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Philips HeartStart MRx ALS monitor

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12-Lead ECG view Philips HeartStart MRx ALS monitor
The HeartStart MRx is the ONLY monitor that displays ALL 12 leads at the same time. This allows the care provider to view and interpret all 12 leads without having to waste valuable time waiting for a printout. Plus caregivers can be confident that they are acquiring a quality 12-lead ECG prior to analysis, interpretation, data capture, and transmission.
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© 2009 Koninklijke Philips Electronics N.V. All rights are reserved.
Philips Healthcare reserves the right to make changes in specifications and/or to discontinue any product at any time without notice or obligation and will not be liable for any consequences resulting from the use of this publication.
Philips Healthcare is part of Royal Philips Electronics
www.philips.com/healthcare [email protected]
Philips Healthcare 3000 Minuteman Road Andover, MA 01810
Please visit www.philips.com/ems
12-Lead ECG view
Philips HeartStart MRx features and benefits
ONLY monitor that displays ALL 12 leads at the same time The benefit of seeing all leads at once offers the clinician:
Ability to see if a lead is off• Ability to acquire, store and transmit a clean 12-lead ECG • the first time Ability to see ST changes in contiguous leads as they occur•
12-lead interpretation and analysis Available on-screen: confirms paramedic’s diagnosis without • waiting for a printed report Performed using Philips DXL algorithm• Critical Values alerts the clinician to any of four • life-threatening conditions
Culprit artery (identifies the occluded vessel) analysis tailored • for pediatric and adult patients Enhanced gender specific • Transmission via Bluetooth and internet is fast and reliable•
STEMI Decision Support Tools to provide clinicians with additional data to support diagnosis or treatment:
Culprit artery• Critical Values• Acute Cardiac Ischemia – Time Insensitive Predictive Instrument • (ACI-TIPI) Thrombolytic Predictive Instrument (TPI)•
Feature Expected benefit Philips MRx
Physio- Control LP12 LP15
Zoll E-Series M-Series CCT
12-lead ECG acquisition Provides the most information at a critical time. 12-lead view No scrolling saves time in checking lead quality 4
Send it right the first time Clinician can see contiguous leads to determine arrhythmias
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STEMI decision support tools Supporting confident decision making: Speeding discovery-to-treatment
12-lead transmission Quick reliable transmission of 12-lead ECG 4 4 4
4 different critical values Identifies multiple life-threatening conditions, not just Acute MI 4
STEMI - Culprit Artery Detection Algorithm notifies clinician of occluded vessel on display 4
Acute Cardiac Ischemia – Time Insensitive Predictive Instrument (ACI-TIPI)
A predictive instrument that uses the 12-lead ECG to generate a 0-100% predicted probability that the patient is experiencing acute cardiac ischemia
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Thrombolytic Predictive Instrument (TPI)
A predictive instrument that uses the 12-lead ECG to predict patient outcome with and without thrombolytic therapy
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12-lead ECG is not available on the LP20 or R-Series.
Physio-Control and LifePak are registered trademarks of Medtronic Inc. Zoll, E-Series, M-Series, and R-Series are registered trademarks of Zoll Medical Inc.
