing Zero Calibration (When TG-970P is Used)” (p. 8-2-10)
Settings:
• AIR: Expose the airway adapter to air for zero calibration.
• N2: Flow N2 gas into the airway adapter for zero calibration.
Setting the Scale

Set the scale for CO2 waveform.
Settings:
• mmHg display: 0-20, 0-40, 0-80
• kPa display: 0.0-2.5, 0.0-5.5, 0.0-10.5

8-2. CO2 Monitoring
Inspection of Measurement Accuracy
Daily Inspection of Measurement Accuracy

Perform daily accuracy inspection, using your own respiration.
Put the larger end of the airway adapter (side for connecting to the patient’s mask
and tracheal tube) into your mouth and after stabilizing breathing, breathe in
the same way as in the resting state at a rate of 5 seconds per breath (12 breaths/
min).
Breathing too quickly or taking deep breaths disables standard measurements.
The standard ETCO2 value is 40 mmHg (5.3 kPa). Check that the CO2 gas
concentration is from 35 to 45 mmHg (4.7 to 6.0 kPa).
Inspection of Measurement Accuracy (Precise Method)

If a CO2 measurement error is suspected, check the measurement accuracy, using
the gas for calibrating sensitivity. Check the measurement accuracy every half 8
year for stable measurement accuracy.
For details on inspection, refer to the service manual.
8-2

8. Monitoring
Measurement Method
The infrared absorption method has two methods (mainstream method and
sidestream method), depending on the expiration sampling method. On this
defibrillator, CO2 is measured with the mainstream method, which measures
CO2 by directly connecting the sensor to the respiration circuit or the patient’s
nasal cavity or mouth.
Infrared Absorption Method
CO2 gas absorbs infrared of 4.3 μm. Using this characteristic, the
infrared absorption method measures CO2 partial pressure.
Merits and Limitations

The mainstream CO2 measurement method has the following merits and
limitations compared with the sidestream method.
Understand these points when performing measurements.
• No delay in the measurement time.

• Measurement is stable over a long period of time.
Merits
• Few measurement troubles due to mixture of water droplets (when
the TG-970P is used).
• The dead space volume is relatively large.

• This method cannot be used with non-intubated patients (when the
Limitations TG-900P or TG-970P is used).
• Due to the weight of the TG-900P CO2 sensor kit, load is easily
imposed on the tracheal tube.
Principles
The CO2 sensor kit of the mainstream method is classified into the two types as
described below, based on the infrared absorption method.
Inspiration Zero Balance Adjustment Method (Semi-

quantitative Method): TG-920P or TG-900P CO2 Sensor Kit
The CO2 gas partial pressure is calculated from the ratio of the infrared
absorption of expirated CO2 and that of inspiration with no CO2 gas. The CO2
concentration in the inspiration is assumed to be 0 mmHg.
Zero calibration is not required.
“Measurement Error when Measuring with the Inspiration Zero
Balance Adjustment Method” (p. 8-2-23)
Single Wave Spectroscopic Method (Quantitative

Method): TG-970P CO2 Sensor Kit
The infrared transmitted from the airway adapter is split into two, and the CO2
gas partial pressure in expiration is calculated from the ratio of CO2 infrared
absorption and base infrared absorption.
This is suitable for the nebulizer or humidifying. If CO2 gas is mixed in the
inspiration, accurate measurement can be performed.

8-2. CO2 Monitoring
Measurement Error when Measuring with the Inspiration Zero

Balance Adjustment Method
With the TG-920P or TG-900P, measurements are based on the assumption that
the inspiration contains no CO2 gas. (calculating based on the inspiration of
0 mmHg: inspiration zero balance adjustment method)
If CO2 gas is mixed during inspiration, measured values may be lower than
normal, as the CO2 gas is assumed as zero.
• When the TG-900P or TG-920P is used • When the TG-920P and oxygen mask are used
CAUTION CAUTION
may be lower than the actual value. 8
When CO2 is mixed in inspiration

8-2
Actual CO2 waveform Displayed CO2 waveform
mmHg mmHg
80 80
Measured value becomes lower.
CO2 mixed in inspiration

0 0
Measurement Error when CO2 is Mixed in the Inspiration

ETCO2 (mmHg)
0 10 20 30 40 50 60 70 80
10
0
Error (mmHg)
10
15
20
25
CO2 mixed in inspiration
1 mmHg
2 mmHg
4 mmHg
8 mmHg

8-3 SpO2 Monitoring
Introduction...................................................................8-3-2
Measuring Procedures .............................................................. 8-3-3
Selecting a Probe.........................................................8-3-4
Types of Probes ........................................................................ 8-3-4
Reusable Probes . .................................................................8-3-4
Disposable Probes ................................................................8-3-5 8
Connecting the Probe to the Defibrillator.....................8-3-6
Attaching the Probe to the Patient................................8-3-6
Starting Measurement (Start of Monitoring).................8-3-7 8-3
Screen Example ........................................................................ 8-3-7
Changing SpO2 Settings...............................................8-3-8
SpO2 Setting Window . ..........................................................8-3-8
Setup Item List .......................................................................... 8-3-8
Displaying the SpO2 Setting Window ........................................ 8-3-9
Changing Alarm Settings............................................8-3-10
Setting Range ..................................................................... 8-3-10
Changing Alarm Settings...........................................................8-3-11
Changing Settings for Monitoring...............................8-3-12
Setting Range ..................................................................... 8-3-12
Changing the Items ................................................................. 8-3-12
Setting the Sync Source to SpO2 ........................................ 8-3-13
Setting the Sync Tone to SpO2 ........................................... 8-3-13
Setting the Pulse Wave Sensitivity ..................................... 8-3-14
Setting the Sensitivity for Measuring the SpO2 Value ......... 8-3-14
8. Monitoring
Introduction
To monitor SpO2, attach a probe to the patient and connect it via the SpO2 socket.
Then measure the pulse wave and SpO2 value.
WARNING WARNING
• When using the TL-201T finger probe, do not SpO2 measurement may be incorrect in the
fasten the probe and cable to the finger by following cases.
wrapping with tape. This may cause burn, • When the patient’s carboxyhemoglobin or
congestion or pressure necrosis from poor blood methemoglobin increases abnormally.
circulation. • When dye is injected in the blood.
• When using probes other than the TL-201T finger • When using an electrosurgical unit.
probe, to avoid poor circulation, do not wrap the • During CPR.
tape too tight. Check the blood circulation • When measuring at a site with venous pulse.
condition by observing the skin color and • When there is body movement.
congestion at the skin peripheral to the probe • When the pulse wave is small (insufficient
attachment site. Even for short-term monitoring, peripheral circulation).
there may be burn or pressure necrosis from
poor blood circulation, especially on neonates or
low birth weight infants whose skin is delicate.
WARNING
Accurate measurement cannot be performed on
When not monitoring SpO2, disconnect the SpO2
a site with poor peripheral circulation.
connection cord from the input unit. Otherwise,
noise from the probe sensor may interfere and
incorrect data is displayed on the screen.
WARNING
Check the circulation condition by observing the
skin color at the measurement site and pulse WARNING
waveform. Change the measurement site every 8
When monitoring SpO2 of a patient who is
hours for disposable probes and every 4 hours for
receiving photodynamic therapy, the light from the
reusable probes (every 8 hours for TL-630T3 or
finger probe sensor may cause a burn.
TL-631T3 probe). The skin temperature may
Photodynamic therapy uses a photosensitizing
increase at the attached site by 2 or 3°C (4 or 5°F)
agent that has a side effect of photosensitivity.
and cause a burn or pressure necrosis. When
using the probe on the following patients, take
extreme care and change the measurement site The SpO2 probe has two wavelengths with peaks in the range of
650 nm and 950 nm. The maximum light intensity is less than
more frequently according to symptoms and 5.5 mW/sr.
degree.
• Patient with a fever
• Patient with peripheral circulation insufficiency
CAUTION
• Neonate or low birth weight infant with delicate Turn off the power of mobile phones, small
skin wireless devices and other devices which produce
strong electromagnetic interference around a
patient (except for devices allowed by the hospital
administrator). Radio waves from devices such as
CAUTION mobile phones or small wireless devices may be
While a patient is on medication which causes mistaken as pulse waves and the displayed data
vasodilation, the pulse waveform may change and may be incorrect.
in rare cases the SpO2 value might not be
displayed.
CAUTION
Normal external light does not affect monitoring but
strong light such as a surgical light or sunlight may
affect monitoring. If affected, cover the measuring
site with a blanket.

8-3. SpO2 Monitoring
Select the probe.
Connect the probe to the defibrillator.

Connect the probe to the SpO2 socket on the defibrillator
via the SpO2 connection cord.
Attach the probe to the patient.
8
8-3
4 When the procedures above are completed, the defibrillator is set to SpO2 measuring state and
monitoring starts.
Refer to p. 8-3-7.
5 Set the pulse-wave sensitivity.

Set the sensitivity for the pulse wave to be monitored.
Refer to p. 8-3-14.
6 Change necessary settings.

Refer to p. 8-3-8.

8. Monitoring
Selecting a Probe
Select the appropriate probe according to the purpose.
WARNING
caused.
Types of Probes
Reusable Probes
Model Patient (Weight) Attachment Site SpO2 Connection Cord
Finger Probe TL-201T JL-900P
Adults, children
(20 kg or more)
Finger Probe TL-630T1 (0.6 m), Finger

TL-630T3 (1.6 m)
Adults, children
(50 kg or more)
Finger Probe TL-631T1 (0.6 m),

TL-631T3 (1.6 m)
Adults, children
(20 kg or more)
Finger or toe
Multi-site Probe TL-220T

Adults, children
(3 kg or more)
Neonates
Instep and sole
(3 kg or less)

Disposable Probes
Model Patient (Weight) Attachment Site SpO2 Connection Cord
TL-271T (0.8 m), TL-271T3 (1.6 m) JL-900P
Adults
(30 kg or more)
Finger or toe
TL-272T (0.8 m), TL-272T3 (1.6 m)
Children
(from 10 to 50 kg)
TL-273T (0.8 m), TL-273T3 (1.6 m) Adults

Finger or toe
(40 kg or more)
Neonates
Instep and sole
(3 kg or less)
TL-274T (0.8 m), TL-274T3 (1.6 m)

Infants
Finger or toe
(from 3 to 20 kg)
8
TL-260T multi-site Y probe Low birth weight Instep
Attachment tape
infants and
Type S
(1 kg or less) sole
attachment
Children, neonates Finger tape
8-3
(3 kg or more) or toe
Instep Type L
Neonates
and attachment
The attachment tape type S or L depends (3 kg or less)
sole tape
on the patient.
TL-051S (0.8 m), TL-052S (1.6 m)
Adults
Finger
(50 kg or more)
40 mm Neonates
Instep and sole
(3 kg or less)
TL-061S (0.8 m), TL-062S (1.6 m)

Adults, children
Finger
(from 15 to 50 kg)
35 mm Children, infants
Toe
(from 3 to 15 kg)
For purchasing a probe and SpO2 connection cord, refer to “For SpO2
Monitoring” (p. 13-7)”.

8. Monitoring
Connecting the Probe to the Defibrillator

Connect the selected probe to the SpO2 socket via the JL-900P
SpO2 connection cord.
1 Open the stopper of the SpO2 connection cord and connect

the probe firmly.
2 Close the stopper.
Stopper
When the TL-201T Finger Probe is Connected 3 Connect the SpO2 connection cord to the SpO2 socket.
JL-900P SpO2 connection

cord
TL-201T
Attaching the Probe to the Patient

For attaching the probe, refer to the manual provided with the probe.


When the preparation before measurements of the patient is completed, the
defibrillator is set to SpO2 measurement state and monitoring starts.
CAUTION CAUTION
When the probe is attached on an appropriate site When a message indicates a faulty probe or faulty
with sufficient circulation and an error message SpO2 connection cord, stop monitoring and replace
about probe attachment repeatedly appears, the the probe or SpO2 connection cord with a new one.
probe may be deteriorated. Replace it with a new
one.
CAUTION
If the attachment site is dirty with blood or bodily
fluids, clean the attachment site before attaching
the probe. If there is nail polish on the attachment
site, remove the polish. Otherwise, the amount of
transmitted light decreases, and measured value
may be incorrect or measurement cannot be
performed.
8
NOTE • Keep the measurement site warm by covering with a blanket
or something similar. Especially for a patient with small pulse
amplitude, warming the site is effective.
• Check that there is a sync sound when starting monitoring. If
there is no sync sound, check the setting of SYNC SOUND in 8-3
VOLUME in the SETUP window and if sync sound is silenced
intentionally.
Section 5 “VOLUME” (p. 5-11)
Screen Example
On the monitor screen, the SpO2 value and pulse waveform are displayed.
• The sweep speed of the displayed SpO2 waveform can be set with ECG Sweep
Speed on the SYSTEM SETUP screen.
• The [GUIDE] key is activated if the technical alarm corresponding to the
GUIDE window is generated. To display the GUIDE window, press the
[GUIDE] key. (Refer to p. 8-0-5.)
Alarm off
mark
SpO2 value
Pulse sync mark Pulse rate

Displayed synchronizing with
the SpO2 pulse wave if SYNC
SOURCE in SpO2 SETUP in
the SETUP window is set to Function keys Waveform Sensitivity
“SpO2”. (Refer to p. 8-3-13.) Refer to “Monitor Screen”
(p. 8-0-3).

8. Monitoring
Changing SpO2 Settings

Display the SpO2 SETUP window to change settings for SpO2 monitoring.
SpO2 Setting Window

The display of the SpO2 SETUP window differs depending on the menu items.
Setup Item List

SpO2 • Upper limit: 51 to 100, OFF

Change the upper and lower limit alarms for SpO2. • Lower limit: OFF, 50 to 99
(%SpO2) (Default: 90)
SpO2
ALARM • Upper limit: 35 to 300, OFF
• HR (bpm) Change the upper and lower limit alarms for HR/ (Default: 140)
• PR (/min) PR (Heart Rate/Pulse Rate). • Lower limit: OFF, 30 to 295
SpO2 (Default: 40)
SETUP
SYNC SOURCE Select the sync sound source. ECG, SpO2
SYNC TONE Select the sync sound tone. FIXED, SpO2
SENSITIVITY Set the pulse-wave sensitivity. AUTO, ×1/8, ×1/4, ×1/2, ×1, ×2, ×4, ×8
SENSITIVITY MODE Set the sensitivity for measuring the SpO2 value. MAX, NORMAL

Displaying the SpO2 Setting Window


item SpO2 SETUP.
set.
A setting window is displayed in which the item selected in step 2) is
highlighted.
8

8-3
screen.

8. Monitoring

Change the settings for upper/lower limit alarms for SpO2 and HR/PR (Heart
Rate/Pulse Rate) in the SpO2 setting window.
in ALARM SETUP in the SETUP window, settings in either of the windows
are reflected to another window.
Setting Range

Upper
51 to 100, OFF
limit
SpO2 %SpO2 1
Lower
OFF, 50 to 90
SpO2 limit
ALARM Upper
35 to 300, OFF
HR: bpm limit
HR/PR 1 1
PR: /min Lower
OFF, 30 to 295
limit
1
The PR (Pulse Rate) alarm can be set when SYNC SOURCE is set to “SpO2”.
The HR/PR alarm can also be set in the setting window shown below.
The settings are linked so that the setting changed in one of the
windows is reflected to other windows.
• ECG SETUP in the SETUP window
CAUTION
alarm limit to Off.


To change the settings, display the SpO2 SETUP window from the SETUP
window.
1) Select SpO2 SETUP in the SETUP window.
2) Select SpO2 ALARM then press the [OK] key.
“Displaying the SpO2 Setting Window” (p. 8-3-9)
1 Change the upper/lower limit alarms.

To set the upper or lower limit alarm off, press the [↓] or [↑] key to set a
8
Measurement value
value is displayed.
Upper limit
8-3
Position of
current
measured value
Lower limit

When the key is held The set value is increased or
pressed, the cursor moves decreased by 1 step.
consecutively. When the key is held pressed,
the setting changes continuously.

8. Monitoring
Changing Settings for Monitoring

Set the items for monitoring (SYNC SOURCE, SYNC TONE, SENSITIVITY,
SENSITIVITY MODE) according to the measurement conditions.
Setting Range
Item Setting Range
SYNC
ECG, SpO2
SOURCE
SYNC TONE FIXED, SpO2
SENSITIVITY AUTO, ×1/8, ×1/4, ×1/2, ×1, ×2, ×4, ×8

SENSITIVITY
MAX, NORMAL
MODE
Changing the Items

To change the settings, display the SpO2 SETUP window from the SETUP
window.
1) Select SpO2 SETUP in the SETUP window.
2) Select among from SYNC SOURCE to SENSITIVITY MODE then
press the [OK] key.
“Displaying the SpO2 Setting Window” (p. 8-3-9)

2) Press the [↓] key or [↑] key to change the item.


Setting the Sync Source to SpO2

The sync sound and pulse rate measurement, which are normally synchronized
with the ECG are synchronized with the SpO2 pulse.
Select SpO2 to set the sync source to “SpO2”.
Settings:
• ECG: Synchronized with the QRS.
• SpO2: S
ynchronized with the SpO2 pulse wave. The pulse sync mark
blinks synchronizing with the SpO2 pulse.
NOTE • If noise may be mixed in with the ECG because of the use of
ESU, set SYNC SOURCE to “SpO2”. If it is set to “ECG”, the
measurement for heart rate will be unstable and synchronization
and pulse rate might not be obtained correctly.
• When IABP is used, the SpO2 pulse wave will be irregular. In
8
such a case, set SYNC SOURCE to “ECG”.
• If SpO2 is not measured, it is synchronized with the ECG.
• If the connection cord is disconnected when SpO2 is selected, the sync
source is changed to ECG. When the connection cord is connected
again, the original sync source is restored.
8-3
• When SYNC SOURCE is set to ECG and the defibrillator power is
turned on or the screen is changed to another screen, the sync source
may temporarily change to SpO2 until the heart rate is displayed.
Setting the Sync Tone to SpO2

Change the sync tone (pitch) according to the measurement value of SpO2. Then
you can recognize the change of the SpO2 value without looking at the screen.
Select SpO2 to set the sync tone to “SpO2”.
Settings:
• FIXED: The pitch is fixed.
• SpO2: T
he pitch changes in 20 steps from high to low for change in
SpO2 value between 100% SpO2 and 81% SpO2.
• W hen SYNC TONE is set to “SpO2” and the measuring conditions are
as described below, the sound pitch is fixed to the pitch for 81% SpO2.
- When the measurement value is below 81% SpO2.
- W hen SYNC SOURCE is set to “ECG” and the measured value of
SpO2 is not displayed.
• W hen SYNC SOURCE is set to SpO2 and the message “SpO2 CHECK
PROBE” or “DETECTING PULSE” is displayed on the home screen,
the sync sound stops.

8. Monitoring
Setting the Pulse Wave Sensitivity

Set the sensitivity for the pulse wave to be monitored.
Settings: AUTO, ×1/8, ×1/4, ×1/2, ×1, ×2, ×4, ×8
When AUTO is selected, the optimum sensitivity is selected

automatically, depending on the amplitude of the patient’s pulse wave.
Setting the Sensitivity for Measuring the SpO2 Value

Set the sensitivity for measuring the SpO2 value.
Settings:
• NORMAL: Usually set to “NORMAL”.
• MAX: A
small pulse or irregular pulse can easily be measured. When
monitoring a patient with peripheral circulation insufficiency or
when an IABP is used, it is recommended to set to “MAX”.
NOTE: When “MAX” is selected, the SpO2 value may appear even when
When MAX is selected, “SENS the probe is not attached to the patient.
MAX” appears on the left of the
SpO2 value display.

9 Alarm Function
Introduction......................................................................9-2
Types of Alarm................................................................................9-2
Alarm Levels...................................................................................9-3
Defibrillator’s Operation when an Alarm is Generated...................9-4
Priority of Alarms............................................................................9-5
Alarm Sound and Alarm Indicator............................................. 9-5
Messages on the Screen.......................................................... 9-5
Alarm Control Marks.......................................................................9-5

Screen Examples–..........................................................9-6
Upper/Lower Limit Alarms..............................................................9-6 9
Arrhythmia Alarms..........................................................................9-7
Technical Alarms............................................................................9-8
Information Display.........................................................................9-9
Silencing or Suspending Alarms....................................9-10

Silencing a Current Alarm.............................................................9-10
Suspending Alarm Sound and Blinking/Lighting of the Alarm
Indicator . .....................................................................................9-11
Suspension of Alarms during Defibrillation Mode....................9-11
Suspension of Alarms during Basic Check.............................. 9-11
Changing Alarm Settings...............................................9-12

Notes on Setting Change.........................................................9-12
Changing the Settings for Upper/Lower Limit Alarms...................9-13
Setting Ranges.........................................................................9-13
Setting Upper/Lower Limits......................................................9-14
Changing the Settings for Arrhythmia Alarms...............................9-15
Setting Ranges.........................................................................9-15
Setting the Arrhythmia Alarms.................................................9-16
Setting All Upper/Lower Limits and Arrhythmia Alarm Settings
to the User Default Settings ........................................................9-17
Setting the Alarm Volume..............................................9-17
Alarm Recording............................................................9-17
9. Alarm Function
Introduction
Alarms inform you of abnormal measurement data of a parameter (exceeding
upper or lower limits), arrhythmia, or abnormal defibrillator condition. Alarms
are shown by screen message, sound, and blinking or lighting of the alarm
indicator.
WARNING WARNING
Do not diagnose a patient based only on alarm A physician must be within the range where he/she
information of the defibrillator. If the alarm is set to can hear the alarm sound of the defibrillator while
off, critical changes in the patient may be over- monitoring a patient on the defibrillator. If the
looked. physician cannot hear the alarm sound, critical
WARNING
If more than one medical equipment is used WARNING
together in the same facility, make sure all Check the alarm settings when you start monitor-
equipments have the same alarm default settings ing a new patient. Check the alarm settings as
(alarm master). If the medical equipments have required during monitoring and change them
different alarm default settings and when initialized, appropriately according to the patient’s condition.
the alarm settings differ with the other equipments The alarm settings return to those specified in
and alarm cannot be managed appropriately in the Alarm Setting on the SYSTEM SETUP screen
facility. If using different alarm default settings about 30 minutes after power-off.
according to areas or wings in the facility, manage
the alarms appropriately.
WARNING
Set the alarm sound volume according to the place
WARNING where the defibrillator is used. If the alarm sound is
When an alarm occurs: too quiet, keep the patient under close observation
• Check the patient first and take necessary and periodically check the defibrillator. Otherwise,
measure to ensure patient’s safety. the alarm sound might not be heard and critical
• Remove the cause of the alarm. changes on the patient or problems in the
• Check the alarm settings on the defibrillator and defibrillator may be overlooked.
change the alarm settings if necessary.
Types of Alarm
Alarms provided with this defibrillator are divided into three categories, as
indicated below.
The places where alarm messages are displayed vary, depending on the type of
alarm.
Apart from the alarms, various informational messages on the
measurement environment and current status of the defibrillator are
also displayed.
Type of alarms Description

An upper/lower limit alarm is generated when the measured value of a parameter
Upper/lower limit alarms
exceeds the upper alarm limit or drops below the lower alarm limit set beforehand.
Arrhythmia alarm An alarm is generated when arrhythmia is detected.
Alarms regarding the measurement environment and the defibrillator itself:
• Measurement environment
Technical alarm ECG electrodes check, analysis impossible, probe check, etc.
• Defibrillator
Running out of recording paper, discharged battery, etc.

9. Alarm Function
Technical alarm messages/information regarding all the

parameters being measured and ECG measurement Technical alarm messages/
• Parameter being measured (example) information regarding the
“PARAMETER NOT AVAILABLE”, “2 SENSORS defibrillator Technical alarm
CONNECTED”, etc. messages regarding
•E CG (example) the measurement
“ECG NOISE”, “ARRHYTHMIA ANALYSIS OFF”, “ECG environment of ECG
LEARNING”, etc.
Upper/lower limit
alarm
(Measurement value
highlighted)
Arrhythmia alarm
message
Technical alarm
messages/information
regarding measurement
of each parameter
When defibrillation mode or pacing mode is selected

Technical alarm
regarding each mode
Operation guidance
and technical alarm
regarding each mode
Alarm Levels
There are three alarm levels, depending on their urgency.
According to these levels, priorities are set for alarm generation and behavior of
the defibrillator when an alarm is generated.
Level Description
Patient is in critical condition or the defibrillator is in failure
CRISIS and the patient’s life may be at risk without immediate
High
action.
↑
Patient is in critical condition, the defibrillator is in failure,
Priority WARNING or operations are not appropriate. Prompt action should be
taken.
↓
Patient is in abnormal condition, the defibrillator is in
Low
ADVISORY failure, or the conditions for accurate measurement or
treatment cannot be met.

9. Alarm Function
Defibrillator’s Operation when an Alarm is Generated

When an alarm is generated, the measurement value of the parameter for which
the alarm is generated and the alarm message are highlighted. According to the
alarm level, the defibrillator operates as described below.
When an upper/lower limit alarm or arrhythmia alarm is generated,
the ECG for 20 seconds (from 10 seconds before to 10 seconds after an
alarm is generated) is automatically stored in the internal memory of the
defibrillator, along with the alarm information, as an alarm waveform
report.
Refer to Section 10-1 “Waveform Report” (p. 10-1-14).
The alarm indicator blinks or

lights.
The measurement value

and alarm message are
highlighted.
An alarm sounds. Alarm recording is performed.
Message displayed
Level Alarm sound Alarm indicator Alarm recording 2
on the screen
Blinking in red
IEC alarm sound 1

CRISIS Highlighted in red
“ceg-gC”
Blinking in yellow
Recording
IEC alarm sound 1 automatically starts
WARNING Highlighted in yellow
“ceg” when an alarm is
generated.
Lit in cyan
IEC alarm sound 1
ADVISORY “ec” (at intervals of Highlighted in cyan
20 seconds)
Alarm sounds specified by the International Electrotechnical Commission

1
(IEC).
Automatic recording is performed when the Alarm Recording setting on the
2
SYSTEM SETUP screen is set to “On”.

9. Alarm Function
Priority of Alarms
If multiple alarms are generated simultaneously, the defibrillator operates as
described below.
Alarm Sound and Alarm Indicator

If multiple alarms with different levels are generated simultaneously, the alarm
sound and blinking/lighting of the alarm indicator become those for the highest-
priority alarm.
Messages on the Screen

Different alarms such as alarm upper/lower limit, arrhythmia, and technical
alarms are displayed in different places on the screen. Alarm priority does not
have any effect.
If more than one technical alarm with the same level occurs at the same time, the
two alarm messages are displayed alternately in the same place on the screen.
Alarm Control Marks

If a current alarm is silenced, or if the upper/lower limit for an upper/lower limit
alarm is set to “OFF”, the alarm control marks indicated in the table below are
displayed.
“Silencing or Suspending Alarms” (p. 9-10)
9
Alarm
Description Display example
control mark
To be displayed when a current alarm is silenced or when all mark
alarm sounds and blinking/lighting of the alarm indicator are
suspended beforehand.
The remaining suspension time is also displayed.
To be displayed when alarm sounds and blinking/lighting of mark
the alarm indicator for vital alarms and technical alarms other
than those for ECG are suspended during manual defibrillation
or synchronized cardioversion
To be displayed during BASIC CHECKS Alarm-off mark “ ”
To be displayed when either the upper or lower limit of an Alarm-off

upper/lower limit alarm is set to “OFF”, or when arrhythmia marks “ ”
analysis is set to “OFF”.

9. Alarm Function

Screen Examples–
Upper/Lower Limit Alarms

An upper/lower limit alarm is generated when the measured value of a
parameter exceeds the upper alarm limit or drops below the lower alarm limit set
beforehand.
If an upper/lower limit alarm is generated, the measurement value is highlighted
in the color specified to each parameter.
“Changing the Settings for Upper/Lower Limit Alarms” (p. 9-13)
Alarm sound and the color of the blinking/lit alarm indicator are different,
depending on the level of the generated alarm.
Refer to “Defibrillator’s Operation when an Alarm is Generated” (p. 9-4).
When an APNEA alarm is generated, the alarm message “APNEA” is displayed

highlighted.
NOTE: If a parameter is not measured correctly, the measurement
value is invalid and “- - -” is displayed. For the parameter whose
measurement value is invalid (“- - -”), an upper/lower limit alarm is
not generated.
Item Level Screen example

HR/PR Example: SpO2 alarm
RR The measurement value is highlighted in
WARNING the color specified for each parameter.
SpO2
ETCO2
VPC ADVISORY
The alarm message “APNEA” is

highlighted in yellow.
APNEA WARNING

9. Alarm Function
Arrhythmia Alarms
An arrhythmia alarm is generated when arrhythmia is detected.
If an arrhythmia alarm is generated, the corresponding alarm message is
highlighted in the color corresponding to the level of the alarm.
Alarm sound and the color of the blinking/lit alarm indicator are different
Arrhythmia alarms are retained for a given time after arrhythmia disappears. The
alarm retention time varies, depending on the level of the alarm:
• CRISIS: 30 seconds
• WARNING: 20 seconds
• ADVISORY: 10 seconds
WARNING
For arrhythmia monitoring, set [ARRHYTHMIA
ANALYSIS] on the ARRHYTHMIA SETUP to ON.
Otherwise, there is no sound or indication for
arrhythmia alarms (except for Asystole).
Section 8-1 “Arrhythmia Analysis” (p. 8-1-27)
NOTE • Arrhythmia alarms other than a “VF/VT DETECTED” alarm are 9

generated only when the limb and chest leads are selected in
monitor mode.
• In pacing mode, arrhythmia alarms are not generated.
in AED mode.
Item Level Screen example

ASYSTOLE 1
VF
CRISIS
VT
VF/VT DETECTED
VPC RUN 1
TACHYCARDIA 1 WARNING
BRADYCARDIA 1
COUPLET 1 An arrhythmia alarm message is highlighted

in the color corresponding to the level of the
EARLY VPC 1 alarm.
ADVISORY
BIGEMINY 1
FREQ VPC 1
1
To be displayed only when an optional QS-831V is installed.

9. Alarm Function
Technical Alarms
Technical alarms include alarms regarding the measurement environment for the
patient and the defibrillator itself.
If a technical alarm is generated, the corresponding alarm message is highlighted
in the color corresponding to the level of the alarm.
Alarm sound and the color of the blinking/lit alarm indicator vary,
Details and levels of technical alarm messages

Section 11 “Screen Messages” (p. 11-2)
Screen Example
Various technical alarm messages are displayed in the upper part of the screen and in the upper part of the measurement value
area of each parameter in the color corresponding to the level of the alarm.
Technical alarm messages
Technical alarm messages regarding the defibrillator regarding the measurement
environment of ECG
Technical alarm
messages regarding
all the parameters
being measured and
ECG measurement
Technical alarm
messages regarding
measurement of each
parameter
When defibrillation mode or pacing mode is selected
Technical alarm
messages
regarding each
mode

9. Alarm Function
Information Display
Apart from the alarms, various informational messages on the measurement
environment and the current status of the defibrillator are also displayed on the
screen of the defibrillator.
• W hen there are technical alarms and two or more information occur at
the same time, the message are displayed alternately.
• No alarm sound nor blinking/lighting of the alarm indicator
acccompanies informational messages.
Details on informational messages

Screen Example
Various messages are displayed and highlighted in the same place as with technical alarm messages.
Example: “ARRHYTHMIA ANALYSIS OFF” and “ALL ALARMS SUSPENDED” displayed

The messages are displayed.

9. Alarm Function
Silencing or Suspending Alarms

You can silence current alarms or suspend all alarm sounds and blinking/lighting
of the alarm indicator beforehand by pressing the silence alarms key.
Silencing a Current Alarm

When an alarm is generated, confirm the cause then press the silence alarms key
to silence the alarm. Operations of the defibrillator vary, depending on the type
of alarm.
NOTE: Subsequently generated alarms must be silenced separately,
one after another. However, if multiple alarms are generated
simultaneously, all the alarms can be silenced when the silence
alarms key is pressed once.
Upper/lower limit
Type of alarms Technical
and arrhythmia
Silencing alarms Silent/Unlit Alarm clear
Operation during
(The alarm is silenced for 2 minutes.) (The alarm indicator is unlit and alarm (The alarm is
silencing
sound is silenced.) cleared.)
Alarm sound To be silenced for 2 minutes To be silenced
Alarm indicator To be unlit for 2 minutes To be unlit
Alarm message To remain displayed with highlighted To be deleted
“ ALARMS SUSPENDED” and the “ ALARM SILENCED” is displayed in

remaining suspension time (in minutes) are the upper part of the screen.
displayed in the upper part of the screen.
When the technical alarms regarding the
Messages
defibrillator is suspended, the messages are
during silencing
displayed alternately every 5 seconds.
Clearing alarm When the cause of an alarm is removed during silencing, the alarm status is cleared and the
status highlighted message/measurement value disappears.
―
• An alarm other than the silenced alarm is • An alarm other than the silenced alarm is
generated. generated.
Conditions where • The cause of the current alarm has not been • The cause of the current alarm was
an alarm is removed after the suspension time has removed once but is generated again.
generated again elapsed.
• The cause of the current alarm was removed
once but is generated again.
As long as another alarm was not generated,
press the silence alarms key again during
Resuming the
silencing. ―
silenced alarm
Alarm sound and blinking/lighting of the
alarm indicator are resumed.
NOTE: Depending on the severity, some alarms cannot be silenced.

