Zoll Aed Plus Manual

Administrator’s Guide
REF 9650-0301-01 Rev. M

This issue date for the ZOLL AED Plus Administrator’s Guide, Revision M, is July 2006.
If more than three years have elapsed since the revision date, contact ZOLL Medical Corporation to
determine if additional product information updates are available.
ZOLL, AED Pro, stat•padz, pedi•padz, pro•padz, and v•pack are registered trademarks of ZOLL Medical
Corporation. AED Plus, PowerCharger, Preconnect, RescueNet, Smart Alarms, CPR-D•padz, Rectilinear
Biphasic, “Real CPR Help,” and “Advancing Resuscitation. Today.” are trademarks of ZOLL Medical
Corporation. All other trademarks and registered trademarks are property of their respective owners.
Copyright © 2006 ZOLL Medical Corporation. All rights reserved.
Table of Contents
PREFACE ......................................................................................................................................................................... V
SAFETY SUMMARY ........................................................................................................................................................VI
Warnings............................................................................................................................................................................ vi
Cautions ............................................................................................................................................................................ vii
Indications for Use............................................................................................................................................................ vii
Contraindications for Use ................................................................................................................................................. vii
Intended Users of the Device............................................................................................................................................ vii
Tracking Requirements....................................................................................................................................................viii
Notification of Adverse Events........................................................................................................................................viii
Unpacking........................................................................................................................................................................viii
Conventions .....................................................................................................................................................................viii
Symbols ............................................................................................................................................................................. ix
INTRODUCTION ............................................................................................................................................................... 1
Using the ZOLL AED Plus................................................................................................................................................. 1
Using the CPR Function ..................................................................................................................................................... 2
OPERATION ..................................................................................................................................................................... 3
Operating Controls and Indicators...................................................................................................................................... 3
Using the ZOLL AED Plus Graphical User Interface ........................................................................................................ 5
Voice Prompts..................................................................................................................................................................... 6
Using the LCD Display....................................................................................................................................................... 9
Using the Passive Airway Support System (PASS) ......................................................................................................... 10
Using Electrodes ............................................................................................................................................................... 11
Applying CPR-D padz ...................................................................................................................................................... 12
Applying Pedi Padz II (Infant/Child Electrodes).............................................................................................................. 13
Using the CPR Monitoring Function -- Real CPR Help................................................................................................... 14
Using the Audio Recording Option .................................................................................................................................. 14
INSTALLATION AND SELF TEST .................................................................................................................................... 15
Inspecting the Unit............................................................................................................................................................ 15
Preparing the ZOLL AED Plus for Use............................................................................................................................ 15
Using the Self Test Feature............................................................................................................................................... 16
Battery Installation Self Test ...............................................................................................................................................................16
Power On Self Test ..............................................................................................................................................................................17
Manual Self Test..................................................................................................................................................................................17
Automatic Self Test .............................................................................................................................................................................18
Installing or Replacing Batteries....................................................................................................................................... 18
Identifying Battery Condition........................................................................................................................................... 20
MAINTENANCE AND TROUBLESHOOTING ..................................................................................................................... 21
Maintaining the Unit......................................................................................................................................................... 21
Maintenance Checklist.........................................................................................................................................................................21
Cleaning the Unit .............................................................................................................................................................. 21
Optional Maintenance for Technical Professionals .......................................................................................................... 22
Troubleshooting ................................................................................................................................................................ 23
Contacting Technical Service ........................................................................................................................................... 24
International Customers.......................................................................................................................................................................24
ZOLL ADMINISTRATION SOFTWARE ........................................................................................................................... 25

Installing ZOLL Administration Software ....................................................................................................................... 25
RescueNet Code Review Software ................................................................................................................................... 25
Setting Up Data Communications .................................................................................................................................... 25
ORDERING ACCESSORIES .............................................................................................................................................. 26
ZOLL AED PLUS Administrator’s Guide iii

APPENDIX A: SPECIFICATIONS ......................................................................................................................................27
Guidance and Manufacturer’s Declaration - Electromagnetic Emissions ........................................................................29
Rectilinear Biphasic Waveform Characteristics ...............................................................................................................33
Clinical Trial Results for the M Series Biphasic Waveform.............................................................................................34
Randomized Multi-Center Clinical Trial for Defibrillation of Ventricular Fibrillation (VF) and Ventricular Tachycardia (VT)......34
ECG Analysis Algorithm Accuracy..................................................................................................................................36
iv ZOLL AED PLUS Administrator’s Guide

Preface
The ZOLL AED Plus Administrator’s Guide is to be used by responsible medical authorities in
conjunction with the ZOLL AED Plus Operator’s Guide (REF 9650-0300-01).
The ZOLL AED Plus is to be used by trained rescuers to provide emergency defibrillation. It
incorporates a sequence of visual and voice prompts to help rescuers follow established AHA/ERC
Guidelines 2005 protocols for use of AEDs. It also incorporates recording/memory capabilities to
allow medical control authorities to review rescuer’s use of the device. Recording includes ECG
rhythms, event data, device identification, and optionally, voice recording of rescuer and ambient
sounds. This information is available via an upload capability to a personal computer for event review
and archiving.
Both the American Heart Association and the European Resuscitation Council publish extensive
information regarding the use of automated external defibrillators and their relationship to
cardiopulmonary resuscitation. The following publications provide supplemental material to be used
in conjunction with the ZOLL AED Plus Administrator’s Guide and Operator’s Guide:
1. 2005 American Heart Association Guidelines for CPR and ECC; Supplement to Circulation,
Volume 112, Issue 24, December 13, 2005.
2. European Resuscitation Council Guidelines for Resuscitation 2005; Resuscitation (2005) 67S1,
S7-S23.
This guide provides information about the operation and care of the AED Plus unit. The administrator,
and user should read each section carefully. Make sure to read the Safety Summary section.
This guide is divided into six sections.
Preface - This page.
Safety Summary - Describes General Warnings and Cautions.
Introduction- Provides a general product overview of the ZOLL AED Plus.
Section 1 - Operation - Describes the functions of all controls and indicator lights of the ZOLL AED
Plus.
Section 2 - Installation, Self Test, Maintenance and Troubleshooting- Describes configuration of the
unit, data communications, troubleshooting, maintenance and how to order accessories and supplies.
Appendices - Provides the specifications of the ZOLL AED Plus, characteristics of the ZOLL
Rectilinear Biphasic waveform, and information on the ECG Analysis Algorithm Accuracy.
ZOLL AED PLUS Administrator’s Guide v

Safety Summar y
The following section describes general warnings and safety considerations for administrators, rescuers,
and patients.
Warnings
• Use the ZOLL AED Plus unit only as described in this manual. Improper use of the device can cause
death or injury.
• DO NOT use or place the ZOLL AED Plus unit in service until you have read the ZOLL AED Plus
Operator’s and Administrator’s Guides.
• DO NOT use or place the ZOLL AED Plus unit in service if the unit’s status indicator window
(located on the left side of the handle) displays a red “X”.
• DO NOT use or place the ZOLL AED Plus unit in service if the unit emits a beeping tone.
• Connect the electrode cable to the ZOLL AED Plus unit after installing batteries.
• Keep the electrode cable connected to the ZOLL AED Plus unit at all times.
• This device should only be used by properly trained individuals.
• Only use electrodes labeled “Infant/Child” on children less than 8 years old or weighing less than
55 lbs (25 kg). Use CPR-D padz if patient is older than 8 years or weighs more than 55 lbs (25 kg).
• Always stand clear of patient when delivering treatment. Defibrillation energy delivered to the
patient may be conducted through the patient’s body and cause a lethal shock to those touching the
patient.
• DO NOT TOUCH the electrode surfaces, the patient, or any conductive material touching the patient
during ECG analysis or defibrillation.
• Move patient away from electrically conductive surfaces prior to use of equipment.
• DO NOT use this unit near or within puddles of water.
• Keep the patient as motionless as possible during ECG analysis.
• DO NOT use this unit near flammable agents, such as gasoline, oxygen-rich atmospheres or
flammable anesthetics.
• Avoid radio frequency interference from high-power sources that might cause the defibrillator to
interpret cardiac rhythms incorrectly by turning off cell phones and 2 way-radios.
• Disconnect non-defibrillation protected electronic devices or equipment from patient before
defibrillation.
• Dry patient’s chest, if wet, before attaching electrodes.
• Apply freshly opened and undamaged electrodes, within the electrode expiration date, to clean and
dry skin to minimize burning.
• DO NOT place the electrodes directly over the patient’s implanted pacemaker. Pacemaker stimuli
may degrade the accuracy of ECG rhythm analyses or the pacemaker may be damaged by
defibrillator discharges.
• Check labeling inside the ZOLL AED Plus cover before using the cover as a Passive Airway Support
System (PASS) device. Ensure it is intended for this use.
• DO NOT use Passive Airway Support System (PASS) if there is a suspected head or neck injury.
Place patient on a firm surface before performing CPR.
• DO NOT recharge, disassemble, or dispose of batteries in fire. Batteries may explode, if mistreated.
• Do not use or stack the ZOLL AED Plus unit with other equipment. If the unit is used or stacked with
other equipment, verify proper operation prior to use.
vi ZOLL AED PLUS Administrator’s Guide

Cautions
• Do not disassemble the unit. A shock hazard exists. Refer all servicing to qualified personnel.
• Use only commercially available type 123A lithium manganese dioxide batteries. Discard batteries
properly after removal from unit. Use only batteries from recommended manufacturers.
• If the device is stored outside the recommended environmental conditions, the electrode pads and/
or batteries may be damaged or their useful life reduced.
• Safety and effectiveness data submitted by ZOLL Medical Corporation to the Food and Drug
Administration (FDA) under section 510(K) of the Medical Device Act to obtain approval to
market are based upon the use of ZOLL accessories such as disposable electrodes. The use of
electrodes from sources other than ZOLL is not recommended. ZOLL makes no representations or
warranties regarding the performance or effectiveness of its products when used in conjunction
with electrodes from other sources. If unit failure is attributable to the use of accessories not
manufactured by ZOLL, this may void ZOLL's warranty.
• The CPR-D Padz Electrode can be connected to other ZOLL Defibrillators with Multifunction
Cables. Defibrillation can be administered when connected to other ZOLL Defibrillators. The CPR
function does not operate with any device other than the ZOLL AED Plus.
Indications for Use

Use the ZOLL AED Plus when a suspected cardiac arrest victim has an apparent LACK OF
CIRCULATION as indicated by:
• Unconsciousness; and
• Absence of normal breathing; and
• Absence of a pulse or signs of circulation.
When the victim is less than 8 years of age or weighs less than 55 lbs (25 kg), the ZOLL AED Plus
should be used with ZOLL AED Plus Pediatric Electrodes. Therapy should not be delayed to determine
the patient’s exact age or weight.
Contraindications for Use

Do NOT use the ZOLL AED Plus when the patient:
• Is conscious; or
• Is breathing; or
• Has a detectable pulse or other signs of circulation.
Intended Users of the Device

The ZOLL AED Plus external defibrillator is intended to be used by personnel who are qualified by
training in the use of the ZOLL AED Plus device, basic life support, advanced life support, or other
physician-authorized emergency medical response to defibrillate victims of cardiac arrest. The CPR
monitoring function provides a metronome designed to encourage rescuers to perform chest
compressions at the AHA/ERC recommended rate of 100 compressions per minute. Voice and visual
prompts encourage a compression depth of 1½ - 2 inches for adult patients. The CPR monitoring
function is not intended for use on patients under 8 years of age.
ZOLL AED PLUS Administrator’s Guide vii