DXL ECG Algorithm Philips HeartStart MRx ALS monitor
The Philips DXL ECG Algorithm is the only algorithm that conforms to the 2007 AHA/ACC/HRS statement recommendations for the standardization and interpretation of the ECG and guidelines for ST Segment Elevation Myocardial Infarction (STEMI) management. Pleth
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1234 HR 72 PR 152 QRSD 96 QT 385 QTc 422
P 71 QRS 54 T 1
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Glasgow Univ. (LP15)
Algorithm development Trusted partner for ECG rhythm analysis
Algorithm developed by monitor/ defibrillator manufacturer
Algorithm designed with clinical feedback from hospital and EMS thought leaders
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Algorithm is an industry standard Wide acceptance of the 12-lead algorithm 4 4
Conforms to the 2007 AHA/ACC/ HRS statement recommendations for the standardization and interpretation of ECGs
Conforms to recent recommendations for ECG interpretation 4
Conforms to guidelines for ST Segment Elevation Myocardial Infarction (STEMI) management
Conforms to recent recommendations for STEMI management 4
STEMI detection Fast, accurate detection of STEMI is critical to reduce door- to-balloon times and save heart muscle
Critical values Statement draws attention to abnormal rhythm Statement clearly identifies Acute MI Identifies multiple life-threatening conditions, in addition to Acute MI
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Gender-specific criteria STEMI criteria subjected to reduced ST limits in women increases accuracy of cardiac state diagnosis
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STEMI decision support Supports confident decision-making STEMI- Culprit Artery Detection Algorithm notifies clinician of specific occluded vessel on display and
12-lead report electronically and on paper 4
Specific coronary arteries listed on the monitor’s display: Left anterior descending (LAD) Right coronary artery(RCA) Left circumflex (LCx) Left main or equivalent multi- vessel disease (LM/MVD)
Pinpointing the culprit artery or probable anatomical site causing the functional ischemia will help to optimize the treatment approach taken in the catheterization laboratory
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© 2009 Koninklijke Philips Electronics N.V. All rights are reserved.
Philips Healthcare reserves the right to make changes in specifications and/or to discontinue any product at any time without notice or obligation and will not be liable for any consequences resulting from the use of this publication.
Philips Healthcare is part of Royal Philips Electronics
www.philips.com/healthcare [email protected]
Philips Healthcare 3000 Minuteman Road Andover, MA 01810
Please visit www.philips.com/ems
DXL ECG Algorithm
STEMI detection Critical Values
Designed to be used as a trigger for EMS or hospital STEMI protocol• Highly visible (highlighted in red on the display with surrounding brackets)• Reports conditions requiring immediate clinical attention• Specific statements are:•
>>> ACUTE MI <<< >>> ACUTE ISCHEMIA <<< >>> COMPLETE HEART BLOCK <<< >>> VERY FAST HEART RATE <<<
STEMI decision support tools STEMI Culprit Artery
Helps paramedic “build a case” for preparation of the cath lab • ahead of the patient Identifies the artery most likely causing the acute • (recent/emergent) symptoms Identifies global ischemia when multiple obstructions exist• Can direct care in the field based on the side of the heart impacted• Can assist in directing treatment in the cath lab to the likely lesion location•
- Left Anterior Descending (LAD) - Right Coronary Artery (RCA) - Left Circumflex (LCx) - Left Main or Multi-Vessel Disease (LM/MVD)
12-lead ECG is not available on the LP20 or R-Series. Physio-Control and LifePak are registered trademarks of Medtronic Inc. Zoll, E-Series, M-Series, and R-Series are registered trademarks of Zoll Medical Inc.
12-Lead transmission Philips HeartStart MRx ALS monitor
The Philips HeartStart MRx offers fast, reliable transmission of 12-lead ECGs via the Internet, radio or ePCR network. Philips provides a flexible “back-end” solution with these multiple destination options and technologies to get the 12-lead ECG into the hands of the treating clinician as quickly as possible.
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Print Acute MI
Sinus bradycardia Second deg AVB, Mobitz I (Wenckebach) Lateral infarct, acute (LAD)
17-Nov-2009 09:57:55
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0911170957169fd6 HR 54 PR QRSD 101 QT 385 QTc 422
P 65 QRS 53 T 63
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© 2009 Koninklijke Philips Electronics N.V. All rights are reserved.
Philips Healthcare reserves the right to make changes in specifications and/or to discontinue any product at any time without notice or obligation and will not be liable for any consequences resulting from the use of this publication.
Philips Healthcare is part of Royal Philips Electronics
www.philips.com/healthcare [email protected]
Philips Healthcare 3000 Minuteman Road Andover, MA 01810
Please visit www.philips.com/ems
Philips HeartStart MRx features and benefits
The Philips HeartStart MRx can transmit over: The internet via a cell phone or air card in a mounted gateway• Two-way public safety radio• Your ePCR Network•
The MRx also: Reduces Discovery to Balloon Time• Offers reliable, fast transmission of 12-lead ECGs• Displays current status of transmission at all times•
Once transmission begins, the provider can continue to focus on other patient needs.