In such a case, even if the silence alarms key is pressed, the
alarm sound is not silenced and the alarm indicator is not turned
off. If the alarms that cannot be silenced as indicated below are
generated, contact your Nihon Kohden representative.
• RELAY DRIVE ERROR • HV MONITOR ERROR
• ERROR Axxx • ERROR Cxxx • ERROR Dxxx
• ERROR Kxxx • ERROR Pxxx • ERROR Exxx

9. Alarm Function
Suspending Alarm Sound and Blinking/Lighting of the Alarm

Indicator
If you press the silence alarms key while no alarm is generated, you can set so
that alarm sound and blinking/lighting of the alarm indicator is suspended for 2
minutes beforehand.
This use of the silence alarms key is useful when generation of an alarm is
expected, such as when you replace the electrodes, etc.
The message “ ALL ALARMS SUSPENDED” and the remaining suspension
time (in minutes) are displayed in the upper part of the screen.
Message
Press the silence alarms key when no
alarm is generated.
WARNING
During alarm suspension (“ALL ALARMS
SUSPENDED” or “ALL ALARMS OFF” message
displayed), all alarms are turned off. Be careful
when you suspend the alarm.
NOTE: Prior setting of suspension of alarms cannot be performed after

an alarm is generated. Pressing the silence alarms key after an
alarm silences the current alarm.
Suspension of Alarms during Defibrillation Mode 9

When the Vital Alarm Sound When Performing Defibrillation setting on the
SYSTEM SETUP screen is set to “Off”, alarm sounds and blinking/lighting of
the alarm indicator for vital alarms and technical alarms other than those for
ECG are suspended during defibrillation (manual defibrillation or synchronized
cardioversion) or in AED mode.
When the defibrillator enters defibrillation mode, the message “ VITAL AND
TECHNICAL ALARMS OFF” is displayed in the upper part of the screen.
Message
Suspension of Alarms during Basic Check

During BASIC CHECK, the message “ ALL ALARMS OFF” is displayed in
the upper part of the screen and all alarms (except for some technical alarms) are
suspended.
Section 12 “Basic Checks” (p. 12-5)

Message

9. Alarm Function

Alarm settings can be changed.
Upper/Lower Limit Alarms

The upper/lower limit settings for each parameter of the upper/lower limit alarms
can be changed in the ALARM SETUP setting in the SETUP window.
Arrhythmia Alarms
The arrhythmia alarm settings can be changed for each type of arrhythmias. If an
optional QS-831V is installed, the ON/OFF setting for arrhythmia analysis can
also be changed.
Notes on Setting Change

Any alarm settings before the defibrillator is turned off are retained for 30
minutes.
If the defibrillator is turned on more than 30 minutes after it was turned off, the
alarm settings change according to the Alarm Setting on the SYSTEM SETUP
screen, as described in the table below.
For details, refer to the Administrator's Guide.
Administrator’s Guide:
• “SYSTEM SETUP”
• “ALARM SETTING LIST”
Alarm Setting
on the SYSTEM Alarm settings
SETUP screen
The latest alarm settings are retained, regardless of the elapsed
Latest
time after the defibrillator is turned off.
All alarm settings are reset to the default settings 30 minutes
Default
after the defibrillator is turned off.
All alarm settings return to the user default (alarm master)
settings in “ALARM SETTING LIST” 30 minutes after the
User Settings defibrillator is turned off.
When an optional QS-831V is installed, arrhythmia analysis is
set to “ON”.
NOTE: If the self test is performed less than 30 minutes after the
defibrillator power was turned off, the alarm settings change
according to the Alarm Setting on the SYSTEM SETUP screen 30
minutes after completion of the self test.

9. Alarm Function
Changing the Settings for Upper/Lower Limit Alarms

The upper/lower limit settings for each parameter of the upper/lower limit alarms
can be changed in the ALARM SETUP setting of the SETUP window.
CAUTION
alarm limit to Off.
Setting Range
Alarm item Upper limit Lower limit Step Unit
HR: bpm
HR/PR 35 to 300, OFF OFF, 30 to 295 1
PR: /min
VPC 1 to 99, OFF ― 1 /min
SpO2 51 to 100, OFF OFF, 50 to 99 1 %SpO2
ALARM SETUP 1
APNEA 5 to 40, OFF ― 5 s
2 to 99, OFF OFF, 1 to 98 1 mmHg2
ETCO2
1.0 to 13.5, OFF OFF, 0.5 to 13.0 0.5 kPa 2
RR 2 to 150, OFF OFF, 0 to 148 2 /min
1
You can also change the upper/lower limit alarm settings in the SETUP
window for each parameter. Any changes in the settings in either of the SETUP
windows will be reflected to the settings in the other window. (The settings in
both SETUP windows are linked to each other.) 9
Section 8 “Monitoring”
The units can be changed in the Pressure Units setting on the SYSTEM SETUP
2
screen.

9. Alarm Function
Setting Upper/Lower Limits

The settings for the upper/lower limit alarm for each parameter can be set as
described below.
2 Display the setting window for the desired parameter.

1) Press the [ ] key or [ ] key to select ALARM
SETUP from the SETUP menu.
2) Press the [ ] key or [ ] key to select a parameter to
be changed.
3) Press the [OK] key to display the setting window for that parameter.
The setting window is displayed with the current setting of the parameter
selected in Step 2) highlighted.
1) Select a SETUP menu item. 2) Select a parameter. 3) [OK]
3 Change settings for the upper and/or lower limit alarm.

2) Press the [↓] key or [↑] key to set the upper/lower limit.
NOTE: If a value lower than the lower limit is set to the upper limit,
the lower limit is automatically decreased to a value lower
than the upper limit. Conversely, if a value higher than
the upper limit is set to the lower limit, the upper limit is
automatically increased to a value higher than the lower
limit. However, the setting does not become “OFF”.
To set the upper/lower limit alarm to “OFF”, press the [↓] key or [↑] key
until a value higher or lower than the setting range is reached. The upper/
lower limit setting changes to “OFF”.

If the key is held pressed, The setting value increases/decreases by
the cursor moves one step.
continuously. If the key is held pressed, the setting value
increases/decreases continuously.

9. Alarm Function
Changing the Settings for Arrhythmia Alarms

The arrhythmia alarm settings can be changed for each type of arrhythmia.
Arrhythmia analysis can also be set to “ON” or “OFF”.
Section 8-1 “Arrhythmia Analysis” (p. 8-1-27)
The settable items vary, depending on whether an optional QS-831V is installed

or not.
WARNING
For arrhythmia monitoring, set [ARRHYTHMIA
ANALYSIS] on the ARRHYTHMIA SETUP to ON.
Otherwise, there is no sound or indication for
arrhythmia alarms (except for Asystole).
CAUTION
When the alarm is turned Off for an arrhythmia,
there will be no alarm for that arrhythmia type.
There is no message or mark to indicate that a
certain arrhythmia alarm is turned off. Therefore,
be careful when you turn off an arrhythmia alarm.
9
Setting Range
Item Setting Range

ASYSTOLE 1 3 to 10 seconds (fixed at ON)
VF/VT ON, OFF
VPC RUN 1
3 to 8 beats, OFF
COUPLET 1 ON, OFF
EARLY VPC 1 ON, OFF
BIGEMINY 1 ON, OFF
ARRHYTHMIA ANALYSIS 1 ON, OFF
1
Available only when an optional QS-831V is installed.

9. Alarm Function
Setting the Arrhythmia Alarms
2 Display the setting window for the desired parameter.

1) Press the [ ] key or [ ] key to select
ARRHYTHMIA SETUP from the SETUP menu.
2) Press the [ ] key or [ ] key to select a type of
arrhythmia from the submenu whose setting is to be changed.
3) Press the [OK] key to display the setting window for that parameter.
The setting window is displayed, with the type of arrhythmia selected in
Step 2) highlighted.
1) Select a SETUP menu item. 2) Select a parameter. 3) [OK]
3 Change settings for the arrhythmia alarm.

2) Press the [↓] key or [↑] key to set the alarm ON/OFF or detection
condition value.

If the key is held pressed, the Set the alarm ON/OFF
cursor moves continuously. and detection condition
value.

9. Alarm Function
Setting All Upper/Lower Limits and Arrhythmia Alarm Settings to

the User Default Settings
You can set all upper/lower limits and arrhythmia alarm settings to the user
default settings at once.
Set Alarm Setting on the SYSTEM SETUP screen to “User Settings” then turn
the defibrillator off. Turn the defibrillator back on again 30 minutes or more after
it was turned off. The settings for all upper/lower limit alarms and arrhythmia
alarms change to the user default settings (alarm master).
When an optional QS-831V is installed, arrhythmia analysis is set to "ON".
The user default settings (alarm master) can be set on the SYSTEM SETUP
screen.
For details, refer to the Administrator's Guide.
• “SYSTEM SETUP”
• “ALARM SETTING LIST”.
Setting the Alarm Volume

You can set the alarm volume in the VOLUME setting in the SETUP window.
Refer to Section 5 “VOLUME” (p. 5-11).
Alarm Recording
If the Alarm Recording setting on the SYSTEM SETUP screen is set to “On”,
the measurement value for each parameter and ECG are automatically recorded
when an upper/lower limit alarm or arrhythmia alarm is generated.

10 Recording and
Data Storing
Introduction.................................................................10-0-2
Recording and Reports ...................................Section 10-1
Saving and Sending Data.................................Section 10-2
Transport Function...........................................Section 10-3
10
10-1
10-2
10-3
10. Recording and Data Storing
Introduction
TEC-5611, TEC-5621 and TEC-5631 have a built-in recorder. The defibrillator
can record data and print reports.
TEC-5601 does not have a built-in recorder and cannot print reports,
but can display them in the report window.
If the specified SD card is inserted in the SD card slot on the right side panel
of the defibrillator, data on items being measured (waveform data, various
information, and sound) and waveform reports saved in the internal memory of
the defibrillator can be saved in the SD card.
You can set whether to save sound with Save Audio Together with ECG
When an optional QI-832V Bluetooth® module is installed in the defibrillator,

you can send the results of the defibrillator’s self-test and waveform reports
saved in the internal memory to external devices such as a PC with wireless
communication.
If Enable Transport on the SYSTEM SETUP screen is set to “On”, the
waveforms and numerical data measured with the defibrillator can be sent to the
bedside monitor.
This section describes the operations in detail.
Recording and Reports (Section 10-1)

This section describes the type of recording and reports, using the built-in
recorder, and gives details on operations and recording examples.
Saving and Sending Data (Section 10-2)

This section describes how to insert an SD card and how to save and send data.
Transport Function (Section 10-3)

This section describes the data transfer functions and the method for transferring
data to the bedside monitor.

10-1 Recording and
Reports
Introduction........................................... 10-1-2 Report Recording............................... 10-1-14

Recording........................................................10-1-2 Waveform Report..........................................10-1-14
Report Recording............................................10-1-3 Recording Example (VF Analysis Report)
.................................................................. 10-1-15
Recording Setting................................. 10-1-4 TRENDGRAPH.............................................10-1-16
Available Settings............................................10-1-4 Recording Example (HR trend)................. 10-1-16
Changing Settings..........................................10-1-4 Periodic List Report.......................................10-1-17
Periodic Recording Interval......................... 10-1-5 Recording Example................................... 10-1-17
Combination of ECG, SpO2 and CO2 Event List Report...........................................10-1-18
Waves.........................................................10-1-6 Examples of Recording............................. 10-1-19
Recording Event List................................. 10-1-19
Manual Recording................................ 10-1-7
Waveform Recording.......................................10-1-7 Printed Characters and Marks............ 10-1-21 10
Recording Example..................................... 10-1-7
10-1
Event Recording..............................................10-1-8
Recording Example.....................................10-1-8
Automatic Recording............................ 10-1-9

Record “Charging Start” After Discharge
(Charge Recording).........................................10-1-9
Recording Example..................................... 10-1-9
Alarm Recording............................................10-1-10
Recording Example (Tachycardia)........... 10-1-10
Periodic Recording........................................ 10-1-11
Recording Example....................................10-1-11
Report Settings................................... 10-1-12

Available Settings..........................................10-1-12
Changing Settings.........................................10-1-12
Setting Interval.......................................... 10-1-13
Delete All Reports..................................... 10-1-13
Introduction
TEC-5611, TEC-5621 and TEC-5631 have a built-in recorder which can print
monitored data and reports.
TEC-5601 does not have a built-in recorder and cannot print reports,
but it can display them in the report window.
NOTE • If the mode is changed with the control dial during recording or
report printng, recording and printing automatically stop. After
changing the mode, perform recording again.
• Long term recording in high temperature may cause lack of
printing. To prevent data loss, insert the SD card to save the
waveforms in the SD card when recording data for a long time.
Recording
The defibrillator has two recording modes: manual and automatic. In manual
recording mode, recording starts when the RECORD key is pressed. In automatic
recording mode, recording starts automatically upon charging or when an alarm
occurs.
Recording Mode Recorded Data Length of Recording Start Recording Stop Recording
Waveform Waveform in the window 1
Continuous from when the
Recording (Real time or delayed) RECORD key is pressed until the
Manual Recording
(Real time or key is pressed again

delayed)
Event Waveform when the [EVENT] 12 seconds [EVENT] key Automatic
Recording key is pressed 1 From 4 seconds before to 8 pressed or when the
seconds after the [EVENT] key RECORD key is
is pressed pressed.
Recording on ECG waveform before and after From the start of charging to 6 or Charging starts
charging after discharge 12 seconds (set on the SYSTEM
discharge SETUP screen) after discharge
Automatic Recording
Alarm Waveform when an alarm 12 seconds Alarm occurrence

Recording occurs 1 From 4 seconds before to 8
seconds after alarm occurrence
Periodic Waveform at a specified 12 seconds Automatic at
Recording interval 1 From 4 seconds before to 8 specified interval
seconds after the preset time
1
The waveform to be recorded can be set on RECORDING SETUP in the
SETUP window.
“Combination of ECG, SpO2 and CO2 Waves” (p. 10-1-6)

10-1. Recording and Reports
Report Recording
The defibrillator automatically saves reports for measurement parameters and
ECG waveforms (upon defibrillation or alarm generation) into the internal
memory.
Reports can be monitored and recorded in the corresponding report window.
If Pressure Units on the SYSTEM SETUP screen is changed, the reports shown
below are deleted.
• Trendgraph
• Periodic list report
Capacity of
Report Recording
Recorded Data Length of Recording Recorded Start/Stop Recording
Mode
Data 1
Defibrillation ECG waveform at discharge and 22 seconds • Start
Report 3 defibrillation information From 10 seconds before to 12 Press the RECORD
seconds after discharge key.
VF Analysis ECG waveform for VF analysis 15 to 22 seconds
Waveform Report
Report and the result of analysis From 10 seconds before to

completion of the VF analysis
Alarm ECG waveforms at alarm 20 seconds Up to 2,000
Report generation and alarm seconds
From 10 seconds before to 10 • Stop
information seconds after alarm generation
Stops automatically or
Report Recording
Event ECG waveforms at when the 20 seconds

2
when the RECORD

Waveform [EVENT] key is pressed and From 10 seconds before to 10 key is pressed.
Report event information seconds after the [EVENT] key
is pressed.
Trendgraph Trendgraph of parameters 10
(1, 2, 4, 8, or 24 hours). Up to 24
hours 10-1
Periodic List Periodically measured values of

Report parameters in table format — Up to 120
You can set the periodic interval. records
(1, 5, 15, 30, or 60 minutes).
Event List Data and numeric values
Up to 1000
Report of events (not including
records
waveforms)
1
There is a limit to the storage capacity for recorded data. The table above is a
rough guide for the maximum amount of data.
2
A maximum of 2,000 seconds of all waveform reports can be stored in the
internal memory of the defibrillator. If the total duration of data exceeds 2,000
seconds, the oldest record is automatically be deleted.
3
ne report is created for continuous defibrillations within a 2-minute period.
O
But a second report is created from the seventh defibrillations or, if there are
many event informations of the defibrillation report such as VF analysis start in
the 2-minute period.

Recording Setting
You can change the recording setting in RECORDING SETUP in the SETUP
window.
Available Settings
Sets the recording interval for
INTERVAL OFF, FREE, 15 min, 30 min, 60 min, 120 min
periodic recording.
RECORDING
SETUP RECORDING Sets the combination of
ECG, ECG+SPO2, ECG+CO2
WAVES waveforms to be recorded.
Changing Settings

1) Press the [ ] key or [ ] key to select RECORDING
SETUP.
set.
The setting window for the item selected in step 2) is displayed.

3 Change settings for recording.

2) Press the [↓] key or [↑] key to change the setting.
The cursor moves to the selected item.
Periodic Recording Interval

Set the interval for periodic recording.
Settings:
• OFF (default): Periodic recording is not performed.
• FREE: Periodic recording is performed at the interval set in Periodic
10
Recording Interval on the SYSTEM SETUP screen. (1 to 120
minutes) 10-1
The first periodic recording is based on the time you change the
setting.
For example, if you change the FREE setting to “15 min” at 9:22 in
the morning, the first interval starts at 9:37 (15 minutes later).
Setting for FREE

9:37 → 9:52 → 10:07
• 15 min, 30 min, 60 min, 120 min:
The first periodic recording is based on the nearest “even” clock time
from the time you change the setting.
Example:
• If you change the INTERVAL setting to “15 min” at 9:22 in the
morning, the first interval starts at 9:30.
9:30 → 9:45 → 10:00.
• If you change the INTERVAL setting to “120 min” at 9:22 in the
morning, the first interval starts at 10:00.
10:00 → 12:00 → 14:00.

Combination of ECG, SpO2 and CO2 Waves

Select the waveforms to be recorded in the following recording modes.
• Waveform recording (manual recording)
• Event recording (manual recording)
• Periodic recording (automatic recording)
• Alarm recording (automatic recording)
Settings: ECG (Default), ECG+SpO2, ECG+CO2
Recording Waves
Setting Upper Part of Lower Part of
Recording Paper Recording Paper
ECG Only ECG (lead) is recorded.
ECG+SpO2 SpO2 pulse wave
ECG (lead)
ECG+CO2 CO2 waveform
CO2 Waveform Scale

When the CO2 waveform is recorded, the scale is automatically adjusted to fit
the paper. The baseline is 5 mm above the bottom of the paper and the top of the
scale is 10 mm above the baseline.
Example: CO2 waveform whose SCALE is set to “0 to 40”
40 mmHg
10 mm
0 mmHg
5 mm
Displayed scale

Manual Recording
The manual recording functions include the waveform recording and event
recording. To perform either of the functions, press the corresponding key.
Waveform Recording
Waveforms displayed on the screen are recorded continuously.
Besides the waveform, the patient’s ID number, the day, time, lead, and
sensitivity are also printed.
If the [EVENT] key is pressed during recording, the event mark is
printed.
A combination of waveforms to be recorded can be set with RECORDING

WAVES in the SETUP window.
Printing speed can be set with Paper Speed (mm/s) on the SYSTEM SETUP
screen.
If Delayed Recording is set to “On” on the SYSTEM SETUP screen, the
waveform from 4 seconds before the record/stop key is pressed is recorded.
Starting Recording
Press the record/stop key to start recording.
10
If the charge recording function is activated during recording
10-1
The mode is switched to the charge recording mode. (Refer to p. 10-1-9.)
Stopping Recording
Press the record/stop key during recording to stop recording.
Recording Example

Event Recording
Press the [EVENT] key to record the waveforms of 12 seconds (from 4 seconds
before to 8 seconds after the key is pressed).
NOTE: For event recording, set Event Recording on the SYSTEM
SETUP screen to “On”.
The combination of waveforms to be recorded can be set with RECORDING

Starting Recording
Press the [EVENT] key to start recording.
When the [EVENT] key is pressed, the ECG waveform of 20 seconds (from 10
seconds before to 10 second after the key is pressed) is stored in the internal
memory as the event waveform report.
Stopping Recording
Recording automatically stops after 12 seconds.
You can also stop recording anytime by pressing
the record/stop key.
Note on the Medication Function

If Medication on the SYSTEM SETUP screen is set to “On”, pressing the
[EVENT] key starts recording and the [MEDICATION] keys are displayed. If
either of the [MEDICATION] keys is pressed during recording, the medication
assigned to the pressed key is recorded as event data.
[MEDICATION] key names can be set in MEDICATION SETUP in the SETUP

window.
Section 5 “MEDICATION SETUP” (p. 5-13)
[MEDICATION] keys
Recording Example
Event mark
Displayed at the point where the [EVENT] key has been pressed.
If a [MEDICATION] key is pressed, the assigned medication name is also recorded.

Automatic Recording
Automatic recording includes charge recording, alarm recording, and periodic
recording. Recording starts according to set conditions.
Record “Charging Start” After Discharge (Charge Recording)

Recording of the ECG waveform starts when charging starts and ends 12 or 6
seconds after discharge.
NOTE: To enable the charge recording function, select “On: 6s After
Shock” or “On: 12s After Shock” in Record “Charge Start” After
Discharge on the SYSTEM SETUP window.
For safety, the defibrillator internally discharges charged energy when the charge
holding time has passed and the charge recording function stops.
The charge holding time is set in Charge Holding Time on the SYSTEM SETUP
screen. (Default value: 40 seconds)
The mode is switched to the charge recording mode.
If discharging is performed again during the auto recording
The ECG waveform of 12 or 6 seconds after the last discharge is recorded.
Stopping Recording
Recording stops automatically 12 or 6 seconds after discharging.
You can also stop recording anytime by 10
pressing the record/stop key.
10-1
Recording Example

Alarm Recording
If an alarm (upper/lower limit alarm or defibrillation alarm) occurs, the
12-second waveform from 4 seconds before to 8 seconds after the alarm is
recorded automatically.
You can print the event on the recording by pressing the [EVENT] key
during recording.
The combination of waveforms to be recorded can be set with RECORDING

NOTE • To enable alarm recording, set Alarm Recording on the

SYSTEM SETUP screen to “On”.
• If an alarm is canceled or suspended, alarm recording is not
performed. However, if an alarm occurs while “ All alarms
are suspended” is displayed, the alarm recording is performed.
If an alarm is generated during another recording
The alarm recording function is not performed.
Stopping Recording
You can also stop recording anytime by
Recording Example (Tachycardia)

Periodic Recording
12 seconds of waveforms are automatically recorded at the preset interval.
Waveforms are recorded from 4 seconds before to 8 seconds after the recording
start time.
The same items as waveform recording are recorded.
You can print the event on the recording by pressing the [EVENT] key
during recording.
The interval and combination of waveforms to be recorded in periodic recording

can be set in RECORDING SETUP in the SETUP window.
• “Periodic Recording Interval” (p. 10-1-5)
• “Combination of ECG, SpO2 and CO2 Waves” (p. 10-1-6)
Printing speed can be set with Paper Speed (mm/s) on the SYSTEM SETUP
screen.
NOTE: If the SETUP window or BASIC CHECKS window is displayed,

periodic recording is not performed.
If recording on charging after discharge starts during periodic recording
Recording on charging after discharge begins. (Refer to p. 10-1-9.)
Stopping Recording
You can also stop recording anytime by
10
Recording Example
10-1

Report Settings
You can change settings for reports in REPORT SETUP in the SETUP window.
Available Settings
Sets the measurement interval for the periodic list 1 min, 5 min, 15 min, 30 min,
INTERVAL
report. 60 min
Deletes all report data stored in the internal
DELETE ALL REPORTS NO, YES
memory.
REPORT SAVE REPORT

SETUP SEND REPORT
TRENDGRAPH Displays the corresponding report window.
PERIODIC LIST
EVENT LIST
Changing Settings

1) Press the [ ] key or [ ] key to select REPORT
SETUP.
set.
The setting window for the item selected in step 2) is displayed. If an
item is selected from SAVE REPORT to EVENT LIST, the corresponding
report window is displayed.

3 Change settings for the reports.

2) Press the [↓] key or [↑] key to change the setting
The cursor moves to the selected item.
Setting Interval
Set the measurement interval for the periodic list report.
Measured data of the parameter being monitored are stored in internal memory
of the defibrillator at the preset intervals.
Settings: 1 min (Default), 5 min, 15 min, 30 min, 60 min

10
10-1
Delete All Reports

All report data stored in internal memory of the defibrillator are deleted.
Settings: No (Default), Yes
1) Press the [↓] key or [↑] key to set DELETE ALL REPORTS to “Yes”.
2) Press the [DELETE] key to delete all reports.

When all reports are deleted, the setting for DELETE ALL REPORTS is
returned to “NO”.
If the [CANCEL] key is pressed, deleting of report data is canceled.
NOTE: Until all report data are deleted, do not perform any other
operations, such as changing a window. If any operation is
performed before all reports are deleted, new reports may not
be recorded.

Report Recording
Display and check the reports stored in internal memory of the defibrillator then
record them.
The TEC-5601 does not have a built-in recorder and cannot print
reports but can display them in the report window for you to check.
Waveform Report
Display the SAVE REPORT window and check and record the reports.
1) Select REPORT SETUP in the SETUP window.
2) Select SAVE REPORT then press the [OK] key.
“Changing Settings” (p. 10-1-12)
In the SAVE REPORT window, the waveform reports stored in internal memory
of the defibrillator are displayed, as shown below.
Waveform Report Description

Defibrillation Report ECG waveform at discharge and defibrillation information
VF Analysis Report ECG waveform for VF analysis and the results of the analysis
Alarm Report ECG waveforms at alarm generation and alarm information
Event Waveform ECG waveforms at when the [EVENT] key is pressed and
Report event information
NOTE: When the SAVE REPORT window is displayed, a waveform

report, such as an alarm report, cannot be stored.
SAVE REPORT LIST

In the SAVE REPORT LIST window, waveform reports are listed.
File name
Displayed in the waveform
Type of waveform report report stored in an SD card.
[▲], [▼]
Displayed when there are
The selected waveform more than 10 waveform
report is highlighted. Created date and reports.
time of a waveform Press the [EVEMT↓] key
Function keys report or [EVENT↑] key to scroll
the list.
• [EVENT↓], [EVENT↑]
For selecting a waveform report.
• [WAVEFORMS]
For displaying the SAVE REPORT
WAVEFORMS window containing
the selected waveform report.
• [SAVE TO CARD]
For storing the selected waveform
report in an SD card. (Refer to
p. 10-2-5.)
For the stored waveform report,
the [SAVE TO CARD] key is not
displayed.
• [MENU]
For returning to the SETUP Free space of an SD card (%)
window.

SAVE REPORT WAVEFORMS

In the SAVE REPORT WAVEFORMS window, the waveform of the selected
waveform report is displayed.
File name
Displayed in the waveform
ECG waveform Type of waveform report report stored in an SD card.
Created date and time of a ECG lead,
Function keys Sweep
waveform report sensitivity
• [←SCROLL], [SCROLL→] speed
For scrolling the waveform
horizontally.
• [TABLE]
For displaying the SAVE REPORT
LIST window.
• [SAVE TO CARD]
For storing the displayed
waveform report in an SD card.
(Refer to p. 10-2-5.)
For the stored waveform report,
the [SAVE TO CARD] key is not
displayed.
• [MENU]
For returning to the SETUP
window. Free space of an SD card (%)
Displayed range of the waveform

Whole waveform
Starting Recording
Select a waveform report to be recorded in the SAVE REPORT LIST window or
display the SAVE REPORT WAVEFORMS window and press the record/stop
key.
Stopping Recording
10
Recording stops automatically. 10-1
Pressing the record/stop key during recording also stops recording.
Recording Example (VF Analysis Report)
Event Waveform Report

If Medication is set to “On” and the [MEDICATION] key is pressed,
the name of the medication is printed at the upper right on the event
waveform report. If two or more [MEDICATION] keys are pressed, the
name of the [MEDICATION] key first pressed is displayed.
“Event Recording” (p. 10-1-8)

TRENDGRAPH
Display and check the TRENDGRAPH window and record the reports.
2) Select TRENDGRAPH then press the [OK] key.
In the TRENDGRAPH window, the graph for the measured value of the
parameter being monitored is displayed (up to 24 hours).
The displayed parameter is highlighted.
Scale
Function keys
• [PARAMETER]
For selecting the parameter to be
displayed.
• [1 HOUR]
For changing the displayed
duration
(1 HOUR, 2 HOURS,
4 HOURS, 8 HOURS,
24 HOURS)
• [←SCROLL], [SCROLL→]
For scrolling the trendgraph
horizontally.
Range of the displayed trendgraph against the time axis
• [MENU]
For returning to the SETUP Time axis: 24 hours
window.
Starting Recording
Display the TRENDGRAPH window and press the record/stop key.
NOTE • During recording, never press the [1 HOUR] key. If the
displayed time axis is changed during recording, the trendgraph
cannot be recorded correctly.
• All parameters are recorded.
Stopping Recording
Recording stops automatically.
Recording Example (HR trend)
Maximum
Average
Minimum

Periodic List Report

Display and check the PERIODIC LIST window and record the report.
2) Select PERIODIC LIST then press the [OK] key.
In the PERIODIC LIST window, the list of the measured values of the
parameters being monitored is displayed (up to 120 parameters).
The interval to save measured values to the list can be set with INTERVAL in the
SETUP window.
“Setting Interval” (p. 10-1-13)
The value at which an upper/

lower limit alarm is generated is
Date and time of highlighted.
measurement
Function keys
For scrolling the list
horizontally.
• [MENU]
window.
10
Range of the displayed list against the whole list 10-1
Whole list
Starting Recording
Display the measurement date and time to start recording on the left in the
PERIODIC LIST window and press the record/stop key.
The measurement values from the measurement date and time displayed on the
left in the window to the latest are recorded.
Stopping Recording
Recording Example

Event List Report

Display and check the EVENT LIST window and record it.
2) Select EVENT LIST then press the [OK] key.
In the EVENT LIST window, up to 1,000 events are listed.

The data of the event list are stored in the internal memory of the defibrillator
and retained even when the defibrillator is turned off. They can be cleared in
REPORT SETUP in the SETUP window.
Use them as a daily report, management history of the defibrillator, etc., as
required.
“Delete All Reports” (p. 10-1-13)
NOTE: If the report is displayed in ELAPSED LAP, the elapsed time is not
displayed when the elapsed time between events exceeds 1 hour.
For ELAPSED LAP display

The elapsed time from the reference
event and the lap time between start
of the two consecutive events are
displayed. Reference event
If the reference event has not been If the reference event has not been
set, the currently selected event is set, the currently selected event
displayed as a reference event. is displayed as a reference event
candidate.
The display type of the
Date and time list is highlighted.
The selected event is highlighted. of events
Function keys
• [EVENT↓], [EVENT↑]
For selecting an event.
• [SET REF EVENT], [REF
EVENT OFF]
For setting the selected event to
the reference event or clearing the
setting.
• [ELAPSED TIME], [CLOCK
TIME]
For changing the display type of
the list
• [MENU]
For returning to the SETUP [▲], [▼]
window. Displayed when there are more than 6 events.
Press the [EVEMT↓] or [EVENT↑] key to scroll
the list.
Starting Recording
Display the EVENT LIST window then press the record/stop key.
Stopping Recording

Examples of Recording
Recording Event List

Events recorded on the defibrillator are as listed below.
Event Description
Power On The defibrillator power was turned on.
Power Off The defibrillator power was turned off.
Charging Start Charging started.
Charging Complete Charging was complete.
Discharge XXXJ Discharge in manual mode was performed with XXXJ.
Synchronized Cardioversion XXXJ Discharge in synchronous mode was performed with XXXJ.
Internal Paddles: Over 50J For using the internal paddles, the output energy was set over 70J.
Internal Discharge (cause of internal discharge) Discharge was performed to inside of the defibrillator.
VF/VT Analysis Start An AED analysis started by pressing the CHARGE/AED button.
Shock Needed The ECG that required discharge was detected.
Shock Not Needed The ECG that required discharge was not detected.
Heart Rhythm Changed Heart rhythm was changed.
VF/VT Analysis Canceled VF/VT analysis was canceled. 10
VF/VT Detected VF or VT was detected.
10-1
Alarm HR start *XXX HR alarm started at XXX bpm.
HR alarm stopped (alarm peak: XXX bpm).
Alarm HR Stop Peak *XXX If an alarm was changed to an upper/lower alarm while the alarm is on, the
peak value of the latest alarm is recorded.
ARRHYTHMIA Alarm Arrhythmia Arrhythmia alarm was generated.
VPC Alarm start * XXX VPC alarm started at XXX/min.
VPC Alarm Stop Peak * XXX VPC alarm stopped (alarm peak: XXX/min).
Fixed Pacing Start (XXXppm, XXXmA) Fixed pacing (XXX ppm, XXX mA) was started.
Demand Pacing Start (XXXppm, XXXmA) Demand pacing (XXX ppm, XXX mA) was started.
Pacing Stop (XXXppm, XXXmA) Pacing (XXX ppm, XXX mA) was stopped.
Event Key Pressed The [EVENT] key was pressed.
Medication 1 to 5 Either of [MEDICATION1] to [MEDICATION5] key was pressed.
ECG Electrode Off ECG electrode was disconnected.
ECG Electrode Set ECG electrode was connected.
Disposable Pads Off Disposable pads were removed.
Dispo Pads Attached Disposable pads were attached.
External Paddles Connected External paddles were connected.
Internal Paddles (without SHOCK Button)
Internal paddles were connected.
Connected
Internal Paddles (with SHOCK Button) Connected Internal paddles with the shock button were connected.

Event Description
Paddles/pads Connector Off The paddles/pads connector was disconnected.
Alarm Suspended An alarm was suspended.
CO2 Zero Calibration Zero calibration for parameters was performed.
Parameter Not Available A connection cord for a parameter which cannot be measured was connected.
Timer Start Timer in AED mode was started.
Timer Stop Timer in AED mode was stopped.
Waveform Freeze Waveform was frozen.
ECG Learning Start ECG learning started.
ECG Learning Stop ECG learning stopped.
AED Adult Mode The defibrillator entered the AED mode for adult.
AED Child Mode The defibrillator entered the AED mode for child.
SpO2 Message Alarm messages and information for measurement conditions of parameters
CO2 Message were displayed.
CANNOT ANALYZE HR calculation and arrhythmia analysis were not able to be performed.
ECG NOISE Noise was added to an ECG.