Tracking Requirements
U.S Federal Law (21 CFR 821) requires the tracking of defibrillators. As an owner of this device, you
have the responsibility under this law to notify ZOLL Medical Corporation if this product has been
received, lost, stolen or destroyed or has been donated, resold or otherwise distributed to a different
organization.
If any of the events described above occur, please contact ZOLL Medical Corporation in writing with the
following information:
1. Originator’s organization - Company Name, Address, Contact Name and Contact Phone Number.
2. Part Number/Model Number and Serial Number.
3. Disposition of Device (e.g. received, lost, stolen destroyed, distributed to another organization).
4. New Location and/or Organization (if different from #1 above) - Company Name, Address, Contact
Name and Contact Phone number.
5. Date change took effect.
Notification of Adverse Events

As a health care provider, you may have responsibilities under the SMDA for reporting to ZOLL and
possibly to the FDA, the occurrence of certain events. These events, described in 21 CFR Part 803,
include device related death and serious injury or illness. In any event, as part of our Quality Assurance
Program, ZOLL should be notified of any device failures or malfunction. This information is required to
assure that ZOLL provides only the highest quality products.
Unpacking
• Carefully inspect each packing container for damage.
• Examine the unit for any signs of damage that may have occurred during shipping.
• If the contents are incomplete or damaged or if the unit fails to pass its self test as indicated by a Red
“X” in the status indicator window after battery installation, contact ZOLL Medical Corporation’s
Technical Service Department.
• Review the shipping list to insure that all items ordered were received.
Conventions
Throughout this document, voice prompts are indicated by capital italicized letters, such as
CALL FOR HELP.
WARNING! Warning statements describe conditions or actions that can result in personal injury or
death.
CAUTION! Caution statements describe conditions or actions that can result in damage to the
unit.
NOTE Notes contain additional information on using the defibrillator.
viii ZOLL AED PLUS Administrator’s Guide

Symbols
Symbols used in this manual or on the equipment include the following:
Class II equipment
Defibrillation protected Type BF patient connection
ATTENTION: Refer to manual for more information
DANGEROUS VOLTAGE
Not new battery cells
New battery cells
Do Not push button
Push button
Do not use this manufacturer
Ok to use this manufacturer
Unit equipped to treat adult and pediatric patients
Manufacturer
Authorized representative in the European

Community
Serial Number
Catalogue number
Consult instructions for use
ZOLL AED PLUS Administrator’s Guide ix

x ZOLL AED PLUS Administrator’s Guide
Introduction
Using the ZOLL AED Plus
The ZOLL AED Plus is an automated external defibrillator (AED) that uses voice prompts and visual
indicators to guide the rescuer through a resuscitation sequence that may include defibrillation and/or
cardiopulmonary resuscitation (CPR). The unit incorporates the ZOLL Rectilinear Biphasic
Defibrillation waveform, and operates in either adult or pediatric mode.
The ZOLL AED Plus supports both adult and pediatric defibrillation electrode pads, and automatically
adjusts the defibrillation energy based on the type of electrode pads connected to it. Following
attachment of electrodes to a patient’s chest, the defibrillator monitors the electrocardiographic (ECG)
rhythm of the patient’s heart, analyzes that rhythm, and determines whether the rhythm is shockable
or non-shockable. When needed, defibrillation energy is delivered through these same electrodes.
When the unit detects a shockable rhythm, it charges and issues the warning DON’T TOUCH
PATIENT, PRESS SHOCK BUTTON. The rescuer presses the Shock Button to deliver the shock. The
rescuer will then be prompted to perform CPR for a period of two minutes, after which the unit
automatically initiates a new ECG analysis.
Some versions of the ZOLL AED Plus include a cover that can also be used as a PASS (Passive
Airway Support System) to support the patient’s neck and shoulders in a position that assists in
maintaining an open airway. Some versions also contain disposable accessories (razor, barrier mask,
scissors, and a towel). The ZOLL AED Plus is powered by ten commercially available consumer
brand lithium-manganese dioxide batteries.
The ZOLL AED Plus can:
• Perform periodic self tests to ensure its continual readiness.
• Use a one-piece electrode assembly that facilitates proper electrode placement and that is easy to
apply to the patient.
• Analyze heart rhythm and inform the rescuer if the rhythm is shockable or non-shockable.
• Deliver defibrillation treatment to victims of cardiac arrest who exhibit shockable ECG rhythms.
• Provide voice prompts and graphics to guide the rescuer regarding what to do and when to do it
during a cardiac emergency, such as calling for help or giving CPR to the patient.
• Provide audible beeps to encourage rescuers to provide CPR compressions at 100 CPM (requires
CPR-D padz).
• Monitor the depth of chest compressions during CPR and provide voice prompts, if compression
depth is inadequate (requires CPR-D padz).
• Provide a unit cover that functions as a Passive Airway Support System (PASS). (Note the PASS
feature is standard with some versions of the product and optional with others.)
• Upload data from the defibrillator to a PC to store events or print event reports.
• Use commercially available batteries.
ZOLL AED PLUS Administrator’s Guide 1

Using the CPR Function
The CPR-D padz include a sensor that detects the rate and depth of CPR chest compressions. This
sensor is placed (as part of the electrodes application) on the patient’s chest so that it is located between
the rescuer’s hands and the patient’s lower sternum during chest compressions. When the rescuer
performs CPR compressions, the sensor detects their rate and depth and sends the information to the
ZOLL AED Plus unit. When used with ZOLL CPR-D padz, the ZOLL AED Plus monitors the depth
and rate of CPR chest compressions. It provides a CPR metronome function designed to encourage
rescuers to perform chest compressions at the AHA/ERC recommended rate of 100 compressions per
minute (CPM) as well as voice and visual prompts to encourage a compression depth of 1½ - 2 inches
for adult patients.
WARNING! The CPR function is intended for use on adult patients only; do not use on patients
under 8 years of age.
The metronome function is disabled during periods when CPR should not be performed (for example,
during ECG analyses and defibrillation shock sequences). During periods when CPR may be indicated,
the metronome begins issuing audible beeps following detection of the rescuer’s first few
compressions. The beeps continue automatically (at rates described below) until a few seconds after
chest compressions are halted by the rescuer or until the recommended “CPR period” ends (1 minute
for AHA and ERC protocols). If the rescuer ceases chest compressions during the CPR period,
metronome beeps stop within a few seconds after compressions are halted. Audible beeps resume
during the CPR period following any re-initiation of CPR compressions. If no CPR compressions are
detected during “CPR periods”, the ZOLL AED Plus periodically re-issues the CONTINUE CPR
prompt.
The rate of beeps issued by the ZOLL AED Plus metronome function adapts to the rescuer’s actual
chest compression rate. The metronome will beep at 100 CPM when chest compressions are delivered
at greater than 80 compressions per minute (CPM). Should the rescuer fail to deliver compressions at
80 CPM or greater, the metronome will beep at a rate that is approximately 15 CPM higher than the
rescuer’s actual rate. This increased metronome rate is intended to encourage the rescuer to increase
his/her chest compression rate until the recommended 100 CPM rate is achieved. The metronome beeps
at a minimum rate of 60 CPM in cases where the rescuer’s compression rate is substantially below
60 CPM.
During CPR, the ZOLL AED Plus may issue one or more audible prompts based on the depth of chest
compressions detected. When the CPR monitoring system determines that compression depth is
consistently less than 1½ inches, a PUSH HARDER prompt will be issued. A GOOD COMPRESSION
prompt will be issued if the rescuer responds by increasing compression depth to 1½ inches or more.
2 ZOLL AED PLUS Administrator’s Guide

Operation
This section describes the following functions:
• Operating Controls and Indicators
• Using the ZOLL AED Plus Graphical User Interface
• Voice Prompts
• Using the LCD Display
• Using the Passive Airway Support System (PASS)
• Using Electrodes
• Applying CPR-D padz
• Applying Pedi Padz II (Infant/Child Electrodes)
• Using the CPR Monitoring Function -- Real CPR Help
• Using the Audio Recording Option
Operating Controls and Indicators

See Table 1: Control Functions for an explanation of each of these controls.
Patient Connector LCD Display (not supplied on

some units)
Graphics Indicator Lights

IrDA Port (on side of unit)
Status
Indicator
Battery Compartment (bottom)
Carrying Handle Microphone (hidden)
On/Off
Speaker (bottom)
Shock Button
Figure 1: Identifying Operating Controls and Indicators

Table 1: Control Function
Control/Indicator Description
ON/OFF Button Turns power ON or OFF.

When held depressed for > 5 seconds initiates self test or data
communications.
Indicator lights Illuminates to indicate which step rescuer must take to treat a patient.
Shock Button Illuminates when the ZOLL AED Plus is charged and ready to deliver a
shock to the patient.
When pressed, causes the charged and ready ZOLL AED Plus to discharge its
energy into the patient.
When the ZOLL AED Plus is not charged the lighted button is extinguished.
Pressing this button initiates a voice prompt that indicates the number of
defibrillator shocks delivered since the unit was powered on.
Pictograms Icons that explain the series of steps needed for resuscitation and
defibrillation.
Status Indicator
Illuminated check mark indicates the unit passed its last self test and is ready
for use.
Illuminated “X” indicates unit has failed its self test and is not ready for use
LCD Display Displays elapsed time, shock count, user prompts, CPR compression depths
and ECG waveforms.
IrDA™ Port Provides a communications link between the defibrillator and a personal
computer or another IrDA™ equipped device.
PASS Cover Some ZOLL AED Plus models include a cover that may be used as a
(optional) shoulder support to aid patient airway management. The PASS can be
ordered separately for other ZOLL AED Plus models (see "Ordering
Accessories" on page 26).
Battery Holds ten (10) 123A lithium manganese dioxide batteries used to power the
Compartment unit.
Patient Connector Connector for attaching electrodes to the ZOLL AED Plus.
Speaker Provides audio prompts and metronome beeps that direct rescuers on what to
do during a resuscitation; also provides voice prompts to indicate if service is
required.
Microphone When voice recording option is installed, this microphone picks up and
(optional) records ambient sounds, including rescuer’s voice.

Using the ZOLL AED Plus Graphical User Interface
The ZOLL AED Plus graphical user interface (see Figure 2) is visible on the top of the unit when the
cover is removed. The pictograms are reminders of the steps to follow when performing a rescue and
reinforce instructions provided through voice prompts and optional display messages.
Each pictogram on the device is associated with an indicator light (LED) and voice prompts. This
combination draws attention to the graphics in a sequence defined by current protocols for use of an
AED by the American Heart Association (AHA) and the European Resuscitation Council (ERC).
Figure 2: Graphical User Interface
The ZOLL AED Plus unit contains an LCD display (some special models do not have an LCD) that
displays elapsed time, number of shocks delivered, text messages corresponding to the voice prompts,
and depth of CPR compressions. The LCD can also be configured to display the acquired ECG signals.
When the device is turned on, the unit automatically initiates the sequence of voice prompts and
graphic illuminations for a rescue event. The sequence continues until the device is turned off or the
electrodes are disconnected from the patient for an extended period of time. As soon as electrodes are
attached to the patient and impedance of the connection is verified, the unit stops cycling through the
above-mentioned voice and graphic illumination sequence and automatically begins analysis of the
ECG rhythm.
Following the results of this ECG analysis, voice prompts tell the rescuer whether a shockable or
non-shockable rhythm has been detected. If a shockable ECG rhythm is present, the graphics
illuminate and voice prompts guide the rescuer through the defibrillation sequence. When no shock is
advised, the ZOLL AED Plus issues the audio prompts, NO SHOCK ADVISED and START CPR, and
illuminates the CPR-related graphics. A period of 2 minutes (depending upon device configuration)
is then allowed for rescuer CPR. Following this “CPR period”, the ZOLL AED Plus automatically re-
initiates a new ECG rhythm analysis.