The MRx can send 12-leads to multiple locations at the same time, like email addresses, fax machines, printers, PDAs and ECG management systems, including Philips TraceMaster Vue.
There are no subscription costs from Philips to transmit or store 12-lead data. Low cost telemedicine server software can be located at EMS station, hospital or anywhere the customer needs it and the software can be downloaded to a computer with basic server specs.
Feature Expected benefit Philips MRx
Physio- Control LP12 LP15
Zoll E-Series M-Series CCT
Monitor sends patient vitals along with 12-lead including via two-way radio
Provide remote caregivers with a more complete clinical picture 4
No subscription costs necessary to transmit or store 12-lead information
Lower cost to the customer and customer has full control over their data
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Device confirms delivery of the 12-lead report to the telemedicine server
User confidence the 12-lead transmission is complete and accurate 4
Transmission status is always displayed • Connecting to network • Connecting to server • Transmitting 0% to 100% • Confirming, Please Wait • Disconnecting
User confidence that device is transmitting correctly 4
12-lead ECG encrypted with Blowfish technology
Protects confidential patient data 4
12-lead ECG is not available on the LP20 or R-Series.
Physio-Control and LifePak are registered trademarks of Medtronic Inc. Zoll, E-Series, M-Series, and R-Series are registered trademarks of Zoll Medical Inc.
ACI-TIPI Philips HeartStart MRx ALS monitor
The Philips Acute Cardiac Ischemia-Time Insensitive Predictive Instrument (ACI-TIPI) is a software tool that enhances the computerized 12-lead ECG analysis capabilities of the HeartStart MRx. It generates a predicted probability score of ACI based on ECG features and patient demographic information such as age, gender, and chest pain status. The probability score supports EMS personnel’s efforts to decrease time from the onset of acute cardiac ischemia (ACI) symptoms to treatment with interventional cardiology.
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12-Feb-2009 16:37:41
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090212163706a0e9 HR 72 PR 152 QRSD 98 QT 369 QTc 404
P 66 QRS 53 T 64
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© 2009 Koninklijke Philips Electronics N.V. All rights are reserved.
Philips Healthcare reserves the right to make changes in specifications and/or to discontinue any product at any time without notice or obligation and will not be liable for any consequences resulting from the use of this publication.
Philips Healthcare is part of Royal Philips Electronics
www.philips.com/healthcare [email protected]
Philips Healthcare 3000 Minuteman Road Andover, MA 01810
Please visit www.philips.com/ems
Philips HeartStart MRx features and benefits
The Philips ACI-TIPI algorithm and report are implementations of work by Harry P. Selker, MD, and his colleagues at New England Medical Center in Boston, MA.
The ACI TIPI predictive instrument is independent of the DXL 12- lead ECG algorithm. ACI-TIPI algorithm is based on weighted values for the patient’s age, gender, chest pain status, and ECG waveform criteria.
With ACI-TIPI, the term cardiac ischemia is used as a general term that includes ischemia, injury, and infarction which are defined as different stages of the cardiac ischemic disease. For example, a STEMI (based on ST elevation) or acute global ischemia (based on severe ST depression) can both have ACI-TIPI scores of 75 percent but would have different diagnostic ECG interpretations.
ACI-TIPI prediction appears in 12-lead display and is printed on the 12-lead paper strip.
ACI-TIPI is useful in:• - Determining when additional diagnostic testing is not required in a low-risk ED population with symptoms suggestive of acute coronary syndrome - Identifying the likelihood of ischemia to help determine the need for stress testing before hospital release - Determining the probability of ischemia to influence the initial triage disposition of AMI patients to CCUs or intermediate units
As with standard 12-lead ECGs, the ACI-TIPI report can be • transmitted via the Philips Telemedicine Server and the Philips TraceMasterVue ECG Management System.