Printed Characters and Marks

Characters and marks recorded on the defibrillator are as listed below.
Item Printed Letters Description

Recording type Event Event recording
Charge Record “Charging Start” After Discharge (Charge
recording)
Alarm Alarm recording
Periodic Periodic recording
VF Report VF analysis report recording
Defib Report Defibrillation report recording
Event Report Event waveform report recording or event list report
recording
Alarm Report Alarm report recording
Trend Report Trend report recording
Periodic List Report Periodic list report recording
Real time/Delayed recording 1 Real Real time recording of waveform recording
Delay Delayed recording of waveform recording
Operation mode Mon Monitoring mode
Manual Defib Defibrillation mode
AED AED mode
Fix Pace Fixed pacing mode
Demand Pace Demand pacing mode
Date 1 YYYY/MM/DD Year/Month/Day
MMM/DD/YYYY Month (JAN to DEC)/Day/Year 10
YYYY/MMM/DD Year/Month (JAN to DEC)/Day
10-1
DD/MM/YYYY Day/Month/Year
Clock time 2 HH:MM:SS Hour:Minute:Second
Instrument ID 1 ID:XXXXX
ECG lead Paddle, Pad, I, II, III, aVR, aVL, aVF, V1, V2, V3, V4, V5, V6, AUX
ECG sensitivity ECG: ×1/4, ×1/2, ×1, ×2, ×4
Paper speed 1 50 mm/s, 25 mm/s
Hum filter 2 Hum filter: ON, OFF Hum filter setting for ECG
If the ECG lead is set to Paddle/Pad, the setting is fixed
to “ON”.
Filter 2 Filter: Diagnosis, Monitor, Maximum Filter setting for ECG
If the ECG lead is set to Paddle/Pad, the setting is fixed
to “Monitor”.
Detection type 2 Adult, Child QRS detection type setting for ECG
SpO2 sensitivity 2
SpO2: ×8, ×4, ×2, ×1, ×1/2, ×1/4, ×1/8, AUTO
CO2 waveform scale 2
0-20 mmHg (0.0-2.5 kPa), 0-40 mmHg (0.0-5.5 kPa), 0-80 mmHg (0.0-10.5 kPa)

Item Printed Letters Description

Heart rate HR: XX (lead)
VPC VPC:XX
SpO2 SpO2:XX%
Measurement
value 3 Pulse rate PR:XX
ETCO2 ETCO2:XXmmHg, XXkPa
Respiration RR:XX
Rate
The point of discharge
Selected energy Set: XXX J

Transthoracic resistance TTR:XXXohm
Delivered energy Delivered: XXX J
Synchronization/non Sync/no display
synchronization
Shock times Shock times: XX
Synchronization point
Pacing rate XXppm

Pacing intensity XXmA
The point of pacing pulse
output
The point of event occurrence E
Medication 2
Medication
The point of implanted
pacemaker pulse output
QRS Annotation N Normal QRS complex
P Paced QRS
V Ventricular premature contraction
? Impossible to classify or during learning
- Impossible to classify due to noise interference.
1
These settings can be set on the SYSTEM SETUP screen.
2
These settings can be set in the SETUP window.
Section 5 “Setup Windows”
3
hen an alarm is generated, “*” is printed before the measurement value.
W
(Example: HR: * 200)

10-2 Saving and
Sending Data
Introduction.................................................................10-2-2
SD Cards....................................................................10-2-2
Formatting an SD Card ........................................................... 10-2-2
Inserting/Removing an SD Card ............................................. 10-2-3
Inserting an SD Card .......................................................... 10-2-3
Removing an SD Card ........................................................ 10-2-3
Saving and Displaying Data.......................................10-2-4

Saving the Data on Measurements in an SD Card ................. 10-2-4
Saved Data ......................................................................... 10-2-4
Saving the Waveform Data in an SD Card .............................. 10-2-5
Displaying the Data Saved in an SD Card .............................. 10-2-6
10
Sending Data..............................................................10-2-7
Setting the Device to be Connected . ...................................... 10-2-7
Setting the Destination Device . .......................................... 10-2-7 10-2
Setting the Device for Auto-saving the Self-test Report .........10-2-11
Sending a Waveform Report ................................................. 10-2-13
Introduction
The TEC-5600 series can save the data on measurements (waveform data,
defibrillation information, event information, sound) and the waveform report in
an SD card (QM-001D or QM-002D SD memory card).
You can set whether to save sound with Save Audio Together with ECG
Refer to Administrator’s Guide: “System Setup”
When the optional QI-832V Bluetooth® module is installed in the defibrillator,

you can send waveform reports and results of the defibrillator’s self-test saved in
internal memory to external devices such as a PC with wireless communication.
SD card QI-832V
(QM-001D or QM-002D SD memory card) Bluetooth® module
For details on installing the QI-832V Bluetooth® module to the defibrillator, refer
to the manual provided with the QI-832V.
Manual provided with the QI-832V Bluetooth® module
SD Cards
NOTE: Also refer to Section 3 “SD Cards”.
Section 3 “SD Cards” (p.3-6)
Formatting an SD Card
An SD card can be formatted with Format SD Card on the SYSTEM SETUP
screen.
When an SD card is formatted, all data saved in the SD card are deleted.
To delete individual data saved in the SD card, use a PC.

10-2. Saving and Sending Data
Inserting/Removing an SD Card
Inserting an SD Card
SD card cover Insert the SD card into the SD card slot on the right side panel of the defibrillator.
NOTE: Do not insert an unspecified SD card into the SD card slot.
1 Open the SD card cover on the right side panel of the defibrillator.
SD card slot SD card 2 Insert the connector side of the SD card into the SC card slot on the right
side panel of the defibrillator until it clicks and is locked.
Face the label side of the card toward the rear panel of the defibrillator.
SD card cover 3 Close the SD card cover.
Removing an SD Card
10
CAUTION
Before removing an SD card, turn the defibrillator
10-2
off. If the SD is removed while the power is on,
data in the SD card may be lost or static electricity
may make it impossible to write data to the card.
damaged.
2 Open the SD card cover on the right side panel of the defibrillator.
SD card SD card cover 3 Push the inserted SD card farther inside and withdraw your finger. The
inserted SD card will be ejected.
NOTE: If the inserted SD card is forcibly pulled, the SD card and SD
card slot may be damaged. Be sure to remove the SD card
following the procedures above.
4 Pull the SC card out and close the SD card cover.

Saving and Displaying Data

Save the data on measurements and the waveform report in an SD card.
The saved data can be displayed using the QP-551VK defibrillator report viewer
software.
Saving the Data on Measurements in an SD Card

If an SD card is inserted in the defibrillator, data on measurements (waveform
being measured, defibrillation information, event information, etc.) are
automatically saved in the SD card in monitor mode, AED mode, defibrillation
mode, pacing mode, or setup mode1.
1
ata on measurements are not stored in the DATE AND TIME window, SAVE
D
REPORT window and SEND REPORT window in the SETUP window.
“Inserting an SD Card” (p.10-2-3)
NOTE • If the power is turned off within 30 seconds after turning it on,
any data accumulated during such a period is not saved.
• If the waveform information (measurement parameter, lead,
sensitivity, etc.) is changed, data 30 seconds after the change is
updated.
• If the battery is discharged and the defibrillator is automatically
turned off, the latest measurement data of maximum
30 seconds may not be saved.
Saved Data
Data listed below are saved in an SD card.
Saved Information Description

Defibrillator Information on the defibrillator such as the model name, VF
information analysis version, etc.
Waveform information Waveform being measuring and sound waveform 1
Measurement value
Measurement values of parameters
information
Defibrillation Information on discharges, such as set energy, number of

information discharges
Measurement Information for parameters such as filter settings, scale, label,

parameter information and units
Anotation information Information for QRS waveform classification, pacing output

Event information Information on events during operation
1
I f Save Audio Together with ECG on the SYSTEM SETUP screen is set to
“On”, waveforms are saved with sound. The playback sound may be distorted if
the microphone was too close to the sound source.
In an SD card, data for up to 30 minutes can be saved for one record.

After 30 minutes elapses, the next stream of measurement data will be saved.
When the SD card is full, old data will be overwritten by new data.
Data are saved continuously for 30 seconds per file in an SD card.
Data being measured for 30 minutes are treated as one record.

When saving continuous ECG data with audio, up to 24 hours (QM-001D

SD card) or 50 hours (QM-002D SD card) of data can be saved. When saving
continuous ECG data without audio, up to 106 hours (QM-001D SD card) or
168 hours (QM-002D SD card) of data can be saved.
NOTE: If data other than measurement data are saved in the SD card,
the storage capacity of the SD card is reduced.
Saving the Waveform Data in an SD Card

Display the SAVE REPORT window to save the waveform report in an SD card.
The symbols related to the SD card are displayed on the screen and
SAVE REPORT window (LIST and WAVEFORMS). If the SAVE
REPORT window shows a different icon than the screen, the icon on
the SAVE REPORT window takes priority.
1 Display the SAVE REPORT window.
Section 10-1 “Waveform Report” (p.10-1-14)
If the “SD: Insert card” message appears,

1) Insert an SD card to the SD card slot on the right side panel of the
defibrillator.
“Inserting an SD Card” (p.10-2-3)
2) The “Do not remove SD card” message is displayed until the SD card
is recognized. Once it is recognized, the free space for the SD card is
displayed in %.
NOTE: Do not remove the SD card while the message is
displayed. If it is removed, the data may be damaged.
10
File name
The file name for the waveform report
saved in the SD card is displayed.
10-2
A message is displayed. Free space of

Example: the SD card (%)
2 Save the displayed waveform report in the SD card.

If the message “Not enough free space on SD card.” is displayed, the
SD card has insufficient free space. Insert another SD card.
If the free space of the SD card is reported to be 0%, data may still be
saved, depending on the volume of data to be saved.

1) In the SAVE REPORT LIST window, select a waveform report to be

saved or activate the WAVEFORMS window and press the [SAVE TO
CARD] key.
Note that a waveform report with a file name cannot be saved because it
has already been stored in the SD card.
2) During saving, the message “Saving data.” is displayed.

NOTE: Do not remove the SD card while the message is being
displayed. The data may be damaged.
To cancel saving, press the [CANCEL SAVING] key.
Message
3) When saving is completed, the file name is displayed.

Example: SAVE REPORT WAVEFORMS window
File name
The file name is a sequential number which
is incremented each time a new file is saved.
3 Press the [MENU] key to close the SAVE REPORT window.
Displaying the Data Saved in an SD Card

To display the measurement data and the waveform report saved in an SD card,
the optional QP-551VK defibrillator report viewer software is necessary.
If QP-551VK is installed on a PC, you can register the data saved in an SD card
with a PC, display the measurement data and reports, and play the sound data.
For details, refer to the manual provided with the QP-551VK defibrillator report
viewer software.
Manual provided with the QP-551VK defibrillator report viewer
software

Sending Data
If the optional QI-832V Bluetooth® module is installed in the defibrillator, you
can set the connection device and send the waveform reports saved in internal
memory via wireless communication.
If Self-test Result Auto-transfer on the SYSTEM SETUP screen is set to “On”,
the test results is automatically sent to the destination device for auto-save after
performing the self-test, via wireless communication.
NOTE: The Self-test Result Auto-transfer function is currently not
available because a compatible device is not available yet.
• Section 12 “Self Tests” (p.12-23)
Setting the Device to be Connected

Set the destination device for sending the waveform report.
NOTE: If the Bluetooth® USB adapter is connected to a PC in which no
Bluetooth® module is installed, be careful on the following:
• If the connected Bluetooth® USB adapter is replaced with
another one after registering the PC as the destination device,
communication with the PC is disabled.
• If you remove the Bluetooth® USB adapter from the PC
registered as a destination device and connect it to another PC,
the defibrillator communicates with the new PC to which the
Bluetooth® USB adapter is connected.
10
Setting the Destination Device
10-2

1) Press the [ ] key or [ ] key to select DEVICE
SETUP.
2) Press the [ ] key or [ ] key to select BLUETOOTH
SETUP.
3) Press the [OK] key to display the BLUETOOTH SETUP SELECT
DEVICE window.

3 Search and register the destination device in the SEARCH window.
Up to 4 devices can be registered.
1) Press the [DESTINATION] key to select a destination device to be

registered then press the [SEARCH] key to display the SEARCH window.
NOTE: Make note of the PIN CODE (default: 0000) displayed in
the SEARCH window.
The destination device to be registered is highlighted.
Make note
of the PIN
CODE.
2) Press the [SEARCH] key to search for the destination device.
3) During searching, the message “Searching.” is displayed and when

searching is completed, the detected device will be displayed.
If the [CANCEL] key is pressed during searching, searching is
canceled.
4) Press the [DEVICE ↓] key or [DEVICE ↑] key to select a device to be

registered then press the [OK] key.
Destination device list
The detected destination
The selected device is highlighted. devices are listed.
Select a device to be registered.
5) If entry of the PIN CODE is requested on the destination device, enter the
PIN CODE noted in step 1).

6) When registration is completed, the EDIT window is displayed and the

registered device is displayed.
The registered device is displayed.
4 Set the FILE FORMAT, PIN CODE, and DESTINATION DEVICE.

To edit the settings for the registered device, display the EDIT window,
following the procedures below.
1) In the SELECT DEVICE window, press the [DESTINATION] key to
select a destination device whose settings are to be edited.
2) Press the [EDIT] key to display the EDIT window.
1) Press the [ITEM] key to select an item.
10
10-2
The selected item is highlighted.
1) Select an item.
2) Change settings for items.
FILE FORMAT
Change settings for the format of the file to be sent.
Press the [←] key or [→] key to change settings.
Settings:
• DAT: For sending the data to a PC.
To reference the data on the destination device, decoding is not
required.
• JPG (Default): For sending the data using a cellular phone.
To reference the data on the destination device, decoding is
required.

PIN CODE, DESTINATION DEVICE

Set the PIN CODE (up to 6 alphanumeric characters) and DESTINATION
DEVICE (up to 20 alphanumeric characters).
Press the [CHARACTER→] key to move the cursor then press the [↓] key
or [↑] key to set a character for that position.
Example: PIN CODE
The selected character is highlighted.
Select a character. Set the character.
5 Press the [SELECT DEVICE] key to return to the SELECT DEVICE

window.
6 Press the [MENU] key to close the SELECT DEVICE window and return to
the SETUP window.

Setting the Device for Auto-saving the Self-test Report

NOTE: The Self-test Result Auto-transfer function is currently not
available because a compatible device is not available yet.
Perform pairing with the destination device to send the self-test report
automatically.
When pairing is performed, the information regarding this defibrillator

is registered to the device for auto-saving the report.

1) Press the [ ] key or [ ] key to select DEVICE
SETUP.
2) Press the [ ] key or [ ] key to select SELF TEST
SETUP.
3) Press the [OK] key to display the SELF TEST SETUP window.
1) Select a SETUP menu item. 2) Select an item. 3) [OK] 10
3 Perform pairing.
10-2
1) Press the [ITEM] key to select PAIRING.
2) Press the [↓] key or [↑] key to select YES to start pairing.
3) Pairing starts on the destination device.

5-digit ID number set on the SYSTEM SETUP screen.

5) During pairing, the message “Pairing.” is displayed, and when pairing is

completed, “Pairing complete.” is displayed.
If the [CANCEL] key is pressed during pairing, pairing is canceled.
The message is displayed.
4 Press the [MENU] key to close the SELF TEST SETUP window and return
to the SETUP window.

Sending a Waveform Report

Activate the SEND REPORT window to send the waveform report to a
destination device, such as a PC.
2 Display the SEND REPORT window.

1) Press the [ ] key or [ ] key to select REPORT
SETUP.
2) Press the [ ] key or [ ] key to select SEND
REPORT.
3) Press the [OK] key to display the SEND REPORT LIST window.
3 Select a waveform report to be sent.
Section 10-1 “Waveform Report” (p.10-1-14)

10
1) Press the [EVENT↓] key or [EVENT↑] key to select a waveform report to
be sent.
2) Press the [SEND] key to display the SEND window. 10-2
Type of waveform report
The selected waveform [▲], [▼]
report is highlighted. Displayed when there are more than
Created date and 10 waveform reports.
time of waveform Press the [EVEMT↓] key or
report [EVENT↑] key to scroll the list.
1) Select a waveform report. 2) [SEND]

3) Check the waveform report to be sent on the SEND window.

ECG waveform Type of waveform report
Created date and time of Sweep
waveform report ECG lead, sensitivity speed
Function keys
• [CHANGE DESTINATION]
For selecting a destination
device to which the waveform
report is sent.
For scrolling the waveform
horizontally.
• [TABLE]
For displaying the SEND
REPORT LIST window.
• [MENU]
window.
Displayed range of the waveform

Whole waveform
4 Send the waveform report.

1) Press the [CHANGE DESTINATION] key on the SEND window to
display the window for sending the report.
2) Press the [CHANGE DESTINATION] key to select the destination
device.
On the SEND REPORT LIST, the destination devices are listed.
“Setting the Destination Device” (p.10-2-7)
3) Press the [SEND] key to send the waveform report.

NOTE • If the setting of the control dial is changed or another
window is displayed during sending of a report, sending
of the report is canceled.
• If sending of a report is canceled, the message “The
defibrillator is busy. Retry after a minute.” is displayed
for 30 seconds after canceling and the report cannot be
sent again. Wait about 30 seconds then retry sending the
report.
1) [CHANGE DESTINATION]
The selected destination device is highlighted.
2) Select a destination device. 3) [SEND]

4) During sending, the message “Sending data” is displayed and when

sending is completed, “Sending complete” is displayed.
If the [CANCEL SENDING] key is pressed during sending, sending
data is canceled.
The message is displayed.
5 Set and check on the destination device.

PIN CODE set in the BLUETOOTH SETUP window.
“Setting the Destination Device” (p.10-2-7)
2) On the destination device, check that the waveform report has been
properly received.
6 Press the [MENU] key to close the SEND REPORT window and return to
the SETUP window.
10
10-2

10-3 Transport Function
Introduction.................................................................10-3-2
Data Which Can Be Transferred................................10-3-3

Waveform Data ....................................................................... 10-3-3
Trend Data .............................................................................. 10-3-3
Event List Data......................................................................... 10-3-3
Transferring Data........................................................10-3-4
10
10-3
Introduction
Waveforms and numerical data measured with the defibrillator can be wirelessly
sent to a bedside monitor which has a QI-670P interface. This is called transport
function.
To send data, install an optional QI-832V Bluetooth® module into the
defibrillator, insert an SD card, and set the Enable Transport setting in the
SYSTEM SETUP items to “On”.
• For installing the QI-832V Bluetooth® module in the defibrillator,
refer to the installation guide of the QI-832V Bluetooth® module.
NOTE • The transport function is only available on TEC-5601, TEC-5621

and TEC-5631 defibrillators with software version 02-01 or later.
For compatible versions of the QI-670P interface and bedside
monitor, refer to the manuals of the interface and bedside
monitor.
• To use the transport function, the defibrillator and other
instruments must be upgraded to the recommended system
versions. If any instrument has an incompatible version, the
transport function might not operate correctly.
• If the date and time are changed while the Enable Transport
setting is set to “On”, the following reports are deleted. Before
changing the date and time, record or save these reports.
-- TRENDGRAPH - PERIODIC LIST - EVENT LIST
TEC-5600 series Bedside monitor
QI-670P
The data are transferred by
Bluetooth® communication.

10-3. Transport Function
Data Which Can Be Transferred

The defibrillator can transfer the waveform, trend and event list data to a bedside
monitor.
Data for the past 2 hours from when the DATA SEND window is displayed can
be transferred.
NOTE: Set the time of the destination monitor to the same time as the
defibrillator. Otherwise, the time indication of the transferred data
becomes incorrect.
Waveform Data
The waveform data extracted from the data on measurements that are saved in an
SD card are sent to the bedside monitor.
“Saving the Data on Measurements in an SD Card” (p.10-2-4)
Each file contains 30 seconds of waveform data.

Aside from the waveform data, the ECG annotation information (QRS
annotation, pacing output) can be sent to the bedside monitor.
NOTE: The ECG data saved in the SD card has the sensitivity and lead
information of every 30 seconds. If data whose ECG sensitivity
and lead have been changed are sent, the ECG sensitivity and
lead displayed on the destination monitor may partially different
from the original data.
10
Trend Data
The defibrillator extracts the maximum, minimum, and average values of every
1 minute of the trendgraphs saved in the defibrillator internal memory and sends
the values to the bedside monitor. 10-3
Each file contains 1 minute of trend data.
Event List Data

The defibrillator extracts the transferable events from the event list report in the
defibrillator internal memory and sends the events to the bedside monitor.
Each file contains 50 events of event-list data.

Transferring Data
Display the DATA SEND window to transfer the data to the destination monitor.
NOTE • After data is sent to a monitor, the data can only be re-sent to
the same monitor.
• If the date and time of the defibrillator are changed, data from
before the date and time change cannot be transferred.
• A patient’s condition cannot be monitored in the DATA SEND
window. Start monitoring the patient on the destination monitor
before transferring the data.
• Before transferring the data, admit a patient to the destination
monitor. If admitting the patient after data transfer, the
transferred data is deleted.
1 Display the DATA SEND window.

1) Turn the control dial to the BASIC CHECK position to display the
BASIC CHECKS window.
2) Press and hold the [DATA SEND] key for about 5 seconds.
Press and hold for about 5 seconds
3) The defibrillator is restarted and the DATA SEND window is displayed.

Once the DATA SEND window is displayed, the defibrillator
automatically starts searching for the destination monitor.

2 If two or more destination monitors to which data can be transferred are

found, the DESTINATION MONITOR window appears. Press the [↓] or [↑]
key to select a destination monitor and press the [OK] key.
If only one destination monitor is found, the DESTINATION MONITOR
window does not appear.
The selected destination monitor is highlighted
Select a destination monitor. [OK]
3 Make Bluetooth® connection between the defibrillator and the destination

monitor.
10
10-3

4 If there are two or more records of turning the power on within 2 hours, the
window for selecting the transfer data appears. Press the [↓] or [↑] key to
select a start time of the data to be transferred and press the [OK] key.
If there is only one record of turning the power on within 2 hours, the
window for selecting transfer data does not appear.
• To change the destination monitor, press the [DESTINATION MONITOR]
key to return to the DESTINATION MONITOR window, wait for
5 seconds, and select a destination monitor.
• If Type of Sent Data on the SYSTEM SETUP screen is set to “Confirm”,
the “Send waveforms?” message is displayed. Press the [Yes] or [No] key
to select the sending data.
- [Yes]: All data including the waveform data are sent.
- [NO]: Only the numerical values are sent.
Refer to Administrator’s Guide: “System Setup”
NOTE • END TIME of DATA RANGE is the time when the DATA
SEND window is displayed.
• The list does not display power-on times from more than
2 hours ago. Power-on times from more than 2 hours ago
are listed as being 2 hours ago.
• To avoid mixing up data, the operator of the defibrillator
should select the data for DATA RANGE.
The selected destination monitor is highlighted.
[▲], [▼]
Displayed when there
are more than
5 records of turning
the power on.
Press the [↓] or [↑]
key to scroll the list.
Select a start time of the data to be transferred. [OK]

Start time
Data range to be sent
Maximum transfer period (2 hours)

5 When the IDENTIFICATION NUMBER window is displayed, check that

the destination monitor is correct and enter the identification number. Press
the YES key on the destination monitor to start transferring.
• The identification number appears on the top part of the destination
monitor.
• To change the destination monitor, press the [DESTINATION MONITOR]
key to return to the DESTINATION MONITOR window, wait for
5 seconds, and select a destination monitor.
NOTE: Before sending the data, confirm with the physician that the
transferring data are correct.
6 When the data is sent, the “Sending data complete.” message appears.
If Confirmation to Delete Data after Sent on the SYSTEM SETUP
screen is set to “On”, the “Delete sent waveforms?” message is
displayed. To delete the waveform, press the [Yes] key. Not to delete it,
press the [No] key.
Refer to Administrator’s Guide: “System Setup” 10
10-3
7 Turn the control dial to the “OFF” position to turn the defibrillator off.
damaged.

11 Messages and
Troubleshooting
Screen Messages.......................................................... 11-2

Messages when Turning Off the Power.......................................11-2
Messages on the Defibrillator.......................................................11-3
Messages on Operation Modes...................................................11-5
Messages on All Parameters being Measured and ECG
Measurement...............................................................................11-9
Messages on Environments of ECG Measurement .................. 11-11
Messages on Individual Parameter Measurements...................11-12
CO2 . ...................................................................................... 11-12
SpO2 ...................................................................................... 11-13
Messages on Data Storage and Transmission...........................11-15
Data Storage.......................................................................... 11-15
Data Transmission................................................................. 11-15
Transport................................................................................ 11-17
Voice Messages.......................................................... 11-18
Troubleshooting........................................................... 11-20
General.......................................................................................11-20
Defibrillation................................................................................11-22 11
Pacing........................................................................................11-22
Individual Parameter Measurements..........................................11-23
Electrocardiogram (ECG)....................................................... 11-23
CO2 . ...................................................................................... 11-24
SpO2 ...................................................................................... 11-25
Recording...................................................................................11-26
Battery........................................................................................11-27
SD Card......................................................................................11-27
Transport....................................................................................11-27
11. Messages and Troubleshooting
Screen Messages
The messages displayed on the screen are listed by type in the following tables.
For error messages, the causes and required actions are described. After taking
the required action, confirm that the error message is cleared and the defibrillator
operates properly before further usage.
NOTE: If the message does not disappear after the following actions,
attach a “Repair request” or “Unusable” label to the defibrillator
and contact your Nihon Kohden representative.
The technical alarm messages are highlighted on the screen in the respective
colors correspond to their priority.
“Defibrillator’s Operation when an Alarm is Generated” (p. 9-4)
Screen example: Message types and locations on the screen

Technical alarm message/
information on the ECG
Technical alarm message/information on measurement environments
the defibrillator
Technical alarm
message/information
on all parameters
being measured and
ECG measurement
Technical alarm
message/information
on individual parameter
measurements
In defibrillation or pacing mode
Technical alarm
message/
information on
operation modes
Messages when Turning Off the Power

damaged.
Message Priority Possible Cause/Problem Action
Saving data and shutting The power was turned off by setting the
down. Do not touch the control dial to OFF.
AC power cord.
S — —
Saving data. DATA SEND The power was turned off by setting the
screen will appear after control dial to OFF before starting data
restart. transport.

Messages on the Defibrillator

The technical alarm messages and information on the defibrillator are displayed
in the area depicted below.
Message/information on the defibrillator

ABNORMAL VOLTAGE Abnormal power voltage was detected. Contact your Nihon Kohden
Warning
representative.
ALARM SILENCED Alarm is silenced.
ALARMS SUSPENDED Alarm is suspended. The remaining time
(1 MIN) for alarm suspension is shown with the
message. —
ALARMS SUSPENDED
A (2 MIN)
ALL ALARMS OFF — All alarms are suspended for the basic
checks.
ALL ALARMS All alarm sounds and alarm indicator Press the silence alarms key again to clear
SUSPENDED 1 MINUTE blinking/lighting are suspended. The the message, and the alarm suspension is
ALL ALARMS remaining time for suspension is shown canceled.
SUSPENDED 2 with the message.
MINUTES
BATTERY CHARGING IS Overheating was detected while charging Put the defibrillator in a place in the
SUSPENDED the battery. specified temperature range and wait until
the message disappears. Once normal
temperature is restored, charging is
─ restarted.
BATTERY EXPIRED The battery is expired. Replace the battery pack and update the
battery replacement date. (Refer to the
B Administrator’s Guide: “Battery Test
Procedure”.)
BATTERY IS LOW Warning The battery remaining mark is 1～3 . Connect to an AC power and charge the
battery.
Advisory The battery remaining mark is .
BATTERY TEMP OUT OF Abnormal temperature was detected at Put the defibrillator in a place in the 11
RANGE Warning the battery. specified temperature range and wait until
the message disappears.
CANNOT JUDGE Faulty discharge circuit in the battery Contact your Nihon Kohden
Warning
REMAINING BATTERY representative.
CHARGE BATTERY The battery is empty (remaining: 0 ). Connect to an AC power and charge the
Crisis
IMMEDIATELY battery.
C
CONNECT THE POWER When the defibrillator is operated on the Connect to an AC power and charge the
CORD WHEN STORING battery only, power was turned on when battery.
the remaining battery power was less
than 1/3 (the status indicator lit in red).
DEMO MODE — Displaying demonstration waveforms. ─
DISCHARGE TEST: An error occurred at the discharge test in Contact your Nihon Kohden
D FAILED the basic checks. representative.
DISCHARGE TEST: OK The discharge test in the basic checks
─
was performed properly.

Messages on the Defibrillator The technical alarm messages and information on the defibrillator
are displayed in the area depicted below.
Message display area
ERROR Axxx Faulty defibrillation circuit Set the control dial to OFF. Then turn on
the defibrillator again and do the same
ERROR Cxxx Communication error
operation that you did when the error
ERROR Dxxx Error in the stored set values or the sum message appeared.
Crisis values in the program If the error message still appears,
Other error immediately turn off the power
ERROR Exxx
and contact your Nihon Kohden
ERROR Kxxx Faulty key unit representative.
E
ERROR Pxxx Faulty pacing circuit “xxx” indicates an error code.
Errors detected in self Defibrillator errors were detected in the Confirm the latest self-test results in the
test. self tests. system setup and take a necessary action.
(Refer to the Administrator’s Guide:
—
“Latest Self-Test”.)
For details on the self tests, refer to “Self
Tests” (p. 12-23).
HV MONITOR ERROR Error inside the defibrillator Set the control dial to OFF. Then turn on
the defibrillator again and do the same
message appeared.
H Crisis
If the error message still appears,
immediately turn off the power
and contact your Nihon Kohden
representative.
INSERT BATTERY PACK No battery when the defibrillator was Install a battery pack.
I Advisory
turned on.
NO REPORT DATA The record key was pressed when there Confirm the report to be recorded.
was no report data.
—
NOW OPERATING ON The defibrillator was switched to AC
N
AC POWER power operation.
—
NOW OPERATING ON The defibrillator was switched to battery
BATTERY power operation.
Advisory Out of recording paper Set the specified recording paper.
OUT OF PAPER
The recorder door is open. Press the recorder door until it clicks.
OVERHEATING Electrical shock is repeated within a short Set the control dial to OFF to turn off the
period. defibrillator and leave it at least for
10 minutes. In an emergency, you can use
O
the defibrillator even when this message
is displayed.
Warning If the error message still appears even
30 minutes have elapsed, immediately
stop using the defibrillator and contact
your Nihon Kohden representative.
RELAY DRIVE ERROR Faulty HV unit Contact your Nihon Kohden
representative.
R
REPLACE BATTERY An error occurred when charging the
Crisis —
PACK battery.
VITAL AND TECHNICAL The alarm sound and alarm indicator
ALARMS OFF blinking/lighting for vital alarms and
V — —
measurement environmental alarms
generated in defibrillation are suspended.

Messages on Operation Modes

The technical alarm messages and information on operation modes for
defibrillation and pacing are displayed in the area depicted below.
Technical alarm
message/
information of
operation modes
ADULT MODE AED in adult mode is selected. To change to child mode, once set the
control dial to a position other than AED,
Adult mode. Stay calm. —
then set it to AED again while pressing
Follow voice instructions.
the CHILD MODE button.
A
Always check if pacing Pacing is continued for an unusually long Confirm the screen indications and the
Advisory
pulse effective. time. condition of the patient.
Analyzing heart rhythm. The defibrillator started AED analysis
—
Do not touch patient. (VF/VT analysis).
Battery empty. Connect — The battery remaining is 0 in AED mode. Replace the battery with another
B AC power. sufficiently charged battery, or connect
an AC power.
Cannot perform sync A paddle/pad-lead ECG is selected Select an appropriate lead. Refer
cardioversion. Select for the sync signal for synchronized to Section 6-3 “Synchronized
ECG lead. Advisory cardioversion with SYNC BY PADDLE Cardioversion” (p. 6-3-1)).
set to “OFF” in the PADDLE SETUP
window.
CHARGED Charging is complete.
11
CHARGING The defibrillator is now charging energy
for electrical shock.
—
Charging complete Charging is complete.
Charging. The defibrillator is now charging energy
C — for electrical shock.
Check pad cable The defibrillator was set to AED mode If this message appears when the
connection to defibrillator. before attaching the disposable pads to the disposable pads are attached to the
patient. patient, check that the connection
between the pads and the defibrillator. If
the cable is properly connected, replace
the disposable pads or the pad adapter.
CHECK PADS The paddle contact of a disposable pad
Advisory has been in open status for more than the
specified period. —
Check skin contact and Disposable pads became detached during
—
cable connection. AED.

Messages on Operation Modes The technical alarm messages and information on operation modes are
displayed in the area depicted below.
Message
display
area
CHILD MODE AED in child mode is selected. To change to adult mode, once set the
control dial to a position other than AED,
Child mode. Stay calm.
then set it to AED again without pressing
Follow voice instructions.
the CHILD MODE button.
If patient is an adult, set
the control dial to AED
—
without pressing the
CHILD MODE button.
Confirm that patient is The defibrillator was set to AED mode
not responding and is not before attaching the disposable pads to the —
breathing. patient.
CONNECT PADDLES/ No paddle/pad is connected to the paddle Connect the paddles or disposable pads.
PADS connector in defibrillation mode.
C The paddle/pad lead was selected in
monitor mode when paddles or disposable
pads were not connected to the paddle
Advisory connector.
CONNECT PADS The defibrillator was set to pacing or Use the disposable pads in pacing or
AED mode when the external paddles or AED mode.
internal paddles were connected.
No paddle/pad is connected to the paddle Connect the disposable pads.
connector in pacing or AED mode.
Continue CPR. Performing CPR
Could not analyze heart — Noise was detected in AED analysis (VF/ —
rhythm. VT analysis).
Defibrillator error. Use An error defibrillation occurred, Set the control dial to OFF. Then turn
another defibrillator. preventing defibrillation. on the defibrillator and do the same
Crisis message appeared. If the error message
still appears, immediately turn off the
power and contact your Nihon Kohden
representative.
Defibrillator not working. A defibrillator error was detected. Contact your Nihon Kohden
Do not use defibrillator. representative.
Start CPR.
D
DEMAND PACING Demand pacing mode is selected.
Do 5 more chest CPR in AED mode ends after 5 more
compressions. Do not chest compressions.
—
touch patient.
Do not touch patient. Immediately before starting AED analysis —
(VF/VT analysis) in AED mode
Do not touch patient. Defibrillation in AED mode is enabled.
Press the flashing
SHOCK button.
ENERGY WAS NOT There is more than the specified amount
Confirm the status of the paddles or
DELIVERED TO PATIENT Advisory of residual charge remaining in the HV
E disposable pads.
condenser after shock was delivered.
Enter password again. An incorrect password was entered. Enter the correct password.
—
F FIXED PACING Operating in fixed pacing mode. —

Heart rhythm changed. The necessity of electrical shock was once

Shock canceled. suggested by the result of AED analysis
— —
(VF/VT analysis) but was canceled after
H the subsequent analysis.
HIGH IMPEDANCE Skin-pad (paddle) impedance is too high Press the paddle electrodes to the patient
Advisory
to obtain biphasic discharge waveforms. firmly.
If you do not perform The defibrillator was set to defibrillation
manual defibrillation, set mode with MANUAL DEFIB
control dial to AED or CONFIRMATION set to “PASSWORD”
I MONITOR. — or “CONFIRM” on the SYSTEM SETUP —
screen.
It is safe to touch patient. Instruction for starting CPR
Start CPR.
LOW IMPEDANCE Skin-pad (paddle) impedance is too low to Check that the paddle electrodes do not
L Advisory
obtain biphasic discharge waveforms. electrically touch each other.
MANUAL MODE Operating in manual defibrillation mode
M
(non-sync or sync defibrillation).
No shock advised. The defibrillator detected non-shockable —
N rhythm in AED analysis (VF/VT
— analysis).
Open package and The defibrillator was set to AED mode Attach the disposable pads to the patient
O remove pads. before attaching the disposable pads to the as instructed.
patient.
PACING Pacing is in progess. ─
Pacing stopped. (ECG Pacing in demand mode stopped for one Pressing the silence alarms key cancels
lead disconnected) of the following reasons: the alarm.
An electrode lead was disconnected Firmly connect the electrode lead to the
from an electrode. ECG electrode.
An electrode became detached from Replace the electrode with a new one.
the patient.
An electrode lead was disconnected Firmly connect the electrode lead to the
from the branch cord. branch cord.
Bad contact between the electrode Replace the electrode lead with a new
and the lead clip one.
Electrode lead discontinuity
Abnormally high polarization voltage Replace the electrodes with new ones.
Pacing stopped. (error) An error occurred during pacing. Contact your Nihon Kohden
Crisis representative.
Pacing stopped. (pad Pacing stopped for one of the following Pressing the silence alarms key cancels
P disconnected) reasons. the alarm. 11
The pad adapter was disconnected Firmly connect the pad adapter to the
from the paddle connector. paddle connector.
The disposable pads became Attach the disposable pads to the patient.
detached from the patient.
The skin-pad contact impedance is • Firmly attach the pads to the patient.
high. • Set the pacing current to “0 mA” then
increase the current gradually to set the
lowest effective pacing current.
If these actions do not solve the problem,
clean the skin and use new disposable
pads. Refer to “Attaching the Disposable
Pads to the Patient” (p. 7-8).
Press AED button. The defibrillator detected shockable Press the CHARGE/AED button. Refer
rhythm in AED mode. to “AED Flowchart” (p. 6-4-3).
—
Press the flashing Charging is complete.
—
SHOCK button.

