Philips Blood Pressure Monitor M5066A User Manual

H e a r t S t a r t D e f i b r i l l a t o r  
O W N E R ’ S M A N U A L  
Guide to Set Up, Operation, Maintenance, and Accessories  
M5066A  
Edition 7  
 
A
A
front view  
back view  
top  
top  
BB  
K
K
L
L
C
D
E
I
F
G
H
The HeartStart Defibrillator M5066A  
A
D
H
Pads Cartridge Handle.  
Information Button. This  
blue “i-button” flashes when it  
Speaker. When the device is  
Pull the handle to turn on the  
HeartStart and remove the  
cartridge’s hard cover.  
being used, its voice instructions  
come from this speaker.  
has information you can access by  
pressing it. It also flashes at the  
beginning of a patient care pause  
when CPR coaching is enabled.  
I
Beeper. The HeartStart  
B
Ready Light. This green light  
“chirps” through this beeper to  
alert you when it needs attention.  
tells you the readiness of the  
E
HeartStart.  
Caution Light. This triangular  
J
SMART Pads Cartridge. This  
light  
flashes during rhythm  
Blinking: standby mode  
(ready for use)  
disposable cartridge contains self-  
adhesive pads with attached cable.  
Shown with adult pads cartridge.  
analysis and is on when a shock is  
advised, as a reminder that no one  
should be touching the patient.  
Solid:  
Off:  
in use  
needs attention  
(HeartStart  
K
SMART Pads Cartridge  
“chirps” and  
i-button flashes)  
F
Shock Button. When  
Latch. Slide the latch to the right  
to release the pads cartridge for  
replacement.  
instructed by the HeartStart to  
deliver a shock, press this flashing  
C
On/Off Button. Press this  
to turn on the  
HeartStart. To turn off the  
orange button  
.
green button  
L
Battery. The non-  
G
Infrared (IR)  
HeartStart, press the green button  
again and hold it down for one (1)  
second.  
rechargeable battery is inserted in  
a recess on the back of the  
HeartStart.  
Communications Port. This  
special lens, or “eye,” is used to  
transfer HeartStart data directly to  
or from a computer.  
 
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HeartStart Defibrillator M5066A  
QUICK REFERENCE  
 
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HeartStart  
M5066A  
Automated External Defibrillator  
O W N E R ’ S M A N U A L  
Edition 7  
IMPORTANT NOTE:  
It is important to understand that survival rates for sudden cardiac arrest  
are directly related to how soon victims receive treatment. For every  
minute of delay, the chance of survival declines by 7% to 10%.  
Defibrillation cannot assure survival. In some victims, the underlying problem  
causing the cardiac arrest is simply not survivable despite any available care.  
 
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About this edition  
Authorized EU representative  
The information in this guide applies to  
the model M5066A HeartStart Defibrillator. Its  
technical contents apply to all models  
in the HeartStart HS1 family of defibrillators,  
including the HeartStart, the HeartStart OnSite,  
and the HeartStart First Aid Defibrillator. This  
information is subject to change. Please contact  
contact your local Philips representative for  
information on revisions.  
Philips Medizin Systeme Boeblingen GmbH  
Hewlett-Packard Strasse 2  
71034 Boeblingen, Germany  
(+49) 7031 463-2254  
CAUTION: Federal law (USA) restricts this  
device to sale by or on the order of a physician.  
The Philips HeartStart Defibrillator is designed to  
be used only with Philips-approved accessories.  
The HeartStart may perform improperly if non-  
approved accessories are used.  
Edition history  
Edition 7  
Device tracking  
Publication date: July 2007  
Publication #: M5066-91901  
Assembly #: 011872-0007  
Printed in the U.S.A.  
In the U.S.A., this device is subject to tracking  
requirements by the manufacturer and distributors.  
If the defibrillator has been sold, donated, lost,  
stolen, exported, or destroyed, notify Philips  
Medical Systems or your distributor.  
Copyright  
© 2007 Philips Electronics North America Corp.  
Device manufacturer  
No part of this publication may be reproduced,  
transmitted, transcribed, stored in a retrieval  
system or translated into any human or  
The HeartStart Defibrillator is manufactured by  
Philips Medical Systems, Seattle, Washington, USA.  
computer language in any form by any means  
without the consent of the copyright holder.  
Patents  
This product is manufactured and sold under one  
or more of the following United States patents:  
US6047212, US6317635, US5892046, US5891049,  
US6356785, US5650750, US6553257, US5902249,  
US6287328, US6662056, US5617853, US5951598,  
US6272385, US6234816, US6346014, US6230054,  
US6299574, US5607454, US5803927, US5735879,  
US5749905, US5601612, US6441582, US5889388,  
US5773961, US6016059, US6075369, US5904707,  
US5868792, US5899926, US5879374, US5632280,  
US5800460, US6185458, US5611815, US6556864,  
US5607454, and other patents pending.  
Unauthorized copying of this publication may  
not only infringe copyright but also reduce the  
ability of Philips Medical Systems to provide  
accurate and up-to-date information to users  
and operators alike.  
HEARTSTART M5066A  
 
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CONTENTS  
1 Introduction to the HeartStart  
Description ........................................................................................................... 1-1  
Sudden Cardiac Arrest ....................................................................................... 1-1  
Indications for Use .............................................................................................. 1-1  
Training and practice .......................................................................................... 1-2  
National and local requirements ...................................................................... 1-2  
For more information ......................................................................................... 1-2  
2 Setting up the HeartStart  
Package contents ................................................................................................. 2-1  
Setting up the HeartStart ................................................................................... 2-1  
Recommended accessories ............................................................................... 2-3  
3 Using the HeartStart  
Overview ............................................................................................................... 3-1  
STEP 1: PULL the green handle ........................................................................ 3-2  
STEP 2: PLACE the pads .................................................................................... 3-3  
STEP 3: PRESS the Shock button ..................................................................... 3-3  
Treating infants and children ............................................................................ 3-4  
When emergency medical services arrive ..................................................... 3-6  
4 After using the HeartStart  
After each use ...................................................................................................... 4-1  
HeartStart data storage ..................................................................................... 4-1  
5 Maintaining the HeartStart  
Routine Maintenance .......................................................................................... 5-1  
Periodic checks .................................................................................................... 5-1  
Cleaning the HeartStart ..................................................................................... 5-2  
Disposing of the HeartStart .............................................................................. 5-2  
Troubleshooting tips ........................................................................................... 5-2  
i
 
ii  
APPENDICES  
A Accessories for the HeartStart  
B Glossary of terms  
C Glossary of symbols/controls  
D Warnings and precautions  
E Technical information  
F Configuration  
G Testing and troubleshooting  
H Additional technical information required for European conformity  
HEARTSTART M5066A  
 