The ZOLL AED Plus automatically adjusts defibrillation energy to adult or pediatric levels based on
the type of electrodes attached to the unit. In its factory default configuration, the unit delivers the first
three shocks at 120J, 150J, and 200J respectively in adult mode, and at 50J, 70J, and 85J in pediatric
mode. However, the device can be configured to deliver shocks at other energy levels, as long as the
setting for each successive shock is the same or greater than the setting for the preceding shock. Shocks
are delivered by depressing the Shock Button (indicated by the heart icon and associated LED) located
in the center of the graphical user interface.
Consult the ZOLL AED Plus Operator’s Guide for more details on the graphics included in the unit’s
graphic interface, the audio prompts issued at each step in the treatment protocol and the rescuer action
associated with these audio and visual prompts.
Loss of contact between the electrodes and the patient interrupts ECG analysis and/or shock delivery
until the electrodes are re-attached and results in a CHECK ELECTRODE PADS prompt to the operator.
Voice Prompts
During clinical use of the ZOLL AED Plus, you may hear the following voice prompts.
Table 2: Clinical Voice Prompts
Voice Prompt Definition
UNIT OK. ZOLL AED Plus has successfully passed its power up self tests.
UNIT FAILED. ZOLL AED Plus has failed its power up self tests and is not
usable for patient care.
CHANGE BATTERIES. ZOLL AED Plus self test has detected a low battery condition
that is insufficient for the device’s use for patient care. Replace
batteries immediately.
STAY CALM. Relax as much as possible and focus on the rescue effort.
CHECK RESPONSIVENESS. Check patient for responsiveness/consciousness by gently

shaking the patient and shouting “Are you all right?”.
CALL FOR HELP. Activate the EMS system or ask a bystander to do it for you.
OPEN AIRWAY. Place patient in the supine position and perform Head Tilt – Chin
Lift or Jaw – Thrust maneuver to open patient’s airway.
CHECK BREATHING. Look, listen or feel for the presence of breathing and/or airflow
from the patient’s lungs.
GIVE TWO BREATHS. If patient is not breathing, give two rescue breaths.
PLUG IN CABLE. Ensure that the electrode cable is properly connected to the
ZOLL AED Plus patient connector.
ATTACH DEFIB PADS TO Attach defibrillation pads to the patient’s bare chest.
PATIENT’S BARE CHEST.
CHECK ELECTRODE PADS. Previously attached electrodes are not making good contact with
the patient’s skin or the electrodes are defective.
ADULT PADS. ZOLL AED Plus has detected adult electrode pads connected to
it and adjusted defibrillation energy settings to adult levels.

PEDIATRIC PADS. ZOLL AED Plus has detected pediatric electrode pads connected
to it and adjusted defibrillation energy settings to pediatric levels.
DON’T TOUCH PATIENT, Do not touch patient, an ECG rhythm analysis is in progress or
ANALYZING. about to begin.
SHOCK ADVISED. ECG rhythm analysis has detected the presence of VF or

shockable VT.
NO SHOCK ADVISED. ECG rhythm analysis has detected a rhythm that is not treatable
by defibrillation.
ANALYSIS HALTED. KEEP ECG rhythm analysis has been halted due to excessive ECG
PATIENT STILL. signal artifact. Stop any ongoing CPR and keep the patient as
motionless as possible.
DON’T TOUCH PATIENT. Warn all persons in attendance of the patient to stand clear and
PRESS FLASHING SHOCK stop touching the patient. Press the Shock Button to deliver
BUTTON. defibrillation therapy.
RELEASE SHOCK BUTTON. Shock Button was depressed before the defibrillator was ready to
defibrillate. Release the Shock Button and press again after the
ready tone sounds.
SHOCK DELIVERED. A defibrillation shock has just been delivered to the patient.
NO SHOCK DELIVERED. No shock was delivered to the patient because rescuer failed to
press Shock Button or an error condition was detected.
n SHOCKS DELIVERED. A total of n shocks have been delivered since the ZOLL AED
Plus was turned on.
START CPR. Begin CPR.
CONTINUE CPR. Continue providing CPR. This prompt may also be issued if the
ZOLL AED Plus CPR monitoring function fails to detect chest
compressions at least ¾ of an inch deep.
PUSH HARDER. CPR compressions are consistently less than 1 ½ inches deep.
GOOD COMPRESSIONS. After prompting to Push Harder, rescuer has succeeded in

delivering chest compressions at least 1 ½ inches deep.
STOP CPR. Stop CPR, the ZOLL AED Plus is about to begin an ECG rhythm
analysis.

Prompts that may be heard during non-clinical use of the ZOLL AED Plus unit include:
Table 2b Non-Clinical Voice Prompts
IF NEW BATTERIES, Press the Battery Reset Button located in the battery compartment
PRESS BUTTON. after replacing ALL batteries in the device with new batteries.
NON-RESCUE MODE. ZOLL AED Plus device has entered the diagnostics/data
communications mode.
COMMUNICATIONS IrDA Communications between the ZOLL AED Plus and a personal
ESTABLISHED. computer or modem have been established.

Using the LCD Display
The ZOLL AED Plus is equipped with a 1.3 x 2.6 inch LCD screen (see Figure 3) that displays the
following information:
CPR Depth of
Shock Count Elapsed Time Compression Indicator
SHOCKS: 05 05:25 SHOCKS: 05 05:25
CHECK
1.5” RESPONSIVENESS 1.5” (3.8 cm)
(3.8 cm)
CHECK depth
2.0” (5.1 cm)
RESPONSIVENESS depth
2.0” (5.1 cm)
depth
With ECG Without ECG
Figure 3: LCD Displays

NOTE Some special ZOLL AED Plus models do not have an LCD.
Shock Count (Upper left corner of screen): Indicates the total number of defibrillation shocks
delivered by the ZOLL AED Plus since it was last powered on. Shock count is saved through brief
power off periods (< 5 seconds). When the ZOLL AED Plus is turned off for more than five (5)
seconds, the shock count is reset to 0.
Elapsed Time (Upper right corner of screen): Indicates the total time in minutes and seconds that has
elapsed since the ZOLL AED Plus was last powered on. Elapsed time continues to be counted through
brief power off periods (< 5 seconds). When the ZOLL AED Plus is turned off for more than five (5)
seconds, elapsed time is reset to 00:00. When elapsed time exceeds 99 minutes and 59 seconds, the
timer wraps around to 00:00 and continues counting.
CPR Depth of Compression Indicator (Right side of screen): A bar graph is displayed that shows
the depth of chest compressions measured during the delivery of CPR. Indicator lines are displayed in
the bar graph area at 1 ½ and 2 inches of compression depth to provide reference points for rescuers
performing CPR.
Visual User Prompts (Lower 1/3 of screen): Whenever the ZOLL AED Plus issues a voice prompt,
the text of the voice prompt is simultaneously displayed on the LCD display.
ECG Waveform (Center portion of screen): Although ZOLL AED Plus units do not display ECG
waveforms in their factory default configuration, the device can be specifically set up to continuously
display ECG signals as they are acquired.

Using the Passive Airway Support System (PASS)
If there is no evidence of head or neck trauma, the head tilt chin lift method is the recommended
maneuver for opening the airway. The PASS may be placed under the patient’s shoulders to help
maintain head tilt.
WARNING! DO NOT use Passive Airway Support System (PASS) if suspected head or neck
injury. Place patient on a firm surface before performing CPR.
If the patient requires airway support and there is no evidence of head or neck trauma, roll the patient
on his/her side and then roll him/her back over so that the PASS is under the patient’s shoulders causing
the head to tilt backwards.
For PASS COVERS only: The shape of the PASS, when placed under the shoulders of the patient, can
be used to help maintain an open airway (see Figure 4).
The unit cover also functions as the Passive Airway Place the PASS under the patient to lift his/her shoulders.
Support System (PASS). Do not use the PASS if there is a suspected head or neck
injury.
Figure 4: Using the PASS Cover

Using Electrodes
WARNING! DO NOT reuse electrodes.
The ZOLL AED Plus supports both adult and pediatric electrode pads. The device automatically
adjusts defibrillation energy to adult or pediatric levels depending on the type of electrodes connected
to it. Make sure that the electrode pads used are appropriate for the patient.
WARNING! DO NOT use adult electrode pads or CPR-D padz on patients under 8 years of age.
The ZOLL AED Plus uses electrode packs that are connected to the unit by a cable. The package
contains electrodes that you attach to the patient.
• Make sure to install a new package of electrodes and connect the electrode cable to the unit after
each use, to prepare for future emergencies.
• Check the electrode expiration date regularly to ensure that electrodes are fresh and ready to use
in an emergency situation.
• Replace electrodes, if expired
• After the ZOLL AED Plus is powered on and completes its self-test, the unit will issue an “Adult
Pads” voice prompt or a “Pediatric Pads” voice prompt to indicate the type of electrodes connected
to the unit. Verify that the connected electrode pads are appropriate for the patient being treated.
Connect alternate electrode pads if necessary.
If the electrodes are not attached properly, the unit issues the CHECK ELECTRODE PADS or the
ATTACH ELECTRODE PADS voice prompt during operation. If the electrode cable is not properly
attached to the unit, the unit issues the PLUG IN CABLE prompt. Make certain to connect the electrode
cable to the ZOLL AED Plus unit and attach the electrodes to the patient properly.
WARNING! Electrodes must be pre-attached to the device. Keep the electrode cable connected
to the ZOLL AED Plus unit at all times.
The electrode package may include:

• Scissors to cut clothing or chest hair.
• Razor to remove excessive hair at the electrode application site, if necessary.
• Small towel to make sure that the patient’s skin is dry.
• Gloves.
• Barrier Mask.
NOTE Electrodes contain no hazardous materials and may be disposed of in general trash unless contaminated
with pathogens. If contaminated, appropriate precautions should be used in their disposal.