Messages on Operation Modes The technical alarm messages and information on operation modes are
displayed in the area depicted below.
Message
display
area

Remove all clothing from The defibrillator was set to AED mode Attach the disposable pads to the patient
patient’s chest. before attaching the disposable pads to the as instructed.
patient.
Remove pads from liner The defibrillator was set to child AED Attach the disposable pads to the patient
and apply to patient as mode before attaching the disposable pads as instructed.
R shown. — to the patient.
Remove pads from liner The defibrillator was set to adult AED
and apply to right upper mode before attaching the disposable pads
chest and left side as to the patient.
shown.
Set energy to 50J or less. Energy of 70 J or higher is selected for
When using the internal paddles, select
Warning discharging when the internal paddles are
50 J or less for electrical shocks.
connected to the defibrillator.
Shock advised. Charging. The defibrillator detected shockable
rhythm in AED analysis (VF/VT
analysis).
Shock delivered. Defibrillation in AED mode was
performed.
S
SYNC MODE Synchronized cardioversion mode is
selected.
Synchronized Charging is complete in synchronized
cardioversion. Confirm cardioversion mode.
that the dotted line
appears on the rising
slope of every QRS wave.
Press and hold SHOCK
— —
button until discharge.
To perform manual The defibrillator was set to defibrillation
defibrillation, enter mode with MANUAL DEFIB
password. CONFIRMATION set to “PASSWORD”
or “CONFIRM” on the SYSTEM SETUP
screen.
To perform manual The defibrillator was set to defibrillation
T defibrillation, press OK. mode with MANUAL DEFIB
CONFIRMATION set to “PASSWORD”
or “CONFIRM” on the SYSTEM SETUP
screen.
To start pacing, press the Tried to start pacing by pressing the
START/STOP key again. START/STOP key while the GUIDE
window was displayed.

Messages on All Parameters being Measured and ECG

Measurement
The technical alarm messages and information on all parameters being measured
and ECG measurement are displayed in the area depicted below.
Technical alarm message/information on all parameters being measured
and ECG measurement
ARRHYTHMIA ANALYSIS The paddle-lead ECG is displayed. Arrhythmia analysis is not performed
OFF for paddle-lead ECG.
The defibrillator is in pacing mode. Arrhythmia analysis is not performed in
pacing mode.
ARRHYTHMIA ANALYSIS Refer to “Changing the Settings for
is set to “OFF” in the ECG Arrhythmia Alarms” (p. 9-15).
A — In SETUP window.
monitor An AUX- or pad-lead ECG is
mode displayed with the VF/VT alarm
set to “OFF”.
—
The defibrillator is in defibrillation mode
with the VF/VT alarm set to “OFF”.
CANNOT ANALYZE Noise interference continues for more Remove noise.
than 30 seconds and heart rate cannot
C Warning
be counted and arrhythmia cannot be
analyzed.
ECG LEARNING ECG LEARN was performed in the ECG Refer to “Relearning ECG (LEARN
SETUP window. ECG)” (p. 8-1-12).
Immediately after power is turned on
The lead for monitoring was changed
(except the paddle/pad and AUX leads).
Recovered from CHECK ELECTRODES
status after continuing for a specified time. 11
ECG NOISE 1
The electrodes are not stable due to Change the electrode sites to reduce
respiration or body movement. movement.
EMG noise is superimposed. Change the electrode sites to where
there is less muscle (e.g. over the ribs).
Warm the patient or reduce tension of
the patient.
E —
The electrode is pulled by the lead. Put some slack into the electrode lead.
The electrode gel is dry. The electrode is Replace the electrode with a new one.
not fitted to the patient.
The contact of an electrode lead clip is poor. Clean the electrode lead clip.
High electrode impedance Rub the skin with “skinPure” skin
preparation gel.
An electric blanket (without a countermeasure Shield the blanket with a cover.
for electromagnetic induction) is used.
Noise due to ESU Refer to “Use with an Electrosurgical
Unit” (p. 3-7).
The defibrillator and/or peripheral devices Ground the devices properly.
are not properly grounded.

FREEZE 1 MIN The [FREEZE] key was pressed and the Press the [UNFREEZE] key to cancel
waveform on the screen is frozen. The frozen status.
F FREEZE 2 MIN — time shows the remaining time of the
FREEZE 3 MIN frozen status.
MP MODULE ERROR Faulty MP module Contact your Nihon Kohden

M
representative.
PARAMETER NOT Advisory The connection cord for a parameter Connect parameters available with the
P AVAILABLE not available with the defibrillator was defibrillator.
connected to the CO2 socket.
1
When the message is displayed, the [GUIDE] key is enabled. Press the
[GUIDE] key to display the GUIDE window.

Messages on Environments of ECG Measurement

The technical alarm messages and information on environments of ECG
measurement are displayed in the area depicted below.
Technical alarm message/information on environments of
ECG measurement
CHANGE ELECTRODES The ECG electrodes are deteriorated. Replace the electrodes with new ones.
CHANGE PADS The disposable pads are deteriorated. Replace the pads with new ones.
CHECK Ca ELECTRODE 1 The electrode referred to became detached Firmly attach the electrode to the
from the patient. patient.
CHECK Cb ELECTRODE 1
CHECK CHEST Multiple electrodes became detached
ELECTRODES 1 from the patient’s chest.
CHECK ELECTRODES 1 An electrode became detached from the
patient.
The ECG connection cord or external Firmly connect the ECG connection
ECG cable was disconnected from the cord or external ECG cable to the
ECG socket. ECG socket.
The electrode lead was disconnected from Firmly connect the electrode lead to
the electrode. the electrode.
C The electrode cannot be attached firmly to Replace the electrode with a new one.
the patient.
The electrode lead was disconnected from Firmly connect the electrode lead to
the ECG connection cord. the ECG connection cord.
Loose connection between the electrode Replace the electrode lead.
Advisory
and the electrode lead clip
Electrode lead discontinuity
CHECK PADS The paddle contact of a disposable pad Firmly attach the disposal pads to the
has been in open status for more than the patient.
specified period.
CONNECT PADDLES/ No paddle/pad is connected to the paddle Connect the paddles or disposable 11
PADS connector in defibrillation mode. pads.
The paddle/pad lead was selected in
monitor mode when no paddle/pad was
connected to the paddle connector.
F (LL) LEAD OFF 1 The electrode referred to became detached Firmly connect the electrode to the
F
from the patient. patient.
L (LA) LEAD OFF 1 The electrode referred to became de
L
tached from the patient.
R (RA) LEAD OFF 1 The electrode referred to became detached
R
from the patient.
USE DISPOSABLE PADS The defibrillator was set to pacing or AED
Use disposable pads in pacing or AED
U mode with the external paddles or internal
mode.
paddles connected.
1

Messages on Individual Parameter Measurements

The technical alarm messages and information on individual parameter
measurements are displayed above the respective measurement values.
Example: In CO2 measurement
Technical alarm message/information on
individual parameter measurements
CO2
APNEA 2 Respiration was not detected for the

A Warning —
specified period.
CHANGE ADAPTER 1 The CO2 adapter is damaged, deteriorated Replace the CO2 adapter with a new one.
or the cable is broken.
CHECK SENSOR 1 Insufficient sensor light Refer to the operator’s manual of the CO2
sensor kit.
CONNECTOR OFF 1 The CO2 sensor kit was removed from the The message is cleared by pressing the
C Advisory
CO2 socket. silence alarms key.
The CO2 sensor kit was disconnected Firmly connect the CO2 sensor kit to the
from the CO2 socket. CO2 socket.
The CO2 sensor kit is damaged. Replace the CO2 sensor kit with a new
one.
NOT CALIBRATED 1 Zero calibration has not been performed. Perform zero calibration. Refer to “CO2
N —
Monitoring” (p. 8-2-1).
SENSOR ERROR 1 The CO2 sensor is damaged or Replace the CO2 sensor with a new one.
S Advisory
deteriorated, or the cable is broken.
Z ZERO CALIBRATING — Sensitivity calibration is being performed. —
1
The APNIA alarm is canceled when CO2 zero calibration is performed

2
or another alarm (CHANGE ADAPTER, SENSOR ERROR, or CHECK

SENSOR) is generated.

Messages on Individual Parameter Measurements

The technical alarm messages and information on individual parameter
measurements are displayed above the measurement values.
Message display area (example in CO2 measurement)
SpO2
CHECK PROBE 1
The probe became detached from the Check the probe attachment and remove
patient. the cause.
When the The probe was Firmly connect the probe to the SpO2
baseline is disconnected from connection cord.
displayed the SpO2 connection
cord.
Loose contact of the
connector
Probe discontinuity Replace the probe with a new one.
When pulses are The probe is attached Attach the probe to the site specified in
displayed to an inappropriate the operator’s manual of the probe.
site.
Probe deterioration Replace the probe with a new one.
Advisory
CHECK PROBE SITE 1 Probe site not proper. Attach the probe to the site specified in
the operator’s manual of the probe.
Probe deterioration Replace the probe with a new one.
CONNECTOR OFF 1
The SpO2 connection cord was removed The message is cleared by pressing the
from the SpO2 socket. silence alarms key
The SpO2 connection cord was Firmly connect the SpO2 connection
disconnected from the SpO2 socket. cord to the SpO2 socket.
The SpO2 connection cord is damaged. Replace the SpO2 connection cord.
CORD The probe was disconnected from the Firmly connect the probe to the SpO2
DISCONNECTED 1 SpO2 connection cord. connection cord.
Loose contact of the connector
11
Probe discontinuity Replace the probe with a new one.
DETECTING PULSE The defibrillator is searching for correct Wait until the pulse waveform is
pulse waveform. detected.
SpO2 value cannot be measured because Check the probe attachment and remove
D —
of unstable pulse waveform. the cause.
The probe became detached from the
patient.

LIGHT INTERFERENCE 1
The measurement site is affected by light Cover the probe site with a blanket to
such as a surgical light, bilirubin light or block ambient light, preventing noise
fluorescent light. from being superimposed on the pulses.
LOW QUALITY SIGNAL 1 Too poor peripheral circulation to Check the patient condition and remove
measure SpO2 the cause by loosening the probe
attachment or changing the attachment
site.
The probe is attached too tightly and is Reattach the probe.
L Advisory
obstructing the blood circulation.
The probe became detached from the Check the probe attachment.
patient.
One of the following messages is Refer to the respective screen message
displayed for 30 seconds. sections and remove the cause.
• LIGHT INTERFERENCE
• CHECK PROBE SITE
• DETECTING PULSE
“M” mark (unstable Considerable body movement If this message appears frequently,
measurement condition) check the patient and probe attachment
— Unstable probe attachment
condition. Reattach the probe to the
M patient if necessary.
MODULE ERROR Faulty SpO2 module Contact your Nihon Kohden

Advisory
representative.
PROBE ERROR 1 Probe deterioration Replace the probe with a new one.
Probe short-circuit
P Warning Faulty SpO2 connection cord Replace the SpO2 connection cord.
Faulty probe Replace the probe. If the error message
still appears after probe replacement,
replace the SpO2 connection cord.
WEAK PULSE 1 Poor peripheral circulation Check the patient condition and change
the attachment site.
W —
The probe is attached too tightly and is Check the probe attachment.
obstructing the blood circulation.
1

Messages on Data Storage and Transmission
Data Storage
The messages displayed when storing a waveform report on the SD card are
listed in the table below.
“Saving the Waveform Data in an SD Card” (p. 10-2-5)
Example: Waveform display screen
C Canceling Data saving was canceled.

Do not remove SD card. The defibrillator is accessing to the SD
D —
card.
NO REPORT DATA There is no report data.
N Not enough free space on There is not enough free space in the SD Delete unnecessary data in the SD card or
SD card. card. use another SD card with enough space.
—
Saving data. Do not Saving data in an SD card Wait until saving finishes.
remove SD card.
SD: Insert card. No SD card is inserted. Insert an SD card.
S
SD: Not available. The SD card could not be accessed. Replace the SD card.
SD: Write-protected. SD card is write-protected. Release the write-protect lock of the SD
card.
Data Transmission
When the optional QI-832V Bluetooth® module is installed, the messages listed
below are displayed in the device search window or data send window while you
are setting the destination device or sending data. 11
“Sending Data” (p. 10-2-7)
Example: SEND REPORT window
Bluetooth connection lost. Connection was lost during data Confirm the destination device.
transmission via Bluetooth®.
B Bluetooth device already — Tried to save the device that has been
registered. Rewrite already registered in the BLUETOOTH —
device? SETUP window.

Canceled sending data. Sending data via Bluetooth was

®
canceled.
Canceling. Destination device search was canceled.
Checking PIN code. The defibrillator started checking the PIN —
code.
Connecting to Bluetooth Connection with the destination device
device. via Bluetooth® is established.
Connection error. An error other than a PIN code error Confirm the destination device.
occurred during service searching via
Bluetooth®.
C Could not access A connection error occurred in data
—
destination. transmission.
Could not find destination. An error occurred for one of the following Confirm the destination device.
reasons during service searching via
Bluetooth®.
• Bluetooth connection is not established
on the destination device.
• PIN code entry was canceled on the
destination device.
• PIN code entered on the destination
device was not correct.
Could not find device. No device was found in device search.
Device search error. The destination device sent back an error
— code during device search.
D
An error occurred during device search
via Bluetooth®.
PIN code error. An incorrect PIN code was entered. Confirm the PIN code.
P Profile unavailable. The profile setting on the defibrillator is Confirm the profile setting available for
not available for the destination device in the destination device.
Searching for Bluetooth Searching for the destination device to
device. send data.
Searching. The defibrillator started searching the
destination device to send data via
Bluetooth®. —
S
Sending complete. Sending data via Bluetooth® is complete.
Sending data. Data transmission via Bluetooth® has
been started.
Sending error. Could not A connection error occurred during data Confirm the destination device.
access destination. transmission via Bluetooth®.
The defibrillator is busy. Data transmission was canceled. When you cancel sending a report,
Retry after a minute. the “Retry after a minute” message
is displayed for approx. 30 seconds,
T
disabling resending.
Wait for more than 30 seconds to restart
data transmission.

Transport
When the optional QI-832V Bluetooth® module is installed, the messages listed
below are displayed in the DATA SEND window while sending data to the
bedside monitor.
“Transferring Data” (p. 10-3-4)
DATA SEND window
A Authenticating destination. Authenticating the destination monitor. —

Bluetooth connection lost. Connection was lost during data transport Confirm the destination monitor.
B via Bluetooth®.
Connecting to ... Connection with the destination device

—
via Bluetooth® is established.
Could not connect to ... An error other than PIN code error Confirm the destination monitor.
C occurred while service searching via
Bluetooth®.
Could not find a destination There is no monitor to send data. Confirm the destination monitor.
monitor.
Deleting error. An error occurred while deleting Delete the waveform data again.
waveform data.
D
Deleting waveforms. The waveform data already sent are
—
being deleted.
Identification number error. — An incorrect identification number was Enter the correct identification number.
entered.
Insert available SD card An invalid SD card was inserted. Insert the SD card in which the report
I
and send waveforms again. data to be sent has been stored.
SD card is write-protected. Release the write-protect lock of the SD
card.
N
No data to send. There is no report data to send. Confirm the waveform report stored in 11
the SD card.
Profile unavailable. The profile setting on the defibrillator is Confirm the profile setting available for
P not available for the destination device in the destination device.
Sending data. Data transport via Bluetooth® has been
started. —
S Sending data complete. Sending data via Bluetooth® is complete.
Sending error. Search and send errors occurred during Confirm the destination monitor.
data transport via Bluetooth®.

Voice Messages
The voice messages listed below are output from the speaker of the defibrillator
according to the operation statuses.
If a voice message is heard, follow the instructions.
Voice message Status
Adult mode. Stay calm. Follow voice AED in adult mode is selected.
instructions. The message may vary, depending on the Voice Instruction setting in AED
A Setup. (Refer to the Administrator’s Guide: “AED Setup”)
Analyzing heart rhythm. Do not touch patient. The defibrillator started AED analysis (VF/VT analysis).
B Battery empty. Connect AC power. The battery remaining is 0 in AED mode.
Charging. Energy charging for electrical shocks is in progress.
Check pad cable connection to defibrillator. The defibrillator was set to AED mode before attaching the disposable
pads to the patient.
Check skin contact and cable connection. Disposable pads became detached during AED.
Child mode. Stay calm. Follow voice AED in child mode is selected.
instructions. If patient is adult, set the control The message may vary, depending on the “Voice Instruction” setting in
dial to AED without pressing the CHILD MODE AED Setup. (Refer to the Administrator’s Guide: “AED Setup”)
C button.
Confirm that patient has no response and is not The defibrillator was set to AED mode before attaching the disposable
breathing. pads to the patient.
Continue CPR. Performing CPR.
The message may vary, depending on the “CPR Cycles per Sequence:
adult/child” and “Number of Rescue Breaths: adult/child” settings in AED
Setup. (Refer to the Administrator’s Guide: “AED Setup”)
Could not analyze heart rhythm. Noise was detected in AED analysis (VF/VT analysis).
Defibrillator not working. Do not use A defibrillator error was detected.
defibrillator. Start CPR. The message may vary, depending on the “CPR Cycles per Sequence:
Setup. (Refer to the Administrator Guide: “AED Setup”)
D
Do not touch patient. Immediately before starting AED analysis (VF/VT analysis) in AED mode
Do not touch patient. Press the flashing Defibrillation in AED mode is enabled.
SHOCK button.
Energy was not delivered to the patient. There is more than the specified amount of residual charge remaining in
E
the HV condenser after a shock was delivered.
Five more chest compressions. Do not touch CPR in AED mode ends after 5 more chest compressions.
F
patient.
Heart rhythm changed. Shock canceled. The necessity of electrical shock was once suggested by the result of AED
H
analysis (VF/VT analysis) but was canceled after the subsequent analysis.
It is safe to touch patient. Start CPR. Instruction for starting CPR.
The message may vary, depending on the “CPR Cycles per Sequence:
I
Setup. (Refer to the Administrator’s Guide: “AED Setup”)
No shock advised. The defibrillator detected non-shockable rhythm in AED analysis (VF/VT
N
analysis).

Voice message Status
Open package and remove pads. The defibrillator was set to AED mode before attaching the disposable
O
Press AED button. An ECG that requires defibrillation was detected in AED mode. Refer to
P
“AED Flowchart” (p. 6-4-3).
Remove all clothing from patient’s chest. The defibrillator was set to AED mode before attaching the disposable
Remove pads from liner and apply to patient as The defibrillator was set to AED mode (child mode) before attaching the
R
shown. disposable pads to the patient.
Remove pads from liner and apply to right The defibrillator was set to AED mode (adult mode) before attaching the
upper chest and left side as shown. disposable pads to the patient.
Shock advised. Charging. The defibrillator detected shockable rhythm in AED analysis (VF/VT
analysis).
Shock cancelled. In AED mode:
• The charging hold time elapsed after completion of charging.
S • The defibrillator detected repeated detachment of one or more disposable
pads.
Shock delivered. Defibrillation in AED mode was performed.
Synchronized cardioversion. Charging starts in sync cardioversion mode.
T Testing voice instructions Voice check of the basic checks is in progress.
Use disposable pads. The defibrillator was set to AED mode with the external paddles or
U
internal paddles connected.
11

Troubleshooting
This section lists troubles and their causes and actions.
After the action, check that the problem is solved and the defibrillator operates
properly before using it again.
NOTE: If the following actions do not solve the problem, attach an
“Repair request” or “Unusable” label to the defibrillator and
contact your Nihon Kohden representative.
General
Problem Possible Cause Action
The defibrillator heats up. The defibrillator was being used for There is no abnormality in the defibrillator.
many hours.
Defibrillator abnormality First set the control dial to OFF and disconnect
the power cord, and contact your Nihon Kohden
representative.
The defibrillator does not turn The power cord was disconnected. Firmly connect the power cord to an AC outlet and the
on. defibrillator.
The battery pack is not installed. • Install the specified battery pack (NKB-301V).
Refer to “Replacement” (p. 12-26).
• In an emergency, operate on AC power.
Refer to “Using AC Power” (p. 4-3).
Remaining power of the battery is low. Charge the battery pack. Refer to “Charging the Battery
Pack” (p. 4-5).
The connection of the battery pack or Set the control dial to OFF to turn off the defibrillator,
the AC power cord is loose. firmly connect the battery or the AC power cord then
turn on the defibrillator.
Dirt or foreign substance is on the Set the control dial to OFF to turn off the defibrillator
connector of the battery pack or the and check the connector. Remove any foreign substance
AC power cord. from the connector, install the battery pack or connect
the power cord again, then turn on the defibrillator.
Defibrillator abnormality Contact your Nihon Kohden representative.
Faulty battery pack Replace the NKB-301V battery pack with a new one.
Faulty LCD unit Stop using the defibrillator and contact your Nihon
Kohden representative.
The status indicator is lit in red Remaining battery power is less than Firmly connect the power cord to an AC outlet and the
while the defibrillator power is 1/3. defibrillator then start the defibrillator.
off.
The battery pack is expired. Replace the NKB-301V battery pack with a new one
and update the battery replacement date. (Refer to the
Administrator’s Guide: “Battery Test Procedure”)
No paddle or pad is connected to the Connect paddles or disposable pads then turn on the
paddle connector. defibrillator.
Faulty CO2 sensor Replace the CO2 sensor then start the defibrillator.
The defibrillator is faulty. Turn on the defibrillator and confirm the latest self-test
results in the system setup to take a necessary action.
(Refer to the Administrator’s Guide: “Latest Self Test”)
If the status indicator remains in red, perform the basic
checks, referring to “Basic Checks” (p. 12-5).
If the basic checks do not solve the problem, contact
The battery pack is not installed. Install the specified battery pack (NKB-301V).


The status indicator is lit in red The battery pack is expired. Set the control dial to OFF to turn off the defibrillator,
while the defibrillator power is replace the NKB-301V battery pack with a new one,
on. and update the battery replacement date. (Refer to the
Administrator’s Guide: “Battery Test Procedure”)
The battery remaining is 0. Connect an AC power to the defibrillator.
No paddle or pad is connected to the Connect paddles or disposable pads.
paddle connector.
Faulty CO2 sensor Replace the CO2 sensor.
The defibrillator is faulty. Turn the defibrillator off then turn it on again and
confirm the latest self-test results in the system setup to
take a necessary action.
(Refer to the Administrator’s Guide: “Latest Self Test”)
If the status indicator remains in red, perform the basic
checks, referring to “Basic Checks” (p. 12-5).
If the basic checks do not solve the problem, contact
Screen is dim. Waveform and Defibrillator abnormality Contact your Nihon Kohden representative.
characters are not seen.
On the screen, there are some Such statuses are due to characteristics The defibrillator is operating normally.
pixels which have randomly of the LCD.
abnormal color or do not light.
• The date and time printed Clock error Set the clock accurately using DATE AND TIME in
on the recording paper are the DEVICE SETUP window. Refer to “DATE AND
incorrect. TIME” (p. 5-9).
• The displayed clock time is
If the date and time is incorrect even Replace the built-in battery with a new one. For
not correct or the date shows
after you enter the correct date and replacement, contact your Nihon Kohden representative.
JAN/01/13.
time and restart the defibrillator, the (Under normal use condition, the lifetime is at least
built-in lithium battery is past its 10 years.)
lifetime.
The sound volume is set to “0”. Change the KEY SOUND setting in the VOLUME
No sound is heard when SETUP window. Refer to “VOLUME” (p. 5-11).
pressing the button or key.
The defibrillator is faulty. Contact your Nihon Kohden representative.
The report data, such as The report data were deleted by Deleted data cannot be recovered.
waveform report and trend DELETE ALL REPORTS in the
report, are not saved. REPORT SETUP window.
The power cord was disconnected Install the specified battery pack (NKB-301V). Refer to
during a shut-down process with no “Replacement” (p. 12-26).
battery installed.
11
All settings for the SETUP and Faulty internal memory Contact your Nihon Kohden representative.
SYSTEM SETUP items return
to the default settings without
user operation.
The defibrillator was suddenly Power voltage varied. Confirm the AC power connection.
switched from AC power If connecting the AC power cord does not solve the
operation to battery operation problem, contact your Nihon Kohden representative.
(with a battery installed).
The defibrillator suddenly shut
off (with no battery installed).

Defibrillation
The defibrillator internally The disposable pads became detached Firmly attach the disposable pads to the patient.
discharges the energy while from the patient.
charging. In battery operation, the battery is In an emergency, operate the defibrillator on AC
almost exhausted. power. The battery is automatically charged when the
defibrillator is connected to AC power.
Faulty HV unit (A system error When the system error is displayed, the defibrillator
occurred.) may be faulty. Use another defibrillator and contact
Cannot switch to SYNC mode. You tried to perform synchronized Set the SYNC BY PADDLE to “ON” in the PADDLE
cardioversion with the paddle or SETUP window and select the paddle or pad lead.
pad lead while setting SYNC BY Refer to “SYNC BY PADDLE” (p. 5-7).
PADDLE to “OFF” in the PADDLE
SETUP window.
Pacing
Although the message Pacing current is set to 0 mA. Set the appropriate pacing current with the PACING
“PACING” is displayed, pacing OUTPUT up/down key.
does not start. In demand pacing mode, the selected Set the pacing rate appropriate for the patient heart rate.
pacing rate is slower than the patient When the patient heart rate is slower than the selected
heart rate. pacing rate, pacing pulse is output automatically.
Faulty pacing function (A system Contact your Nihon Kohden representative.
error “ERROR PXXX”) occurred.)
The message “Pacing stopped Skin-pad contact impedance is high. • Firmly attach the pads to the patient.
(pad disconnected)” appears • Set the pacing current to “0 mA” then increase the
and pacing stops before current gradually to set the lowest effective pacing
completion. current.
If these actions do not solve the problem, clean the skin
and use new disposable pads. Refer to “Attaching the
Disposable Pads to the Patient” (p. 7-8).

Individual Parameter Measurements
Electrocardiogram (ECG)
Dotted lines appear instead of An ECG electrode became detached. Remove the cause. If it does not solve the problem,
the ECG waveforms. change the lead. If changing the lead does not solve the
The clip of the electrode lead was
problem, the defibrillator may be faulty. Contact your
disconnected from the ECG electrode.
Nihon Kohden representative.
The ECG connection cord was
disconnected from the ECG socket.
Discontinuity of the ECG connection
cord or the electrode lead
Baseline drifting Patient body movement. Check the patient.
AC interference on the ECG A 2-prong power cord is used without Use the provided 3-prong power cord.
waveform grounding.
In the ECG SETUP window, HUM • Set HUM FILTER to “ON” in the ECG SETUP
FILTER is set to “OFF”. window.
Refer to Section 8-1 “ECG Monitoring” (p. 8-1-1).
• Check if there is AC interference with other
instruments, and remove the cause.
• Set “AC Line Frequency (Hz)” properly on
the SYSTEM SETUP screen. (Refer to the
Administrator’s Guide: “System Setup”)
ECG waveform cannot Electrode lead discontinuity Replace the electrode lead or the electrode with a new
be recorded even though one.
Dirty electrode
electrodes are connected
properly. New and old or different types of Use the same type of electrodes which are purchased
electrodes are used together. together.
No sync sound Faulty speaker or speaker cable Repair is necessary. Contact your Nihon Kohden
discontinuity representative.
SYNC SOURCE is not set to “ECG” Set SYNC SOURCE to “ECG” in the SpO2 SETUP
in the SpO2 SETUP window. window. Refer to “SpO2 Monitoring” (p. 8-3-1).
The SYNC SOUND volume set to “0” Set the SYNC SOUND volume to “1” or more in the
in the VOLUME SETUP window. VOLUME SETUP window.
Refer to “VOLUME” (p. 5-11).
QRS sync mark is not PACING REJECT is set to “ON” in • Remove the cause of the noise.
displayed. the QRS SETUP window, and large • Set HUM FILTER to “ON” in the ECG SETUP
amplitude AC interference noise is window.
superimposed on the ECG waveform. • Set PACING REJECT to “OFF” in the QRS SETUP
11
window.
Refer to Section 8-1 “ECG Monitoring” (p. 8-1-1).
In the SpO2 SETUP window, SYNC Set SYNC SOURCE to “ECG” in the SpO2 SETUP
SOURCE is not set to “ECG”. window. Refer to “SpO2 Monitoring” (p. 8-3-1).
Sync sound is irregular Noise was misjudged to be QRS. Remove the cause of the noise.
although there is no
arrhythmia.
No alarm is generated. Alarms are silenced or suspended. Press the silence alarms key again.
The alarm function is deactivated. Activate the alarm function. Refer to “Changing Alarm
Settings” (p. 9-12).
Faulty speaker or speaker cable Repair is necessary. Contact your Nihon Kohden
discontinuity representative.

CO2

The measured value is low. The airway adapter is dirty. Replace the airway adapter with a new one.
CO2 gas is in the inspiration (TG-900G, Measurement error. Refer to Section 8-2 “CO2
TG-920P). Monitoring” (p. 8-2-1).
The measurement was performed where Consider the atmospheric pressure when making
atmospheric pressure was low, such as at evaluations.
high altitude.
Zero calibration has not been performed Perform zero calibration. Refer to Section 8-2 “CO2
(TG-970P). Monitoring” (p. 8-2-1).
The measured value is Anesthetic gas is used. Remove the cause and measure again.
high.
High concentration of oxygen is inhaled.
The measured value is Oscillation Check the respirator and remove the cause.
inaccurate.
The respiration rate of the patient is very Cannot measure correctly.

high or the respiration is irregular.
Performing suction with a suction Do not let the suction catheter in the airway adapter.
catheter in the airway adapter (TG-900P,
TG-920P).
Jackson Rees respiration circuit or Cannot measure correctly.
Mapleson D respiration circuit is
connected to the patient (TG-900P,
TG-920P).
The respiration waveform Oscillation Check the respirator and remove the cause.
does not appear.
The airway adapter became detached Check the respiration circuit and attach the airway adapter
from the patient. properly.
The LED on the CO2 Faulty CO2 sensor or CO2 adapter Replace the CO2 sensor or CO2 adapter with a new one.
adapter blinks in red. (TG-900P, TG-920P)
Apnea for longer than 20 seconds The LED blinks in red when respiration has not been
(TG-900P, TG-920P) detected for longer than 20 seconds regardless of the
alarm setting on the defibrillator.
Only “---” appears for the After starting the measurement, the The measured value is displayed when the defibrillator
measurement value. defibrillator detects fewer than 3 detects 3 breathes or more.
breathes.
Respiration has not been detected for The measured value is displayed when respiration is
longer than 40 seconds after detecting detected again.
the latest breath.
The time depends on the apnea setting.
Zero calibration was performed The measurement value is displayed when the
(TG-970P). defibrillator detects 3 breathes or more.