1
1
Introduction to the HeartStart  
Description  
The HeartStart Defibrillator M5066A is part of the Philips HeartStart HS1 family  
of defibrillators. Small, lightweight, and battery powered, it is designed for simple  
and reliable operation.  
Sudden Cardiac Arrest  
The HeartStart is used to treat the most common causes of sudden cardiac arrest  
(SCA), including ventricular fibrillation (VF). SCA is a condition that occurs when  
the heart unexpectedly stops pumping. SCA can occur to anyone – infant, child,  
adult, male or female – anywhere, at any time. Many victims of SCA do not have  
warning signs or symptoms.  
VF is a chaotic quivering of the heart muscle that prevents it from pumping blood.  
The only effective treatment for VF is defibrillation. The HeartStart treats VF by  
sending a shock across the heart, so it can start beating regularly again. Unless this  
is successful within the first few minutes after the heart stops beating, the victim is  
not likely to survive.  
Indications for Use  
The HeartStart should be used to treat someone you think may be a victim of  
SCA. A person in SCA:  
does not respond when shaken, and  
is not breathing normally.  
If in doubt, apply the pads. Follow the voice instructions for each step in using the  
defibrillator.  
1-1  
 
1-2  
Training and practice  
The HeartStart is one part of a well-designed emergency response plan. Any  
emergency response plan should be under the oversight of a physician and should  
include training in cardiopulmonary resuscitation (CPR). Philips recommends that  
you train on the device you will be using.  
Several national and local organizations offer combined CPR/defibrillator training.  
Contact your Philips representative, or visit us on-line at  
NOTE: Training accessories are available from Philips for practicing use of the  
HeartStart. See Appendix A for information on ordering accessories.  
National and local requirements  
Check with your local health department to see if there are any national or local  
requirements about owning and using a defibrillator.  
For more information  
Contact your local Philips representative for additional information about the  
HeartStart. They will be happy to answer any questions you may have and to  
provide you with copies of the clinical summaries of several key studies using  
*
Philips automated external defibrillators.  
heartstart. Technical information about all Philips HeartStart automated external  
defibrillators is also available online, in the Technical Reference Guide for HeartStart  
Defibrillators.  
* Clinical summaries also include Heartstream ForeRunner and FR2 Defibrillators.  
HEARTSTART M5066A  
 
2
Setting up the HeartStart  
2
Package contents  
Check the contents of the HeartStart Defibrillator M5066A box to be sure it  
contains:  
1 HeartStart Defibrillator  
1 battery M5070A  
1 Adult SMART Pads Cartridge M5071A,  
containing one set of adhesive defibrillation pads  
1 Owner’s Manual  
1 Quick Reference Guide  
Training materials and optional accessories for the HeartStart are also available  
from Philips. See Appendix A for a description of these items.  
Setting up the HeartStart  
Setting-up the HeartStart Defibrillator is simple and quick.  
1. Remove the HeartStart from its packaging.  
*
2. Remove a new SMART Pads Cartridge from its package.  
* To replace a used cartridge or insert a different cartridge,  
first locate the latch at the top edge of the defibrillator, and  
slide it to the side. The pads cartridge will be released. Lift  
out the cartridge and replace as described in steps 2 and 3.  
2-1  
 
2-2  
3. Insert the cartridge into the cartridge well on the front of the defibrillator. It  
should click into place when properly seated. The green PULL handle should  
be all the way down.  
NOTE: To prevent the pads’ adhesive gel from drying out, do not open the hard  
cover or film seal of the cartridge until you need to use the pads.  
4. Remove the battery from its packaging. Install it in the battery compartment  
on the back of the defibrillator.  
5. The HeartStart will automatically run a self-test when the battery is inserted.  
Press the Shock button when instructed. When the self-test is over, the  
defibrillator will report the result, and tell you to push the green On/Off  
button in case of an emergency. (Do not push the green button unless this is an  
actual emergency.) Then the defibrillator will turn off and go to standby mode.  
The green Ready light will be blinking to show the HeartStart is ready  
*
for use.  
NOTE: Always store the HeartStart with a pads cartridge and a battery installed,  
so it will be ready to use and can perform daily self-tests.  
* As long as a battery is installed, turning the HeartStart “off” puts it into standby mode,  
which means that it is ready for use.  
HEARTSTART M5066A  
 
2-3  
6. Place the defibrillator in the carry case, pressing it firmly into place. Insert the  
*
Quick Reference Guide, face up, in the clear plastic window on the inside of  
the case. If you purchased a spare SMART Pads Cartridge or an Infant/Child  
Pads Cartridge, place it in the storage area in the case.  
2
NOTE: Do not store anything in the defibrillator carry case that it is not  
designed to accommodate. Store all objects in their intended location in the  
case.  
7. Store the HeartStart in accordance with your sites emergency response  
protocol. Typically, this will be in a high-traffic area that is easy to access,  
convenient for checking the Ready light periodically, and easy to hear the  
alarm chirp if the battery power gets low or the defibrillator needs attention.  
Ideally, the HeartStart should be stored near a telephone, so the Emergency  
Response Team or Emergency Medical Services can be alerted as fast as  
possible in the event of a possible SCA. If possible, keep the spare SMART  
Pads Cartridge and other accessories with the defibrillator in the carry case  
if one is used for quick access when needed. In general, treat the HeartStart  
as you would any piece of electronic equipment, such as a computer. Be sure  
to store the defibrillator according to its specifications. See Appendix E for  
details. As long as a battery and a pads cartridge are installed, the green Ready  
light should be blinking to show that the HeartStart has passed its most  
recent self-test and is therefore ready to use.  
NOTE: If you have a training pads cartridge, it is recommended that you  
store it separately from the HeartStart, so the training pads cannot be confused  
with the regular pads in an emergency.  
* The illustration on the cover of the Quick Reference Guide is a 3-step guide to using the  
HeartStart. Detailed illustrated directions are inside, for reference in an emergency, or if  
you are hearing impaired or using the HeartStart where it is hard to hear the voice  
instructions.  
 