Applying CPR-D padz
Prepare the patient before attaching the electrodes.
WARNING! CPR-D padz are intended for use on adult patients only; do not use on patients
To prepare the patient:

1. Remove all clothing covering the patient’s chest.
2. Ensure the patient’s chest is dry.
3. If the patient has excessive chest hair, clip or shave the hair to help ensure proper adhesion of the
electrodes.
To apply the electrodes:
1. Tear open the electrode package and unfold the electrodes. Place the electrodes on the patient
according to the graphics on the package (see Figure 5).
2. Hold the CPR sensor and place the sensor between the nipples and on the middle of the patient’s
breastbone, using the sensor’s cross hairs to guide you.
3. Press the CPR sensor with your right hand and pull the number 2 tab to peel the protective backing
from the electrode. Press the electrode from the center out to make sure it adheres properly to the
patient’s skin.
4. Press the CPR sensor with your left hand and pull the number 3 tab to peel the protective backing
from the electrode. Press the electrode from the center out to make sure it adheres properly to the
patient’s skin.
NOTE If the patient is large or there is a need to place the electrode under a breast, you may need to tear away the
lower pad at the perforated line (see Figure 5) and extend the pad. Place the pad slightly to the patient’s left
and below the patient’s left breast.
NOTE If the patient has an implanted pacemaker or defibrillator in the upper right chest, angle the electrodes
slightly to avoid placing the electrodes over either device. Make certain that the CPR sensor maintains a
position over the lower half of the breastbone.
ZOLL Medical Corporation 269 Mill Road

Chelmsford, MA 01824-4105 USA 978-421-9655
Figure 5: Placement of CPR-D padz

Applying Pedi Padz II (Infant/Child Electrodes)
Prepare the patient before attaching the electrodes.
Important! This symbol indicates that an AED Plus unit is equipped for treating adult and pediatric patients.
An AED Plus unit without this symbol is not equipped to treat pediatric patients and will NOT
work with the pedi•padz II ™ pediatric electrodes. To upgrade an AED Plus unit for use with
ZOLL pedi•padz II pediatric electrodes, contact ZOLL Medical Corporation or an authorized
ZOLL distributor for information on the ZOLL AED Plus Pediatric Upgrade Kit.
To apply the electrodes:
1. Tear open the electrode package and unfold the inner package to expose the electrodes. Place the
electrodes on the patient according to the graphics on the package (see Figure 6).
2. Remove the round electrode from its backing material and place it on the patient’s chest (as shown
in Figure 6).
3. Place your hand on the electrode edge and, using the other hand, gently roll the electrode onto the
patient’s chest, pushing any air out from beneath the electrode as you go.
4. Roll the patient onto his/her chest, remove the square electrode from its backing and place it on
the patient’s back (as shown in Figure 6).
5. Place your hand on the electrode’s edge and, using your other hand, roll the electrode onto the
patient’s skin, pushing any air out from beneath the electrode as you go.
6. Roll the patient onto his/her back and follow the ZOLL AED Plus prompts.
NOTE The Pedi Padz II (infant/child electrodes) can also be used with ZOLL pacemaker products for up to one
hour of pacing (see the M Series Operator’s Guide for information about pacing).
TM
II
Infant/Child Defibrillation Electrodes
0-8 Years <55lbs / 25kg
3
2
0197
ZOLL Medical Corporation 269 Mill Road
Chelmsford, MA 01824-4105 USA 978-421-9655
9305-0627-01 Rev. 1
Figure 6: Placement of pedi padz II

Using the CPR Monitoring Function -- Real CPR Help
When used with ZOLL CPR-D padz, the ZOLL AED Plus monitors the rate and depth of CPR chest
compressions. The ZOLL AED Plus provides a CPR metronome function designed to encourage
rescuers to perform chest compressions at the AHA/ERC recommended rate of 100 compressions per
minute. Voice and visual prompts encourage a compression depth of 1 ½ - 2 inches for adult patients.
The CPR monitoring function operates only when CPR-D padz are used, and is intended for use on adult
patients only.
To use the ZOLL AED Plus CPR monitoring function you must do the following:
1. Connect CPR-D padz to the ZOLL AED Plus unit.
2. Apply the CPR-D padz to the patient as described in the previous section
Ensure that the CPR sensor is centered on the lower half of the patient’s sternum.
3. If no signs of circulation are present when the ZOLL AED Plus issues the START CPR prompt,
place your hands on top of the CPR sensor and push on the sensor to deliver chest compressions to
the patient.
After your first few compressions, the ZOLL AED Plus metronome will begin issuing timing
beeps. Try to maintain synchronization between these beeps and your chest compressions. Shortly
after you stop chest compressions to deliver rescue breaths the metronome will stop beeping.
NOTE If the ZOLL AED Plus prompts you to PUSH HARDER, your compressions are less than 1½ inches deep.
Increase your compression depth to improve CPR performance.
4. Deliver the appropriate number of rescue breaths then resume chest compressions. The metronome
will begin to beep again after your first few compressions have been delivered.
Using the Audio Recording Option

If installed and configured, the unit contains an audio recording option that records and stores
20 minutes of continuous audio and clinical event data during a rescue. (The unit records and stores at
least 7 hours of clinical event data if the audio recording option is disabled.) The recorded audio data is
synchronized to the clinical event data. The audio recording starts when the unit issues the STAY CALM
prompt.
NOTE The unit allows for up to 3 minutes of audio recording prior to electrode attachment. When you turn the
unit off, the first indicator light (LED) on the graphical user interface illuminates and the second indicator
light (LED) flashes intermittently while the unit stores the data in memory.
Whenever the device detects a clinical event in rescue mode, the unit deletes previously stored data
(ECG, Audio and Event) from memory before data for the current rescue is recorded. Overwriting of
old ECG, audio and event data begins 10 seconds after the electrodes are properly connected to the
patient. However, if the unit is started in Non-rescue Mode, the recorded data of the last rescue is
retained and may be uploaded to a data storage or archiving system.

Installation and Self Test
This section describes the following functions to prepare the ZOLL AED Plus for use:
• Inspecting the Unit
• Preparing the ZOLL AED Plus for Use
• Using the Self Test Feature
• Installing or Replacing Batteries
• Identifying Battery Condition
Inspecting the Unit

Once unpacked, inspect the device for any signs of damage due to shipping. Check for accessories and
any other parts ordered.
Preparing the ZOLL AED Plus for Use

To ensure that the ZOLL AED Plus is functioning properly and is ready for use in an emergency
situation, the following set-up and checkout procedures should be performed before placing the device
into service and after each clinical use.
1. Inspect all external surfaces of the unit to ensure that they are clean and free of structural damage
such as cracks, broken or missing parts.
2. Inspect the patient connector to ensure that there are no broken or missing connector pins.
3. Verify that new CPR-D•padz, stat• padz II® or pedi•padz II to be used with the ZOLL AED Plus
are well within their expiration date.
4. Follow instructions provided with the new electrodes to pre-connect them to the patient connector
on the device and pack them within the ZOLL AED Plus cover.
NOTE If the electrodes are not connected to the ZOLL AED Plus unit, the device will fail the self test and
display a red “X” in the status indicator window.
5. If the status indicator displays a red X, install new batteries. (See "Installing or Replacing
Batteries" on page 18.)
6. Close the top cover of the ZOLL AED Plus unit and initiate a self test by pressing the Power
Button. Verify that the unit issues the UNIT OK voice prompt. This prompt indicates that the new
batteries and electrodes are properly installed and that the unit is ready for service.
7. Verify that the ZOLL AED Plus unit issues the appropriate “Adult Pads” or “Pediatric Pads” voice
prompt.
8. Turn the ZOLL AED Plus unit off.
9. Wait 2 minutes. Verify that the green check symbol ( ) appears in the status indicator window
and that the unit does not emit a beeping tone.
10. Place the ZOLL AED Plus unit in service.
11. Check the ZOLL AED Plus unit periodically to ensure that the green check symbol ( ) appears
in the status indicator window.
NOTE If the status indicator displays a red X following completion of the above test, the ZOLL AED Plus is
not ready for use and may be defective. Remove the ZOLL AED Plus from service and consult the
Troubleshooting section on page 23 of this guide to help determine the problem.

Using the Self Test Feature
The ZOLL AED Plus unit performs the following self tests to verify unit integrity and its readiness for
emergency use:
• Battery Installation Self Test
• Power On Self Test
• Manual Self Test
• Automatic Self Test
Following successful completion of all self tests, the ZOLL AED Plus’s status indicator displays a green
check ( ) to show that all tests passed and that the unit is ready to use.
If the status indicator displays a red X following completion of any self test, the ZOLL AED Plus is not
ready for use and may be defective. Remove the ZOLL AED Plus from service and consult the
Troubleshooting section of this guide to help determine the problem.
Battery Installation Self Test

The ZOLL AED Plus unit performs a self test whenever batteries are installed and verifies the following
functions:
1. Defibrillation Electrodes Connection: Verifies that the defibrillation electrodes are properly pre-
connected to the device.
2. ECG Circuitry: Verifies that the ECG signal acquisition and processing electronics are functional.
3. Defibrillator Charge and Discharge Circuitry: Verifies that the device’s defibrillator electronics are
functional and can charge and discharge at 2 joules.
4. Microprocessor Hardware/Software: Verifies proper function of the ZOLL AED Plus
microprocessor electronics and the integrity of its software.
5. CPR Circuitry and Sensor: Verifies that CPR monitoring and compression depth detection are
functional.
6. Audio Circuitry: Verifies that voice prompts are functional.
At the end of this self test, the ZOLL AED Plus prompts the user to press the Battery Reset Button,
located inside the battery compartment. Pressing this button resets the unit’s battery usage indicator to
full charge.
CAUTION! DO NOT press the Battery Reset Button unless all batteries are new. Pressing the Battery Reset
Button when used batteries are installed may result in a false high reading of battery capacity. See
the "Installing or Replacing Batteries" on page 18 for more information.

Power On Self Test
The ZOLL AED Plus unit performs a self test whenever the unit is turned on and verifies the following
functions:
1. Battery Capacity: Verifies that the battery usage indicator shows at least 50% of full battery
capacity remaining.
4. Defibrillator Charge and Discharge Circuitry: Verifies that the device’s defibrillator electronics
are functional and can charge and discharge at 2 joules.
functional.
Manual Self Test

You can initiate a manual self test on the ZOLL AED Plus unit by pressing and holding the unit’s On/
Off button for 5 seconds. The ZOLL AED Plus illuminates all graphic indicators and issues voice and
LCD display messages to allow user verification of the device’s visual and auditory output
functionality. In addition, the LCD shows the application software version currently running on the
unit.
Shock Count Elapsed Time
SHOCKS: 00 00:12
Boot File Version
B:03.31 P:05.10 Application Software Version
Language File Version L:05.00 C:02.00 Firmware Version
H:10.00
Hardware Version
This self test verifies the following ZOLL AED Plus functions:
capacity remaining.
4. Defibrillator Charge and Discharge Circuitry: Verifies that the device’s defibrillator electronics
are functional and can charge and discharge at 2 joules.
functional.
8. Display: Verifies that visual indicators are functional.

Automatic Self Test
By default, the ZOLL AED Plus unit performs an automatic self test once every seven (7) days (this
interval can be configured to 1, 2, 3, 4, 5, 6, or 7 days) when the unit is stored with batteries installed.
This self test verifies the following ZOLL AED Plus functions:
capacity remaining.
4. Defibrillator Charge and Discharge Circuitry: Verifies that the device’s defibrillator electronics are
functional and can charge and discharge at 2 joules.
functional.
Installing or Replacing Batteries

To power the unit, use ten (10) consumer type 123A Photo Flash lithium manganese dioxide batteries.
You can purchase these batteries at many department, camera or electronics stores.
CAUTION! Use Duracell, Sanyo or Varta batteries only. Do not use Panasonic or Rayovac batteries.
Use of Panasonic or Rayovac batteries may result in significantly longer defibrillator
charging times than those required during emergency situations.
These batteries:
• Should be used well before their labeled expiration date.
• Should be checked periodically for the expiration date.
Batteries produced by all recommended manufacturers have a 10 year from date of manufacture shelf
life when not installed in a ZOLL AED Plus unit.
The following examples demonstrate how to read date codes on Duracell, Sanyo and Varta batteries.
Duracell:
The first digit indicates the year of manufacture (Example: 7=1997, 6=1996 etc.).
The second character is a letter from A-L that indicates the month of manufacture (Example:
A=January, B=February and so on to L for December.)
Sanyo:
The first letter indicates the year of manufacture (Example: A=1996, B=1997, etc.).
The second letter indicates the month of manufacture (Example: A=January, B=February, etc.).
Varta:
The BRAUNSCHWEIG - Code (always two letters) is printed on the side of the can in axial direction
to cell height.
The first letter indicates the month of manufacture (Example: B=January, R=February, A=March, etc.).
The second letter indicates the year of manufacture (Example: B=2001, R=2002, A=2003, etc.).
To install the batteries:

1. Ensure that the unit is turned off. Open the battery compartment by removing the battery cover
from the back of the unit.
To remove the battery cover, insert a small tool (e.g., flat blade screw driver) into the two slots on
the rear of the unit to depress the latches, then insert the tool into the groove on the bottom to lift
the cover (see Figure 7).
2) Lift cover here
Battery
Compartment
Door
1) Depress latch
here
Figure 7: Removing the Battery Compartment Door
2. Remove all batteries at once and dispose of batteries properly. Place new batteries into the battery
bank, observing battery polarity markings and making sure that all batteries are securely seated
and properly oriented. After placing the first 5 to 9 batteries in the battery well, the
INSTALL BATTERIES audio prompt reminds you to install the remaining batteries in the battery
compartment.
Battery Reset Button
Figure 8: Battery Compartment

3. After installing new batteries, press the Battery Reset Button inside the battery compartment when
prompted (see Figure 8). Pressing the button resets the battery usage indicator to full charge.
CAUTION! You MUST replace all ten (10) batteries at once. Do not replace individual batteries. The
unit cannot detect whether all batteries or only a few batteries have been replaced. Do not
place used batteries into the unit. Using less than fully charged batteries can affect the
unit when performing a rescue. DO NOT press the Battery Reset Button if all the
batteries are not new. The unit then assumes that they are the same batteries that were just
removed.
NOTE If you do not press the Battery Reset Button in the battery well within 15 seconds after installing all
batteries, the device assumes that the batteries installed in the device were temporarily removed, and are
not fully charged.
NOTE Because Lithium Manganese Dioxide battery cells do not contain toxic materials, they may be disposed of
in general trash after discharge or when properly protected against shorting between terminals.
Identifying Battery Condition

Battery capacity depletes during standby operation of the unit, while the unit is operating, and as a result
of each defibrillation. Battery capacity also gradually diminishes over a shelf life of years without use.
The unit monitors energy remaining in the installed batteries. When battery capacity is low or depleted,
the unit will not function to specification. When a low battery condition occurs, the unit:
• emits an audible alarm or “beep” once every minute, if the unit is off
• issues the CHANGE BATTERIES audio prompt, if the unit is on
• displays a red “X” in the status indicator window, indicating that the batteries have less than 50%
of full capacity remaining or that the unit has failed other self tests.
Table 3: Battery Condition
Battery Condition Indications Correction
Low Battery with unit off. Audible beep from unit once Replace batteries.
every minute.
Low Battery during power CHANGE BATTERIES prompt Replace batteries.

up self test. (when unit is powered on)
Low Battery or other self Status Indicator has red “X” Replace batteries. Check or
test failure with unit indicating failure to operate replace electrodes. If red “X”
powered off or during self (when off). remains, return to ZOLL
test. Technical Support for service.
Low Battery with unit CHANGE BATTERIES prompt Replace batteries as soon as
powered on. (unit powered on). possible.
Dead Battery. Status Indicator has red “X” Replace batteries. If red “X”
indicating failure to operate remains, return to ZOLL
(when off). Technical Support for service.

Maintenance and Troubleshooting
This section describes the following functions to maintain the ZOLL AED Plus:
• Maintaining the Unit
• Cleaning the Unit
• Optional Maintenance for Technical Professionals
• Troubleshooting
Maintaining the Unit

• Inspect frequently, as necessary.
• Check for the green check ( ) showing that the unit is ready to use.
• Verify that electrodes are within their expiration date.
• Verify that batteries are within their expiration date.
• Verify that electrodes are pre-connected to the input connector.
• Verify that supplies are available for use (razor, mask, gloves, extra batteries.)
Maintenance Checklist
Use the following maintenance checklist when you periodically check your unit.
Table 4: Maintenance Checklist
Check the following Pass Fail
Is the unit clean, undamaged, free of excessive wear?
Are there any cracks or loose parts in the housing?
Verify electrodes are connected to the unit and sealed in their package.
Replace if expired.
Are all cables free of cracks, cuts and exposed or broken wires?
Turn the unit on and off and verify the green check indicates ready for use.
Batteries within expiration date. Replace if expired.
Check for adequate supplies.
Cleaning the Unit

• After each use, clean and disinfect the unit with a soft, damp cloth using 90% isopropyl alcohol,
or soap and water, or chlorine bleach and water mixture (30 ml/liter water).
• Do not immerse any part of the unit in water.
• Do not use ketones (MEK, acetone, etc.) to clean the unit.
• Avoid using abrasives (e.g., paper towel) on the display window or IrDa port.
• Do not sterilize the device.

Optional Maintenance for Technical Professionals
The ZOLL AED Plus unit automatically performs maintenance testing during periodic self tests.
However, if a qualified technical professional wishes to test the ZOLL AED Plus further, the following
checkout procedure can be followed:
1. Connect a ZOLL AED Plus Simulator/Tester (or equivalent) to the unit’s patient connector.
2. Power on the simulator and ZOLL AED Plus unit. Verify that all of the following occur:
• The status indicator (located on the left side of the handle) initially displays a red “X” which
changes to a green check ( ) within 4 to 5 seconds after the unit is turned on.
• All top panel user interface lights (LEDs) illuminate sequentially.
• The unit issues the UNIT OK voice prompt within 5 seconds after power-up (and displays the
message if equipped with an LCD).
• If the unit has an LCD, the message “SHOCKS: 0” appears in the upper left corner and the
elapsed time (since power-up) appears in the upper right corner of the screen.
3. Using the simulator, input a VF rhythm to the ZOLL AED Plus. Verify that after the ZOLL AED
Plus unit proceeds through its sequence of patient assessment prompts, it:
• analyzes the ECG rhythm
• issues the SHOCK ADVISED voice prompt
• charges the defibrillator
• issues the DON’T TOUCH PATIENT, PRESS FLASHING SHOCK BUTTON voice prompt
4. Verify that the charge ready tone is heard and that the Shock Button illuminates.
5. Press the Shock Button and verify that the simulator shows that a shock was delivered. Verify that
the message “Shocks: 1” displays on LCD screen.
NOTE This test checks the device’s ability to defibrillate. It does not, however, verify that the correct
defibrillation energy was delivered. A defibrillator analyzer should be used in place of the ZOLL AED
Plus simulator/tester to verify the accuracy of the delivered energy.
6. Following shock delivery, verify that the AED Plus unit issues the START CPR messages.
7. Activate the simulator’s CPR function. Verify that the metronome begins to beep and that the
following voice prompts/messages are issued within 60 seconds: PUSH HARDER followed by
GOOD COMPRESSIONS.
8. After approximately two minutes of CPR, verify that the STOP CPR prompt is issued. Set the
simulator to NSR and verify that a new ECG analysis begins.
9. Verify that a NO SHOCK ADVISED prompt is issued.
10. Turn the ZOLL AED Plus and Simulator off.
See "Preparing the ZOLL AED Plus for Use" on page 15 for instructions on placing the ZOLL AED
Plus unit back into service.

Troubleshooting
The following table summarizes common error indications on the unit, and their associated corrective
action. Return the unit to ZOLL’s Technical Service Department if the unit is not working properly.
Table 5: Troubleshooting
Technical Problem Recommended Action
Self test failed. Initiate manual self test by pressing and holding the
ON/OFF Button for more than 5 seconds. Attempt
to repair the device by replacing the batteries or
electrodes. If unit fails test again, remove unit from
service and contact ZOLL Technical Service.
CHANGE BATTERIES prompt. Replace all batteries with new batteries at the same
time. Press the Battery Reset Button when
prompted.
Red “X” in status indicator window. Initiate manual self test by pressing and holding the
ON/OFF Button for more than 5 seconds.
Check to see if cable is attached properly to unit or
replace the electrodes.
Cycle power on the ZOLL AED Plus unit by
turning the unit off, then on again.
Replace all batteries at the same time with new
batteries. Press the Battery Reset Button when
prompted.
If unit still does not operate correctly, remove unit
from service and contact ZOLL Technical Service.
Beeping noise when unit is off. Remove unit from service and replace batteries.
Replace all batteries at the same time with new
batteries. Press the Battery Reset Button when
prompted.
If beeping continues, contact ZOLL Technical
Service.
PLUG IN CABLE prompt. Check cable connection between electrodes and

ZOLL AED Plus unit.
ANALYSIS HALTED. KEEP PATIENT Excessive artifact detected during ECG analysis.
STILL prompt. Patient must be motionless during ECG analysis.
Do not touch the patient during analysis. Keep the
patient still. If the rescuer is using the device in an
emergency vehicle, bring the vehicle to a halt
before performing ECG analysis.
RELEASE SHOCK BUTTON prompt. Release Shock Button, then press and hold Shock
Button until discharge occurs. If voice prompt
continues, contact ZOLL Technical Service.

Contacting Technical Service
If a ZOLL product requires service, contact the ZOLL Technical Service Department:
Telephone: 1-978-421-9655
Toll free: 1-800-348-9011
Fax: 1-978-421-0010
Have the following information available for the Technical Service representative:
• Unit serial number.
• Description of the problem.
• Purchase Order or credit card number to allow tracking of loan equipment.
• Purchase Order or credit card number for a unit with an expired warranty.
If you need to send the unit to ZOLL Medical Corporation, obtain a service order request number from
the Technical Service representative. Units are available on loan at an additional cost while your unit is
being repaired.
Remove all batteries from the unit and return the unit and batteries in its original container (or
equivalent packaging) with the service order request number on it to the following address:
ZOLL Medical Corporation
269 Mill Road
Chelmsford, MA 01824-4105
Attn: Technical Service Department
International Customers
Customers outside of the United States should remove all batteries from the unit and return the unit and
batteries in its original container (or equivalent packaging) to the nearest authorized ZOLL Medical
Corporation Service Center. To locate an authorized service center, contact the nearest ZOLL Sales
office or authorized distributor.

ZOLL Administration Software
ZOLL Administration Software helps you perform software maintenance tasks when your
defibrillator is connected to your personal computer (PC). ZOLL Administration Software lets you
upload data from a defibrillator to a PC, then transmit that data to your main network, or print the data
locally from your PC to your printer.
See the online Help for instructions on how to use ZOLL Administration Software.
Installing ZOLL Administration Software

To install ZOLL Administration Software, insert the ZOLL Administration Software CD into the
CD-ROM drive on your PC. The installation program starts automatically.
If the installation program does not start automatically:
• Select RUN from the Start menu.
• In the Open field, enter X:Setup.exe, where X is the correct letter of your CD-ROM drive.
• Click OK.
• Follow the instructions that appear on the screen to complete the installation.
RescueNet Code Review Software

RescueNet Code Review software allows you to analyze resuscitation incident information uploaded
from the ZOLL AED Plus defibrillator to a personal computer (PC). Using RescueNet Code Review
software, you can:
• access and review patient event information
• add or modify patient information
• view animated versions of ECG traces
• annotate ECG traces
• print ECG stripcharts and case reports
See the RescueNet Code Review User’s Guide for more information.
Setting Up Data Communications

You can exchange data between a ZOLL AED Plus unit and a personal computer without any cable
connection by transferring data using two IrDA (infrared interface standard) ports. One IrDA™ port
is located on the side of the ZOLL AED Plus unit. The second IrDA™ port may be on your personal
computer. In some cases, you will be sending data from the IrDA port on your unit to an IrDA port on
a modem which then transmits the data to a remote computer.
For best transmission results, IrDA ports must be facing each other and the path between the two
devices must be clear of obstacles. Beaming distances between devices may vary but should be at least
10 inches and not more than 18 inches. Power up the PC and have the ZOLL Administration Software
and/or RescueNet Code Review software running. Press and hold the ON/OFF Button on the AED for
at least 5 seconds to establish contact with the computer or modem. Once connected properly, you hear
the COMMUNICATIONS ESTABLISHED audio prompt and see a message on your computer screen
that the connection was successful.