SpO2

Unstable SpO2 value The probe size is inappropriate. Use the correct size probe.
The probe is attached to the same limb Attach the probe to the opposite limb. Eliminate
as that used for NIBP or invasive blood measurement at a site where the blood flow volume varies
pressure measurement. considerably.
An ESU is used. Locate the ESU as far as possible from the probe cable
and SpO2 connection cord and wait until the pulse wave
stabilizes.
Measuring at a site with venous pulse. Cannot measure correctly.
The value is not the same The probe is not attached properly (such Attach the probe properly.
as that obtained with the as when the light-emitting element and
gas analyzer. light-sensitive element do not face each
other).
The probe is attached to an inappropriate Attach the probe to the site specified in the operator’s
site. manual of the probe.
The measurement site is dirty. Clean the site before measurement.
The patient’s carboxyhemoglobin or Cannot measure correctly.
methemoglobin increases abnormally.
Dye (such as methylene blue and
indocyanine green) is injected in the
blood.
Measuring while CPR is in progress.
Probe is deformed or Probe was disinfected by an unspecified Disinfect the probe using the specified method. Refer to
damaged. procedure. “SpO2 Connection Cord” (p. 12-31).
The probe has been repeatedly used. If the probe is deteriorated, replace the probe with a new
one.
Sine wave noise on the Interference from ambient light Cover the probe site with a blanket to block ambient light.
pulse wave
11

Recording
Printing is blurred. The specified paper is not used. Use the specified recording paper.
Dots are missing.
The thermal head is dirty or worn, or • Clean the thermal head with a thermal head cleaning
poor in contact. pen. If it does not solve the problem, the thermal
head must be replaced. Contact your Nihon Kohden
representative.
• Perform RECORDER CHECK in the basic checks and
check the quality of printing. Refer to “Recorder Check
(TEC-5611, TEC-5621, TEC-5631)” (p. 12-20).
Recording paper cannot be The specified paper is not used. Use the specified recording paper.
set correctly.
Nothing is printed. Recording paper is not loaded. Load new recording paper. Refer to “Loading the
Recording Paper (TEC-5611, TEC-5621, TEC-5631)”
(p. 4-9).
The recorder door was not properly Close the door until it clicks.
closed.
Recording paper was set with the wrong Set the recording paper correctly. Refer to “Loading the
side facing up. Recording Paper (TEC-5611, TEC-5621, TEC-5631)”
(p. 4-9).
The recorder unit temperature is too high. Move the defibrillator to a cooler place.
If this does not solve the problem, the recorder unit is
faulty. Contact your Nihon Kohden representative.
Paper skews to one side. Recording paper was not loaded Set the paper straight. Refer to “Loading the Recording
correctly. Paper (TEC-5611, TEC-5621, TEC-5631)” (p. 4-9).
Printout is faint. The recorder unit temperature is too high. Move the defibrillator to a cooler place.
If this does not solve the problem, the recorder unit is
faulty. Contact your Nihon Kohden representative.

Battery
Battery charging lamp is The defibrillator heats up. Move the defibrillator to a cooler place. Battery charging
blinking. is restarted when normal temperature is restored.
Battery charging stops before Faulty battery pack. Replace the battery pack with a new one. Refer to
completion. (Neither the “Replacement” (p. 12-26).
battery charging lamp nor the
Battery charge circuit is not Faulty charging circuit. Contact your Nihon Kohden
battery charging completion
working. representative.
lamp lights.)
The battery pack is deteriorated. Replace the battery pack with a new one. Refer to
“Replacement” (p. 12-26).
Neither the battery charging Faulty battery pack and defibrillator Contact your Nihon Kohden representative.
lamp nor the battery charging
completion lamp is lit.
The defibrillator does not turn Battery connector contact failure. Set the control dial to OFF to turn off the defibrillator and
on when operating on the check the battery pack connector. Remove any foreign
battery. substance from the connector, install the battery pack
again until it locks, then turn on the defibrillator.
SD Card
Data cannot be saved in the No card was set in the defibrillator. Insert a specified card.
SD card.
The card was not inserted properly. Properly insert the card.
A card other than specified card was Insert a specified card.
inserted.
Memory is full. Use a new card, or delete unnecessary data.
The card is write-protected. Release the write protect (LOCK) of the SD card.
The SD card was removed while Turn off the defibrillator then turn it on again.
the defibrillator power was on,
being affected by static electricity.
11
Transport
Data cannot be transported. The destination monitor does not Confirm the destination monitor.
support Bluetooth® communication.
The QI-832V Bluetooth® module is Install the QI-832V Bluetooth® module in the
not installed in the defibrillator. defibrillator.

12 Maintenance
Daily Check..............................................12-2 Expiration Date, Replacement and

Check Before Turning the Power On.................. 12-2 Disposal..................................................12-25
Check After Turning the Power On and Defibrillator....................................................... 12-25
During Operating................................................ 12-3 Periodic Replacement Parts........................ 12-25
Check Before/After Turning the Power Off......... 12-4 Disposal....................................................... 12-25
NKB-301V Battery Pack (Option)..................... 12-26
Basic Checks............................................12-5 Expiration Date............................................. 12-26
Preparations for the Basic Checks..................... 12-5 Replacement................................................ 12-26
Disposal....................................................... 12-28
When Using the External Paddles................. 12-5
When Using Disposable Pads........................ 12-6 JC-865V Pad Adapter (TEC-5621,
When Using the Internal Paddles................... 12-7 TEC-5631)........................................................ 12-28
Performing the Basic Checks............................. 12-7 Expiration Date and Replacement............... 12-28
SD Card Check.............................................. 12-9 Disposal....................................................... 12-28
Out-of-Paper Check (TEC-5611, Disposable Pads (Option)................................ 12-28
TEC-5621, TEC-5631)................................... 12-9 Expiration Date and Replacement............... 12-28
System Check...............................................12-10 Disposal....................................................... 12-28
Paddle Check................................................12-10 Other Options................................................... 12-28
Defibrillation Check.......................................12-11
Pacing Check (TEC-5631)............................12-13 Cleaning, Disinfecting and Storage........12-29
Battery Check...............................................12-14 Defibrillator....................................................... 12-29
12
Status Indicator Check..................................12-15 Cleaning the Exterior................................... 12-29
Voice Check..................................................12-16 Cleaning the Recorder (TEC-5611,
Alarm Check..................................................12-17 TEC-5621, TEC-5631)................................. 12-29
ECG Check (TEC-5611, TEC-5621, Storage of Recording Paper (TEC-5611,
TEC-5631).....................................................12-17 TEC-5621, TEC-5631)................................. 12-30
Multi-Parameter Check.................................12-18 Cables and Paddles......................................... 12-31
Bluetooth® Check (When Connecting
Pad Adapter, Electrode Leads, ECG
QI-832V).......................................................12-19
Connection Cord.......................................... 12-31
Recorder Check (TEC-5611, TEC-5621,
SpO2 Connection Cord................................. 12-31
TEC-5631).................................................... 12-20
External Paddles.......................................... 12-32
Confirming the Check Results.......................... 12-21 Internal Paddles........................................... 12-32
Confirming the Checking History...................... 12-22 Other Options................................................... 12-32
Self Tests................................................12-23 Periodic Inspection.................................12-33
Repair Parts Availability Policy...............12-33

12. Maintenance
Daily Check
The defibrillator contains parts which gradually deteriorate with use. Original
performance might not be delivered if any part of the defibrillator is deteriorated.
Perform regular maintenance checks to assure continued safe operation.
If you found any abnormalities, take the appropriate action by referring to
the Service Manual. If the defibrillator is suspected to be faulty, attach an
“Unusable” or “Repair request” label to the defibrillator and contact your Nihon
If there are not enough consumables, contact your Nihon Kohden representative.
Check Before Turning the Power On

Item Check
Surrounding environment There are no objects preventing operations around or on the defibrillator.
Accessories Paddles, pads and cables are prepared.
There is enough recording paper (TEC-5611, TEC-5621, TEC-5631).
Sterilized electrodes for internal paddles are prepared, if necessary.
There are enough disposable pads, if necessary.
There is enough contact gel (GELAID) for the external paddles, if
necessary
There is enough number of ECG electrodes (TEC-5611, TEC-5621, TEC-
5631).
Connections, settings The power cord is properly connected.
Recording paper is loaded (TEC-5611, TEC-5621, TEC-5631).
The battery is fully charged (the battery charging completion lamp is lit).
Appearance No part on the defibrillator is dirty, rusted, or damaged.
The operation panel is not torn or broken.
All keys, buttons and control are not damaged.
The power cord is not damaged.
The electrode leads are not frayed.
The defibrillator is not in contact with liquid.

12. Maintenance
Check After Turning the Power On and During Operating

Item Check
Turning the power on The AC power lamp properly lights when operating on AC power.
There is no fire, smoke or smell.
The following indicator, buttons, and lamps properly light.
• Alarm indicator (sequentially lights in red, yellow and cyan)
• SHOCK button
• PACING PULSE lamp (TEC-5631)
• Paddle contact lamp (when external paddles are used)
• Shock buttons (when external paddles are used)
There is a power-on sound.
There is no electrical shock when touching the defibrillator, and the
defibrillator is not abnormally hot.
There is no error message on the screen.
The time displayed on the screen is correct.
The defibrillator does not affect surrounding equipment.
Basic operation The screen display is correct (brightness, clarity, and colors).
The status indicator lights properly.
All keys, buttons and control dial operate properly.
All settings are correct.
The battery is charged enough.
Alarm functions properly.
• The alarm indicator lights in red, yellow and cyan.
• Alarm sounds properly.
• Alarm sound volume is set properly.
No abnormality is found in the basic checks.
The paper is fed correctly (no wandering or jam) (TEC-5611, TEC-5621,
TEC-5631).
Waveforms and letters are clearly printed (TEC-5611, TEC-5621,
TEC-5631).
There is no error message or abnormality during operation.
Alarm Alarm settings, such as the upper/lower values, are correct.
NOTE • Before use, make sure that the date and time displayed on the
screen are correct. Periodically check them during use. The
date and time printed on recording paper are important parts of 12
the medical records.
• When the status indicator becomes red, restart the defibrillator
in monitor mode and check the message on the screen.
• If any message does not appear, refer to the descriptions for
“The status indicator is lit in red” under “Troubleshooting” in
Section 11 (p. 11-20).

12. Maintenance
Check Before/After Turning the Power Off

Check the following items after use to ensure normal and proper operation for
the next use.
If there are not enough consumables, contact your Nihon Kohden representative.
Item Check
Before turning off the The SETUP or SYSTEM SETUP items temporarily changed during
power operation were returned to the original settings.
“0” is displayed on the screen when the control dial is set to DISARM.
Charging is not in progress.
All cords/cables were disconnected.
Abnormality No abnormality was detected during use.
There is no error indication on the screen.
The screen display is normal and clear.
There is no abnormally hot part when you touch the defibrillator.
The setup is in the status you wish.
The status indicator is lit in green (the defibrillator is ready for use) after
the power is turned off.
Appearance The defibrillator is not dirty or damaged.
The test electrode plates and the metal surfaces of the paddles are not
discolored.
The operation panels or labels on the defibrillator are not blurred or lost.
There is no damage or crack on the defibrillator and paddles.
There is no damage on the power cord.
The date to check or replace the battery has not elapsed.
The external paddles were cleaned after use.
The internal paddles were sterilized and disinfected after use.
There is sufficient GELAID left after using the external pads.
The defibrillator was wiped and dried thoroughly if it was in contact with
liquid.
The accessories were well organized after use.
Disposable pads and ECG electrodes were properly disposed of so as not
to cause second infection (TEC-5611, TEC-5621, TEC-5631).
There are sufficient consumables, such as recording paper.
The power cord is connected to an AC power source to charge the battery.
The control dial is set to OFF.
No chemicals and liquid are left around the defibrillator.

12. Maintenance
Basic Checks
The basic functions and operations of the defibrillator are checked.
Be sure to perform the basic checks on a regular basis.
NOTE: Do not replace the battery pack during the basic checks.
“Check After Turning the Power On and During Operating” (p. 12-3)
In the basic checks, the following checks are performed.

• SD card check
• Out-of-paper check (TEC-5611, TEC-5621, TEC-5631)
• System check
• Paddle check
• Defibrillation check
• Pacing check (TEC-5631)
• Battery check
• Status indicator check
• Voice check
• Alarm check
• ECG check (TEC-5611, TEC-5621, TEC-5631)
• Multi-parameter check
• Bluetooth® connection check (only when the optional QI-832V is connected)
• Recorder check (TEC-5611, TEC-5621, TEC-5631)
When the SD card check results in “OK”, a text file “EASYTEST.TXT”
containing the basic check results is stored in the card.
If you set “Basic Check Type” to “Detailed” in the system setup, detailed checks
can be performed.
Preparations for the Basic Checks

The following preparations are necessary before starting the basic checks.
The necessary preparations depend on the connected paddles/pads.
To perform basic checks for disposable pads or internal paddles, the AX-103VK
defibrillator analyzer manufactured by Nihon Kohden is required.
When Using the External Paddles

Paddle contact lamp When using the external paddles, place them on the paddle holders (paddle cups) 12
and turn the control dial to the DISARM position. Then confirm that the paddle
contact lamp lights in green.
If the paddle contact lamp lights in orange or yellow, clean the external paddles
and test electrode plates. (You can apply electrical shocks even when the lamp
lights in orange or yellow.)
Place the paddles on the paddle holders.

WARNING
performing the defibrillation check using the

12. Maintenance
When Using Disposable Pads

Connect the defibrillator and the AX-103VK defibrillator analyzer using the
JJ-202V analyzer connection cable.
The JJ-202V analyzer connection cable is provided with the AX-103VK
defibrillator analyzer.
WARNING
When performing a basic check, make sure that
the disposable pads are not attached to the
patient. Failure to follow this warning may lead to
unintended electrical shock to the patient.
Connection between TEC-5611 and AX-103VK defibrillator analyzer

TEC-5611 JJ-202V
analyzer
connection
JJ-202V analyzer cable
connection cable
Paddle
receptacle
AX-103VK defibrillator analyzer
Connection between TEC-5621 or TEC-5631, and AX-103VK defibrillator

analyzer
TEC-5621 or TEC-5631
JJ-202V
analyzer
JC-865V pad adapter
connection
cable
Paddle
receptacle JC-865V pad
adapter
JJ-202V analyzer
connection cable JJ-202V analyzer
connection cable

12. Maintenance
When Using the Internal Paddles

Using the internal paddle adapters, connect the AX-103VK defibrillator analyzer
to the defibrillator. When the sterilized internal paddles are connected for the
basic checks, sterilize the internal paddle adapters as well.
For details on sterilization of the internal paddle adapters, refer to the
operator’s manual supplied with the AX-103VK defibrillator analyzer.
The internal paddle adapters are supplied with the AX-103VK defibrillator
analyzer.
Internal paddle
adapters
Paddle
receptacle
Performing the Basic Checks

For the basic checks, proceed as follows.
During the basic checks, “ ALL ALARMS OFF” is displayed, indicating that
all alarms (except some technical alarms) are suppressed.
1 Check that the paddles or pads are not connected to a patient.
2 Set the control dial to the BASIC CHECK position to open the BASIC
CHECK window.
The maintenance history (such as the date/time of the latest checks) is
displayed in the window when opened.
MAINTENANCE HISTORY
Indicates the historical data, including the date of
execution of the latest checks. 12
• LATEST BASIC CHECKS
If more than two days have elapsed since the
latest basic checks have been performed, the
date is indicated in yellow.
•L ATEST DATE AND TIME SETUP
• LATEST BATTERY TEST
If one month or more has elapsed since the
latest battery test, the date is indicated in
yellow.
• CURRENT TIME
Displays guidance messages.
Pressing the [HISTORY] key opens the basic check history window, permitting
you to confirm the history of the basic checks.
“Confirming the Checking History” (p. 12-22)

12. Maintenance
3 Press the [START] key to start the basic checks. The checks are started from
the SD card check, and performed in sequence. Proceed with the checks by
pressing the specified keys in accordance with the on-screen guidance.
For details, refer to the corresponding items mentioned on the subsequent
pages.
From “SD Card Check” (p. 12-9) to “Recorder Check (TEC-5611, TEC-5621,
TEC-5631)” (p. 12-20)
• The item being checked is highlighted on the screen and “CHECKING” is

displayed.
• When the current check is finished, the result is displayed in the right
column for the item and “CHECKING” appears for the next check item.
Example: Paddle Check

Check in progress
Check completed
Result
4 When the basic checks have been completed, the check result window is
displayed and the all results are recorded.
NOTE: Make sure that the date and time printed on the recording
paper are correct. The dates and times on the recording
paper are important parts of the medical records.
“Confirming the Check Results” (p. 12-21)

12. Maintenance
SD Card Check
The defibrillator performs writing/reading check to the SD card.
When “Basic Check Type” is set to “Detailed” on the SYSTEM SETUP screen,
the capacity (remaining) of the SD card is also checked.
After confirming that the pads are not attached to a patient, press the [START]
key.
If you use an SD card other than the optional QM-001D or QM-002D,
the “Insert SD card and press NEXT” message is displayed on the
screen. Press the [CANCEL] key to skip the SD card check.
NOTE: When the “NOT ENOUGH SPACE 0.00 MBYTE” message is

displayed on the screen, the SD card writing check cannot be
performed. Delete unnecessary data then perform the SD card
check again. Otherwise, data may not be saved in the SD card
even when there is enough free space in the SD card.
Check Result Description Action

SD card check has been completed without
OK −
problems.
ERROR Could not detect an SD card.
Contact your Nihon Kohden representative.
ACCESS ERROR Read/write error
Release the write-protect lock of the SD
WRITE-PROTECTED The SD card is write-protected.
card then perform the SD card check again.
Delete unnecessary data in the SD card then
NOT ENOUGH SPACE Not enough free space in the SD card
perform the SD card check again.
There are invalid files in the SD card (in the Delete the invalid files and perform the SD
INVALID FILE
DEFSOUND folder). card check again.
NOT CHECKED SD card check was canceled. −
Out-of-Paper Check (TEC-5611, TEC-5621, TEC-5631)

The defibrillator checks if recording paper is properly loaded.
Set the recording paper then press the [NEXT] key.
Section 4 “Loading the Recording Paper (TEC-5611, TEC-5621, TEC-5631)” 12
(p. 4-9)
If the out-of-paper check has been completed without problems, recording starts
for the recorder check.
If you press the [CANCEL] key during out-of-paper check, “NOT
CHECKED” is displayed in the result column and the next check is
started.

Out-of-paper check has been completed
OK −
without problems.
ERROR Could not detect recording paper. Contact your Nihon Kohden representative.
NOT CHECKED Out-of-paper check was canceled. −

12. Maintenance
System Check
The defibrillator checks if there is any system error.
The system check is automatically started and the check result is displayed.
If an error is detected in the system check, the basic checks are canceled.

System check has been completed without
OK −
problems.
ERROR An error is detected in the system.
RTC BATTERY EMPTY The built-in RTC backup battery is empty.
Paddle Check
The defibrillator checks the type of connected device (paddle or pads) and if they
are properly connected.
Follow the guidance displayed in the BASIC CHECKS window.
If you press the [CANCEL] key during a paddle check, “NOT
CHECKED” is displayed in the result column. The defibrillation check
and pacing check (only for TEC-5631) are skipped and the battery
check is started.
If the paddle check resulted in “ERROR”, the defibrillation check and pacing
check (only for TEC-5631) are skipped and the battery check is started.
Paddle Check Flow

Start
Automatically detects the type of the connected
paddles or pads and displays the following guidance.
Detected external Detected internal Detected internal Detected disposable

paddles. paddles (with SHOCK paddles (without pads.
Is this correct? button). SHOCK button).
Is this correct? Is this correct? Is this correct?
Confirm the connected paddles, and press Confirm whether the disposable pads are
[YES] or [NO]. connected, and press [YES] or [NO].
Do not disconnect Check result: ERROR Confirm that pads are not
connection cable until attached to patient. [OK]
check finishes. [OK]
Check result: OK

Paddle check has been completed without
OK −
problems.
ERROR Could not detect paddles or pads. Contact your Nihon Kohden representative.
NOT CHECKED Paddles check was canceled. −

12. Maintenance
Defibrillation Check
NOTE: When operating the defibrillator on the battery and the
mark indicating remaining battery power is 1～3 or 0 , the
defibrillation check cannot be performed. Charge the battery
before the defibrillation check.
If you press the [CANCEL] key during a defibrillation check, “NOT
started.
1 When the remaining battery power is enough and paddle or pad contact is
good enough for check, the massage “Press the CHARGE/AED button” is
displayed.
If the paddles or pads are not connected properly, an error message is
displayed to indicate that they need to be set to the paddle holders or
defibrillator analyzer. Connect them properly then press the [NEXT] key.
When using the external paddles Connections of the paddles/pads:

“Preparations for the Basic Checks” (p. 12-5).
CHARGE/AED button
2 Press the charge or CHARGE/AED button to start charging.

Intermittent peep sounds are generated and the message “CHARGING xxxJ”
is displayed on the screen.
CHARGING xxxJ
When using the internal paddles
or disposable pads
When using the external paddles

Shock buttons 3 When charging completes, a continuous beep sound is generated and the
Firmly press the shock buttons on both screen displays the guidance “Press SHOCK button firmly until discharge”.
paddles.
Check that the message “CHARGING COMPLETE” and the discharged
energy value “50J” are displayed on the screen, and firmly press the shock
button(s) to start discharging.
Example: When the external paddles are connected

CHARGING COMPLETE with the discharge value
12
(with no shock button) or disposable pads

(with a shock button) or disposable pads
Shock button

12. Maintenance
When using the external paddles

Charge button
4 When discharging completes, the message “Press CHARGE/AED button” is
displayed.
5 Press the charge or CHARGE/AED button to start charging.

Intermittent peep sounds are generated and the message “CHARGING xxxJ”
is displayed on the screen.
CHARGING xxxJ
or disposable pads
6 When the charging completes, the energy is discharged internally. The

message “INTERNAL DISCHARGING xxxJ” is displayed on the screen.
When the internal discharging is complete, the defibrillation check is
terminated.
INTERNAL DISCHARGING xxxJ

Defibrillation check has been completed
OK −
without problems.
Connection of the paddles or pads has been Connect the paddles or pads correctly and
PADDLE ERROR
changed. perform the defibrillation check again.
Remaining battery power is too low to Charge the battery or connect an AC power.
BATTERY LOW
perform the defibrillation check. Then perform the defibrillation check again.
The shock button has not been pressed for Perform the defibrillation check again. The
TIMEOUT the specified period after charging was shock button must be pressed soon after
completed. charging is completed.
ERROR An error detected. Contact your Nihon Kohden representative.
• Defibrillation check was canceled.
NOT CHECKED −
• Paddle check was canceled.

12. Maintenance
Pacing Check (TEC-5631)

The defibrillator checks the output current for pacing.
If you press the [CANCEL] key during the pacing check, “NOT
started.
1 When the paddles or disposable pads are properly connected, the guidance
“Press START/STOP key” is displayed.
If the paddles or pads are not connected properly, an error message is
displayed to indicate that they need to be set to the paddle holders or
defibrillator analyzer. In this case, connect the paddles or the disposable pads
properly then press the [NEXT] key.
Connections of the paddles/pads:

“Preparations for the Basic Checks” (p. 12-5)
PACING PULSE lamp 2 Press the START/STOP key to start the pacing check.
The check is performed with changing the pacing pulse current.
• Pacing mode: Fixed
• Pacing rate: 180 ppm
• Pacing pulse current: 10 to 200 mA
Each pacing pulse current is checked eight times.
Each time the pacing pulse is detected properly, an “*” mark is displayed on
the screen.
Pacing pulse current Counts of pacing
The pacing check is terminated once pacing has been performed on every
current.

Pacing check has been completed without
OK −
problems.
12
Connection of the paddles or pads has been Connect the paddles or pads correctly and
PADDLE ERROR
changed. perform the pacing check again.
ERROR An error detected in pacing check. Contact your Nihon Kohden representative.
• Pacing check was canceled.
NOT CHECKED −
• Paddle check was canceled.

12. Maintenance
Battery Check
The defibrillator checks the condition of the battery connected to the instrument.
The check is automatically performed and the check result is displayed.
If you press the [CANCEL] key during the battery check, “NOT
started.
When a message is displayed on the screen during the battery check, confirm the
content and press the [OK] key.
Message during the check

Battery check has been completed without
OK −
problems.
1/3 Battery remaining:
Charge the battery.
EMPTY Battery remaining: 1～3 or 0
Replace the battery with a new one. Refer

EXPIRATION DATE Expired battery to “Expiration Date, Replacement and
Disposal” (p. 12-25).
ERROR An error other than above occurred. Contact your Nihon Kohden representative.
NOT CHECKED Battery check was canceled. −
NOT CONNECTED No battery is connected. −

12. Maintenance
Status Indicator Check

The defibrillator checks that the status indicator works correctly.
Follow the guidance displayed on the screen.
If you press the [CANCEL] key during the status indicator check,
“NOT CHECKED” is displayed in the result column and the next check
is started.
Status indicator indications
Status Indicator Check Flow
START
red green
Is the status indicator red?
Confirm the status indicator and press

[YES] or [NO].
Is the status indicator green?
Confirm the status indicator and press

[YES] or [NO].
Check result: PASSED Check result: FAILED

Status indicator check has been completed
PASSED −
without problems.
The status indicator did not function
FAILED Contact your Nihon Kohden representative.
properly.
NOT CHECKED Status indicator check was canceled. −
12

12. Maintenance
Voice Check
The defibrillator checks that voice instructions are properly output and the
speaker lead is not disconnected.
If you press the [CANCEL] key during the voice check, “NOT CHECKED”
is displayed in the result column and the next check is started.
Voice Check Flow

START
When there is “Testing voice instructions” message, press [YES].
Check the voice and press [YES] or [NO].

Voice check has been completed without
PASSED −
problems.
• Voice is not output properly.
• Speaker disconnected
NOT CHECKED Voice check was canceled. −

12. Maintenance
Alarm Check
The defibrillator checks alarm sound generation and alarm indicator operation.
Section 9 “Defibrillator’s Operation when an Alarm is Generated” (p. 9-4)

If you press the [CANCEL] key during the alarm check, “NOT
started.
In the alarm check, the defibrillator gives the appropriate alarm sound or
indicator light for each instruction.
Alarm indicator
Alarm Check Flow
START
Was there a crisis alarm sound with blinking indicator?
Confirm the alarm sound and indicator, and press

[YES] or [NO].
Was there a warning alarm sound with blinking indicator?
Confirm the alarm sound and indicator, and

press [YES] or [NO].
Was there an advisory alarm sound with lit indicator?
Confirm the alarm sound and indicator and


12
Alarm check has been completed without
PASSED −
problems.
Alarm sound and/or indicator did not work
properly.
NOT CHECKED Alarm check was cancelled. −
ECG Check (TEC-5611, TEC-5621, TEC-5631)

The defibrillator checks that the built-in ECG module operates properly.
The ECG check is automatically performed and the check result is displayed.

ECG check has been completed without
OK −
problems.
ERROR An error was detected in the defibrillator. Contact your Nihon Kohden representative.

12. Maintenance
Multi-Parameter Check
If an optional multi parameter/SpO2 unit is mounted, the defibrillator checks that
there is no abnormality in the CO2 module.
The multi-parameter check is performed with a CO2 adapter connected to the
CO2 socket.
The following two items are checked in the multi-parameter check.
CO2 adapter 1) Communication error and start-up check
2) CO2 module check
If no CO2 adapter is connected, pressing the [CANCEL] key cancels the
check without performing “(2) CO2 module check”.
In this case, if “(1) Communication error and start-up check” is
successfully terminated, “OK” is displayed in the result column and the
next check is started.
Multi-Parameter Check Flow

START
Connection to a CO2 adapter
is automatically confirmed.
CO2 adapter unconnected CO2 adapter connected
Connect CO2 adapter and press [NEXT].
Connect a CO2 adapter to the CO2 socket and press [NEXT].
Auto check execution

The parameters are automatically checked.

Multi-parameter check has been completed
OK −
without problems.
Connect another CO2 adapter and perform
• Could not detect the CO2 adapter. the multi-parameter check again. If an
CO2 ERROR
• CO2 module error error is detected again, contact your Nihon
SpO2 ERROR An error was detected in the respective
MULTI PARA ERROR modules.
No optional multi parameter/SpO2 unit is

NOT CONNECTED −
mounted.
NOT CHECKED Multi-parameter check was canceled. −

12. Maintenance
Bluetooth® Check (When Connecting QI-832V)

The defibrillator checks that the optional QI-832V Bluetooth® module operation.
The Bluetooth check is automatically performed and the check result is
displayed.
If you press the [CANCEL] key during the Bluetooth check, “NOT
started.

Bluetooth check has been completed
OK −
without problems.
Check that the destination device is correctly set
in the BLUETOOTH SETUP window.
No destination device was detected.
(Section 10-2 “Setting the Device to be
ERROR
Connected” p. 10-2-7)
An error was detected in the Bluetooth
module.
• Make sure that the destination device is
operating.
Could not connect to the registered • Check that the destination device is correctly
CONNECTION FAILED
destination device. set in the BLUETOOTH SETUP window.
(Section 10-2 “Setting the Device to be
Connected” p. 10-2-7)
Optional Bluetooth® module is not
NOT CONNECTED −
connected.
NOT CHECKED Bluetooth check was canceled. −
12

12. Maintenance
Recorder Check (TEC-5611, TEC-5621, TEC-5631)

Confirm the data recorded after the out-of-paper check to check that the recorder
operates properly.
If you press the [CANCEL] key during the recorder check, “NOT
CHECKED” is displayed in the result column and the recorder check is
terminated.
When the recorder check results in “PASSED”, the basic check result window is
displayed and all results are recorded.
NOTE: Make sure that the date and time printed on the recording
paper are correct. The date and time on the recording paper are
important parts of the medical records.
“Confirming the Check Results” (p. 12-21)
Recorder Check Flow

START
Press [YES] if printing OK.
Confirm data printed on the recording paper and

Test recording example
Triangular 25-mm/s 50-mm/s

wave test wave test wave

Recorder check has been completed
PASSED −
without problems.
FAILED Data could not be recorded properly. Contact your Nihon Kohden representative.
NOT CHECKED Recorder check was canceled. −

12. Maintenance
Confirming the Check Results

When the basic checks have been completed, the check result window appears.
The results of all checked items are displayed in the check result window,
showing the detailed results of the selected item.
Press the record/stop key on the front panel to print the manual check
list on recording paper.
• The item for which the detailed results is displayed can be changed by pressing
the [ ] or [ ] key.
• When you press the [DEFIBRILLATION INFO] key, the defibrillation
information window appears. Pressing the [BACK] key restores the check
result window.
• Press the [PRINT RESULTS] key to print the detailed check result.
The selected item is highlighted. Message
RESULTS
Lists the results of all check
items.
: OK or PASSED
: ERROR or FAILED
DETAILS
Shows the detailed results
of the check item selected
on the list.
Press to change the check Print the detailed

item selection on the list. check result.
DEFIBRILLATION INFORMATION window
DEFIBRILLATION
INFORMATION
Information of the discharged 12
waveform for the
defibrillation check is
displayed.

12. Maintenance
Confirming the Checking History

You can confirm the historical data of the basic checks in the history result
window.
The basic check history list window displays a maximum of 31 basic check
executions (including the latest one).
Press the record/stop key on the front panel to print the history list from
the selected date/time to the latest ones on recording paper.
1 Press the [HISTORY] key on the BASIC CHECKS window to display the
history list window.
2 To confirm the results of a certain execution, display the history result

window.
1) Press the [ ] or [ ] key and select the date and time
to display the results of the basic checks.
2) Press the [DISPLAY] key to display the history result window.
HISTORY
Lists the history of the basic
check executions.
Press to change the history

date/time selection on the list.
Press to store the basic check data from the Press to restore the
selected date/time to the latest ones in an SD card. BASIC CHECKS
window.
HISTORY
Lists the results of all check items.
: OK or PASSED
: ERROR or FAILED
DETAILS
Shows the detailed result of the
check item selected on the list.
Press to change the check item

selection on the list.
Press to store the check data from the Press to display the DEFIBRILLATION
selected date/time to the latest in an INFORMATION window for the displayed
SD card. basic checks. The contents are the same as
the window shown on the previous page.
History of a maximum of 31 basic check executions can be stored in an
SD card. When the number of executions reaches 31, the data for the
oldest execution are removed.
12. Maintenance
Self Tests
The defibrillator performs the self-tests every month (the 15th day of each
month), every day, when the defibrillator power is turned on/off, and when the
power cord is connected/disconnected.
The self-tests are automatically performed periodically by the defibrillator itself,
checking the conditions of the battery and internal circuits.
The time to perform the self-tests every day and on the 15th day of each month
can be set under SELF TEST TIME in the SELF TEST SETUP window (default
setting: 12:00).
Section 5 “SELF TEST SETUP” (p. 5-10)
Indications of the status indicator The status indicator is lit in red during the self-tests. If no problem is found, the
indicator lights in green. It remains red if there is an error.
If the indicator remains in red, restart the defibrillator in monitor mode and check
red (operation green the error message.
disabled) (operation
enabled) If no message is displayed even when the defibrillator is restarted, refer to the
descriptions for “The status indicator is lit in red” under “Troubleshooting” in
Section 11 (p. 11-20).
• If the defibrillator is turned on while the monthly self test is performed,

the status indicator may light in red for up to 10 seconds.
However, if there is no problem on the defibrillator, the defibrillator can
be used immediately.
• If you turn the control dial to the defibrillation mode (desired energy
position) while the HV Test (Energy Charge) is performed, the charging
energy may be displayed.
However, if there is no problem on the defibrillator, the defibrillator can
be used immediately.
The test items to be performed depend on the triggers (monthly, daily, power-on,
power-off, or power cord connection/disconnection) as follows:
NOTE: If the power cord is connected and disconnected three or more
times a day, the daily self-test starts after the third connection.
12
Power cord
Power Power
Test Item Description Monthly Daily connect/
on off
disconnect
Paddle Check If no paddle is connected to the paddle connectors,
Yes Yes Yes Yes Yes
the status indicator lights in red.
Remaining Battery If the battery remaining is decreased to 1/3 or less
Power when operating the defibrillator on the battery only, Yes Yes No Yes Yes
If the battery is empty when you turn on the
defibrillator to operate it on the battery only, the No No Yes No No
status indicator lights in red.
Battery Voltage If no battery is connected or abnormal voltage is
Yes Yes Yes Yes Yes
detected, the status indicator lights in red
Battery Expire Date If the scheduled battery replacement date is passed,
Yes Yes Yes No Yes
Sub Battery Voltage If the sub-battery voltage is below the specified value,
Yes Yes Yes No Yes

12. Maintenance
Power cord
Power Power
Test Item Description Monthly Daily connect/
on off
disconnect
Backup Battery Voltage If an error is detected, the status indicator lights in
Yes Yes Yes No Yes
red.
RTC Alarm If the self test does not start properly, the status
Yes Yes Yes No Yes
indicator lights in red.
HV Test (Energy If an error is detected during charging, the status
Charge) indicator lights in red.
If the paddles or pads are replaced during charge,
a paddle error is generated and the status indicator Yes No No No Yes
lights in red.
When the defibrillation check in the basic checks
resulted in “OK”, the status indicator lights in green.
HV Test (Internal Internal discharge is performed after a charge for
Discharge) measuring the discharge time. If it takes longer than Yes No No No Yes
the specified time, the status indicator lights in red.
Memory (ROM/RAM) If a memory error is detected, the status indicator

Yes Yes Yes No Yes
lights in red.
Speaker Wire Break If a speaker disconnection is detected, the status
Yes No No No No
System Error Check If a system error is detected, the status indicator lights
Yes Yes Yes No Yes
in red.
Status Indicator If an error is detected in the control function of the
status indicator, the indicator lights in red and check
Yes Yes Yes Yes Yes
results are not displayed on the Latest Self Test
screen of the SYSTEM SETUP screen.
If an error is detected in the circuit which monitors
the control function of the status indicator, the Yes No No No No

12. Maintenance
Expiration Date, Replacement and Disposal
Defibrillator
Periodic Replacement Parts

The following parts must be replaced periodically at the described intervals to
maintain the function and performance of the defibrillator.
For replacing the periodic replacement parts, contact your Nihon Kohden
representative.
Periodic Replacement Part Expiration
Defibrillator
NKB-301V battery pack (option) Usable for approx. 2 years
Electrode springs (Code No. 6114-927936)

(test electrode plates in the right and left paddle Usable for approx. 2 years
holders)
Supplied Accessory (TEC-5621, TEC-5631)
JC-865V pad adapter Usable for approx. 2 years
Disposal
CAUTION
Dispose of Nihon Kohden products according to
your local laws and your facility’s guidelines for
waste disposal. Otherwise, it may affect the
environment. If there is a possibility that the
product may have been contaminated with
infection, dispose of it as medical waste according
12
to your local laws and your facility’s guidelines for
medical waste. Otherwise, it may cause infection.
When an optional NKB-301V battery pack has been installed, remove it before
disposal.