2-4  
Recommended accessories  
It is always a good idea to have a spare battery and a spare pads set. Other things  
that are useful to keep with the HeartStart include:  
scissors — for cutting the victim’s clothes if needed  
disposable gloves — to protect the user  
a disposable razor — to shave the chest if hair prevents good pads  
contact  
a pocket mask or face shield — to protect the user  
a towel or absorbent wipes — to dry the victim's skin for good pads  
contact  
Philips has a Fast Response Kit with all these items. See Appendix A for details.  
If you may need to defibrillate an infant or a child under 25 kg (55 pounds) or 8 years  
old, it is recommended that you order the Infant/Child SMART Pads Cartridge,  
available separately. When the Infant/Child Pads Cartridge is installed in the  
HeartStart, the HeartStart automatically reduces the defibrillation energy to an  
energy level more appropriate for infants and children. In addition, if optional CPR  
coaching is selected, the HeartStart provides coaching appropriate for infants and  
children. Directions for using the Infant/Child SMART Pads are provided in  
Chapter 3, “Using the HeartStart.”  
HEARTSTART M5066A  
 
3
Using the HeartStart  
IMPORTANT NOTE: Be sure to read the Reminders section at the end of this  
chapter as well as the warnings and precautions in Appendix D.  
Overview  
3
If you think someone is in SCA, act quickly and calmly. If someone else is available,  
ask him or her to call for emergency medical assistance while you get the  
HeartStart. If you are alone, follow these steps:  
Call your emergency services provider.  
Quickly get the HeartStart and bring it to the victim’s side. If there is any  
delay in getting the defibrillator, check the patient and perform  
cardiopulmonary resuscitation (CPR) if needed until the HeartStart is  
available.  
If the patient is an infant or child, first perform CPR, then call for  
emergency medical services (EMS) before you apply the HeartStart. See  
special section on treating infants and children on page 3-5.  
Check the immediate environment for flammable gases. Do not use the  
HeartStart in the presence of flammable gases, such as an oxygen tent.  
However, it is safe to use the HeartStart on someone wearing an oxygen  
mask.  
There are three basic steps to using the defibrillator to treat someone who may be  
in sudden cardiac arrest:  
1. PULL up the handle on the SMART Pads Cartridge.  
2. PLACE the pads on the patients bare skin.  
3. PRESS the flashing Shock button  
if instructed.  
The following pages provide details about each step.  
3-1  
 
3-2  
STEP 1: PULL the green handle  
*
Turn on the HeartStart by pulling the SMART Pads Cartridges green handle.  
Remove the hard cover from the pads cartridge and set it aside. Remain calm and  
follow the HeartStart’s instructions.  
The HeartStart starts by directing you to remove all clothes from the patient’s  
chest. If necessary, rip or cut off the clothing to bare the person’s chest  
* You can also turn on the HeartStart Defibrillator by pressing the green On/Off button.  
HEARTSTART M5066A  
 
3-3  
STEP 2: PLACE the pads  
Pull the tab at the top of the pads cartridge to peel off the film seal. Inside are two  
adhesive pads on a plastic liner. Remove the pads from the cartridge.  
3
Peel one pad off the liner. Place the pad on the patient’s bare skin, exactly as shown  
in the picture on the pad. Press the pad down firmly. Then repeat this with the other  
pad. Be sure the pads have been removed from the liner before placing them.  
Where to place pads on adults and children over  
25 kg/55 pounds or 8 years old (anterior-anterior).  
Where to place pads on infants or children under  
25 kg/55 pounds or 8 years old (anterior-posterior).  
 
3-4  
STEP 3: PRESS the Shock button  
As soon as the HeartStart detects that the pads are attached to the patient, it  
begins analyzing the patient’s heart rhythm. It tells you that no one should be  
touching the patient, and the Caution light  
begins flashing as a reminder.  
If a shock is needed:  
The Caution light  
goes from flashing to solid, the orange Shock button  
starts flashing, and the defibrillator tells you to press the flashing orange button.  
Before you press the button, make sure no one is touching the patient. When you  
press the Shock button, the defibrillator tells you that the shock has been  
delivered. Then the HeartStart tells you it is safe to touch the patient, instructs  
you to begin CPR, and invites you to press the flashing blue i-button  
Coaching if desired.  
for CPR  
If a shock is not needed:  
The HeartStart tells you it is safe to touch the patient and instructs you to  
perform CPR if needed. (If CPR is not needed – for example, if the patient is  
moving or regaining consciousness – follow your local protocol until emergency  
medical personnel arrive.) Then the HeartStart invites you to press the flashing  
blue i-button  
for CPR Coaching, if desired.  
For CPR Coaching:  
Press the flashing blue i-button  
during the first 30 seconds of the patient care  
*
pause to activate CPR Coaching. (If the Infant/Child SMART Pads Cartridge is  
inserted, CPR Coaching will provide coaching for infant/child CPR.) When the  
pause is over, the defibrillator tells you to stop CPR, so it can analyze the patient’s  
heart rhythm. The motion caused by CPR can interfere with analysis, so be sure to  
stop all motion when instructed.  
* The default configuration for the HeartStart provides CPR Coaching when you press the  
i-button in this situation; however, the default setting can be revised by your Medical  
Director using Philips software available separately. See Appendix F for more  
information.  
HEARTSTART M5066A  
 
3-5  
Treating infants and children  
WARNING: Most cardiac arrests in children are not caused by heart problems.  
When responding to cardiac arrest in an infant or child:  
• Provide infant/child CPR while a bystander calls EMS and brings the  
HeartStart.  
• If no bystander is available, provide 1-2 minutes of CPR before calling EMS  
and retrieving the HeartStart.  
• If you witnessed the child's collapse, call EMS immediately and then get the  
HeartStart.  
3
Alternatively, follow your local protocol.  
If the patient is under 55 pounds or 8 years old, and you have an Infant/Child Pads  
Cartridge:  
*
Remove the Infant/Child Pads Cartridge from its package.  
Locate the latch at the top edge of the defibrillator, and slide it to the  
side. The pads cartridge will be released. Remove the old cartridge.  
Install the new cartridge: slide the bottom end of the cartridge into the  
recess, then press in the cartridge until the latch clicks into place. Be sure  
the green handle is pressed down firmly. The HeartStart will tell you that  
Infant/Child pads have been inserted, then it will turn off to be ready for  
use.  
Pull the green handle to start the rescue.  
Remove all clothing from the upper body, to bare both the chest and the  
back. Place one pad in the center of the chest between the nipples, and  
the other in the center of the back (anterior-posterior).  
With the Infant/Child Pads Cartridge inserted, the HeartStart automatically  
reduces the defibrillation energy from the adult dose of 150 joules to 50 Joules  
and provides optional infant/child CPR Coaching. Place the pads exactly as shown  
on the illustration on the pads.  
* Philips recommends that the HeartStart be stored with an adult pads cartridge installed,  
as pediatric cardiac arrest is not common.  
† This lower energy level may not be effective for treating an adult.  
 