Ordering Accessories
You can order the following accessories from the ZOLL Customer Service Department.
Table 6: Ordering Accessories
Item REF
CPR-D padz electrode including accessory kit 8900-0800-01
Adult stat padz II electrode (single) 8900-0801-01
Adult stat padz II electrode (case) 8900-0802-01
Pedi padz II electrode (single) 8900-0810-01
Set of 10 Batteries 8000-0807-01
Administrator’s Guide 9650-0301-01
Operator’s Guide 9650-0300-01
Simulator/Tester 8000-0800-01
Public Safety PASS 8000-0812-01
PASS Cover 8000-0808-01
Low Profile Cover 8000-0803-01
Soft Case 8000-0802-01
Universal Adapter Cable 8000-0804-01
Administration Guide with ZOLL Administration Software CD 9659-0302-01
Mounting Bracket 8000-0809-01
Flush Mount Wall Box 8000-0811
Recess Mount Wall Box 8000-0814
Surface Mount Wall Box 8000-0817
USB IrDA PC Adapter 8000-0815
RS-232 IrDA PC Adapter 8000-0816
RescueNet Code Review Software 8000-0813-01
AED Plus Trainer 8008-0104-01
Replacement Trainer 1008-0115-01
Replacement Trainer Control 1008-0113-01
Trainer AC Adapter
US 9355-0802
EURO 9355-0803
UK 9355-0804
Switzerland 9355-0805
Australia 9355-0806
Trainer Cord 9355-0801

Appendix A: Specifications
Table 7: General Specifications
DEVICE
Size (H x W x D) 5.25" x 9.50" x 11.50"; 13.3 cm x 24. 1 cm x 29.2 cm
Weight 6.7 lbs.; 3.1 kg
Power User Replaceable Batteries. 10 -Type 123A Photo Flash lithium

manganese dioxide batteries
Device Classification Class II and internally powered per EN60601-1
Design Standards Meets applicable requirements of UL 2601, AAMI DF-39,

IEC 601-2-4, EN 60601-1, IEC 60601-1-2
ENVIRONMENT
Operating Temperature PS Model: 32° to 122° F; 0° to 50° C

PA Model: 50° to 104° F; 10° to 40° C
Storage Temperature PS Model: -22° to 158° F; -30° to 60° C

PA Model: 32° to 122° F; 0° to 50° C
Humidity: 10 to 95% relative humidity, non-condensing
Vibration MIL Std. 810F, Min Helicopter Test
Shock PS Model: IEC 68-2-27; 100G

PA Model: IEC 68-2-27; 50G
Altitude PS Model: -300 to 15,000 ft.; -91m to 4573m

PA Model: -300 to 7,500 ft.; -91m to 2287m
Aircraft Method RTCA/DO-160D: 1997

Section 21, Category M – all operating modes.
Particle and Water Ingress IP-55
DEFIBRILLATOR
Waveform Rectilinear Biphasic
Defibrillator Charge Hold 30 seconds

Time
Energy Selection Automatic pre-programmed selection

(Adult mode: 120J, 150J, 200J; Pediatric mode: 50J, 70J, 85J)
Patient Safety All patient connections are electrically isolated.
Charge Time Less than 10 seconds with new batteries.
Electrodes ZOLL stat padz II, CPR-D padz or Pedi Padz II
Built in Defibrillator Self Test Included

DEFIBRILLATOR (cont’d)
CPR *Metronome Rate: Variable 60 to 100 CPM

Depth: ¾" to 3"; 1.9 to 7.6 cm
Defibrillation Advisory Evaluates electrode connection and patient ECG to determine if

defibrillation is required.
Shockable Rhythms: Venticular fibrillation with average
amplitude>100 microvolts and wide complex ventricular
tachycardia with rates greater than 150 BPM (adult mode) and
200 BPM (pediatric mode). Refer to ECG Analysis Algorithm
Accuracy Section for sensitivity and specificity performance.
Electrode Patient Impedance 0 to 300 ohms

Measurement Range
Defibrillator Electrode ECG Protected

Circuitry
ECG Bandwidth 2-30Hz
Display Format Optional LCD with Moving Bar

Size: 2.6" x 1.3"; 6.6 cm x 3.3 cm
Viewing Time: 2.6 seconds
Display Sweep Speed 25 mm/sec
Battery Capacity Typical new battery (20° C):

• stand-by life with batteries installed: 5 years, or
• 300 continuous shocks, or
• at least 13 hours of continuous Monitoring time
PC Minimum Requirements Windows® 98, Windows® 2000 Windows®NT, Windows® XP

IBM-compatible PII with 16550 UART (or higher) computer
64MB RAM.
VGA monitor or better
CD-ROM drive
IrDA™ port
20MB disk space
*
Testing reports validating performance and accuracy of CPR depth measurement capability,
metronome feature function and rescuer performance, and the PASS (Passive Airway Support
System) cover function are on file with ZOLL Medical Corporation and are available for review.
Contact ZOLL Technical Support to request a copy of the following report(s) if desired:
• Using the ZOLL AED Plus Cover to Aid in Airway Patency
• Depth and Compression Rate Response of the ZOLL AED Plus CPR System
• ZOLL AED Plus CPR System Test Results.

Guidance and Manufacturer’s Declaration - Electromagnetic
Emissions
Table 8: EMC Specifications
The ZOLL AED Plus is intended for use in the electromagnetic environment specified below.
The customer or the user of the ZOLL AED Plus should assure that it is used in such an
environment.
Emissions test Compliance Electromagnetic environment -

guidance
RF emissions CISPR11 Group 1 The ZOLL AED Plus uses RF

energy only for its internal function.
Therefore, its RF emissions are very
low and are not likely to cause any
interference in nearby electronic
equipment.
RF emissions CISPR 11 Class B
Harmonic Emission Not applicable

IEC 61000 3-2
Voltage Fluctuations/Flicker Not applicable

Emission
IEC 61000 3-3
Medical Electrical Equipment needs special precautions regarding EMC and needs to be installed and
put into service according to EMC information provided in this document.
environment.
Immunity test IEC 60601 test Compliance Electromagnetic environment -

level level guidance
Electrostatic ± 6 kV contact ± 6 kV contact Floors should be wood, concrete or

discharge (ESD) ± 8 kV air ± 8 kV air ceramic tile. If floors are covered with
IEC 61000-4-2 synthetic material, the relative
humidity should be at least 30%.
Electrical fast ± 2 kV for power Not applicable

transient/burst supply lines
IEC 61000-4-4 ± 1 kV for input/ ± 1 kV I/O
output lines
Surge ± 1 kV differential Not applicable

IEC 61000-4-5 mode
+/- 2 kV common Not applicable
mode

Voltage dips, <5% Ut (>95% dip Not applicable

short in Ut) for 0.5 cycle
interruptions and 40% Ut (60% dip in Not applicable
voltage variations Ut) for 5 cycles
on power supply 70% Ut (30% dip in Not applicable
input lines. Ut) for 25 cycles
IEC 61000-4-11 <5% Ut (>95%dip Not applicable
in Ut) for 5 sec
Power frequency 3 A/m 3 A/m Power frequency magnetic fields

(50/60 Hz) should be at levels characteristic of a
magnetic field typical location in a typical
IEC 61000-4-8 commercial or hospital environment
NOTE Ut is the a.c. mains voltage prior to application of the test level.
environment.

Portable and mobile RF

communications equipment should be
used no closer to any part of the
ZOLL AED Plus, 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 = 1.17 √P

IEC 61000-4-6 150 kHz to 80 MHz
outside ISM bandsa
10 Vrms 10 Vrms d = 1.20 √P

150 kHz to 80 MHz
in ISM bandsa

(cont’d) level (cont’d) level (cont’d) guidance (cont’d)
Recommended separation distance
Radiated RF 10 V/m 10 V/m d = 1.20 √P 80 MHz to 800 MHz

IEC 61000-4-3 80 MHz to 2.5 GHz
d = 2.30 √P 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
metres (m).b
Field strengths from fixed RF
transmitters, as determined by an
electromagnetic site survey,c should
be less than the compliance level in
each frequency range.d
Interference may occur in the vicinity
of equipment marked with the
following symbol:
NOTE 1 At 80 MHz, the higher frequency range applies.

NOTE 2 These guidelines may not apply in all situations. Electromagnetic propagation is affected by
absorption and reflection from structures, objects and people.
a
The ISM (industrial, scientific and medical) bands between 150 KHz and 80 MHz are 6.765 MHz to
6.795 MHz; 13.553 MHz to 13.567 MHz; 26.957 MHz to 27.283 MHz; and 40.66 MHz to 40.70
MHz.
b
The compliance levels in the ISM frequency bands between 150 kHz and 80 MHz and in the
frequency range 80 MHz to 2.5 GHz are intended to decrease the likelihood that mobile/portable
communications equipment could cause interference if it is inadvertently brought into patient areas.
For this reason, an additional factor of 10/3 is used in calculating the recommended separation
distance for transmitters in these frequency ranges.
c
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 ZOLL AED Plus is used exceeds the applicable RF compliance level
above, the ZOLL AED Plus should be observed to verify normal operation. If abnormal
performance is observed, additional measures may be necessary, such as reorienting or relocating
the ZOLL AED Plus.
d
Over the frequency range 150 kHz to 80 MHz, field strengths should be less than 10 V/m.

Recommended separation distances between portable and mobile RF communications
equipment and the ZOLL AED Plus
The ZOLL AED Plus is intended for use in an environment in which radiated RF disturbances are controlled. The
customer or the user of the ZOLL AED Plus can help prevent electromagnetic interference by maintaining a
minimum distance between portable and mobile RF communications equipment (transmitters) and the ZOLL
AED Plus as recommended below, according to the maximum output power of the communications equipment.
Separation distance according to frequency of transmitter

m
Rated maximum 150 kHz to 80 150 kHz to 80 80 MHz to 800 800MHz to 2.5
output power of MHz outside MHz in ISM MHz GHz
transmitter ISM bands bands
W d =[ 3.5
3
] √P d = [ 12
10 √P
] d = [ 12
10 √P
] d =[ 23 ]
10 √P
0.01 0.17 0.12 0.12 0.23
0.1 0.37 0.38 0.38 0.73
1 1.17 1.20 1.20 2.3
10 3.69 3.79 3.79 7.27
100 11.70 12.00 12.00 23.00
For transmitters rated at a maximum output power not listed above, the recommended separation
distance d in metres (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 The ISM (industrial, scientific and medical) bands between 150 kHz and 80 MHz are 6.765
MHz to 6.795 MHz; 13.553 MHz to 13.567 MHz; 26.957 MHz to 27.283 MHz; and 40.66 MHz to
40.70 MHz.
NOTE 3 An additional factor of 10/3 is used in calculating the recommended separation distance for
transmitters in the ISM frequency bands between 150 kHz and 80 MHz and in the frequency range
80 MHz to 2.5 GHz to decrease the likelihood that mobile/portable communications equipment
could cause interference if it is inadvertently brought into patient areas.
NOTE 4 These guidelines may not apply in all situations. Electromagnetic propagation is affected by
absorption and reflection from structures, objects and people.