12. Maintenance
NKB-301V Battery Pack (Option)
Expiration Date
Replace the battery pack with a new one every 2 years.
If it is used continuously without replacement over 2 years, the defibrillator may
not fully enable its functions and the backup time in battery operation may be
危険
shortened.
DAN
Estimated Battery Operation Time

GER
使用
開始
年月
日
Note that the operation time depends on the usage conditions.

The following operation times are estimated using a fully charged new battery at
NKB-301V battery pack 20°C (68°F) ambient temperature.
Defibrillation
100 discharges or more of 270 J defibrillation energy
(3 charge/discharge cycles in a minute followed by a pause for a minute)
Monitoring
Continuous monitoring for 180 minutes or more
Pacing (TEC-5631)
Pacing at 180 ppm and 200 mA in fixed mode for 120 minutes
The following operation time is estimated using a fully charged new battery at
0°C (32°F) ambient temperature.
Defibrillation
50 discharges or more of 50 J defibrillation energy
(3 charge/discharge cycles in a minute followed by a pause for a minute)
Replacement
NOTE • Use only the NKB-301V battery pack.
• Be sure to write the date of replacement on the label of a new
battery before installing it.
• Leave battery replacement to your Nihon Kohden representative
or a person with expertise.
• When replacing the battery in TEC-5611, TEC-5621 or
TEC-5631, be careful not to face the right side panel downward.
This may damage the door release lever, and result in disabling
the recorder.
1
危険
DAN
Before replacement, write the starting date of use on the label of the new
GER
使用
開始
battery.
年月
日
2 Set the control dial to OFF to turn off the power, then disconnect the power
cord from the defibrillator.
Write the date when use of
the battery is started.
CAUTION
When inserting or removing the battery, disconnect
the power cord from the defibrillator. Otherwise, the
operator may receive electrical shock.
damaged.

12. Maintenance
3 Loosen the screw with a flat-blade screwdriver, and

remove the battery cover.
Battery cover
4 Disconnect the battery cable connector and remove the

battery pack from the battery case.
Lock
Hold the lock NOTE: Do not pull the cable forcibly. Disconnect the
pressed to
release it and cable while holding the lock pressed.
remove the
connector.
5 Set the new battery pack in the battery case and connect
Black lead the battery cable connector.
NOTE • Insert the battery pack and the battery
cable connector in the correct direction.
• Make sure that the connector clicks and is
securely locked.
Battery pack
Setting direction
12
6 Attach the battery cover with the screw. Make sure the
battery cable is not pinched under the cover.
7 Perform the battery test, referring to the Administrator’s

Guide.
Battery cover Administrator’s Guide: “Battery Test Procedure”
NOTE: Press the [RESET] key during the

battery test to update the date of battery
replacement.

12. Maintenance
Disposal
The battery pack uses a nickel-metal hydride (Ni-MH) battery.
Do not dispose of the battery pack with other waste. To dispose of it, contact
your Nihon Kohden representative. The battery pack will be recycled for
environmental protection.
When disposing of the defibrillator, it is necessary to remove the battery pack
from it.
JC-865V Pad Adapter (TEC-5621, TEC-5631)
Expiration Date and Replacement

Replace the JC-865V pad adapter every two years.
Disposal
To dispose of the JC-865V, contact authorized personnel for medical waste.
Disposable Pads (Option)
Expiration Date and Replacement

The expiration date of disposable pads is indicated on the package. Be sure to
observe the date.
WARNING
Do not use the disposable pads if they are past the
delivery of shock.
CAUTION
When disposable pads are attached to a patient,
replace them every 24 hours. After 24 hours, the
gel becomes dry and this may reduce performance
of the pads.
Disposal
To dispose of used pads, contact authorized personnel for medical waste.
Other Options
Refer to the documents (including the operator’s manuals) supplied with the
respective products.

12. Maintenance
Cleaning, Disinfecting and Storage
Defibrillator
CAUTION
Before maintenance, cleaning or disinfection, turn
the defibrillator power off and disconnect the power
cord from the AC socket. Failure to follow this
instruction may result in electrical shock and
defibrillator malfunction.
NOTE: Avoid using flammable disinfectants such as ethanol in a closed

place. Ventilate the room if you use flammable disinfectants.
Cleaning the Exterior

When to clean: Every time after use
When the external paddles are After use, wipe with a non-abrasive cloth moistened with disinfecting ethanol
connected (concentration: 76.9 to 81.4 vol% at 15°C or 59°F), neutral detergent diluted
Paddle holders (paddle cups) with water, or isopropyl alcohol.
Test electrode plates When connecting the external paddles, wipe off any dirt from both paddle
holders (paddle cups) and any contact gel (GELAID) remaining on the test
electrode plates.
NOTE • Do not use organic solvents such as thinners, benzine or
industrial alcohol. These may melt or crack the surface.
• Do not leave saline-soaked gauze on the paddle holders. It
would cause discoloration (rusting) of the metal surfaces of the
test electrode plates or paddles.
Cleaning the Recorder (TEC-5611, TEC-5621, TEC-5631)

When to clean: Every 6 months
To maintain clear printing, clean the thermal head, paper feed roller, and sensors. 12
When paper has been set, once detach it and set it again after cleaning.
Refer to Section 4 “Loading the Recording Paper (TEC-5611, TEC-5621,
TEC-5631)” (p. 4-9).
CAUTION
unit. The thermal head may be damaged by static
failure.
NOTE: Be sure to clean the recorder in the power-off status.

12. Maintenance
To clean the thermal head and paper feed

roller
Door release lever 1 Push up the door release lever and open the recorder door.
The door once stops at the half-opened position for
security reasons. Pull the door by hand to fully open it.
Thermal head 2 Clean the gold-colored part (heat generation block) of

the thermal head with the supplied Y-001 thermal head
cleaning pen.
3 Clean the paper feed roller with a soft cloth moistened with
disinfecting ethanol (concentration: 76.9 to 81.4 vol% at
15°C or 59°F).
Paper feed roller
To clean the sensors

To properly detect the out-of-paper status, clean the sensor
surfaces with a cotton swab.
Storage of Recording Paper (TEC-5611, TEC-5621, TEC-5631)

Long-term storage at high temperature or high humidity or under direct sunlight
or fluorescent light causes discoloration of the color-developing surface.
Especially avoid a place exceeding 50°C (122°F) or a place exposed to drops of
water. Storage in a dry, cool, dark place is recommended.

12. Maintenance
Cables and Paddles

NOTE • For details on cleaning and disinfecting leads, cables and cords,
also refer to the manual.
• Use the described cleaning and disinfection methods.
• Avoid using flammable disinfectants such as ethanol in a closed
place. Ventilate the room if you use flammable disinfectants.
Pad Adapter, Electrode Leads, ECG Connection Cord

When to clean: After every use
Cleaning
After use, wipe with a non-abrasive cloth moistened with disinfecting ethanol
(concentration: 76.9 to 81.4 vol% at 15°C or 59°F) or neutral detergent diluted
with water, and then wipe dry with a dry cloth.
NOTE: Do not wet the connector.
Disinfecting
Wipe with a non-abrasive cloth moistened with any of the disinfectants listed
below.
Glutaraldehyde solution: 2%
Alkyldiaminoethylglycine hydrochloride: 0.5%
Benzalkonium chloride: 0.2%
Benzethonium chloride solution: 0.2%
Chlorhexidine gluconate solution: 0.5%
NOTE • Do not wet the connector.
• Always use the correct disinfectant concentration.
• Do not disinfect with hypochlorous acid.
• Do not sterilize or disinfect with ultraviolet light or ozone.
SpO2 Connection Cord

Cleaning
After use, wipe with a non-abrasive cloth moistened with neutral detergent 12
diluted with water, and then wipe dry with a dry cloth.
NOTE: Do not wet the connector.
Disinfecting
Wipe with a non-abrasive cloth moistened with any of the disinfectants listed
below.
Glutaraldehyde solution: 2%
Alkyldiaminoethylglycine hydrochloride: 0.5%
Benzalkonium chloride: 0.2%
Benzethonium chloride solution: 0.2%
Chlorhexidine gluconate solution: 0.5%
NOTE • Do not wet the connector.
• Always use the correct disinfectant concentration.
• Do not disinfect with hypochlorous acid.
• Do not sterilize or disinfect with ultraviolet light or ozone.
12. Maintenance
External Paddles
To clean and disinfect the external paddles

After use, wipe off the contact gel (GELAID) on the electrode surfaces or
handles with a soft cloth moistened with disinfecting ethanol (concentration:
76.9 to 81.4 vol% at 15°C or 59°F).
When cleaning the external paddles, also wipe off the dirt on the both paddle
holders (paddle cups) and the contact gel (GELAID) on the test electrode plates.
NOTE • The external paddles cannot be disinfected.
• Do not expose the external paddles to heat over 60°C (140°F),
Paddle holder (paddle cup)
and prevent their being dropped into water or other liquid.
Test electrode
plates
Internal Paddles
To clean, disinfect, and sterilize the internal paddles

For details on cleaning, disinfecting and sterilization of the internal paddles, refer
to the document (including operator’s manual) supplied with the paddles.
Other Options
Refer to the documents (including operator’s manuals) supplied with the
respective products.

12. Maintenance
Periodic Inspection
The defibrillator is a medical treatment apparatus.
Degradation or loss of defibrillator functions may lead to misdiagnosis.
Service personnel should perform the periodic inspection at least once every
year and make sure that the defibrillator operates properly and replace the
consumables.
If you found abnormalities as a result of inspection and the defibrillator is
suspected to be faulty, attach an “Unusable” or “Repair request” label to the
defibrillator and contact your Nihon Kohden representative.
For inspection, refer to the Service Manual.
Repair Parts Availability Policy

Nihon Kohden Corporation (NKC) shall stock repair parts (parts necessary to
maintain the performance of the instrument) for a period of 8 years from the
date of delivery. In that period NKC or its authorized agents will repair the
instrument. This period may be shorter than 8 years if the board or part necessary
for the faulty section is not available.
12

13
Standard
Accessories,
Options and
Consumables
Standard Accessories....................................................13-2
TEC-5611, TEC-5621, TEC-5631.................................................13-2
Options and Consumables............................................13-3

Defibrillator...................................................................................13-3
Installation....................................................................................13-3
Defibrillator Analyzer....................................................................13-4
Paddles and Disposable Pads.....................................................13-4
For ECG Monitoring................................................................ 13-5
For CO2 Monitoring................................................................. 13-6
For SpO2 Monitoring.................................................................13-7
13
13. Standard Accessories, Options and Consumables
Standard Accessories
For the standard accessories only use Nihon Kohden specified parts and
accessories to satisfy the safety and performance.
Some accessories may differ depending on the destination country or region.
TEC-5611, TEC-5621, TEC-5631

1 2 3
No. Name Qty Model/Code No. Supply Code

1 ECG connection cord 1 JC-906P K922
2 Thermal head cleaner pen 1 404617B Y011
3 Recording paper 1 RQS50-3 A128

Options and Consumables
WARNING
caused.
NOTE: The parts which are marked with * have not been checked for
compliance with the MDD (Medical Device Directive). For EC
member countries, Nihon Kohden recommends the use of parts
that comply with MDD.
Defibrillator
Name Qty Model/Code No. Supply Code
Power cord (For Central and Eastern Europe) 1 547748A –
Power cord (For Brazil) 1 9000-000082 –
Battery pack, NKB-301V 1 YZ-024H9 X065
1 GB 1 QM-001D Y154D
SD memory card
2 GB 1 QM-002D Y154F
Multi parameter/SpO2 unit 1 QI-564V –
Bluetooth® module 1 QI-832V –
Defibrillator report viewer software 1 QP-551VK –
Upgrade kit (For arrhythmia analysis) 1 QS-831V –
Software kit 1 QS-009V –
For Kimberly-Clark Company disposable
1 JC-855V K342A
Pad adapter pads 1
For Nihon Kohden disposable pads 1 JC-865V K342B
Electrode springs
1 6114-927936 –
(test electrode plates in the right and left paddle holders)
GELAID (contact gel) 1 Z-101EA F015
13
1
For purchasing Kimberly-Clark disposable pads, contact Kimberly-Clark or its representative.
Installation
Name Qty Model/Code No. Description Supply Code
Cart 1 KD-561V For TEC-5600 series defibrillators
Basket 1 DI-831V For the KD-561V cart
Wall mount 1 KG-561V For TEC-5600 series defibrillators
–
Paste holder kit 1 YZ-025H0 For holding GELAID (contact gel)
For hooking defibrillator onto a bed
Bed rail hook 1 YZ-047H4
board

Defibrillator Analyzer
Name Qty Model/Code No. Description Supply Code
Defibrillator analyzer 1 AX-103VK For defibrillation check ─
Paddles and Disposable Pads

Name Description Qty Model/Code No. Supply Code
External paddles 1 ND-831V
For adults and children
External paddles (ERC) 1 1 ND-832V
Adult electrode assy For ND-831V 12 ND-618V
Adult electrode assy (ERC) 1 For ND-832V 12 ND-838V
External paddle holder For ND-831V 1 DP-560V
External paddle holder (ERC) 1 For ND-832V 1 DP-562V
When the external paddles are not
Top cover 1 YZ-052H4
used
35 mm dia 1 ND-863V
─
45 mm dia 1 ND-864V
Internal paddle electrode 55 mm dia 1 ND-865V
65 mm dia 1 ND-866V
75 mm dia 1 ND-867V
35 mm dia 1 ND-893V
45 mm dia 1 ND-894V
Internal paddle electrode
55 mm dia 1 ND-895V
(with switch)
65 mm dia 1 ND-896V
75 mm dia 1 ND-897V
Disposable pads For adults 1 P-511 H327
Disposable pads for infant For infants 1 P-513 H312
Defibrillation pads For adults and children 1 P-530K H324A
Defibrillation pads for adult For adults 1 P-531K H324C
Defibrillation pads for child For children 1 P-532K H324E
For adults, children and infants 3
1 P-711 H329
(Cable length 1.5 m)
For adults, children and infants 3
Disposable pads 1 P-721 H331
Infants (less than 1 year old)
1 P-713 H330
For Nihon Kohden disposable
1 AX-250V Y206A
pads
Test load unit
For Kimberly-Clark disposable
1 AX-251V Y206B
pads 4
1
The whole dimensions of the external paddle electrodes should be 150 cm2 or more.
2
For both paddles, require 2 adult electrode assies.
3
For infants less than 1 year old, use of the P-713 disposable pads takes priority over use of the P-711 or P-721 disposable pads.
4
For purchasing Kimberly-Clark disposable pads, contact Kimberly-Clark or its representative.

For ECG Monitoring

Name Description Length (m) Qty Model Supply Code
IEC, clip type BR-903P K911
AHA, clip type 0.8 BR-903PA K911A
IEC, snap type BR-913P K910A
3 electrodes
IEC, clip type 1.5 BR-923P K917
Connector to R: 0.8
Electrode lead IEC, clip type R to L: 0.5 BR-963P* K916
L to F: 0.3
IEC, clip type BR-906P K912
1
AHA, clip type 0.8 BR-906PA K912A
6 electrodes
IEC, snap type BR-916P* K915
IEC, clip type 1.5 BR-926P K918
3/6 electrodes (IEC) JC-906P K922
ECG connection 3
3/6 electrodes (AHA) JC-906PA K922A
cord
3/6 electrodes (IEC) 1.5 JC-916P K925
External ECG
For the external monitor 3 JC-831V L154
cable
30 × 5 Bs-150 G201
30 × 5 C-150 G204
30 × 5 R-150 G254
3 × 50 F-150M G210D
3 × 50 F-150U3 G209A
General – 3 × 50 F-150U5 G209B
30 × 20 G-600 G221
30 × 5 J-150 G250
30 × 5 M-150 G236
30 × 20 K-600 G222
30 × 5 L-150 G203
General, X-ray – 30 × 5 L-150X G207
Disposable
3 × 30 V-09IO3 G278A
electrodes, Vitrode
General with DIN type lead 1.5 4 × 10 V-04IO4 G273A
6 × 10 V-06IO6 G274A
3 × 30 V-090M3 G272A
General with DIN type lead, X-ray 1.0 4 × 10 V-040M4 G272B
13
6 × 10 V-060M6 G272C
General
You can sterilize the electrode by – 3 × 30 D-90 G217
autoclaving.
3 × 40 V-120S3 G271A
For neonates and premature infants
0.6 3 × 40 V-120SK G271K
For NICU with DIN type lead
3 × 10 N-03IS3 G300A
For neonates and premature infants
– 3 × 50 F-150S G210C
For NICU

For CO2 Monitoring

Name Length (m) Qty Model/Code No. Supply Code
Semi-quantitative Method (TG-900P)
CO2 sensor kit (CO2 adapter and CO2 sensor) 3 TG-900P P903
CO2 adapter 2 1 JG-900P K981
CO2 sensor 1 TG-101T P922A
Airway adapter – 50 YG-101T R801
Semi-quantitative Method (TG-920P)
CO2 sensor kit (CO2 adapter and CO2 sensor) 3.5 TG-920P P907
CO2 adapter 2 1 JG-920P K984
CO2 sensor 1.5 TG-121T P923
Airway adapter 30 YG-111T R804
For nasal breathing 30 YG-120T V921
For naso-oral breathing 30 YG-121T V922
Nasal adapter
For oxygen cannula –
30 YG-122T V923
adjustment
Oxygen cannula For YG-122T 25 1103 V927
Surgical tape 1 #1527 Y242
Quantitative Method (TG-970P)
CO2 sensor kit (CO2 adapter and CO2 sensor) 3.5 TG-970P P909
CO2 adapter 0.5 1 JG-970P K987
CO2 sensor 3 TG-221T P924
Airway adapter – 30 YG-211T R805
Neonatal/Infant airway YG-213T R806

For neonates and infants – 30
adapter YG-214T R807

For SpO2 Monitoring

Length
Name Description Qty Model/Code No. Supply Code
(m)
SpO2 connection For Nihon Kohden SpO2 probes
2.5 JL-900P K931
cord
Adults or children (20 kg or more) Finger 1.6 TL-201T P225F
Adults or children (50 kg or more) Finger 0.6 TL-630T1 P310A
Finger probe
1.6 TL-630T3 P310C
(BluPRO®) 1
Adults or children (20 kg or more) Finger or toe 0.6 TL-631T1 P311A
1.6 TL-631T3 P311C
Adults or children (3 kg or more) Finger or toe
Multi-site probe
1.6 TL-220T P225G
(BluPRO®)
Neonates (less than 3 kg) Instep and sole
Adults (30 kg or more) Finger or toe Qty 5: P204A
0.8 TL-271T
Qty 24: P203A
Qty 5: P204E
1.6 TL-271T3
Qty 24: P203E
Children (from 10 to 50 kg) Finger or toe Qty 5: P204B
0.8 TL-272T
Qty 24: P203B
5 Qty 5: P204F
1.6 TL-272T3
Disposable SpO2 Qty 24: P203F
or
probe (BluPRO®) Neonates (less than 3 kg) Instep Qty 5: P204C
0.8 24 TL-273T
Adults (40 kg or more) Finger or toe Qty 24: P203C
Qty 5: P204G
1.6 TL-273T3
Qty 24: P203G
Infants (from 3 to 20 kg) Finger or toe Qty 5: P204D
0.8 TL-274T
Qty 24: P203D
Qty 5: P204H
1.6 TL-274T3
Qty 24: P203H
• Type S attachment tape
Low birth weight infants (1 kg or less) Instep
and sole
Disposable Children, neonates (3 kg or more) Finger or toe 1.6 TL-260T P205A
Multi-site Y probe
• Type L attachment tape
Neonates (3 kg or less) Instep and sole
5
Adults (50 kg or more) Finger 0.8 TL-051S P228A
Neonates (3 kg or less) Instep and sole
Disposable SpO2 1.6 TL-052S P228B
probe Children (from 15 to 50 kg) Finger 0.8 TL-061S P229A
Infants (from 3 to 15 kg) Toe 13
1.6 TL-062S P229B
Attachment tape For BluPRO® finger and multi-site probes
3 × 30 P263
for BluPRO®
Sponge Type S attachment tape P260A
attachment tape Type L attachment tape 24
for TL-260T multi- – P260B
site Y probe
–
Clip adapter For TL-260T multi-site Y probe 1 P256
For TL-051S, TL-052S, TL-061S or TL-062S
Foam tape 4 × 25 P260C
disposable probes
COTTONY tape For attaching probes 20 340703* P259
Probe fastener 30 – P267

14 Setting Items and
Default Settings
Setting Items, Setting Content and Default Settings.....14-2

GUIDE..........................................................................................14-2
ALARM SETUP............................................................................14-3
PADDLE SETUP..........................................................................14-3
ECG SETUP.................................................................................14-3
QRS SETUP.................................................................................14-4
ARRHYTHMIA SETUP.................................................................14-4
SpO2 SETUP................................................................................14-4
CO2 SETUP..................................................................................14-5
REPORT.......................................................................................14-5
RECORDING SETUP..................................................................14-5
DEVICE SETUP...........................................................................14-6
14
14. Setting Items and Default Settings
Setting Items, Setting Content and Default

Settings
This section describes the settings items on the defibrillator and their setting
content, default settings, and backup statuses.
The “Backup” column is identified with the following marks:
• Yes: The setting of this item is retained in memory even if the power of the
• No: There is no default setting or backup for this item.
• Alarm: The alarm setting is retained for 30 minutes after the defibrillator is
turned off. If the defibrillator is turned on after more than 30 minutes
have elapsed after it was turned off, the alarm setting changes
according to the Alarm Setting value made on the SYSTEM SETUP
screen.
• “System Setup”
• “Alarm Setting List”
SYSTEM SETUP
Alarm Setting Contents
(Alarm Setting)
The alarm settings are retained regardless of the elapsed time
Latest
after the defibrillator was turned off.
All the alarm settings return to the default settings when 30
Default
minutes elapse after the defibrillator was turned off.
All the alarm settings return to the settings specified with
ALARM SETTING LIST when 30 minutes elapse after the
User Settings defibrillator was turned off.
When the optional QS-831V is installed, ARRHYTHMIA
ANALYSIS is set to “ON”.
GUIDE
Item Settings Backup
?ECG
?SpO2 Displays the GUIDE window for each parameter. No
?CO2

ALARM SETUP
Settings
Item Unit Default Backup
Setting Range Step
Upper Limit HR:bpm 35 to 300, OFF 140
HR/PR 1
Lower Limit PR:/min OFF, 30 to 295 40
VPC Upper Limit /min 1 to 99, OFF 1 10
Upper Limit 51 to 100, OFF OFF
SpO2 %SpO2 1
Lower Limit OFF, 50 to 99 90
APNEA Upper Limit s 5 to 40, OFF 5 OFF Alarm
2 to 99, OFF
Upper Limit OFF
mmHg (1.0 to 13.5, OFF) 1
ETCO2
(kPa) 1 OFF, 1 to 98 (0.5)
Lower Limit OFF
(OFF, 0.5 to 13.0)
Upper Limit 2 to 150, OFF OFF
RR /min 2
Lower Limit OFF, 0 to 148 OFF
1
The unit can be changed in Pressure Units on the SYSTEM SETUP screen.
PADDLE SETUP
Item Settings Default Backup
SYNC BY PADDLE ON, OFF

OFF Yes
HR ALARM ON, OFF
ECG SETUP
The alarm settings and default settings are the same as those in
ECG ALARM HR, PR Alarm
ALARM SETUP. Refer to “ALARM SETUP” (p. 14-3).
HUM FILTER ON, OFF ON
FILTER DIAGNOSIS, MONITOR, MAXIMUM MAXIMUM
Ca LEAD V4 Yes 14
V1 to V6
Cb LEAD V5
CASCADE ON, OFF OFF

QRS SETUP
ECG LEARNING Press the [OK] key to perform ECG learning. No

QRS SETUP PACING REJECT ON, OFF ON
Yes
DETECTION TYPE ADULT, CHILD ADULT
ARRHYTHMIA SETUP
ASYSTOLE 1 3 to 10 seconds (by 1 step) 5 seconds

VF/VT ON, OFF ON
VPC RUN 1 3 to 8 beats (by 1 step), OFF OFF
COUPLET 1
ON, OFF OFF Alarm
EARLY VPC 1 ON, OFF OFF
BIGEMINY 1
ON, OFF OFF
ARRHYTHMIA SETUP 1 ON, OFF ON
1
Available only when the optional QS-831V is installed.
SpO2 SETUP
SpO2
SpO2 ALARM Alarm
HR, PR
SYNC SOURCE ECG, SpO2 ECG

SYNC TONE FIXED, SpO2 FIXED
Yes
SENSITIVITY AUTO, ×1/8, ×1/4, ×1/2, ×1, ×2, ×4, ×8 AUTO
SENSITIVITY MODE MAX, NORMAL NORMAL

CO2 SETUP
CALIBRATE (AIR, N2) Press the [OK] key to perform zero calibration. No
ETCO2
CO2 ALARM RR Alarm
APNEA
CALIBRATION METHOD AIR, N2 AIR
Yes
SCALE mmHg (kPa) 1
0-20, 0-40, 0-80 (0.0-2.5, 0.0-5.5, 0.0-10.5) 0-40 (0.0-5.5)
1
The unit can be changed in Pressure Units on the SYSTEM SETUP screen.
REPORT
INTERVAL 1 min, 5 min, 15 min, 30 min, 60 min 1 min

Yes
DELETE ALL REPORTS YES, NO NO
SAVE REPORT, SEND REPORT,
TRENDGRAPH, PERIODIC LIST, Displays various reports. No
EVENT LIST
RECORDING SETUP
INTERVAL OFF, FREE 1, 15 min, 30 min, 60 min, 120 min OFF

Yes
RECORDING WAVES ECG, ECG+SpO2, ECG+CO2 ECG
1
The recording time can be changed in Periodic Recording Interval on the
SYSTEM SETUP screen.
14

DEVICE SETUP
YEAR 2000 to 2079

MONTH 1 to 12
DATE AND TIME DAY 1 to 31 Current time No
HOUR 0 to 23
MINUTE 0 to 59
SELF TEST HOUR 0 to 23 12

TIME MINUTE 0 to 59 00
SELF TEST
SETUP SELF TEST
REPORT
PAIRING NO, YES NO
AUTO
TRANSFER
FILE FORMAT DAT, JPG JPG

Set for each PIN CODE Up to 6 alphanumeric characters 0000
BLUETOOTH
connected
SETUP
device. DESTINATION
Up to 20 characters Blank space
DEVICE
VOICE INSTRUCTION 4
ALARM SOUND 1, 2, 3, 4 4
Yes
CHARGE SOUND 4
VOLUME
SYNC SOUND 0, 1, 2, 3, 4 2
KEY SOUND 0, 1, 2, 3, 4 2
OPERATION SOUND 1, 2, 3, 4 4
MEDICATION 1 Adrenalin
MEDICATION 2 Medication2
MEDICATION
MEDICATION 3 Up to 13 characters Medication3
SETUP
LARGE
NUMERICS LARGE NUMERICS ON, OFF OFF
SETUP

15 Technical
Resources
Specifications...........................................15-2 Environment Conditions................................... 15-22
Functions............................................................ 15-2 Storage Environments.................................. 15-22

Transport Environments............................... 15-22
Defibrillator..................................................... 15-2
Operation Environments and Power
Transcutaneous Pacing.................................. 15-3
Requirements............................................... 15-22
Monitor........................................................... 15-3
Mechanical Strength.................................... 15-23
Indications......................................................15-4
Recording.......................................................15-6 EMC Application Standards.............................. 15-23
Sounds........................................................... 15-7 Dimensions and Weight................................... 15-23
External Interface...........................................15-8 Requirements from International Standards..... 15-24
Maintenance...................................................15-8
IEC 60601-1-8 Amendment 1: 2012............. 15-24
Operations...................................................... 15-9
IEC 60601-2-27: 2011................................... 15-25
Transportation................................................ 15-9
ISO 80601-2-61: 2011.................................. 15-26
Performance..................................................... 15-10 ISO 80601-2-55: 2011.................................. 15-27
Defibrillator................................................... 15-10 Electromagnetic Emissions and Immunity........ 15-28
Transcutaneous Pacing................................ 15-15
System Composition for EMC Test................... 15-31
ECG.............................................................. 15-15
SpO2 ............................................................ 15-17 Reference...............................................15-32
CO2 . ............................................................ 15-17
Screen Displays........................................... 15-17
Recorder...................................................... 15-17
SD Card Storage.......................................... 15-17
Alarm Functions........................................... 15-18
Power Requirements.................................... 15-19
Applicable Laws and Regulations.................... 15-20
Applicable Laws........................................... 15-20
15
Applicable Regulations................................ 15-20
Classifications.................................................. 15-21
15. Technical Resources
Specifications
Functions
Defibrillator
Manual mode: For charging to a user-specified energy level by using the CHARGE/AED
button
Manual sync mode: For charging to a user-specified energy level by using the CHARGE/AED
button, then discharging in synchronization with the R-wave of an ECG
after the SHOCK button is pressed
AED mode: For charging up to the automatically specified energy level when
defibrillation is required for the ECG. The energy level varies, depending
on the sequence defined in advance
AED mode (child mode): For charging up to the automatically specified energy level for a child
when defibrillation is required for the ECG. The energy level varies,
depending on the sequence defined in advance. This mode is for preschool
children only
Output energy (with loading of 50 Ω)
External paddles: 2, 3, 5, 7, 10, 15, 20, 30, 50, 70, 100, 150, 200, or 270 J selectable
Internal paddles: 2, 3, 5, 7, 10, 15, 20, 30, or 50 J selectable
Disposal pads: 2, 3, 5, 7, 10, 15, 20, 30, 50, 70, 100, 150, 200, or 270 J selectable
AED mode: 1st: 150 J, 2nd: 200 J, 3rd: 200 J (default settings)
(The settings can be selected from among 50, 70, 100, 150, 200, and 270 J.)
AED mode (child mode):
1st: 50 J, 2nd: 70 J, 3rd: 70 J (default settings)
(The settings can be selected from among 50, 70, and 100 J.)
VF/VT analysis: Analysis is performed in the background or when the AED button is
pressed (depending on the setting). In AED mode, the requirement for
defibrillation is determined for ventricular fibrillation waveform of
amplitude more than 0.1 mV and a ventricular tachycardia more than
180 bpm.
Internal discharge: For discharging the charged energy to the internal resistance in the
following cases:
• When power is turned off
• When the control dial is set to DISARM, AED, MONITOR, BASIC
CHECK, PACING, or SETUP
• When 40 seconds or more have elapsed from when a charge completed,
depending on the setting of “Charge Holding Time” (default setting:
40 seconds) in the system setup
• When a paddle is disconnected from the defibrillator
• When a disposal pad is disconnected from the patient
• When discharging with the released external or internal paddles
• When detecting an ECG that requires no defibrillation in AED mode
TTR detection: For measuring the transthoracic electric resistance of a patient
Discharged energy detection:
For measuring the discharged energy

Transcutaneous Pacing
Demand mode: For delivering pacing pulses at the specified pacing output current when
there is no spontaneous QRS within the time calculated from the specified
pacing rate
Fixed mode: For delivering pacing pulses at the specified pacing rate and output
current for a patient having no spontaneous QRS
Monitor
Induction
Disposal pads: Pads
External or internal paddles:
Paddles
3 leads: I, II, III
6 leads: I, II, III, aVR, aVL, aVF, Va, Vb
External ECG input: AUX
Filter: “DIAGNOSIS”, “MONITOR”, or “MAXIMUM” selectable for ECG

Pacemaker pulse rejection:
Equipped with a function activated to prevent output waveforms of the
pacemaker installed in a patient from being detected as QRS
Hum filter: “ON” or “OFF” selectable for the hum noise (50 or 60 Hz)
ESU filter: Equipped with a filter for rejecting noise incorporated into the ECG when
an ESU is used
Electrode disconnection detection:
Equipped with a function to detect disconnection of an electrode
Abnormal polarization detection:
Equipped with a function to detect possible distortion of an ECG caused
by polarizing voltage
Arrhythmia analysis: When arrhythmia analysis is “ON” in monitor mode (with the limb/
chest lead selected), the analysis is performed. Depending on the setting
for QRS detection type, the method of arrhythmia analysis is switched
between “CHILD” and “ADULT”.
SpO2
Pulse rate, pulse wave, and SpO2 value can be measured by connecting a
probe to the SpO2 socket.
CO2
ETCO2 value, CO2 waveform, and respiration rate can be measured by
15
connecting a CO2 sensor kit to the CO2 socket.