3-6  
If the patient is under 55 pounds or 8 years old, but you do NOT have an Infant/Child  
Pads Cartridge:  
DO NOT DELAY TREATMENT.  
Remove all clothing from the torso, to bare both the chest and the back.  
Apply the HeartStart using the adult pads cartridge, but place one pad in the  
center of the chest between the nipples, and the other in the center of the  
back (anterior-posterior).  
If the patient is over 55 pounds or 8 years old, or if you are not sure of the exact weight  
or age:  
DO NOT DELAY TREATMENT.  
Remove all clothing from the chest.  
Apply the HeartStart using the adult pads cartridge, and place the pads as  
illustrated on the pads (anterior-anterior). Make sure the pads do not overlap  
or touch each other.  
When emergency medical services arrive  
When Emergency Medical Services (EMS) personnel arrive to care for the patient,  
they may decide to apply another defibrillator to allow monitoring of the patient.  
The SMART Pads should be removed from the patient prior to using another  
*
defibrillator. EMS personnel may want a summary of the last-use data stored in  
the HeartStart. To hear the summary data, hold down the i-button until the  
HeartStart beeps.  
NOTE: After the EMS team removes the SMART Pads from the patient,  
remove the used pads cartridge, and insert a new pads cartridge before  
returning the HeartStart to service, to be sure it is ready for use.  
* See Chapter 4, “After using the HeartStart” for details about data storage.  
HEARTSTART M5066A  
 
3-7  
Remove any medicine patches and residual adhesive from the patient’s chest  
Reminders  
before applying the pads.  
Do not allow the pads to contact other electrodes or metal parts that are in  
contact with the patient.  
Avoid placing the pads directly over an implanted pacemaker or defibrillator.  
A noticeable lump with a surgical scar should indicate the position of an  
implanted device.  
If the pads do not stick well, check that the pads adhesive has not dried out.  
Each pad has a layer of adhesive gel. If the gel is not sticky to the touch,  
replace the pads with a new set.  
3
Keep the patient still and keep any movement around the patient to a  
minimum during rhythm analysis. Do not touch the patient or the pads while  
the Caution light is on solid or flashing. If the HeartStart is unable to analyze  
due to electrical “noise” (artifact), it will tell you to stop all movement and  
remind you not to touch the patient. If the artifact continues for more than  
30 seconds, the HeartStart will pause briefly to allow you to deal with the  
source of the noise, then resume analysis.  
The HeartStart will not deliver a shock unless you press the flashing orange  
Shock button. If you do not press the Shock button within 30 seconds after  
the defibrillator tells you to, it will disarm itself, and (for the first CPR  
interval) give a reminder to make sure emergency medical services have been  
called, then begin a CPR interval. This is designed to minimize interruption of  
CPR and help ensure ongoing patient support.  
While waiting for you to press the Shock button, the HeartStart will  
continue to analyze the heart rhythm. If the patients rhythm changes before  
you press the Shock button, and a shock is no longer needed, the  
defibrillator will disarm and tell you a shock is not advised.  
If for any reason you want to turn off the defibrillator during a use, you can  
press the On/Off button – holding it down for at least one second – to  
return the device to standby mode.  
 
Notes  
HEARTSTART M5066A  
 
4
After using the HeartStart  
After each use  
1. Check the outside of the HeartStart for signs of damage, dirt, or  
contamination. If you see signs of damage, contact Philips for technical  
support. If the defibrillator is dirty or contaminated, clean it according to the  
guidelines in Chapter 5, “Maintaining the HeartStart.”  
2. Insert a new SMART Pads cartridge into the HeartStart. Check supplies and  
accessories for damage and expiration dates. Replace any used, damaged or  
expired items. For directions on changing the pads and replacing the battery,  
please see Chapter 2, “Setting up the HeartStart.” The single-use pads must  
be replaced after being used.  
4
3. Unless your protocol requires that the battery remain installed, remove the  
battery for five seconds, then reinstall it to run the battery insertion self-test  
*
to check the operation of the defibrillator. When the test is complete, check  
that the green Ready light is blinking.  
4. Return the HeartStart to its storage location so it will be ready for use when  
needed.  
HeartStart data storage  
The HeartStart automatically stores data about its last clinical use in its internal  
memory. The stored data can be conveniently transferred to a personal computer  
or a handheld computer running the appropriate application in the Philips  
HeartStart Event Review data management software suite. Event Review software  
is for use by trained personnel only. Information about HeartStart Event Review is  
* If you leave the battery in the HeartStart after using the defibrillator, then transfer the  
last-use data to a computer running HeartStart Event Review software, the software will  
calculate the local date and time of the device use. However, if you remove the battery  
prior to transferring the data, the software will only show elapsed time.  
4-1  
 
4-2  
Follow your local protocol with regard to prompt data transfer for medical review  
*
after using the HeartStart. Details about data transfer and timing are provided in  
Event Review documentation.  
The information automatically stored by the HeartStart includes a summary of  
last-use data and detailed data about its last clinical use. You can get a voice  
summary of information about the last use of the defibrillator by holding the i-  
button down until it beeps once. The HeartStart will tell you how many shocks  
were delivered and how long it has been since it was turned on. Summary data are  
available anytime the defibrillator is ready for use (the battery and pads are  
installed, and the defibrillator is not turned on) or while it is actually in use.  
Removing the battery erases the summary data for the last use.  
Last-use data stored in internal memory include:  
ECG recordings (a maximum of 15 minutes following pads application )  
the HeartStarts status (entire incident)  
the HeartStarts rhythm analysis decisions (entire incident)  
the elapsed time associated with stored events (entire incident)  
* The HeartStart automatically stores information about its last clinical use in its internal  
memory for at least 30 days, so the data can be downloaded to a computer running  
appropriate Event Review software. (If the battery is removed during this period, the  
defibrillator retains the files. When the battery is reinstalled, the last-use ECG recording  
will be kept in defibrillator memory for an additional 30 days.) After this time, the last-  
use ECG recordings will automatically be erased to prepare for a future use.  
† If ECG recordings from a previous use have not been erased, the maximum time for new  
ECG recordings may be less.  
HEARTSTART M5066A  
 
5
Maintaining the HeartStart  
Routine Maintenance  
The HeartStart is very simple to maintain. The defibrillator performs a self-test  
every day. In addition, a battery insertion self-test is run whenever a battery is  
installed in the device. The defibrillator’s extensive automatic self-test features  
eliminate the need for any manual calibration. The HeartStart has no user-  
serviceable parts.  
WARNING: Electrical shock hazard. Do not open the HeartStart, remove its  
covers, or attempt repair. There are no user-serviceable components in the  
HeartStart. If repair is required, return the HeartStart to Philips for service.  
Reminders:  
• Do not leave the HeartStart without a pads cartridge installed; the  
defibrillator will start chirping and the i-button will start flashing. For  
directions on changing the pads cartridge, see Chapter 2, “Setting up the  
HeartStart.”  
5
• The HeartStart runs daily self-tests. As long as the green Ready light is  
blinking, it is not necessary to test the defibrillator by initiating a battery  
insertion self-test. This uses battery power and risks draining the battery  
prematurely.  
Periodic checks  
Other than the checks recommended after each use of the HeartStart,  
maintenance is limited to periodically checking the following:  
Check the green Ready light. If the green Ready light is not blinking, see  
Troubleshooting Tips, below.  
Replace any used, damaged or expired supplies and accessories  
Check the outside of the defibrillator. If you see cracks or other signs of  
damage, contact Philips for technical support.  
5-1  
 