Feature Expected benefit Philips MRx
Physio- Control LP12 LP15
Zoll E-Series M-Series CCT
ACI-TIPI is an orderable option on the monitor/defibrillator
Output is a probability score (0 – 100%) that patient is experiencing acute cardiac ischemia; this is another tool to help the caregiver provide quality patient care
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ACI-TIPI prediction appears in 12-lead display and printer on the 12-lead paper strip
Provides caregiver with additional information to assist appropriate care for patient
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12-lead ECG is not available on the LP20 or R-Series.
Physio-Control and LifePak are registered trademarks of Medtronic Inc. Zoll, E-Series, M-Series, and R-Series are registered trademarks of Zoll Medical Inc.
TPI (Thrombolytic Predictive Instrument) Philips HeartStart MRx ALS monitor
Clinical evidence shows acute myocardial infarction patient outcome may depend directly on thrombolytic therapy (TT). In an effort to predict the efficacy of TT for the treatment of AMI, Philips has incorporated a cardiac decision support tool into the HeartStart MRx.
© 2009 Koninklijke Philips Electronics N.V. All rights are reserved.
Philips Healthcare reserves the right to make changes in specifications and/or to discontinue any product at any time without notice or obligation and will not be liable for any consequences resulting from the use of this publication.
Philips Healthcare is part of Royal Philips Electronics
www.philips.com/healthcare [email protected]
Philips Healthcare 3000 Minuteman Road Andover, MA 01810
Please visit www.philips.com/ems
Philips HeartStart MRx features and benefits
TPI can be used in conjunction with ACI-TIPI. As with standard 12-lead ECGs, the TPI report can be transmitted to the Philips Telemedicine Server and Philips TraceMasterVue ECG Management System, and stored on the TraceMasterVue System.
Understanding the Philips TPI variables The Philips TPI evaluated eleven predicators of thrombolysis-related benefits and risks – seven clinical factors and four ECG features. The seven clinical factors are:
Patient’s age• Patient’s gender• Patient’s weight• Patient’s blood pressure•
Feature Expected benefit Philips MRx
Physio- Control LP12 LP15
Zoll E-Series M-Series CCT
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TPI prediction appears in 12-lead display and printer on the 12-lead paper strip
Provides caregiver with additional information to assist appropriate care for patient
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12-lead ECG is not available on the LP20 or R-Series
Physio-Control and LifePak are registered trademarks of Medtronic Inc. Zoll, E-Series, M-Series, and R-Series are registered trademarks of Zoll Medical Inc.
Patient’s history of diabetes• Patient’s history of hypertension• Time since ischemic symptom onset•
The four ECG features are: The presence or absence of pathological or significant Q waves• The presence of and degree of ST segment elevation or depression• The presence and degree of T wave elevation and inversion• Heart rate•
While none of these features alone are diagnostic, they represent the most prominent indication of the thrombolysis-related benefits and risks.
Q-CPR view Philips HeartStart MRx ALS monitor
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Perform high quality CPR from the start
Q-CPR helps to minimize interruption • to chest compressions and the resulting drop in coronary perfusion pressure. Immediate feedback can help reduce • CPR performance variability. Rapid, on-scene deployment even prior • to using an auto assist CPR device. Avoids hyperventilation.• Flexible configuration to meet a variety • of protocols including continuous chest compressions. Ideal for responder training and actual • clinical use on a patient. Data capture available for retrospective • review for those teachable moments.
© 2009 Koninklijke Philips Electronics N.V. All rights are reserved.
Philips Healthcare reserves the right to make changes in specifications and/or to discontinue any product at any time without notice or obligation and will not be liable for any consequences resulting from the use of this publication.