Indications
Screen Indications
Display: 6.5-inch diagonal, color TFT-LCD
Display area: 132.48 mm × 99.36 mm
Number of pixels: 640(H) × 480(V) pixels
Waveform Indications
Number of waveforms
ECG only: 1 trace of ECG waveform or 2 traces of ECG cascade 1
In SpO2 measurement: Pulse waveform 1
In CO2 waveform measurement:
Respiration waveform 1
1
Selectable by the setup
Waveform sensitivity
ECG: 1/4, 1/2, 1, 2, or 4
Pulse wave: 1/8, 1/4, 1/2, 1, 2, 4, 8, or automatic
CO2: 0 to 20 mmHg, 0 to 40 mmHg, or 0 to 80 mmHg
Sweep rate
ECG, SpO2: 25 or 50 mm/s
CO2: 12.5 or 6.25 mm/s
Numeric Indications
Displayed parameters: HR, SpO2, PR, ETCO2, RR
Defibrillator energy indications (with loading of 50 Ω):
In manual mode, the current energy value at the high-pressure condenser
is displayed during a charge operation and the output energy is displayed
after the charge operation is completed.
Pacing rate indication: The currently set pacing rate is displayed in pacing mode.
Pacing current intensity indication:
The currently set pacing current intensity is displayed in pacing mode.
Pacing duration indication:
The pacing duration time is displayed during pacing.
Clock indication: The current clock setting is displayed.
Timer indication: The time from when pressing the [START TIMER] key to when pressing
the [STOP TIMER] key is displayed in AED mode.
Character, Symbol, and Graphic Symbol Indications
Battery remaining: Indicates the battery remaining.
Recorder operation: Indicates operation statuses of the recorder.
SD card operation: Indicates operation statuses of an SD card.
Bluetooth® indication: Indicates connection statuses of a Bluetooth® module.
Defibrillation mode: Indicates manual mode, synchronized cardioversion mode, AED mode, or
AED mode (child mode) for defibrillation.
Pacing mode: Indicates the selected mode, fixed or demand, with “PACING”.
Analysis/charging/charging complete messages:
Indicate “ANALYZING” in VF analysis, “CHARGING” in energy
charging, or “CHARGING COMPLETE” when charging is complete.

Number of discharges: Indicates the number of discharges after power-on.

Voice message indication: Displays the same messages as the voice messages in AED mode.
Vital alarm: Displays an alarm message if any measured value of a parameter exceeds
the upper or lower limit of an alarm or if an arrhythmia is detected.
Technical alarm: If an error for the defibrillator or for measurement environment is
detected, an alarm message is displayed.
Display language: Language selection is enabled by a setting. Installing the software
program enables you to select the language.
Status Indicator
After a self test, the indicator shows “○” in green if the test ends normally.
During a self test or if any problem occurs in the defibrillator, the
indicator shows “×” in red.
Alarm Indicator
The indicator lights or blinks in cyan, yellow or red if vital information
exceeds the upper or lower limit of an alarm, or depending on the
measurement environment and defibrillator status such as a battery status.
LED Indications
AC power lamp: Lights when the power cord is connected and an AC power is supplied to
the defibrillator.
Battery charging lamp: Lights when the power cord is connected and the installed battery is in
charging. If the battery temperature is not suitable for charging, the lamp
blinks.
Battery charging completion lamp:
Lights when the power cord is connected and charging to the installed
battery is completed.
PACING PULSE lamp: Lights in synchronization with pacing pulse outputs.
SHOCK button lamp: The SHOCK button flashes when energy charging is completed and
discharging is enabled.
Shock button lamps: The shock buttons on external paddles flash when energy charging is
completed and discharging is enabled.
Paddle contact lamp: Lights in green, yellow or orange, depending on the resistance (in 3
stages) between the external paddles.
Frozen Waveform Display
Pressing the [FREEZE] key in monitor mode freezes the displayed
waveform for 3 minutes.
15

Recording
Waveform Recording
Continuous real-time recording:
Pressing the record button initiates continuous waveform recording with
no delay, in accordance with the user setting.
Continuous delayed recording:
Pressing the record button initiates continuous waveform recording with a
delay, in accordance with the user setting.
Event recording: When the [EVENT] key is pressed, data for the certain periods before and
after pressing the key are recorded. The function can be turned on/off by a
user setting.
Alarm recording: Recording is automatically started when a vital alarm is generated. The
function can be turned on/off by a user setting.
Periodic recording: Recording is started at the user-specified time.
Charging start recording: Recording automatically starts when charging begins, and it automatically
stops after defibrillation. The function can be turned on/off by a user
setting.
Report Recording
Defibrillator report: Stores an ECG waveform in the defibrillator when defibrillation is
performed, enabling it to be printed as a discharged waveform when
required. Defibrillator information can also be stored in the defibrillator
when defibrillation is performed, enabling it to be printed as a
defibrillation report when required.
Alarm report: Stores a waveform in the defibrillator when a vital alarm is generated,
enabling it to be printed when required.
Event report: Stores the waveforms before and after your pressing the [EVENT] key in
the defibrillator, enabling them to be printed when required.
VF analysis report: Stores an ECG waveform for which VF analysis is performed in the
defibrillator, enabling it to be printed as an analyzed waveform report.
Trend report: Stores the past vital data in the defibrillator, which can be provided as a
trend graph output.
Periodic list report: Stores HR, SpO2, PR, ETCO2, and RR data measured at the specified
times.
Self-test report: Stores the self-test result as a report.
Basic-check report: Stores the basic-check result as a report.
Event list: Outputs an event report, listing the time and defibrillator status data in
time-series format.
Operation history: Stores a history of defibrillator operations.
Defibrillator history: Stores a history of errors, basic checks and other items related to the
defibrillator.
Recording Information
• Record types can be printed.
• Additional information with respect to recording can be printed.
• Present or delayed vital information can be printed.
• When pacing is performed in pacing mode, information of pacing can
be printed.
• Information regarding the performed defibrillation can be printed.

Continuous Waveform Recording

ECG, ECG+SpO2, or ECG+CO2 can be selected by a user setting.
However, SpO2 and CO2 are valid only when measuring the concerned
parameters.
Recording Speed
25 mm/s or 50 mm/s can be selected by a user setting.
Recording Paper
Rolls of 50 mm in width can be used.
SD Card Storage
• Continuous ECG data with voice and numeric data of parameters being
measured can be stored in SD cards.
• Report data can be stored in SD cards.
• Data stored in SD cards can be displayed on a PC on which the
QP-551VK Defibrillator report viewer software is installed.
Sounds
In Normal Operations
Sound when buttons or keys are pressed:
Sounds when a button, switch or key is pressed.
Sound for heart rate or pulse wave synchronization:
Sounds in synchronization with QRS of an ECG or SpO2 pulse waves
when enabled by a user setting.
Sound for heart rate synchronization:
The tone for heat rate synchronization varies, depending on SpO2 values.
The function can be turned on/off by a user setting.
For Defibrillation
Sound during charging: Continuous sound is heard during charging.
Sound at charge completion:
Continuous sound is heard when charging is complete.
Operation sounds: In manual mode, the function can be turned on/off by a user setting. In
AED mode, continuous sound is heard except when analyzing an ECG.
For Alarms
Technical alarm sound: An alarm sound is generated when an error occurs in the defibrillator or in
the measurement environment.
Vital alarm sound: An alarm sound is generated when vital information on any parameter
exceeds the upper/lower limits of the allowable range.
Alarm sound priority: Alarm sounds have priority and vary in tone in accordance with the
priority. 15
Voice
AED mode: Voice instructions are made for the sequence in AED mode.
AED mode (child mode): Voice output is made to announce child mode. Voice instructions for the
sequence are the same as those in AED mode.
Microphone input: Ambient sounds are captured by the microphone and stored with ECG,
SpO2, and CO2 on an SD card.
Sound Volume Adjustment
Volumes of synchronization sounds, charging sounds, operation sounds,
alarm sounds, and voice instructions can be adjusted to the values in
accordance with the user settings in setup mode.

External Interface
Transmission output: Defibrillation, alarm, event or VF analysis reports, SD card data, and data
in internal memory can be output via a Bluetooth® module.
SD card: The measured data can be stored. Recovery of the defibrillator software is
also possible.
External ECG input: Applying 1/1000 to an external ECG enables you to enter it in the lead
ECG, which is displayed on the screen.
Maintenance
Self Tests
The defibrillator automatically performs the self test at power on/off or
power cord connection/disconnection, every day or every month.
Operation when an abnormality is detected:
The status indicator is set to the disabled condition (red).
Basic Checks
This mode enables easy daily inspection.
SD card check: To check whether an SD card can be written and read. The remaining
capacity can also be checked.
System check: To check whether there is an error history.
Paddle check: To check the type of paddles connected to the paddle connector.
Defibrillation check: To check the capacity of the high-pressure condenser. By discharging
to the external paddles or to the test load connected, the supplied
energy, TTR, and charge time are measured for normal or abnormal
determination.
Pacing check: To check a pacing output for normal or abnormal determination
(TEC-5631 only).
Status indicator check: To check whether indications of the status indicator change.
Voice check: To check whether voice instructions can be heard.
Alarm check: To check the alarm indicator and alarm sounds.
ECG check: To check whether communication is properly made with the lead ECG
section (except TEC-5601).
Multi-parameter check: To check whether communication is properly made with the multi
parameter unit (only when QI-564V is connected).
Battery check: To check the battery remaining and expiration date.
Bluetooth® check: To check communication with an external device (only when QI-832V is
connected).
Recorder check: To check whether data can be normally printed on papers (except
TEC-5601).
Maintenance Information
Defibrillator history: When an error occurs, the history is used to store the error generation
status for subsequence investigation.
Time for battery replacement:
A message to prompt battery replacement is displayed upon time for
replacement.

Operations
Control dial: Using this rotary switch, the following modes can be selected.
• Power OFF
• Monitor mode
• AED mode
• Internal discharge
• Energy setting
• Setup
• Basic check
• Transcutaneous pacing fixed mode
• Transcutaneous pacing demand mode
SYNC button: Press for synchronized defibrillation.
CHILD MODE button: To select AED mode for children, turn the control dial to the AED
position while holding this button pressed.
CHARGE/AED button: To start an energy charge in manual mode. VF analysis can also be started
by pressing the button in AED mode.
SHOCK button: Press the SHOCK button to start discharging. It flashes when charging is
complete.
Function keys (1 to 5): The key functions are changed in accordance with the operation screens.
• Initial assignments in monitor mode:
LEAD (to select the ECG lead), SENSITIVITY (to select the ECG
sensitivity), EVENT, FREEZE, and GUIDE
• Major function keys in other statuses:
Start/stop pausing the analysis, start/stop the timer, medication events,
start/stop CPR operation sound, CO2 calibration
Record key: To start/stop recording.
Alarm cancel key: To temporarily stop alarms.
PACING RATE up/down keys:
To increase/decrease the pacing rate.
PACING OUTPUT up/down keys:
To increase/decrease the pacing output current.
PACING START/STOP key:
To start/stop pacing.
Charge button: To start energy charging in manual mode when external paddles are
connected.
Shock buttons (external paddles):
To apply a shock, press the buttons on the left or right of the connected
external paddles. The buttons flash when charge is complete.
Shock buttons (internal paddles):
To apply a shock when you press the buttons on the handles of the 15
connected internal paddles (with switch).
Transportation
Cart: You can carry the defibrillator mounted on a cart.
Bed rail hook: You can hang the defibrillator over the hook.
Wall mount: You can mount the defibrillator in a vehicle, using the wall mount.

Performance
Defibrillator
Output Waveforms
Discharging waveform: Truncated exponential constant power biphasic
Shape of discharging waveform:
Parameters for load resistances of the above discharged waveform must

conform to the values in the following tables.
NOTE: D2 of the discharged waveform indicates the width at 50%
of Ipk2, and D3 indicates the width up to 10% between the
end of the first phase and Ipk2.
Parameters for Load Resistances [Standard Values]
Output energy: 270 J

Load resistance
Parameter
25 Ω 50 Ω 75 Ω 100 Ω 125 Ω 150 Ω 175 Ω
First-phase pulse width D1 (ms) 3.85 6.35 8.86 11.4 13.9 16.4 18.9
Second-phase pulse width D2 (ms) 3.62 3.62 3.62 3.62 3.62 3.62 3.62
Second-phase pulse width D3 (ms) < 6.5 < 6.5 < 6.5 < 6.5 < 6.5 < 6.5 < 6.5
Time between the first and second
≤ 0.5 ≤ 0.5 ≤ 0.5 ≤ 0.5 ≤ 0.5 ≤ 0.5 ≤ 0.5
phases (ms)
First-phase peak current Ipk1 (A) 67.3 41.1 29.5 22.9 18.8 15.9 13.8
First-phase terminal current It (A) 26.8 15.5 11.0 8.5 6.94 5.86 5.08
Second-phase peak current Ipk2 (A) 15.5 12.7 11.0 9.81 8.96 8.29 7.76

Load resistance
Parameter
25 Ω 50 Ω 75 Ω 100 Ω 125 Ω 150 Ω 175 Ω
≤ 0.5 ≤ 0.5 ≤ 0.5 ≤ 0.5 ≤ 0.5 ≤ 0.5 ≤ 0.5
phases (ms)


Load resistance
Parameter
25 Ω 50 Ω 75 Ω 100 Ω 125 Ω 150 Ω 175 Ω
≤ 0.5 ≤ 0.5 ≤ 0.5 ≤ 0.5 ≤ 0.5 ≤ 0.5 ≤ 0.5
phases (ms)
Output energy: 50 J
Load resistance
Parameter
25 Ω 50 Ω 75 Ω 100 Ω 125 Ω 150 Ω 175 Ω
≤ 0.5 ≤ 0.5 ≤ 0.5 ≤ 0.5 ≤ 0.5 ≤ 0.5 ≤ 0.5
phases (ms)
Allowable ranges of parameters

Specified energy
Parameter
2 to 15 J 20 to 270 J
First-phase pulse width D1 (ms) ±15% ±10%
Second-phase pulse width D2 (ms) ±20% ±10%
First-phase peak current Ipk1 (A) ±15% ±10%
First-phase terminal current It (A) ±15% ±10%
Second-phase peak current Ipk2 (A) ±20% ±20%
Load resistance range of biphasic waveform:

15 to 175 Ω
Output Energy
Output energy (with loading of 50 Ω):
2, 3, 5, 7, 10, 15, 20, 30, 50, 70, 100, 150, 200 or 270 J
Upper limit of charge energy 15
External paddles: 270 J
Disposal pads: 270 J
Internal paddles: 50 J
Internal paddles (with switch):
50 J
AED mode: 1st: 50 J, 2nd: 200 J, 3rd: 200 J (default settings)

(The settings can be selected from among 50, 70, 100, 150, 200, and 270 J.)
AED mode (child mode): 1st: 50 J, 2nd: 70 J, 3rd: 70 J (default settings)
(The settings can be selected from among 50, 70, and 100 J.)

Output Energy Accuracy1

1
Essential performance in EMC
Load resistance of 50 Ω
2 J: ±0.5 J
3 J: ±1 J
5, 7, 10, 15 J: ±2 J
20 J or more to 270 J or less: ±10%
2 J: (0.85 × Eset)±1 J
3 J: (0.85 × Eset)±2 J
5, 7, 10, 15 J: (0.85 × Eset)±3 J
20 J or more to 270 J or less: (0.85 × Eset)±15%
2 J: (1.06 × Eset)±1 J
3 J: (1.06 × Eset)±2 J
5, 7, 10, 15 J: (1.06 × Eset)±3 J

2 J: (1.10 × Eset)±1 J
3 J: (1.10 × Eset)±2 J
5, 7, 10, 15 J: (1.10 × Eset) ±3 J

2 J: (1.12 × Eset)±1 J
3 J: (1.12 × Eset)±2 J
5, 7, 10, 15 J: (1.12 × Eset)±3 J

2 J: (1.14 × Eset)±1 J
3 J: (1.14 × Eset)±2 J
5, 7, 10, 15J: (1.14 × Eset)±3 J

2 J: (1.16 × Eset)±1 J
3 J: (1.16 × Eset)±2 J
5, 7, 10, 15 J: (1.16 × Eset)±3 J
20 J or more to 270 J or less:
(1.16 × Eset)±15%

Energy Charge Time

Charge time
Manual mode (from the beginning to the end of charging)
AC (rated voltage): Less than 5 seconds for 270 J and less than 4 seconds for 200 J
Battery (fully charged new battery at 20°C, −4°F):
Less than 5 seconds for 270 J and less than 4 seconds for 200 J
AC (90% of the rated voltage):
Within 7 seconds for 270 J
Battery (after 15 discharges of 270 J using a fully charged new battery at 20°C, −4°F):
AED mode (from the beginning of analysis to the end of charging)

AC (rated voltage): Within 8 to 15 seconds for 270 J
Battery (fully charged new battery at 20°C, −4°F):
Within 8 to 15 seconds for 270 J
Battery (after 15 discharges at 270 J using a fully charged new battery at 20°C, −4°F):
Charge time from when power is turned on to when the charge is complete
Manual mode
Battery (after 15 discharges at 270 J using a fully charged new battery at 20°C, −4°F):
AED mode
Battery (after 15 discharges at 270 J with a fully charged new battery at 20°C, −4°F):
Sync Mode 1
1
Delay from R wave to discharge

Paddle ECG: 60 ms or less
Lead ECG: 60 ms or less
VF/VT Analysis 15
Analysis time
When “Continuous VF Analysis” in AED Setup is “Off”:
Analysis of shockable rhythm: Minimum 5 seconds
Analysis of non-shockable rhythm: Minimum 8 seconds
When “Continuous VF Analysis” in AED Setup is “On”:
Analysis of shockable rhythm: Minimum 3 seconds
Analysis of non-shockable rhythm: Minimum 5 seconds
Shockable rhythm: Ventricular fibrillation of amplitude 0.1 mV or more and ventricular

tachycardia of 180 bpm or more

Waveform analysis accuracy 1

Sensitivity to shockable rhythm (VF):
more than 90%
Sensitivity to shockable rhythm (VT):
more than 75%
Specificity to non-shockable rhythm:
more than 95%
1
The verifications have been made using official database provided by AHA (American Heart Association)
and MIT (Massachusetts Institute Technology) and a database of over 3000 ECGs from hospitals in Japan.
The accuracies meet IEC60601-2-4: 2010 201.107.
Influence of pacemaker pulses:

Pacemaker pulses of amplitude less than 2.0 mV and pulse width less than
1.3 ms satisfy the above analysis accuracies.
Internal Discharge
Charge holding time: The charged energy is reset when:
• 40±5 seconds have elapsed after full charge.
• the control dial is set to OFF, the positions for internal discharge, or
those for other than defibrillation mode.
• discharging with the paddles released.
• the paddles are disconnected.
TTR
Detecting range: 15 to 254 Ω
Measuring accuracy: 15 to 100 Ω ±10% or ±5 Ω (whichever greater)
101 to 254 Ω ±15%
Discharged Energy Detection
Load resistance range: 15 to 225 Ω
Measuring accuracy: ±10% (for 50 to 270 J)
Paddle Contact Lamp
The lamp lights in accordance with the paddle contact (contact resistance
between the paddles and a patient) as follows (allowable error range:
±20%).
Paddle Contact Status of Paddle Contact

Lamp Color (contact resistance with a patient)
Green 0 Ω < Paddle contact (Ω) ≤ 100 Ω
Yellow 100 Ω < Paddle contact (Ω) ≤ 200 Ω
Orange 200 Ω < Paddle contact (Ω)

Transcutaneous Pacing
Pacing waveform: Modified trapezoidal
Pulse width: 40 ms±10%
Pacing output current (with a load resistance of 250 Ω)
Setting range: 0 mA, 8 mA to 200 mA
Accuracy: ±10% or ±2 mA (whichever greater)
Pacing rate (with a load resistance of 250 Ω)

Setting rate: 30, 40, 50, 60, 70, 80, 90, 100, 110, 120, 130, 140, 150, 160, 170, or
180 ppm
Accuracy: ±10%
Maximum load resistance: 350 Ω (at 200 mA)

Refractory period
When the pacing rate is between 30 and 90 ppm:
350 ms
When the pacing rate is between 100 and 180 ppm:
240 ms
ECG
ECG Inputs
Paddles/pads
Sensitivity: 10 mm/mV±15% (sensitivity ×1)
Input impedance: 100 kΩ or more (when a polarization of ±300 mV is added at 10 Hz,
2 mVp-p)
Hum filter attenuation: –20 dB at 50 and 60 Hz
Transient property: 0.32 seconds or more, 1 second or less
Maximum input voltage: ±5 mV or more
Frequency response: 0.5 to 20 Hz (attenuation of 3 dB or less for 10 Hz)
Heart rate measurement: 0, 15 to 300 bpm ±3% ± 1 bpm
Monitor recovery
Defibrillation output from an external device:
Within 3 seconds
Internal defibrillation output:
Within 3 seconds
VF recognition time: Within 20 seconds
15
Recovery time for disposable pads attached:
Within 10 seconds
VF recognition time for disposable pads attached:
Within 20 seconds
Monitor disturbance: Disturbance during charge or internal discharge

0.2 mV or less and under 20% at a sinusoidal input of 10 Hz, 1 mVp-p
QRS detection level: Input conversion 0.5 mV or more (at sensitivity ×1)

Leads
Sensitivity: Within 10 mm/mV±5% (sensitivity ×1)
Input impedance: 5 MΩ or more (when a polarization of ±600 mV is added at 10 Hz and
2 mVp-p)
Hum filter attenuation
Monitor mode
Power frequency 50 Hz:
–20 dB or more at 50 Hz
Power frequency 60 Hz:
–20 dB or more at 60 Hz
Manual mode/pacing mode
–20 dB or more at 50 and 60 Hz

Transition property
DIAGNOSIS filter: 3.2 seconds or more
MONITOR filter: 0.32 seconds or more, 1 second or less
Anti-polarization voltage: ±400 mV or more

Frequency response: 0.05 to 150 Hz (attenuation of 3 dB or less for 10 Hz: recording only)
Pacemaker pulse rejection:
±2 mV to ±0.7 V, not synchronized with 0.1-ms to 2-ms square pulses
(at sensitivity ×1)
QRS detection level: Input conversion 0.5 mV ore more (at sensitivity ×1)
Heart rate measurement range
Defibrillation mode and monitor mode:
0, 15 to 300 bpm
Pacing mode: 0, 15 to 220 bpm
Heart rate measurement error:

±3% ±1 bpm (rounded to the closest whole number)
Monitor recovery
Within 10 seconds
Within 3 seconds
Monitor disturbance: Disturbance during charge or internal discharge

Less than 0.2 mV and under 20% at a sinusoidal input of 10 Hz, 1 mVp-p
ECG Input (AUX)
Input impedance: 100 kΩ ±10%
Frequency response: 0.05 to 150 Hz (attenuation of 3 dB or less for 10 Hz: recording only)

SpO2
SpO2 measurement accuracy (rms1):
±2%SpO2 (80%SpO2 ≤ SpO2 ≤ 100%SpO2)
±3%SpO2 (70%SpO2 ≤ SpO2 ≤ 80%SpO2)
Not specified for SpO2 < 70%SpO2
(Accuracy-guaranteed ambient temperatures: 18ºC to 40ºC, 64.4ºF to
104ºF)
Heart rate measurement accuracy (rms1): ±3% ±1 bpm (30 to 300 bpm)
1
The rms is the difference between measurement value and standard reference values by root-mean square.
CO2
The specifications in this section depend on TG-900-series models.
Measurement range
0 to 13.3 kPa (0 to 99 mmHg)
Measurement accuracy
TG-900P/TG-920P: ±0.40 kPa (0 ≤ CO2 ≤ 1.33 kPa) (±3 mmHg (0 ≤ CO2 ≤ 10 mmHg))
±0.53 kPa (1.33 < CO2 ≤ 5.33 kPa) (±4 mmHg (10 < CO2 ≤ 40 mmHg))
±10% reading (5.33 < CO2 ≤ 13.3 kPa) (40 < CO2 ≤ 99 mmHg)
At 1 atmospheric pressure, air inspiration, no condensation
TG-970P: ±0.27 kPa (0 ≤ CO2 ≤ 5.33 kPa) (±2 mmHg (0 ≤ CO2 ≤ 40 mmHg))
No condensation
Detectable respiration counts

3 to 150 counts/minute±10%
Screen Displays
Waveform display sensitivity:
10 mm/mV±10% or less (sensitivity ×1, including ECG amplifier)
Waveform sweep speed: 25 mm/s, 50 mm/s±10% or less
Recorder
Recording sensitivity: 10 mm/mV±10% or less
Frequency response: 0.05 to 150 Hz (attenuation 3 dB or less) for a sinusoidal input of
2 mVp-p and 10 Hz as the reference
Recording paper speed: 25 mm/s±10% or less or 50 mm/s±10% or less
15
SD Card Storage
Storage capacity: 1 GB (QM-001D) or 2 GB (QM-002D)
Time for storage: QM-001D: Max. 24 hours of continuous ECG data with audio
Max. 106 hours of continuous ECG data without audio
QM-002D: Max. 50 hours of continuous ECG data with audio
Max. 168 hours of continuous ECG data without audio

Alarm Functions
Alarm Range
Upper or lower limit alarms
Parameter Upper limit Lower limit Step Importance

HR/RR beat/min 35 to 300, OFF OFF, 30 to 295 1 Warning
VPC count/min 1 to 99, OFF ― 1 Advisory
RR count/min 2 to 150, OFF OFF, 0 to 148 2 Warning
SpO2 % SpO2 51 to 100, OFF OFF, 50 to 99 1 Warning
APNEA s 5 to 40, OFF ― 5 Warning
mmHg 2 to 99, OFF OFF, 1 to 98 1 Warning
ETCO2
kPa 1.0 to 13.5, OFF OFF, 0.5 to 13.0 0.5 Warning
Alarm Levels
The alarms of the defibrillator are classified according to the importance, as follows:
Crisis alarm: Generated in an abnormal condition of a patient or of the defibrillator, or
if no proper operation is performed. If no immediate action is taken, the
patient’s life may be at risk.
Warning alarm: Generated in an abnormal condition of a patient or of the defibrillator, or
if no proper operation is performed, requiring prompt action.
Advisory alarm: Generated if the condition is not appropriate for accurate measurement or
proper treatment.
Colors of the Alarm Indicator
Alarms for patients or the defibrillator are indicated.
Crisis: Blinks in red
Warning: Blinks in yellow
Advisory: Lit in cyan
Indications by the Alarm Indicator
Crisis alarm: Blinks in red at a frequency of approx. 1.6 Hz (approx. 640 ms), duty
50%
Warning alarm: Blinks in yellow blinking at a frequency of approx. 0.8 Hz (approx. 1280
ms), duty 50%
Advisory alarm: Lit in cyan
Alarm Sounds
Crisis alarm: Sound conforming to IEC60601-1-8
Warning alarm: Sound conforming to IEC60601-1-8
Advisory alarm: Sound conforming to IEC60601-1-8
Alarm Sound Volume
Volume range: 45 to 85 dB (A)

Alarm Suppression
To temporarily silence an alarm sound:
When an alarm is generated, press the silence alarms key to stop the alarm
sound for a certain time (temporary silence time: 2 minutes).
To suspend all the alarm sounds:
While no alarm is generated, press the silence alarms key to suspend all
alarm sounds for a certain time (suspend time: 2 minutes).
Power Requirements
Alternate Current (AC)
Power-supply voltage range:
100 V to 240 V
Power frequency: 50 Hz or 60 Hz
Power Input
Continuous loading: 150 VA or less
Intermittent loading: 300 VA or less
Battery
Type: Ni-MH battery
Capacity: 2800 mAh
Rated voltage: 12 V (allowable voltage variable range: 9.0 to 18.0 V)
Operation time
Fully charged new battery at 20ºC, 68ºF
Defibrillation (270 J) in manual mode:
100 discharges or more
Monitor mode: 180 minutes or more (defibrillator and external paddles connected, other
parts or accessories not connected)
Pacing: 120 minutes or more (180 ppm, 200 mA)
Fully charged new battery at 0ºC, 32ºF
Defibrillation (270 J) in manual mode:
Defibrillation (270 J) in AED mode:
Charging request: At least 3 charge/discharge cycles for 270 J are allowed after a request for
charging is instructed
Charge complete indication:
“CHARGING COMPLETE” indicated 15
7 days unattended
7 days unattended (at 20ºC, 68ºF, 65%)
15th 270 J charge time in manual mode:
15 seconds or less
From the 15th VF input to charging completion in AED mode:
30 seconds or less

Applicable Laws and Regulations
Applicable Laws
• Medical Device Directive (Classification: Class II b)
• WEEE Directive
• RoHS Directive
Applicable Regulations
• IEC 60601-1: 2005
• IEC 60601-1 Amendment 1: 2012
• IEC 60601-1-2: 2007
• IEC 60601-1-6: 2010
• IEC 60601-1-8: 2006
• IEC 60601-1-8 Amendment 1: 2012
• IEC 60601-1-9: 2007
• IEC 60601-2-4: 2010
• IEC 60601-2-27: 2011 1 2 4
• IEC 60601-2-49: 2011 1 2
• ISO 10993-1: 2009
• ISO 14971: 2007
• EN ISO 14971: 2012
• ISO 80601-2-55: 2011 1 3
• ISO 80601-2-61: 2011 1 3
• EN 1789: 2007
• EN 1789 Amendment 1: 2010
Applicable only for monitor mode (when limb and chest lead ECG selected)
1
This defibrillator complies with clause 201.11.8 when using the battery pack.
2
This defibrillator complies with clause 201.11.8.101 when the battery remaining alarm
3
is not generated.
The hum filter setting of this defibrillator is not displayed. This defibrillator complies
4
with IEC 60601-2-27: 2011 except for clause 201.12.4.101.1.