5-2  
Cleaning the HeartStart  
The outside of the HeartStart and its carry case can be cleaned with a soft cloth  
dampened in soapy water, chlorine bleach (2 tablespoons per quart or liter of  
water), or ammonia-based cleaners.  
Reminders:  
Do not use isopropyl (rubbing) alcohol, strong solvents such as acetone or  
acetone-based cleaners, abrasive materials, or enzymatic cleaners to clean  
your HeartStart.  
Do not immerse the HeartStart in fluids or allow fluids to spill onto it.  
Do not sterilize the defibrillator or its accessories.  
Disposing of the HeartStart  
The HeartStart and its accessories should be disposed of in accordance with local  
regulations.  
Troubleshooting tips  
The HeartStarts green Ready light is your guide to knowing if the defibrillator is  
ready for use.  
If the Ready light is blinking: The HeartStart has passed the battery  
insertion self-test and the last periodic self-test and is therefore ready  
for use.  
If the Ready light is solid: The HeartStart is in use or running a self-test.  
If the Ready light is off, the HeartStart is chirping, and the i-button is  
flashing: A self-test error has occurred, there is a problem with the pads  
or the battery power is low. Press the i-button for instructions.  
If the Ready light is off but the HeartStart is not chirping and the i-button  
is not flashing: there is no battery inserted, the battery is depleted, or the  
defibrillator needs repair. Insert/replace battery and run the self-test. As  
long as the HeartStart passes the self-test, you can be assured it is ready  
for use.  
More detailed testing and troubleshooting information is available in  
Appendix G.  
HEARTSTART M5066A  
 
A
A
Accessories for the HeartStart  
*
Accessories for the HeartStart Defibrillator available separately from your Philips  
Battery (spare recommended) [REF: M5070A]  
Pads  
Adult SMART Pads Cartridge (spare recommended) [REF: M5071A]  
Infant/Child SMART Pads Cartridge [REF: M5072A]  
Carry Cases  
Standard carry case, with paramedic’s scissors and room for spare pad  
cartridge and battery [REF: M5075A]  
Slim carry case, with paramedics scissors [REF: M5076A]  
Plastic waterproof hardshell carry case [REF: YC]  
Fast Response Kit (pouch containing a pocket mask, a disposable razor, 2 pairs  
of gloves, a pair of paramedic’s scissors, and an absorbent wipe)  
[REF: 68-PCHAT]  
Data Management Software  
HeartStart Configure PDA software [REF: 989803143041]  
HeartStart CaseCapture PDA software [REF: 989803143051]  
HeartStart Review Express Connect [REF: 861311 option A01]  
HeartStart Event Review, single PC license [REF: M3834A]  
HeartStart Event Review, organization-wide license [REF: 989803141811]  
HeartStart Event Review Pro, single PC license [REF: 861276 option A01]  
HeartStart Event Review Pro, three-PC license [REF: 861276 option A02]  
HeartStart Event Review Pro, organization-wide license  
[REF: 861276 option A03]  
Infrared cable for use with HeartStart Event Review software [REF: ACT-IR]  
HeartStart Defibrillator Quick Reference [REF: M5066-97800]  
* Certain accessories require a prescription in the United States.  
A-1  
 
A-2  
Training  
Adult Training Pads Cartridge [REF: M5073A]  
Adult Training Replacement Pads [REF: M5093A]  
Adult Pads Placement Guide [REF: M5090A]  
Infant/Child Training Pads Cartridge [REF: M5074A]  
Infant/Child Training Replacement Pads [REF: M5094A]  
Infant/Child Pads Placement Guide [REF: 989803139281]  
HeartStart HS1 and FR2+ Instructor's Training Toolkit, NTSC  
[REF: M5066-89100] or PAL [REF: M5066-89101]  
HeartStart Trainer [REF: M5085A]  
Internal Manikin Adapter [REF: M5088A]  
External Manikin Adapter, 5 pack [REF: M5089A]  
HEARTSTART M5066A  
 
B
Glossary of terms  
B
The terms listed in this Glossary are defined in the context of the Philips  
HeartStart Defibrillator and its use.  
AED  
Automated external defibrillator (a semi-automatic defibrillator).  
AED mode  
The standard treatment mode for the HeartStart Defibrillator. It provides voice  
instructions guiding the rescuer through applying the adhesive pads, waiting for  
rhythm analysis, and delivering a shock if needed.  
analysis  
arrhythmia  
artifact  
See “SMART analysis.”  
An unhealthy, often irregular, beating of the heart.  
Electrical “noise” caused by sources such as muscle movements, CPR, patient  
transport, or static electricity that may interfere with rhythm analysis.  
battery  
Caution light  
configuration  
The sealed lithium manganese dioxide battery used to power the HeartStart  
Defibrillator. It is provided in a pack that fits into a compartment on the back of  
the defibrillator.  
A triangular light on the front of the HeartStart Defibrillator that flashes during  
rhythm analysis and is on solid when a shock is advised, as a reminder not to touch  
the patient.  
The settings for all operating options of the HeartStart Defibrillator, including  
treatment protocol. The factory default configuration can be modified by  
authorized personnel using HeartStart Event Review software.  
CPR  
Cardiopulmonary resuscitation. A technique for providing artificial respiration and  
heart compressions.  
CPR Coaching  
Basic verbal instructions for performing cardiopulmonary resuscitation, including  
hand placement, rescue breathing, compression depth and timing, provided by the  
HeartStart when the flashing blue i-button is pressed during the first 30 seconds of  
a patient care pause.  
defibrillation  
ECG  
Termination of cardiac fibrillation by applying electrical energy.  
Electrocardiogram, a record of the electrical rhythm of the heart as detected  
through defibrillation pads.  
B-1  
 