Rectilinear Biphasic Waveform Characteristics
The following table shows the Rectilinear Biphasic waveform’s characteristics when discharged into
25 ohm, 50 ohm, 100 ohm, and 125 ohm loads at a maximum energy setting of 200 Joules.
Table 9: Biphasic Waveform
Discharged Discharged Discharged Discharged

into 25 ohm into 50 ohm into 100 ohm into 125 ohm
load load load load
First Phase 32 A 26 A 21 A 17 A
Maximum Initial
Current
First Phase 28 A 22A 16 A 13 A

Average Current
First Phase Duration 6 ms 6 ms 6 ms 6 ms
Interphase duration 150 µsec 150 µsec 150 µsec 150 µsec
between first and second
phases
Second Phase Maximum 33 A 19 A 12 A 11 A

Initial Current
Second Phase Average 21 A 14 A 11 A 10 A

Current
Second Phase Duration 4 ms 4 ms 4 ms 4 ms
The efficacy of ZOLL's Rectilinear Biphasic Waveform has been clinically verified during a
Ventricular Fibrillation (VF) and Ventricular Tachycardia (VT) defibrillation study. This study (which
was conducted using ZOLL M Series defibrillators) and the findings are described below. Since the
ZOLL AED Plus's rectilinear biphasic waveform employs the same first and second phase timing,
similar first and second phase currents/voltages and essentially the same mechanisms for controlling
defibrillation waveshape, the ZOLL M Series and ZOLL AED Plus defibrillation waveforms are
considered substantially equivalent.

Clinical Trial Results for the M Series Biphasic Waveform
The efficacy of ZOLL’s Rectilinear Biphasic Waveform has been clinically verified during a study of
defibrillation of Ventricular Fibrillation (VF)/Ventricular Tachycardia (VT). A feasibility study was
performed initially for defibrillation of VF/VT (n=20) on two separate groups of patients to ensure
waveform safety and energy selection. Subsequently a separate, multi-center, randomized clinical trial
was performed to verify the waveform’s efficacy. A description of this study is provided below. The
study was performed using ZOLL defibrillation systems consisting of ZOLL defibrillators, the ZOLL
Rectilinear Biphasic Waveform and ZOLL Multi-Function Pads.
Randomized Multi-Center Clinical Trial for Defibrillation of Ventricular Fibrillation

(VF) and Ventricular Tachycardia (VT)
Overview: The defibrillation efficacy of ZOLL’s Rectilinear Biphasic Waveform was compared to a
monophasic damped sine waveform in a prospective, randomized, multi-center study of patients
undergoing ventricular defibrillation for VF/VT during electro-physiological studies, ICD implants and
test. A total of 194 patients were enrolled in the study. Ten (10) patients who did not satisfy all protocol
criteria were excluded from the analysis.
Objectives: The primary goal of this study was to compare the first shock efficacy of the 120J
Rectilinear Biphasic Waveform with a 200J monophasic waveform. The secondary goal was to compare
all shock (three consecutive 120, 150, 170J) efficacy of the Rectilinear Biphasic Waveform with that of
a monophasic waveform (three consecutive 200, 300, 360J). A significance level of p=0.05 or less was
considered statistically significant using Fischer’s Exact test. Also, differences between the two
waveforms were considered statistically significant when the customary 95% or AHA recommended
90%* confidence interval between the two waveforms was greater than 0%.
Results: The study population of 184 patients had a mean age of 63 ±14 years. 143 patients were males.
98 patients were in the biphasic group (ventricular fibrillation/flutter, n=80, ventricular tachycardia,
n=18) and 86 patients were in the monophasic group (ventricular fibrillation/flutter, n=76, ventricular
tachycardia, n=10). There were no adverse events or injuries related to the study.
The first shock, first induction efficacy of biphasic shocks at 120J was 99% versus 93% for monophasic
shocks at 200J (p=0.0517, 95% confidence interval of the difference of -2.7% to 16.5% and 90%
confidence interval of the difference of -1.01% to 15.3%).
Monophasic Biphasic
1st Shock Efficacy 93% 99%
p-value 0.0517
95% Confidence Interval -2.7% to 16.5%
Successful defibrillation with rectilinear biphasic shocks was achieved with 58% less delivered
current than with monophasic shocks (14 ±1 vs. 33 ±7 A, p=0.0001).

The difference in efficacy between the rectilinear biphasic and the monophasic shocks was greater in
patients with high transthoracic impedance (greater than 90 ohms). The first shock, first induction
efficacy of biphasic shocks was 100% versus 63% for monophasic shocks for patients with high
impedance (p=0.02, 95% confidence interval of the difference of -0.021% to 0.759% and 90%
confidence interval of the difference of 0.037% to 0.706%).
Monophasic Biphasic
1st Shock Efficacy (High 63% 100%

Impedance Patients)
p-value 0.02
90% Confidence Interval 0.037% to 0.706%
A single patient required a second biphasic shock at 150J to achieve 100% efficacy versus six patients
for whom monophasic shocks of up to 360J were required for 100% total defibrillation efficacy.
Conclusion: The data demonstrate the equivalent efficacy of low energy rectilinear biphasic shocks
compared to standard high energy monophasic shocks for transthoracic defibrillation for all patients
at the 95% confidence level. The data also demonstrate the superior efficacy of low energy rectilinear
biphasic shocks compared to standard high energy monophasic shocks in patients with high
transthoracic impedance at the 90% confidence level. There were no unsafe outcomes or adverse
events due to the use of the rectilinear biphasic waveform.
* Kerber, R., et. al., AHA Scientific Statement, Circulation, 1997; 95: 1677-1682:
“... the task force suggests that to demonstrate superiority of an alternative waveform over standard
waveforms, the upper boundary of the 90% confidence interval of the difference between standard and
alternative waveforms must be < 0% (i.e., alternative is greater than standard).”

ECG Analysis Algorithm Accuracy
Sensitivity and specificity are expressions of ECG analysis algorithm performance when compared to
ECG interpretation by a clinician or expert. Sensitivity refers to the algorithm’s ability to correctly
identify shockable rhythms (as a percentage of the total number of shockable rhythms); specificity
refers to the algorithm’s ability to correctly identify non-shockable rhythms (as a percentage of the total
number of non-shockable rhythms). The data in Table 10 and Table 11 summarizes the accuracy of the
ECG analysis algorithm as tested against ZOLL’s ECG Rhythm Database.
The algorithm sequence takes approximately 9 seconds and proceeds as follows:
• Divides the ECG rhythm into three-second segments.
• Filters and measures noise, artifact, and baseline wander.
• Measures baseline content (‘waviness’ at the correct frequencies - frequency domain analysis) of
signal.
• Measures QRS rate, width, and variability.
• Measures amplitude and temporal regularity (‘auto-correlation’) of peaks and troughs.
• Determines if multiple 3 second segments are shockable then prompts the user to treat patient.
Table 10: Clinical Performance Results (Adult Patients)
Rhythms Sample Performance Observed 90% One-sided

Size Goals Performance Lower
Confidence
Limit
Shockable (250 Total min.) 618

Coarse VF 535 >90% sensitivity 97.38% 95.65%
Rapid VT 83 >75% sensitivity 91.57% 83.39%
Non-shockable (300 Total min.) 3039
NSR 2205 >99% specificity 99.86% 99.60%
AF, SB, SVT, Heart block, 770 >95% specificity 100% 99.52%
idioventricular, PVCs
Asystole 64 >95% specificity 100% 99.40%
Intermediate 88
Fine VF 64 Report only 93.75% sensitivity 84.76%
Other VT 24 Report only 91.67% sensitivity 73.00%

Table 11: Clinical Performance Results (Pediatric Patients)
Rhythms Sample Performance Observed 90%

Size Goals Performance One-sided Lower
(9 second Confidence Limit
records)
Shockable (23 Patients)

Coarse VF (1) 42 >90% sensitivity 100% (42/42) 93.1%
Rapid VT (2) 51 >75% sensitivity 92.2% (47/51) 82.9%
Non-shockable (121 Patients)
NSR (3) 229 >99% specificity 100% (229/229) 98.7%
AF, SB, SVT*, Heart block, 415 >95% specificity 100% (415/415) 99.3%
idioventricular, PVCs (4)
Asystole (5) 14 >95% specificity 100% (14/14) 80.7%
Intermediate (15 Patients)
Fine VF (6) 0 Report only NA ---
Other VT (7) 22 Report only 77.3% (17/22) 58.0%
*155 of the 415 abnormal rhythm records were SVT (39 patients).
1. Arrhythmia Performance is reported according to the article, RE Kerber, LB Becker, JD Bourland,

RO Cummins, AP Hallstrom, MB Michos, G Nichol, JP Ornato, WH Thies, RD White, BD
Zuckerman, “Automated External Defibrillators for Public Access Defibrillation:
Recommendations for Specifying and Reporting Arrhythmia Analysis Algorithm Performance,
Incorporation New Waveforms, and Enhancing Safety”, Circulation 1997, Vol 95, No 6, 1677-1681
References:
Young KD, Lewis RJ: “What is confidence? Part 2: Detailed definition and determination of
confidence intervals”. Annals of Emergency Medicine, September 1997; 30; 311-218
“CRC Standard Mathematical Tables 28th Edition”, William H. Beyer, Ph.D., CRC Press, Inc, Boca
Raton, FL., 1981, Percentage Points, F-Distribution Table, pg 573.

ZOLL AED Plus Administrator’s Guide Insert
Important: This symbol indicates that the AED Plus unit is equipped for
treating adult and pediatric patients. An AED Plus unit without this symbol is not
TM
equipped to treat pediatric patients and will not work with the pedi•padz II pediatric
electrodes. To upgrade an AED Plus unit for use with ZOLL pedi•padz II pediatric
electrodes, contact ZOLL Medical Corporation or an authorized ZOLL distributor for
information on the ZOLL AED Plus Pediatric Upgrade Kit.
If an AED Plus unit is equipped for treating adult and pediatric patients, when you
connect the cable for adult electrodes, the AED Plus unit switches automatically to adult mode for cardiac
rhythm detection and automatic shock energy selection (120 Joules, 150 Joules, 200 Joules) and issues the
voice and display prompt , ADULT PADS. When you connect the cable for ZOLL pedi•padz II pediatric
electrodes, the AED PLUS unit switches automatically to pediatric mode for cardiac rhythm detection and
automatic shock energy selection (50 Joules, 70 Joules, 85 Joules) and issues the voice and display
prompt, PEDIATRIC PADS.
Applying pedi•padz II (Infant/Child) Electrodes

Prepare the patient before attaching the pedi•padz II electrodes.