Philips Healthcare is part of Royal Philips Electronics
www.philips.com/healthcare [email protected]
Philips Healthcare 3000 Minuteman Road Andover, MA 01810
Please visit www.philips.com/ems
Q-CPR view Philips HeartStart MRx features and benefits Feature Expected benefit Philips
MRx Physio- Control LP15
Zoll E-Series M-Series R-Series
CPR feedback Provides critical information in real time 4 4
Visual feedback on the meter
Easy-to-use and intuitive feedback where you want it: on the patient’s chest 4
Tiered feedback Tier 1: visual feedback on the meter Tier 2: visual feedback on the meter (for example, arrow to compress deeper) Tier 3: audible feedback is given if caregiver doesn't correct for visual feedback
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All CPR feedback is viewable on monitor display at all times 4 4
Verbal feedback Voice prompts provide corrective information about compression performance Voice is easily muted or configured to be off
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Visual feedback Compressions are shown on monitor display 4 4
True compression waveform is shown on the monitor 4 4 (R-Series
only) Ventilations are shown on monitor display (in the form of a lung icon) 4
Numerics for compression rate, “no flow” hands-off time, and number of compressions are displayed on the monitor
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Compressions Identified as critical in 2005 AHA Guidelines “No flow” or hands-off time
Displayed as “seconds” timer once compressions stop, also supported by voice prompts Alerts rescuers to resume compression
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Compression rate Displayed as numeric value and supported by voice prompts Helps rescuer maintain 90-100 compressions per minute
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Compression depth Simple visual feedback where you want it – on the patient’s chest (displayed on CPR meter as well as on the monitor); helps rescuer maintain target compression depth
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Incomplete release Simple visual feedback where you want it – on the patient’s chest (displayed on CPR meter as well as on the monitor); ensures that the rescuer comes off the chest completely, allowing the heart to fill completely up with blood before the next compression squeezes it out and into circulation
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Ventilations Only ventilation monitoring device available Ventilation icon and rate
Lung icon as well as displayed rate numeric on MRx screen helps rescuer avoid excessive ventilations, providing protection from hyperventilation
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Protocol flexibility Ventilations can be configured as off to support continuous chest compression protocols 4
CPR data Excellent quality improvement tool CPR data capture CPR compression event data can be downloaded for retrospective review 4 4
CPR ventilation event data can be downloaded for retrospective review 4
Research Proven technology Peer reviewed published manuscripts
Published research using CPR feedback technology showing improvements to CPR as well as patient benefit See application note for details
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Uses standard HeartStart multifunction pads; no need to purchase expensive specialty pads
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CPR feedback is not available on the LP12, LP20 or CCT.
Physio-Control and LifePak are registered trademarks of Medtronic Inc. Zoll, E-Series, M-Series, and R-Series are registered rademarks of Zoll Medical Inc. Q-CPR is a registered trademark of Laerdal Medical.
Code view Philips HeartStart MRx ALS monitor
Code view displays the most critical information at the most critical time – cardiac arrest. Philips code view automatically optimizes viewing of waveforms and numerics based on the patient’s condition.
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© 2009 Koninklijke Philips Electronics N.V. All rights are reserved.
Philips Healthcare reserves the right to make changes in specifications and/or to discontinue any product at any time without notice or obligation and will not be liable for any consequences resulting from the use of this publication.
Philips Healthcare is part of Royal Philips Electronics
www.philips.com/healthcare [email protected]
Philips Healthcare 3000 Minuteman Road Andover, MA 01810
Please visit www.philips.com/ems
Philips HeartStart MRx features and benefits Feature Expected benefit Philips
MRx Physio-Control LP12 LP15 LP20
Zoll E-Series M-Series R-Series CCT
Code view screen Prioritizes the most important information during a cardiac arrest
Largest ECG waveform on an ALS monitor display
Visibility allows clinicians to see ECG changes even from a distance
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Vital information is prioritized by design 4
EtCO2 waveform moves up under the primary ECG
Give clinicians the total picture 4
Alarms silenced Once clinician selects the energy, the alarms are automatically silenced
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Running a code with the MRx Single energy selection for adult defibrillation
With SMART biphasic the first shock is the best shock; eliminates the step of changing energy levels
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Rapid charge to full energy Less than five second charge to full energy provides rapid defibrillation; importance of decreased hands-off to defibrillation time supported by resuscitation science; time is muscle
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Capnography during a code: no need to zero out, no warming up time
View the capnography waveform and value in seconds, providing quick confirmation for clinician; annual calibration
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Physio-Control and LifePak are registered trademarks of Medtronic Inc. Zoll, E-Series, M-Series, and R-Series are registered trademarks of Zoll Medical Inc.
Monitor mode Philips HeartStart MRx ALS monitor
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