B-2  
fibrillation  
A disturbance of the normal heart rhythm that results in chaotic, disorganized  
activity that cannot effectively pump blood. Ventricular fibrillation (fibrillation in  
the lower chambers of the heart) is associated with sudden cardiac arrest.  
HeartStart Event Review  
A suite of data management software applications for use by trained personnel to  
review and analyze HeartStart Defibrillator patient use and by authorized  
personnel to alter HeartStart configuration. Information is available from Philips  
eventreview.  
i-button  
A blue “information” button on the front of the HeartStart Defibrillator. If the  
i-button is pressed during the 30 seconds it flashes during a patient care pause, the  
HeartStart provides CPR Coaching; if the i-button is pressed when it is flashing  
*
and the HeartStart is chirping, the HeartStart provides troubleshooting guidance.  
At other times, if the i-button is pressed and held until it beeps once, the  
HeartStart provides summary information about its last clinical use and device  
status. When the i-button is on solid (not flashing), it indicates the user may safely  
touch the patient.  
infrared  
communications  
A method of sending information using a special part of the light spectrum. It is  
used to transmit information between the HeartStart Defibrillator and a computer  
running HeartStart Event Review software.  
NSA  
“No Shock Advised,” a decision made by the HeartStart Defibrillator that a shock  
is not needed, based on analysis of the patients heart rhythm.  
NSA pause  
A pause provided by the HeartStart Defibrillator following an NSA decision. The  
pause can be configured to a “standard” NSA pause or a “SMART” NSA pause.  
During a standard NSA pause the defibrillator performs no background  
monitoring of patient rhythm. During a SMART NSA pause, the defibrillator  
conducts background monitoring and, if it detects an artifact-free shockable  
rhythm, will exit the pause and begin rhythm analysis. If the HeartStart detects  
artifact such as that created by CPR, or if the user presses the i-button for CPR  
Coaching during a SMART NSA pause, the defibrillator will not exit the pause for  
rhythm analysis in order to allow CPR to be completed uninterrupted.  
non-shockable rhythm  
On/Off button  
A heart rhythm that the HeartStart Defibrillator determines is not appropriate for  
defibrillation.  
A green button located on the front of the HeartStart Defibrillator. Pressing the  
On/Off button when the defibrillator is in standby mode turns the defibrillator on;  
pressing and holding the On/Off button for one second when the defibrillator is on  
turns the defibrillator off and disarms the defibrillator. In addition, pressing the  
* Pressing the i-button for CPR Coaching during a SMART NSA pause turns off  
background monitoring.  
HEARTSTART M5066A  
 
B-3  
On/Off button stops the battery insertion self-test that automatically runs when a  
battery is inserted.  
pads  
See “SMART pads.”  
patient care pause  
A defined pause to allow patient assessment, treatment, and/or CPR. See  
“NSA pause” and “protocol pause.”  
B
periodic self-tests  
Daily, weekly, and monthly tests automatically conducted by the HeartStart  
Defibrillator when it is in its standby mode. The tests monitor many key functions  
and parameters of the defibrillator, including battery capacity, pads cartridge  
readiness, and the state of its internal circuitry.  
protocol  
A sequence of operations performed by the HeartStart Defibrillator to direct  
patient care in the AED mode.  
protocol pause  
A pause provided by the HeartStart Defibrillator after a shock series, during which  
the responder can administer CPR. The defibrillator does not conduct background  
monitoring of the patients heart rhythm during this pause.  
Ready light  
A green LED showing the readiness for use of the HeartStart Defibrillator. A  
blinking Ready light means the defibrillator is ready for use; a solid Ready light  
means the defibrillator is being used.  
rhythm analysis  
Shock button  
See “SMART analysis.”  
An orange button with a lightning bolt symbol on it, located on the front of the  
HeartStart Defibrillator. The Shock button flashes when a shock is advised. You  
must press the button for the shock to be delivered.  
shockable rhythm  
A heart rhythm that the HeartStart Defibrillator determines is appropriate for  
defibrillation, such as ventricular fibrillation and some ventricular tachycardias  
associated with sudden cardiac arrest.  
shock series interval  
SMART analysis  
A configurable interval between shocks, used by the HeartStart Defibrillator to  
decide if the shocks are part of the same shock series.  
The proprietary algorithm used by the HeartStart Defibrillator to analyze the  
patients heart rhythm and determine whether the rhythm is shockable.  
SMART biphasic  
waveform  
The patented, low-energy defibrillation shock waveform used by the HeartStart  
Defibrillator. It is an impedance-compensated biphasic waveform. Used with the  
Adult SMART Pads, it delivers 150 Joules, nominal, into a 50 ohm load; used with  
the Infant/Child SMART Pads, it delivers 50 Joules, nominal, into a 50 ohm load.  
SMART NSA pause  
SMART Pads  
See “NSA pause.”  
The adhesive pads, supplied in a cartridge, used with the HeartStart Defibrillator.  
Pulling the handle on the cartridge turns on the defibrillator and opens the  
 
B-4  
cartridge. The pads are applied to the patients bare skin and used to detect the  
patients heart rhythm and to transfer the defibrillation shock. Only HeartStart  
SMART Pads can be used with the HeartStart Defibrillator.  
standby mode  
The operating mode of the HeartStart Defibrillator when a battery has been  
installed, and the unit is turned off and ready for use when needed. Shown by  
blinking green READY light.  
standard NSA pause  
See “NSA pause.”  
sudden cardiac arrest  
(SCA)  
The sudden stopping of the heart’s pumping rhythm, accompanied by loss of  
consciousness, absence of respiration, and lack of a pulse.  
waveform  
See “SMART biphasic waveform.”  
HEARTSTART M5066A  
 
C
Glossary of symbols/controls  
symbol description  
Pads cartridge handle. Green. Pulling the handle turns on  
the defibrillator and opens pads cartridge for use.  
PULL  
C
Refer to operating instructions.  
On/Off button. Green. Pressing the On/Off button when  
the defibrillator is in standby mode turns the defibrillator  
on; pressing and holding the On/Off button for one  
second when the defibrillator is on turns the defibrillator  
off and disarms the defibrillator. In addition, pressing the  
On/Off button stops the battery insertion self-test that  
automatically runs when a battery is inserted.  
Information button (i-button). Blue. Pressing the i-button while it is  
flashing during a patient care pause provides CPR Coaching; pressing it  
while it is flashing and the defibrillator is chirping provides  
troubleshooting guidance. Pressing it until it beeps at other times  
provides summary information about the defibrillator’s last clinical use  
and device status.  
Caution light. Flashes during rhythm analysis, and is on  
but not flashing when a shock is advised, as a reminder  
not to touch the patient.  
Shock button. Orange. Flashes when the defibrillator is  
charged. If a shock is needed, the defibrillator directs the  
user to press the Shock button to deliver a shock to the  
patient.  
Defibrillation protection. Defibrillation protected, type  
BF patient connection.  
Meets the requirements of the European medical device directives 93/  
42/EEC.  
Indicates that this device is optimized for Guidelines 2005.  
C-1  
 
C-2  
symbol description  
Certified by the Canadian Standards Association.  
Reference order number.  
Expiration date.  
Lithium manganese dioxide battery.  
One battery in package.  
Do not crush the battery.  
Do not expose the battery to high heat or open flames.  
Do not incinerate the battery.  
Do not mutilate the battery or open the battery case.  
Class 9 miscellaneous dangerous goods. (Symbol  
required on outer packaging by freight carrier regulations  
to identify shipments containing lithium batteries.)  
Install the battery in the defibrillator before the date  
(MM-YYYY) shown on the associated label.  
Do not expose to moisture.  
Handle with care.  
HEARTSTART M5066A  
 
C-3  
symbol description  
This side up.  
Transportation requirements (refer to associated thermometer  
symbol).  
Storage requirements (refer to associated thermometer symbol).  
C
Environmental (temperature and relative humidity) requirements.  
These pads are disposable and are for single patient use  
only.  
Cartridge contents: one set of two defibrillation pads.  
Store the pads at temperatures between 0° and 43° C  
(32° and 110° F).  
This product is not sterile.  
NON-  
STERILE  
This product does not contain natural rubber latex.  
LATEX  
Meets the requirements of the European electromagnetic compatibility  
directive 89/336/EEC.  
Pads intended for use on infant or child under 8 years or 55 pounds  
(25 Kg).  
Expiration (see associated date code).  
 