Classifications
Type of protection against electrical shock
• When connecting to an AC power (commercial use):
Class I ME equipment
• When not connecting to an AC power (commercial use):
Internally powered ME equipment
Degree of protection against electrical shock
• Type BF applied parts:
External paddles, disposable pads
• Type CF applied parts:
Internal paddles, internal paddles (with switch)
• Defibrillation-proof type CF applied parts:
ECG connection cable, electrode leads, SpO2 probes, CO2 sensor kit
Protection against harmful ingress of water or fine particulates
• IP44: TEC-5621 and TEC-5631 with a pad adapter or internal paddles,
TEC-5611
• IP41: TEC-5621 and TEC-5631 with external paddles, TEC-5601
Applicable when connecting all patient cables (except the recorder)
Sterilization or disinfection methods specified by manufacturers
• Internal paddles, internal paddles with switch:
High-pressure steam sterilization (autoclave sterilization), plasma gas
sterilization, ethylene oxide gas sterilization (EOG sterilization)
• Except internal paddles and internal paddles (with switch):
Not for sterilization
Qualifications for use in a high-oxygen atmosphere
Not qualified
Safety level for use in air and flammable anesthetic gas or oxygen/nitrous oxide and
flammable anesthetic gas
Not applicable
Mode of operation
Continuous operation
Installation conditions
Indoor and in-vehicle uses
Frequency of use (class by IEC 60601-2-4: 2010)
High frequent use 15

Environment Conditions
Storage Environments
Ambient temperature: –25 to +70ºC, –13 to +158ºF
Relative humidity: 10 to 95% (noncondensing)
Atmospheric pressure: 500 to 1060 hPa
Transport Environments
Ambient temperature: –25 to +70ºC, –13 to +158ºF
Operation Environments and Power Requirements

Operation Environments
Ambient temperature: –5 to +45ºC, +23 to +113ºF
For operation environments of the accessories and options, refer to the
operator’s manuals.
Power Requirements
For both AC and DC
Power voltages
AC operation: 100 V to 240 V (allowable variation range: 80 V to 264 V)
Battery operation: 12 V (allowable variation range: 9 V to 18 V)
Power input: 150 VA or less with continuous loading or 300 VA or less with
intermittent loading
Power frequency: 50 or 60 Hz
Battery rated capacity: 2800 mAh
Battery charging current: 2000 mA
Noise
Less than 48 dB SPL
Cooling System
Natural cooling

Mechanical Strength
Protection against Vibration
• MIL-STD-810F 514.5 Category 4 Restrained Cargo
• Exposure level Annex A 2.2.1C(1)
• MIL-STD-810F 514.5 Category 9 Helicopter
Exposure time: 4 hours for each of XYZ axes
• EN 1789: 2007
Impact
• IEC 60068-2-27: 2008
Impact peak value: 50G
Impact peak value: 10G, repeated times: 1000±10 times
• EN 1789: 2007
Drop
• IEC 60068-2-32: 1975
• IEC 60068-2-32 Amendment 2: 1990
• EN 1789: 2007
EMC Application Standards

• IEC 60601-1-2: 2007
• IEC 60601-2-4: 2010
Dimensions and Weight

Dimensions
311(W) × 288(H) × 242(D) mm±10%
Weight
TEC-5601: 6.4 kg±10% (defibrillator, battery pack, external paddles, external paddle
holders)
TEC-5611: 5.7 kg±10% (defibrillator, battery pack)
TEC-5621: 6.8 kg±10% (defibrillator, battery pack, external paddles, external paddle 15
holders)
TEC-5631: 6.9 kg±10% (defibrillator, battery pack, external paddles, external paddle
holders)

Requirements from International Standards
IEC 60601-1-8 Amendment 1: 2012
Alarm Delay Time

Heart rate
When increasing the heart rate from 80 to 120 bpm (upper limit: 100 bpm): 10 seconds or less
When decreasing the heart rate from 80 to 40 bpm (lower limit: 60 bpm): 10 seconds or less
Time to generate an alarm for tachycardia

When ventricular tachycardia (heart rate 206 bpm, 1 mVp-p) generated
at ×1 gain (test waveform: aami4a 1): 4 to 10 seconds
at ×0.5 gain (test waveform: aami4a_h 1): 4 to 10 seconds
at ×2 gain (test waveform: aami4a_d 1): 4 to 10 seconds
When ventricular tachycardia (heart rate 195 beats/min, 2 mVp-p) generated

at ×1 gain (test waveform: aami4b 1): 4 to 10 seconds
at ×0.5 gain (test waveform: aami4b_h 1): 4 to 10 seconds
1
at ×2 gain (test waveform: aami4b_d ): 4 to 10 seconds
1
The test waveforms (aami4a through aami4b_d) can be downloaded at:
http://www.physionet.org
Pulse rate
When increasing the pulse rate from 80 to 120 bpm (upper limit: 100 bpm): 15 seconds or less
When decreasing the pulse rate from 80 to 40 bpm (lower limit: 60 bpm): 20 seconds or less
VPC
Approx. 1 second after a measurement value reaches the alarm threshold
Respiration rate
Within 3 seconds after a measurement value reaches the alarm threshold (calculated from intervals
among the previous 4 breaths)
SpO2
Within 3 seconds after a measurement value reaches the alarm threshold
CO2 partial pressure (mainstream method)
Within 3 seconds after a measurement value reaches the alarm threshold (calculated when the next
breath is detected)

IEC 60601-2-27: 2011
Electrode disconnection detection
The detecting function is available for each electrode.
Active electrode: Less than 100 mA
Reference electrode: Less than 900 mA
Influence by ESU and defibrillation
Influence on the measurement accuracy:
Use of an ESU or defibrillation may cause a temporary decrease in
measurement accuracy. However, the original operation mode is resumed
within 10 seconds. There is no influence on the security of patients of the
defibrillator, as well as the stored data.
Time to resume normal operations after defibrillation voltage applied
Monitor recovery
Within 10 seconds
Within 3 seconds
Waveform display
Aspect ratio (ECG display sensitivity ratio to the sweep speed)
Standard: 0.4 seconds/mV
Setting range: 0.05 to 6.4 seconds/mV
Heart rate displays

Delay time (sync mark): 100 to 200 ms or less (after detecting QRS)
Display update cycle: Once per second
Calculation of the average heart rate
Instant heart rate calculation for the average rate:
Calculated using the nearest 4 or 12 beats (min. 4 beats and max.
12 beats)
High T-wave rejection capability
Complies with ANSI/AAMI EC13: 2002 Sect. 4.1.21(c)
(T-wave level: 0 to 1.2 mV)
Heart rate meter accuracy and response to irregular rhythms
Ventricular bigeminy (test waveform: aami3a1): 80 bpm
Slow alternating ventricular bigeminy (test waveform: aami3b1): 60 bpm 15
Rapid alternating ventricular bigeminy (test waveform: aami3c1): 120 bpm
Bidirectional systoles (test waveform: aami3d1): 90 bpm
1
The test waveforms (aami4a through aami4b_d) can be downloaded at:
http://www.physionet.org
Response time of the heart rate meter to change in heart rate

When increasing the heart rate from 80 to 120 bpm: 6 to 9 seconds
When decreasing the heart rate from 80 to 40 bpm: 6 to 8 seconds

Pacemaker pulse rejection capability

Pacemaker pulse detection for fast ECG signals
Slew rate at which the pacemaker pulse detector responds:
6 to 8 V/s
The test is made according to the method specified in ANSI/AAMI EC13:
2002 Sect. 4.1.4.3.
Pacemaker pulse rejection, without overshoot

Complies with ANSI/AAMI EC13: 2002 Sect. 4.1.4.1. In this section, the
pacemaker pulse is defined as follows:
• Pacemaker pulse: ±2 to ±700 mV
• Pulse width: 0.1 to 2 ms
Pacemaker pulse rejection, with overshoot
Rejectable overshoot: When QRS detection type is “ADULT”:
±0.18 mV/100 ms to ±2 mV/4 ms (overshoot amplitude/time constant)
When QRS detection type is “CHILD”:
±0.22 mV/100 ms to ±2 mV/4 ms (overshoot amplitude/time constant)
The test is made in accordance with method B specified in ANSI/AAMI
EC13: 2002 Sect. 4.1.4.2. In method B, the amplitude and width of a
pacemaker pulse are specified as follows.
• Pacemaker pulse: ±4 mV/2 ms to ±80 mV/0.1 ms
ISO 80601-2-61: 2011

SpO2
Display update cycle: Every 3 seconds
Averaging time: 8 seconds
Setting range: 0 to 100%SpO2
SpO2 measurement accuracy (rms1):
±2%SpO2 (80%SpO2 ≤ SpO2 ≤ 100%SpO2)
±3%SpO2 (70%SpO2 ≤ SpO2 ≤ 80%SpO2)
Not specified for SpO2 < 70%SpO2
(Accuracy-guaranteed ambient temperatures: 18 to 40ºC, 64.4 to 104 ºF)
Pulse rate measurement accuracy (rms 1):
±3% ±1 bpm (30 to 300 bpm)
1
The SpO2 accuracy was tested using the TL-201T, TL-271T and TL-273T SpO2 probes and JL-302T SpO2
connection cord. The testing was performed during induced hypoxia on healthy volunteers (Ethnicity:
10 Caucasians, 2 Africans, 1 Asian and 3 Indians), (Skin: 8 Light, 4 Medium, 4 Dark), (Age: 21 to 34),
(5 women and 11 men) under the condition of no motion. Arterial blood was sampled and measured by a
CO-oximeter. The difference between SpO2 measured by the SpO2 probe and functional SaO2 measured by a
CO-oximeter was calculated using the root-meansquare (rms). This measurement accuracy figure represents
2/3 of all test measurements.
NOTE: A pulse oximeter tester that generates simulated signals can be used to check the
difference from the design specification, but it cannot be used as a replacement for
human signals for testing accuracy.
Monitor recovery
Within 3 seconds
Alarm condition delay: Within 12 seconds after a measurement value reaches the alarm threshold
Alarm signal generation delay:
Within 3 seconds after a measurement value reaches the alarm threshold

ISO 80601-2-55: 2011

CO2
Display update cycle: Every 3 seconds
Measurement range
0 to 13.3 kPa (0 to 99 mmHg)
Measurement accuracy
TG-900P, TG-920P: ±0.40 kPa (0 ≤ CO2 ≤ 1.33 kPa) (±3 mmHg (0 ≤ CO2 ≤ 10 mmHg))
±0.53 kPa (1.33 < CO2 ≤ 5.33 kPa) (±4 mmHg (10 < CO2 ≤ 40 mmHg))
At 1 atmospheric pressure, air inspiration, no condensation
TG-970P: ±0.27 kPa (0 ≤ CO2 ≤ 5.33 kPa) (±2 mmHg (0 ≤ CO2 ≤ 40 mmHg))
No condensation
Detectable respiration counts:

3 to 150 counts/minute±10%
Enter respiration using a pseudo respiration generator and check that the error is within the
allowable range.
Monitor recovery
Within 3 seconds
15

Electromagnetic Emissions and Immunity

Electromagnetic Emissions
The TEC-5600 series essential performances in EMC standard satisfy the following criteria.
The TEC-5600 series is intended for use in the electromagnetic environment specified below. The
customer or the user of the TEC-5600 series should assure that it is used in such an environment.
Emissions test Compliance Electromagnetic environment - guidance

RF emissions Group 1 The TEC-5600 series uses RF energy only for its internal
function. Therefore, its RF emissions are very low and are
CISPR 11
not likely to cause any interference in nearby electronic
equipment.
RF emissions Class B The TEC-5600 series is suitable for use in all establishments,
including domestic establishments and those directly
CISPR 11
connected to the public low-voltage power supply network
Harmonic emissions Class A that supplies buildings used for domestic purposes.
IEC 61000-3-2
Voltage fluctuations/ Complies
flicker emissions
IEC 61000-3-3

Electromagnetic Immunity
The TEC-5600 series essential performances in EMC standard satisfy the following criteria.
The TEC-5600 series is intended for use in the electromagnetic environment specified below. The
customer or the user of the TEC-5600 series should assure that it is used in such an environment.
Electromagnetic environment -
Immunity test IEC 60601 test level Compliance level
guidance
Electrostatic discharge ±6 kV contact ±6 kV contact Floors should be wood, concrete or ceramic
(ESD) tile. If floors are covered with synthetic
±8 kV air ±8 kV air
material, the relative humidity should be at
IEC 61000-4-2
least 30%.
Electrical fast transient/ ±2 kV for power supply ±2 kV for power supply lines Mains power quality should be that of a
burst lines typical commercial or hospital environment.
When there is large noise on the AC power
IEC 61000-4-4 ±1 kV for input/output lines ±1 kV for input/output lines
line, supply the power from the battery pack.
Surge ±1 kV differential mode ±1 kV differential mode Mains power quality should be that of a
typical commercial or hospital environment.
IEC 61000-4-5 ±2 kV common mode ±2 kV common mode
Voltage dips, short < 5% UT < 5% UT Mains power quality should be that of a
interruptions and voltage (> 95 % dip in UT) for (> 95% dip in UT) for typical commercial or hospital environment.
variations on power supply 0.5 cycles 0.5 cycles If the user of the TEC-5600 series requires
input lines continued operation during power mains
interruptions, it is recommended that the
IEC 61000-4-11 40% UT 40% UT
TEC-5600 series be powered from an
(60% dip in UT) for (60 % dip in UT) for
uninterruptible power supply or a battery.
5 cycles 5 cycles
70% UT 70% UT
(30% dip in UT) for (30% dip in UT) for
25 cycles 25 cycles
< 5% UT < 5% UT
(> 95 % dip in UT) for (> 95 % dip in UT) for
5 seconds 5 seconds
Power frequency 3 A/m 3 A/m Power frequency magnetic fields should be at
(50/60 Hz) magnetic field levels characteristic of a typical location in a
typical commercial or hospital environment.
IEC 61000-4-8
NOTE 1: UT is the AC mains voltage prior to application of the test level.
NOTE 2: Noise from the AC power line may generate noise which is superimposed on the ECG waveforms.
15

Immunity test IEC 60601 test level Compliance level Electromagnetic environment - guidance
Portable and mobile RF communications equipment should be
used no closer to any part of the TEC-5600 series, including
cables, than the recommended separation distance calculated
from the equation applicable to the frequency of the transmitter.
Recommended separation distance

Conducted RF 3 Vrms 3 Vrms d = 1.2
150 kHz to 80 MHz
IEC 61000-4-6
Radiated RF 3 V/m 3 V/m d = 1.2 80 to 800 MHz

80 MHz to 2.5 GHz
IEC61000-4-3 d = 2.3 800 MHz to 2.5 GHz
Requirement of IEC- Additional requirement of IEC 60601-2-4

60601-2-4:
Correct operation of Correct operation of RRD:
RRD:
10 V/m 10 V/m d = 0.4 80 to 800 MHz
80 MHz to 2.5 GHz
d = 0.7 800 MHz to 2.5 GHz
No inadvertent energy No inadvertent energy delivery is allowed:

delivery is allowed:
20 V/m 20 V/m d = 0.2 80 to 800 MHz
80 MHz to 2.5 GHz
d = 0.4 800 MHz to 2.5 GHz
where P is the maximum output power rating of the transmitter

in watts (W) according to the transmitter manufacturer and d is
the recommended separation distance in meters (m).
Field strengths from fixed RF transmitters, as determined by an
electromagnetic site survey, 1 should be less than the compliance
level in each frequency range. 2
Interference may occur in the vicinity of equipment marked
with the following symbol:
NOTE 1: At 80 MHz and 800 MHz, the higher frequency range applies.
NOTE 2: These guidelines might not apply in all situations. Electromagnetic propagation is affected by absorption and reflection from
structures, objects and people.
1
Field strengths from fixed transmitters, such as base stations for radio (cellular/cordless) telephones and land mobile radios, amateur
radio, AM and FM radio broadcast and TV broadcast cannot be predicted theoretically with accuracy. To assess the electromagnetic
environment due to fixed RF transmitters, an electromagnetic site survey should be considered. If the measured field strength in the
location in which the TEC-5600 series is used exceeds the applicable RF compliance level above, the TEC-5600 series should be
observed to verify normal operation. If abnormal performance is observed, additional measures may be necessary, such as re-orienting
or relocating the TEC-5600 series.
2
Over the frequency range 150 kHz to 80 MHz, field strengths should be less than 3 V/m.
• RRD is the abbreviation of Rhythm Recognition Detector.

Recommended Separation Distances between Portable and Mobile RF Communications

Equipment
The TEC-5600 series is intended for use in an electromagnetic environment in which radiated RF
disturbances are controlled. The customer or the user of the TEC-5600 series can help prevent
electromagnetic interference by maintaining a minimum distance between portable and mobile RF
communications equipment (transmitters) and the TEC-5600 series as recommended below, according
to the maximum output power of the communications equipment.
Separation distance according to frequency of transmitter (m)

Rated maximum output
power of transmitter (W) 150 kHz to 80 MHz 80 MHz to 800 MHz 800 MHz to 2.5 GHz
d = 1.2 d = 0.4 d = 0.7
0.01 0.12 0.04 0.07

0.1 0.38 0.13 0.22
1 1.2 0.4 0.7
10 3.8 1.3 2.2
100 12 4 7
For transmitters rated at a maximum output power not listed above, the recommended separation distance d in meters (m) can be
determined using the equation applicable to the frequency of the transmitter, where P is the maximum output power rating of the
transmitter in watts (W) according to the transmitter manufacturer.
NOTE 1: At 80 MHz and 800 MHz, the separation distance for the higher frequency range applies.
NOTE 2: These guidelines might not apply in all situations. Electromagnetic propagation is affected by absorption and reflection from
structures, objects and people.
The equations and values in the above table show the condition that the RRD (Rhythm Recognition Detector) regulated in IEC 60601-
2-4: 2010 does not receive electromagnetic interference.
System Composition for EMC Test

The TEC-5600 series is tested to comply with IEC 60601-1-2: 2007 and IEC 60601-2-4: 2010 with
the following composition. If any part which is not specified by Nihon Kohden is used, the EMC
specifications might not comply.
Units Cable length (m)

TEC-5631 defibrillator —
JC-865V pad adapter 3.5
JC-906P ECG connecting cord 3.0
BR-926P electrode lead 1.5
QI-564V multi parameter/SpO2 unit —
JL-900P SpO2 connection cord 2.5
TL-201T finger probe 1.6 15
TG-970P CO2 sensor kit 3.5
QI-832V Bluetooth module
®
—
NKB-301V battery pack —
QM-002D SD memory card —
Power cord 2.5

Reference
• ANSI/AAMI DF2-1996 Cardiac defibrillator devices
4.3.2 Energy range
A. 4.3.2 Energy range
• Kerber, RE, Carter, J., Klein, S, et al.

Open chest defibrillation during cardiac surgery: Energy and current
requirements.
American Journal of Cardiology, 46:393-396, 1980
• Tacker, WA, Guinn, GA, Geddes, LA, et al.

The electrical dose for direct ventricular defibrillation in man.
Journal of Thoracic Cardiovascular Surgery, 75:224-226, 1978
• Rubio, PA And Farrell, EM.

Low-energy direct defibrillation of the human heart
Annals of Thoracic Surgery, 27:32-33, 1979

INDEX
Changing CO2 Settings......................................8-2-15
Changing ECG SETUP and QRS SETUP
Settings..............................................................8-1-17
Changing Settings.....................4-10, 10-1-4, 10-1-12
Changing SpO2 Settings......................................8-3-8
A Changing the Settings for Arrhythmia Alarms........ 9-15
Changing the Settings for Upper/Lower Limit
AC Operation........................................................... 4-2
Alarms................................................................... 9-13
Accuracy of the Built-in Clock................................ 4-10
Changing to the Pediatric Electrode Plate............6-1-4
Administrator Settings........................................... 4-10
Charging the Battery Pack...................................... 4-5
AED
Check After Turning the Power On and During
AED Flowchart......................................................... 6-4-3
Operating............................................................... 12-3
Pause Function....................................................... 6-4-15
Check Before Turning the Power On..................... 12-2
Recording Waveforms............................................ 6-4-16
Check Before/After Turning the Power Off............ 12-4
Screen Example........................................................ 6-4-2
Checking the Delay Time for Synchronized
Timer Operation..................................................... 6-4-16
Cardioversion.....................................................6-1-15
AED Procedure....................................................6-4-4
Checking the Dominant QRS.............................8-1-10
Alarm Control Marks................................................ 9-5
Cleaning, Disinfecting and Storage..................... 12-29
Alarm Levels............................................................ 9-3
CO2
Alarm Recording.....................................9-17, 10-1-10
Measurement Error when Measuring with the
Alarm Sound and Alarm Indicator............................ 9-5
Inspiration Zero Balance Adjustment Method....... 8-2-23
Approximate Battery Operation Time...................... 4-4
Merits and Limitations........................................... 8-2-22
Approximate Charging Time.................................... 4-7
Notes on Measurement........................................... 8-2-13
Arrhythmia Alarms................................................... 9-7
Principles................................................................ 8-2-22
Arrhythmia Analysis............................................8-1-27
Combination of ECG, SpO2 and CO2 Waves......10-1-6
Attaching Disposable Electrodes........................6-1-12
Composition............................................................ 1-5
Attaching the Disposable Electrodes....................8-1-7
Confirming the Number of Electrodes and Type of
Automatic Energy Charging Standard................6-4-14
Leads and Connecting the Electrode Leads...... 6-1-11
Automatic Recording..........................................10-1-9
Connecting an External Monitor.........................6-1-14
Connecting Disposable Pads...............................6-1-5
B Connecting External Paddles (TEC-5621,
TEC-5631)............................................................6-1-4
Basic Checks
Connecting Internal Paddles (TEC-5621,
Confirming the Check Results................................. 12-21
TEC-5631)..........................................................6-1-10
Confirming the Checking History........................... 12-22
Connecting Paddles/Pads....................................6-1-3
Performing the Basic Checks.................................... 12-7
Connecting the CO2 Sensor Kit to the
Preparations for the Basic Checks............................. 12-5
Defibrillator...........................................................8-2-9
Basic Settings.......................................................... 5-4
Connecting the Electrode Lead to the
Battery Operation.................................................... 4-2
Defibrillator...........................................................8-1-6
Connecting the Power Cord.................................... 4-3
C Connecting the Probe to the Defibrillator.............8-3-6
Calibrating by Air................................................ 8-2-11
External Paddles’ Electrodes..............................6-1-21
Calibrating with N2 Gas......................................8-2-12
Criteria for Arrhythmia Alarm..............................8-1-28
Caution Labels and Caution Marks......................... 3-2
CO2......................................................................... 8-2-17
ECG........................................................................ 8-1-19
SpO2........................................................................ 8-3-10
Operator’s Manual TEC-5600 series Index 1

D I
Daily Check........................................................... 12-2 Information Display.................................................. 9-9
Daily Inspection of Measurement Accuracy.......8-2-21 Inserting an SD Card............................................. 4-10
DATE AND TIME..................................................... 5-9 Inserting/Removing an SD Card.........................10-2-3
Defibrillation Inspection of Measurement Accuracy................8-2-21
Flow of Operation.................................................... 6-2-2 Inspection of Measurement Accuracy (Precise
Recording Waveforms.............................................. 6-2-4 Method)..............................................................8-2-21
Screen Example........................................................ 6-2-3 Installation and Connection..................................... 3-9
Defibrillation Using the Disposable Pads........... 6-2-11 Installing a Battery Pack.......................................... 4-5
Defibrillation Using the External Paddles.............6-2-5
Defibrillation Using the Internal Paddles............6-2-16
Defibrillator’s Operation when an Alarm is
L
Generated............................................................... 9-4 LARGE NUMERICS SETUP................................. 5-14
Delete All Reports.............................................10-1-13 Loading the Recording Paper (TEC-5611,
DEVICE SETUP...................................................... 5-9 TEC-5621, TEC-5631)............................................. 4-9
Disconnecting Paddles/Pads (TEC-5621,
TEC-5631)............................................................6-1-3
Displaying the Data Saved in an SD Card.........10-2-6
M
Displaying the GUIDE Screen................................. 5-6 Making Volume Settings for Various Sounds......... 5-12
Displaying the Monitor Screen.............................8-0-2 Manual Recording..............................................10-1-7
Displaying Values Large.......................................8-0-4 Measurement Error when Using Volatile
Anesthetic Agents...............................................8-2-14
Measurement Parameters....................................... 1-3
E Measuring an ECG for Synchronized
ECG SETUP Window.........................................8-1-17 Cardioversion..................................................... 6-1-11
Entering Characters................................................ 5-5 Measuring Procedures
Event List Report..............................................10-1-18 CO2........................................................................... 8-2-2
Event Recording.................................................10-1-8 ECG.......................................................................... 8-1-2
Expiration Date, Replacement and Disposal....... 12-25 SpO2.......................................................................... 8-3-3
MEDICATION SETUP........................................... 5-13
Messages on the Screen......................................... 9-5
F Models and Functions............................................. 1-3
Flow of Preparation..............................................6-1-2 Monitor Screen.....................................................8-0-3
Formatting an SD Card......................................10-2-2 Monitoring ECG with the Disposable Pads..........8-1-7
G N
General Requirements for Connecting Medical Naming a Medication Key..................................... 5-13
Electrical Systems................................................. 3-10 Number of Electrodes and Measuring Leads.......8-1-3
GUIDE..................................................................... 5-6
GUIDE Window....................................................8-0-5
O
Optimum Lead for Monitoring.............................8-1-15
H Options and Consumables.................................... 13-3
HR ALARM.............................................................. 5-8
2 Index Operator’s Manual TEC-5600 series

P S
Pacing Saving and Displaying Data...............................10-2-4
Pacing in DEMAND Mode....................................... 7-13 Saving the Data on Measurements in an SD
Pacing in FIXED Mode............................................. 7-10 Card....................................................................10-2-4
Pacing Procedure......................................................... 7-3 Saving the Waveform Data in an SD Card.........10-2-5
Preparation................................................................... 7-4 Screen Example
Connecting Disposable Pads.............................................. 7-7 CO2......................................................................... 8-2-14
Connecting the Pad Adapter............................................... 7-4 ECG.......................................................................... 8-1-9
Measuring the ECG and Selecting the Lead...................... 7-6
SpO2.......................................................................... 8-3-7
Setting and Checking the Pacing Rate and Current........... 7-5
Screen Messages.................................................. 11-2
PADDLE SETUP..................................................... 5-7
SD Cards............................................................10-2-2
Panel Description
Selecting a CO2 Sensor Kit...................................8-2-3
External Paddles.......................................................... 2-7
Selecting a Probe.................................................8-3-4
Internal Paddles (Option)............................................ 2-8
TEC-5601.................................................................... 2-2
Cord and Disposable Electrodes..........................8-1-5
TEC-5611, TEC-5621, TEC-5631............................... 2-4
SELF TEST SETUP.............................................. 5-10
Performing Zero Calibration (When TG-970P is
Sending a Waveform Report............................10-2-13
Used)..................................................................8-2-10
Sending Data......................................................10-2-7
Periodic Inspection.............................................. 12-33
Setting All Upper/Lower Limits and Arrhythmia
Periodic List Report..........................................10-1-17
Alarm Settings to the User Default Settings.......... 9-17
Periodic Recording........................................... 10-1-11
Setting CALIBRATION METHOD and SCALE...8-2-19
Periodic Recording Interval................................10-1-5
Setting Chest Leads...........................................8-1-23
Periodic Replacement Parts................................ 12-25
Setting Filter and Cascade Display....................8-1-21
Power...................................................................... 4-2
Setting Interval.................................................10-1-13
Printed Characters and Marks..........................10-1-21
Setting Items, Setting Content and Default
Priority of Alarms..................................................... 9-5
Settings................................................................. 14-2
Setting the Alarm Volume...................................... 9-17
Q Setting the Detection Type for Pacing Reject
and QRS.............................................................8-1-24
QRS Annotation.................................................. 8-1-11
Setting the Device for Auto-saving the Self-test
QRS SETUP Window.........................................8-1-17
Report............................................................... 10-2-11
Setting the Device to be Connected...................10-2-7
R Setting the ECG Sensitivity................................8-1-16
Setting the Monitoring Leads..............................8-1-14
Record "Charging Start" After Discharge
Setting the Pulse Wave Sensitivity.....................8-3-14
(Charge Recording)............................................10-1-9
Setting the Sensitivity for Measuring the SpO2
Recording...........................................................10-1-2
Value...................................................................8-3-14
Recording Event List........................................10-1-19
Setting the Sync Source to SpO2.......................8-3-13
Recording Setting...............................................10-1-4
Setting the Sync Tone to SpO2...........................8-3-13
Reference............................................................ 15-32
Silencing a Current Alarm...................................... 9-10
Relearning ECG (LEARN ECG).........................8-1-12
Silencing or Suspending Alarms............................ 9-10
Remaining Battery Power Display........................... 4-8
Specifications........................................................ 15-2
Repair Parts Availability Policy............................ 12-33
Standard Accessories............................................ 13-2
Report Recording................................10-1-3, 10-1-14
Report Settings.................................................10-1-12
CO2......................................................................... 8-2-13
ECG.......................................................................... 8-1-8
SpO2.......................................................................... 8-3-7
Storing the Value of Zero Calibration in
Memory...............................................................8-2-12
Operator’s Manual TEC-5600 series Index 3

Suspending Alarm Sound and Blinking/Lighting
of the Alarm Indicator............................................ 9-11
Suspension of Alarms during Basic Check............ 9-11
Suspension of Alarms during Defibrillation
Mode..................................................................... 9-11
Symbols................................................................... 1-6
SYNC BY PADDLE.................................................. 5-7
Flow of Operation.................................................... 6-3-2
Recording Waveforms.............................................. 6-3-4
Screen Example........................................................ 6-3-3
Disposable Pads................................................6-3-12
Paddles................................................................6-3-5
Paddles..............................................................6-3-19
T
Technical Alarms..................................................... 9-8
Transport..................................................11-17, 11-27
Transport Function
Transfer Data.......................................................... 10-3-3
Transferring Data.................................................... 10-3-4
TRENDGRAPH................................................10-1-16
Trickle Charging...................................................... 4-7
Troubleshooting................................................... 11-20
Types of Alarm......................................................... 9-2
Types of Power........................................................ 4-2
U
Upper/Lower Limit Alarms....................................... 9-6
Using AC Power...................................................... 4-3
Synchronizing Signal..........................................6-1-14
Using Paddle/Pad-Lead ECG as the
Synchronizing Signal..........................................6-3-25
Using the Battery..................................................... 4-4
V
Voice Messages.................................................. 11-18
VOLUME............................................................... 5-11
W
Warnings and Cautions........................................... 3-4
Waveform Recording..........................................10-1-7
Waveform Report.............................................10-1-14
4 Index Operator’s Manual TEC-5600 series

Manufacturer
NIHON KOHDEN CORPORATION NIHON KOHDEN ITALIA S.r.l.
1-31-4 Nishiochiai, Shinjuku-ku Tokyo 161-8560, Japan Via Fratelli Bronzetti 28, 24124 Bergamo, Italy
Phone +81 3- 5996 -8036 Phone + 39 035-219543
Fax +81 3- 5996- 8100 Fax + 39 035-232546
NIHON KOHDEN UK LTD

North and South America Trident Court 118, 1 Oakcroft Road
Chessington, Surrey KT9 1BD, UK
Phone + 44 20-8391- 6800
NIHON KOHDEN AMERICA, INC. Fax + 44 20-8391-6809
15353 Barranca Parkway, Irvine, CA 92618, U.S.A.
Toll-free +1-800-325-0283
Phone +1 949- 580-1555 Asia
Fax +1 949- 580-1550
NIHON KOHDEN LATIN AMERICA S.A.S SHANGHAI KOHDEN

Carrera 16 No.93A-36 Of. 802. Bogota D.C., Colombia MEDICAL ELECTRONIC INSTRUMENT CORP.
Phone + 57 1-300-1742 567 Huancheng Bei Road
Fax + 57 1- 300 -1825 Shanghai Comprehensive Industrial Development Zone
Shanghai 201401, China
NIHON KOHDEN DO BRASIL LTDA. Phone + 86 21-5743-6998
Rua Gomes de Carvalho Fax + 86 21- 5743-6939
1507-Bloco A 9 andar-cjto 91A Vila Olimpia
CEP 04547-005 Sao Paulo-SP. Brasil NIHON KOHDEN SINGAPORE PTE LTD
Phone +55 11-3841-9943 1 Maritime Square, #10-34 HarbourFront Centre
Fax + 55 11-3044- 0463 Singapore 099253
Phone + 65 6376-2210
Fax +65 6376-2264
Europe
NIHON KOHDEN INDIA PVT. LTD.
308, Tower A, Spazedge, Sector 47, Sohna Road
European Representative
Gurgaon-122 002 Haryana, India
NIHON KOHDEN EUROPE GmbH Toll-free +91 1800-103-8182
Raiffeisenstrasse 10, D-61191 Rosbach, Germany Phone +91 124-493-1000
Phone + 49 6003- 827-0 Fax + 91 124-493-1029
Fax +49 6003- 827-599
NIHON KOHDEN MIDDLE EAST FZE
NIHON KOHDEN FRANCE SARL P.O.Box 261516, JAFZA View 19
8, rue Francois Delage, 94 230 Cachan, France Room 308 Jebel Ali Free Zone, Dubai, U.A.E
Phone +33 1- 49- 08 -05 -50 Phone +971 4- 884-0080
Fax + 33 1- 49- 08- 93 -32 Fax + 971 4- 880-0122
NIHON KOHDEN IBERICA S.L. NIHON KOHDEN KOREA, INC.

C/Ulises 75A, E-28043 Madrid, Spain 5F Miso Bldg.
Phone + 34 91-7-161080 890-47 Daechi-dong, Gangnam-gu, Seoul, 135-280 Korea
Fax + 34 91- 3- 004676 Phone + 82 2-3273 -2310
Fax + 82 2- 3273-2352
Contact information is accurate as of Jan 2015. Visit www.nihonkohden.com for the latest information.
The model and serial number of your instrument are identified on the rear or bottom of the unit.
Write the model and serial number in the spaces provided below. Whenever you call your representative concerning
this instrument, mention these two pieces of information for quick and accurate service.
Model Serial Number
Your Representative
TEC-5600_0614-907188C

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OPERATOR’S MANUAL

1st Edition: 04 Apr 2014

Operator’s Manual (this manual)

Bluetooth® and its logo are trademarks of Bluetooth SIG, Inc.

The contents of this manual are subject to change without notice.

Operator’s Manual TEC-5600 series I

II Operator’s Manual TEC-5600 series

Operator’s Manual TEC-5600 series III

Individual Defibrillation Modes

IV Operator’s Manual TEC-5600 series

Defibrillation Using Various Types of Paddles

Operator’s Manual TEC-5600 series V

With Internal Paddles

With Disposable Pads

VI Operator’s Manual TEC-5600 series

Cables, Electrodes, Paddles and Probes

Operator’s Manual TEC-5600 series VII

VIII Operator’s Manual TEC-5600 series

Operator’s Manual TEC-5600 series IX

X Operator’s Manual TEC-5600 series

CO2 Monitoring (TG-900P CO2 Sensor Kit)

CO2 Monitoring (TG-970P CO2 Sensor Kit)

Operator’s Manual TEC-5600 series XI

CO2 Monitoring (with YG-122T/YG-121T Nasal Adapter)

XII Operator’s Manual TEC-5600 series

Operator’s Manual TEC-5600 series XIII

XIV Operator’s Manual TEC-5600 series

Operator’s Manual TEC-5600 series XV

2. When installing or storing the instrument, take the following precautions:

5. To Shutdown After Use

7. The instrument must not be altered or modified in any way.

8. Maintenance and Inspection

XVI Operator’s Manual TEC-5600 series

In the USA and Canada other warranty policies may apply.

Operator’s Manual TEC-5600 series XVII

3. Effect of direct or indirect electrostatic discharge:

6. Use with other equipment:

7. Use of unspecified accessory, transducer and/or cable:

XVIII Operator’s Manual TEC-5600 series

8. Use of unspecified configuration:

9. Measurement with excessive sensitivity:

Operator’s Manual TEC-5600 series XIX

3 Safety Information Using an ECG from an External Monitor as a

Caution Labels and Caution Marks.......................... 3-2 6-4

Operator’s Manual TEC-5600 series Contents 1

8 Monitoring Changing Alarm Settings.....................................8-3-10

8-1 ECG Monitoring

8-2 CO2 Monitoring 10-2 Saving and Sending Data

Changing Alarm Settings.....................................8-2-17 Introduction..........................................................10-3-2

2 Contents Operator’s Manual TEC-5600 series

Periodic Inspection............................................... 12-33 6-2

Setting Items, Setting Content and Default 9

Operator’s Manual TEC-5600 series Contents 3

Defibrillator (1) Manuals Certification (1)

TEC-5611, TEC-5621, TEC-5631

Manuals Certification (1)

Operator’s Manual TEC-5600 series i

Warnings and Cautions

Icons in this Manual

Indicates the important points and other operation methods.

Indicates related pages in this manual which give more detailed

ii Operator’s Manual TEC-5600 series

Defibrillator TEC-5600 series

Operator’s Manual TEC-5600 series I

II Operator’s Manual TEC-5600 series

Operator’s Manual TEC-5600 series III

IV Operator’s Manual TEC-5600 series

Operator’s Manual TEC-5600 series V

VI Operator’s Manual TEC-5600 series

Operator’s Manual TEC-5600 series VII

VIII Operator’s Manual TEC-5600 series

Operator’s Manual TEC-5600 series IX

X Operator’s Manual TEC-5600 series

Operator’s Manual TEC-5600 series XI

XII Operator’s Manual TEC-5600 series

Operator’s Manual TEC-5600 series XIII

XIV Operator’s Manual TEC-5600 series

Operator’s Manual TEC-5600 series XV

XVI Operator’s Manual TEC-5600 series

Operator’s Manual TEC-5600 series XVII

XVIII Operator’s Manual TEC-5600 series

Operator’s Manual TEC-5600 series XIX

Operator’s Manual TEC-5600 series Contents 1

2 Contents Operator’s Manual TEC-5600 series

Operator’s Manual TEC-5600 series Contents 3

Operator’s Manual TEC-5600 series i

ii Operator’s Manual TEC-5600 series

Operator’s Manual TEC-5600 series iii

iv Operator’s Manual TEC-5600 series

1-2 Operator’s Manual TEC-5600 series

Operator’s Manual TEC-5600 series 1-3

1-4 Operator’s Manual TEC-5600 series

Operator’s Manual TEC-5600 series 1-5

1-6 Operator’s Manual TEC-5600 series

Operator’s Manual TEC-5600 series 1-7

1-8 Operator’s Manual TEC-5600 series

2-2 Operator’s Manual TEC-5600 series

Operator’s Manual TEC-5600 series 2-3

2-4 Operator’s Manual TEC-5600 series