To apply the pedi•padz II electrodes:

1. Tear open the electrode package and unfold the inner package to expose the electrodes. Place the
electrodes on the patient according to the graphics on the electrode package.
2. Remove the round electrode from its backing material and place it on
the patient’s chest (as shown on the electrode package graphics).
3. Place your hand on the electrode edge and, using the other
hand, gently roll the electrode onto the patient’s chest, pushing any
air out from beneath the electrode as you go.
4. Roll the patient onto his/her chest, remove the square electrode
from its backing and place it on the patient’s back (as shown on the
electrode package graphics).
5. Place your hand on the electrode’s edge and, using your other
hand, gently roll the electrode onto the patient’s skin, pushing any
air out from beneath the electrode as you go.
6. Roll the patient onto his/her back and follow the ZOLL AED Plus
prompts.
NOTE You can also use pedi•padz II (infant/child electrodes) with ZOLL pacemaker products for up to
one hour of pacing (see the M Series Operator’s Guide for information about pacing).
Indications for Use

Use the ZOLL AED Plus when a suspected cardiac arrest victim has an apparent LACK OF CIRCULATION
as indicated by
Unconsciousness; and
Absence of normal breathing; and
Absence of a pulse or signs of circulation.
When the victim is less than 8 years of age and weighs less than 55 lbs (25 kg), the ZOLL AED Plus should
be used with the ZOLL AED Plus Pediatric Electrodes. Therapy should not be delayed to determine the
patient’s exact age or weight.
9652-0839-01 Rev. B
Warning! Set-up and Check-out Procedure:
Use the AED Plus unit only as described in this manual. Improper use of the 1. Insert 10 new batteries into AED Plus unit.
device can cause death or injury. 2. Connect electrode cable to AED Plus unit and pack sealed electrodes
DO NOT use or place the AED Plus unit in service until you have read the AED inside unit cover. Close cover.
Plus Operator’s and Administrator’s Guides. 3. Turn unit on and wait for “Unit OK” audio message. Verify that unit
DO NOT use or place the AED Plus unit in service if the unit’s status indicator
issues appropriate “Adult Pads” or “Pediatric Pads” audio message.
window (located on the left side of the handle) displays a red “X”. 4. Turn unit off.
5. Wait 2 minutes. Verify that green check symbol ( ) appears in status
DO NOT use or place the AED Plus unit in service if the unit emits a beeping tone.
indicator window (located on left side of handle) and that unit does not
Connect the electrode cable to the AED Plus unit after installing batteries. emit a beeping tone.
Keep the electrode cable connected to the AED Plus unit at all times. 6. Place AED Plus unit in service.
This device should only be used by properly trained individuals. 7. Check AED Plus unit periodically to ensure that green check symbol ( )
Only use electrodes labeled “Infant/Child” on children less than 8 years old or appears in status indicator window.
weighing less than 55 lbs (25 kg). Use CPR-D padz if patient is older than 8 years
or weighs more than 55 lbs (25 kg).
Battery Replacement
Always stand clear of patient when delivering treatment. Defibrillation energy Replace batteries before expiration date or if unit prompts. Use only type
delivered to the patient may be conducted through the patient’s body and cause
a lethal shock to those touching the patient. 123A lithium manganese dioxide batteries from recommended manufacturers.
DO NOT touch the electrode surfaces, the patient, or any conductive material Remove all batteries from battery compartment and discard before
touching the patient during ECG analysis or defibrillation. installing any new batteries.
Insert 10 new batteries into battery well. Do not use old batteries.
Move patient away from electrically conductive surfaces prior to use of equipment.
Press button in battery well only after installation of new batteries.
DO NOT use the unit near or within puddles of water.
Keep the patient as motionless as possible during ECG analysis.
DO NOT use the unit near flammable agents, such as gasoline, oxygen-rich
Cleaning
atmospheres, or flammable anesthetics. Clean and disinfect unit with soft, damp cloth using 90% isopropyl
Avoid radio frequency interference from high-power sources that might cause the alcohol or soap and water, or chlorine bleach (30 ml/liter water).
defibrillator to interpret cardiac rhythms incorrectly by turning off cell phones and Do not immerse any part of the unit in water.
2-way radios. Do not use ketones (MEK, acetone, etc.).
Avoid using abrasives (e.g., paper towels) on the LCD display, if so
Disconnect non-defibrillation protected electronic devices or equipment from
patient before defibrillation. equipped.
Do not sterilize the unit.
Dry victim’s chest, if wet, before attaching electrodes.
Apply freshly opened and undamaged electrodes, within the electrode expiration
date, to clean and dry skin to minimize burning.
DO NOT place electrodes directly over the patient’s implanted pacemaker.
Pacemaker stimuli may degrade the accuracy of ECG rhythm analyses or the
TROUBLESHOOTING Automated External Defibrillator
Operator’s Guide
pacemaker may be damaged by defibrillator discharges.
Check labeling inside the ZOLL AED Plus cover before using the cover as a Passive
Airway Support System (PASS) device to ensure it is intended for this use.
Problem Recommended Action
DO NOT use the Passive Airway Support System (PASS) if there is a suspected
head or neck injury. Place the patient on a firm surface before performing CPR.
Self-test failed. Manually test by pressing and AHA/ERC 2005
DO NOT recharge, disassemble, or dispose of batteries in fire. Batteries may
explode if mistreated. holding the ON/OFF button for
more than 5 seconds. If unit fails
DO NOT use or stack the AED PLUS unit with other equipment. If the unit is used test again, remove from service.
or stacked with other equipment, verify proper operation prior to use.
Caution!
“Change batteries” Replace all batteries at the For technical support or repair:
prompt. same time.
DO NOT disassemble the unit. A shock hazard exists. Refer all servicing to Technical Service Department
qualified personnel. Red “X” in Status Perform manual test.
Indicator window Check to see if cable is ZOLL Medical Corporation
Use only commercially available type 123A lithium manganese dioxide batteries. OR attached properly to unit.
Discard batteries properly after removal from unit. Use only batteries from 269 Mill Road
recommended manufacturers. See the AED Plus Administrator’s Guide (P/N beeping noise Replace batteries. Chelmsford, MA 01824-4105
9650-0301-01) for a list of recommended battery manufacturers. when unit is OFF. If unit still does not operate 978-421-9655 • 800-348-9011
correctly, remove from service. Fax: 978-421-0010
If the device is stored outside the recommended environmental conditions, the
electrode pads and/or batteries may be damaged or their useful life reduced.
Red “X” in Status Indicator Power cycle the unit. If Red “X”
The CPR-D Padz Electrode can be connected to other ZOLL defibrillators with window when unit is ON. is still present in Status Indicator International Service: Contact your local distributor.
Multifunction Cables. Defibrillation can be administered when connected to window, remove unit from
other ZOLL defibrillators.The CPR function does not operate with any device
service.
other than the AED Plus defibrillator.
Important!
This symbol indicates that an AED Plus unit is equipped for treating adult and
pediatric patients. An AED Plus unit without this symbol is not equipped to treat
pediatric patients and will NOT work with pedi•padz II ™ pediatric electrodes. To Federal (U.S.A.) law restricts this device for sale to or on the order of a physician. © ZOLL Medical Corp. Inc. 2006
upgrade an AED Plus unit for use with ZOLL pedi•padz II pediatric electrodes,
Conformité Européene - Complies with the Medical Device Directive 93/42/EEC REF 9650-0300-01 Rev. H
contact ZOLL Medical Corporation or an authorized ZOLL distributor for
information on the ZOLL AED Plus Pediatric Upgrade Kit.
Indicator light flashes. If unresponsive, Open Airway.
Indicator light flashes. Open airway.
Call for help.

What you see. Lift chin and tilt head back.
Option: Place Passive Airway
Call or send someone Support System (PASS) under
for help. shoulders to tilt head. DO NOT use
What you hear.
PASS if suspected head or neck injury.
What you do.

Indicator light flashes.
Check responsiveness.
Shout, "Are you OK?”

Check Breathing.
Indicator light flashes. Look for chest rising and falling.
as you shake the person.
Listen for air flow during exhalation.
Prompts you may see in the LCD screen: Check breathing. Feel for air flow during exhalation.
LCD screen Give two breaths. Look for normal breathing, coughing, or movement.
Text messages
Shock counter
Elapsed time If not breathing, Give 2 Breaths, 1 second per breath
(AHA Guidelines 2005 only).
ECG waveform
Stay calm.
Unit equipped to Attach defib pads to patient’s

treat adult and bare chest.
pediatric patients.
Attach adult or infant/child
electrode pads to patient's
start Turn unit on.
bare chest.
Place electrode pads as
Person collapses— Follow electrode pads
here suspected package instructions. shown on patients under
cardiac arrest. Unit OK. 8 years of age or < 55 lbs (25 kg).
Self-test; unit OK.

Start CPR.
After one shock... Indicator light flashes. Don't touch patient.
Other prompts you What you should do: Analyzing.
may hear: Administer CPR: Shock advised.
2 breaths for every Don't touch patient.
30 compressions. Press flashing shock button.
Plug in cable. Attach electrode cable. Give STAND CLEAR
Warning.
Unit failed. Turn unit off and then on. DO NOT touch patient.
If unit still fails, perform CPR. Press button.
Release shock button. Let go of shock button. Shock delivered.
Change batteries. Replace all 10 batteries.

After 2 minutes of CPR...
(n) shocks delivered.
Stop CPR.
No shock advised.
INDICATIONS FOR USE CONTRAINDICATIONS FOR USE INTENDED USER

Use when a patient has an apparent lack of Do NOT use when a patient: The ZOLL AED Plus external defibrillator is intended to be used by
circulation indicated by: Is conscious; or personnel who are qualified by training in the use of the AED Plus device
Unconsciousness; and Is breathing; or and basic life support, advanced life support, or other physician-
Absence of normal breathing; and Has a detectable pulse or other signs of circulation. authorized emergency medical response to defibrillate victims of cardiac ZOLL Medical Corporation
Absence of pulse or signs of circulation. arrest. The CPR monitoring function provides a metronome designed to 269 Mill Road
encourage rescuers to perform chest compressions at the AHA/ERC Chelmsford, MA 01824-4105
When a victim is less than 8 years of age or weighs less than 55 lbs 978-421-9655 • 800-348-9011
(25 kg), the ZOLL AED Plus should be used with ZOLL AED Plus recommended rate of 100 compressions per minute. Voice and visual
prompts encourage a compression depth of 1½ - 2 inches for adult www.zoll.com
Pediatric Electrodes. Therapy should not be delayed to determine the
patient’s exact age or weight. patients. The CPR monitoring function is not intended for use on patients

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Administrator’s Guide

REF 9650-0301-01 Rev. M

ZOLL ADMINISTRATION SOFTWARE ........................................................................................................................... 25

ZOLL AED PLUS Administrator’s Guide iii

iv ZOLL AED PLUS Administrator’s Guide

ZOLL AED PLUS Administrator’s Guide v

vi ZOLL AED PLUS Administrator’s Guide

Indications for Use

Contraindications for Use

Intended Users of the Device

ZOLL AED PLUS Administrator’s Guide vii

Notification of Adverse Events

NOTE Notes contain additional information on using the defibrillator.

viii ZOLL AED PLUS Administrator’s Guide

Defibrillation protected Type BF patient connection

ATTENTION: Refer to manual for more information

Not new battery cells

New battery cells

Do Not push button

Do not use this manufacturer

Ok to use this manufacturer

Unit equipped to treat adult and pediatric patients

Authorized representative in the European

Consult instructions for use

ZOLL AED PLUS Administrator’s Guide ix

ZOLL AED PLUS Administrator’s Guide 1

2 ZOLL AED PLUS Administrator’s Guide

Operating Controls and Indicators

Patient Connector LCD Display (not supplied on

Graphics Indicator Lights

Battery Compartment (bottom)

Carrying Handle Microphone (hidden)

Figure 1: Identifying Operating Controls and Indicators

ZOLL AED PLUS Administrator’s Guide 3

ON/OFF Button Turns power ON or OFF.

4 ZOLL AED PLUS Administrator’s Guide

Figure 2: Graphical User Interface

ZOLL AED PLUS Administrator’s Guide 5

Voice Prompt Definition

CHECK RESPONSIVENESS. Check patient for responsiveness/consciousness by gently

6 ZOLL AED PLUS Administrator’s Guide

SHOCK ADVISED. ECG rhythm analysis has detected the presence of VF or

START CPR. Begin CPR.

GOOD COMPRESSIONS. After prompting to Push Harder, rescuer has succeeded in

ZOLL AED PLUS Administrator’s Guide 7

Voice Prompt Definition

8 ZOLL AED PLUS Administrator’s Guide

SHOCKS: 05 05:25 SHOCKS: 05 05:25

With ECG Without ECG

Figure 3: LCD Displays

ZOLL AED PLUS Administrator’s Guide 9

Figure 4: Using the PASS Cover

10 ZOLL AED PLUS Administrator’s Guide

The electrode package may include:

ZOLL AED PLUS Administrator’s Guide 11

To prepare the patient:

ZOLL Medical Corporation 269 Mill Road

Figure 5: Placement of CPR-D padz

12 ZOLL AED PLUS Administrator’s Guide

Figure 6: Placement of pedi padz II