C-4  
symbol description  
Serial number.  
Lot number.  
Federal law (USA) restricts this device to sale by or on the order of a  
physician.  
Dispose of in accordance with your country's requirements.  
Printed on recycled paper.  
HEARTSTART M5066A  
 
D
Warnings and precautions  
It is important to understand how to use your HeartStart Defibrillator safely.  
Please read these warnings and precautions carefully.  
A warning describes something that could cause serious personal injury or death.  
A precaution describes something that could cause minor personal injury,  
damage to the HeartStart, loss of data stored in the HeartStart, or less chance of  
successful defibrillation.  
NOTE: The HeartStart Defibrillator is designed to be used only with Philips-  
approved accessories. The HeartStart may perform improperly if non-  
approved accessories are used.  
D
Warnings  
flammable gases  
If the HeartStart is used to give a shock in the presence of flammable gases such as  
in an oxygen tent, there is a risk of explosion. Move supplemental oxygen and  
oxygen delivery devices away from the defibrillation pads. (However, it is safe to  
use the HeartStart on someone wearing an oxygen mask.)  
battery  
fluids  
The HeartStart M5070A battery is not rechargeable. Do not try to recharge,  
open, crush, or burn the battery, or it may explode or catch fire.  
Do not let fluids get into the HeartStart. Avoid spilling any fluids on the HeartStart  
or its accessories. Spilling fluids into the HeartStart may damage it or cause a fire  
or shock hazard. Do not sterilize the HeartStart or its accessories.  
accessories  
Using damaged or expired equipment or accessories may cause the HeartStart  
Defibrillator to perform improperly, and/or injure the patient or the user.  
patient handling  
Performing CPR or otherwise handling or moving the patient while the HeartStart  
is analyzing heart rhythm can cause an incorrect or delayed analysis. If the  
HeartStart tells you a shock is advised while you are handling or moving the  
patient, stop the vehicle or CPR and keep the patient as still as possible for at least  
15 seconds. This will give the HeartStart time to reconfirm the analysis before  
telling you to press the Shock button.  
cell phones  
The HeartStart can work correctly when it is fairly close to equipment like  
emergency two-way radios and cell phones. Normally, using a cell phone near the  
patient should not cause a problem for the HeartStart. However, it is best to keep  
such equipment only as close as necessary to the patient and the HeartStart.  
D-1  
 
D-2  
pads  
Do not allow the pads to contact other electrodes or metal parts that are in  
contact with the patient.  
Precautions  
device handling  
The HeartStart was designed to be sturdy and reliable for many different use  
conditions. However, handling the HeartStart too roughly can damage it or its  
accessories and will invalidate the warranty. Check the HeartStart and accessories  
regularly for damage, according to directions.  
maintenance  
skin burns  
Improper maintenance may damage the HeartStart or cause it to function  
improperly. Maintain the HeartStart according to directions.  
Do not let the pads touch each other or other electrodes, lead wires, dressings,  
medicine patches, etc. Such contact can cause electrical arcing and skin burns  
during a shock and may also divert the electrical current away from the patients  
heart. During a shock, air pockets between the skin and pads can cause skin burns.  
To help prevent air pockets, make sure pads stick well to the skin. Do not use  
dried out pads because they will not provide good contact with the skin.  
patient handling  
Before delivering a shock, it is important to disconnect the patient from other  
medical electrical equipment, such as blood-flow meters, that may not incorporate  
defibrillation protection. In addition, make sure the pads are not in contact with  
metal objects such as a bed frame or stretcher.  
HEARTSTART M5066A  
 
E
Technical information  
HeartStart Defibrillator specifications  
The specifications provided in the following tables are nominal values. Additional  
information can be found in the Technical Reference Manual for HeartStart  
Physical  
category  
size  
specifications  
2.80” H x 7.40” D x 8.30” W (7.1cm H x 19cm D x 21cm W).  
Approximately 3.3 lbs (1.5 kg) with battery and pads cartridge installed.  
weight  
Environmental  
specifications  
category  
E
temperature and  
relative humidity  
Operating (battery and pads cartridge installed):  
32° to 122° F (0° to 50° C)  
0% to 95% RH (non-condensing).  
Standby (battery and pads cartridge installed):  
50° to 109° F (10° to 43° C)  
10% to 75% RH (non-condensing).  
Storage/shipping (with battery and pads cartridge):  
-4° to 140° F (-20° to 60° C) for up to 2 days  
0% to 85% RH (non-condensing)  
altitude  
Operates at 0 to 15,000 feet; can be stored at up to 8,500 feet, in standby  
mode.  
shock/drop abuse  
tolerance  
Withstands 1 meter drop to any edge, corner, or surface.  
vibration  
Operating: meets EN1789 random, road ambulance.  
Standby: meets EN1789 swept sine, road ambulance.  
E-1  
 
E-2  
category  
sealing  
specifications  
Drip proof per EN60529 class IPx1.  
Solid Objects per EN60529 class IP2x.  
ESD/EMI (radiated and  
immunity)  
See Electromagnetic Conformity tables.  
Controls and indicators  
category  
controls  
specifications  
Green SMART Pads cartridge handle  
Green On/Off button  
Blue i-button  
Orange Shock button  
indicators  
Ready light: green; blinks when the defibrillator is in standby mode (ready for  
use); solid when the defibrillator is being used.  
i-button: blue, flashes when information is available, on solid during patient care  
pause.  
Caution light: flashes when the defibrillator is analyzing, comes on solid when  
the defibrillator is ready to deliver a shock.  
Shock button: orange, flashes when the defibrillator is charged and ready to  
deliver a shock.  
audio speaker  
beeper  
Provides voice prompts and warning tones during normal use.  
Provides chirps when troubleshooting is needed.  
HEARTSTART M5066A  
 
E-3  
Defibrillation Waveform  
category  
specifications  
waveform parameters  
Biphasic truncated exponential. Waveform parameters are automatically  
adjusted as a function of patient defibrillation impedance. In the diagram at left,  
D is the duration of phase 1 and E is the duration of phase 2 of the waveform, F  
is the interphase delay (500 µs), and Ip is the peak current.  
The HeartStart delivers shocks to load impedances from 25 to 180 ohms. The  
duration of each phase of the waveform is dynamically adjusted based on  
delivered charge, in order to compensate for patient impedance variations, as  
shown below:  
adult defibrillation  
load  
phase 1  
phase 2  
peak  
delivered  
energy (J)  
resistance (Ω) duration (ms) duration (ms) current (A)  
25  
50  
75  
100  
125  
150  
175  
2.8  
4.5  
6.25  
8.0  
9.65  
11.5  
12.0  
2.8  
4.5  
5.0  
5.3  
6.4  
7.7  
8.0  
65  
40  
30  
24  
21  
18  
16  
128  
150  
155  
157  
159  
160  
158  
pediatric defibrillation  
E
(using M5072A infant/child reduced-energy defibrillator pads)  
load  
phase 1  
phase 2  
peak  
delivered  
resistance (Ω) duration (ms) duration (ms) current (A)  
energy (J)  
25  
50  
75  
100  
125  
150  
175  
4.1  
5.1  
6.2  
7.2  
8.3  
9.0  
9.0  
2.8  
3.4  
4.1  
4.8  
5.5  
6.0  
6.0  
28  
20  
15  
12  
10  
9
35  
46  
52  
54  
56  
57  
55  
8
 
E-4  
category  
energy*  
(pediatric doses indicated  
are based on CDC  
growth charts for the  
50th percentile weights  
for boys.)  
specifications  
Using HeartStart Adult SMART Pads: 150 J nominal ( 15%) into a 50 ohm load.  
Using HeartStart Infant/Child SMART Pads: 50 J nominal ( 15%) into a 50 ohm  
load. Sample pediatric energy doses:  
age  
newborn  
1 year  
energydose  
14 J/kg  
5 J/kg  
2 3 years  
4 5 years  
6 8 years  
4 J/kg  
3 J/kg  
2 J/kg  
*
National Center for Health Statistics in collaboration with the National Center for Chronic  
Disease Prevention and Health Promotion. CDC growth charts: weight-for-age percentiles, revised  
and corrected November 28, 2000. Atlanta, GA: Centers for Disease Control and Prevention ©  
2000.  
charge control  
Controlled by Patient Analysis System for automated operation.  
Shock button flashes, audio tone sounds.  
“charge complete”  
indicator  
shock-to-shock cycle time  
<20 seconds, typical, including analysis.  
patient care  
pause-to-shock time  
Quick Shock. 8 seconds, typical, from end of patient care pause to shock  
delivery.  
disarm (AED mode)  
Once charged, the defibrillator will disarm if:  
• the patients heart rhythm changes to non-shockable rhythm,  
• a shock is not delivered within 30 seconds after the defibrillator has charged  
for shock delivery,  
• the On/Off button is pressed and held down for at least one (1) second to  
turn off the defibrillator,  
• the adhesive pads are removed from the patient or the pads cartridge is  
disconnected from the defibrillator,  
• the battery is removed or is completely depleted or  
• the impedance between pads is out of range.  
adult shock  
delivery vector  
Via adhesive pads placed in the anterior-anterior (Lead II) position.  
infant/child shock  
delivery vector  
Via adhesive pads typically placed in the anterior-posterior position.  
HEARTSTART M5066A  
 
E-5  
ECG analysis system  
specifications  
category  
function  
Evaluates impedance of adhesive pads for proper contact with the patients skin,  
and evaluates the ECG rhythm and signal quality to determine if a shock is  
appropriate.  
shockable rhythms  
Ventricular fibrillation (VF) and some ventricular tachycardias associated with a  
lack of circulation, including ventricular flutter and polymorphic ventricular  
tachycardia (VT). The HeartStart uses multiple parameters to determine if a  
rhythm is shockable.  
NOTE: For patient safety reasons, some very low-amplitude or low-frequency rhythms  
may not be interpreted as shockable VF rhythms. Also, some VT rhythms usually  
associated with circulation will not be interpreted as shockable rhythms.  
non-shockable rhythms  
SMART Analysis is designed to detect non-shockable rhythms as defined by  
AHA/AAMI DF-80. See following table. On detection of any non-shockable  
rhythm, the HeartStart prompts user to perform CPR if needed.  
pacemaker detection  
artifact detection  
Pacemaker artifact is removed from the signal for rhythm analysis.  
If electrical “noise” (artifact) is detected which interferes with accurate rhythm  
analysis, analysis will be delayed until the ECG signal is clean.  
E
analysis protocol  
Depending on results of analysis, either prepares for shock delivery or provides  
a pause. For details of protocol, see Appendix F, Configuration.”  
 
E-6  
ECG analysis performance  
b
meets AHA recommendations for adult defibrillation  
ECG test  
rhythm class  
a
observed  
90% one-sided  
lower confidence limit  
sample size  
performance  
shockable rhythm —  
ventricular fibrillation  
300  
100  
300  
100  
450  
sensitivity >90%  
(87%)  
(67%)  
(97%)  
(92%)  
(88%)  
(meets AAMI DF80 requirement)  
shockable rhythm —  
ventricular tachycardia  
sensitivity >75%  
(meets AAMI DF80 requirement)  
non-shockable rhythm —  
normal sinus rhythm  
specificity >99%  
(meets AAMI DF80 requirement)  
non-shockable rhythm —  
asystole  
specificity >95%  
(meets AAMI DF80 requirement)  
non-shockable rhythm —  
all other non-shockable  
specificity >95%  
(meets AAMI DF80 requirement)  
c
rhythms  
a. From Philips Medical Systems Heartstream ECG rhythm databases.  
b. American Heart Association (AHA) AED Task Force, Subcommittee on AED Safety & Efficacy. Automatic External Defibrillators for Public  
Access Use: Recommendations for Specifying and Reporting Arrhythmia Analysis Algorithm Performance, Incorporation of New  
Waveforms, and Enhancing Safety. Circulation 1997;95:1677-1682.  
c. Supraventricular tachycardia (SVT) is specifically included in the non-shockable rhythm class, in accordance with AHA recommendationsb  
and the AAMI standard DF80.  
HEARTSTART M5066A  
 
E-7  
Accessories specifications  
Battery M5070A  
category  
battery type  
capacity  
specifications  
9 VDC, 4.2 Ah, lithium manganese dioxide. Disposable, long-life primary cell.  
When new, a minimum of 200 shocks or 4 hours of operating time at 77° F  
(25° C). (IEC 60601-2-4 2002)  
shelf life  
(prior to insertion)  
A minimum of 5 years from date of manufacture when stored and maintained  
according to directions provided in this Owner’s Manual.  
standby life  
(after insertion)  
Typically, 4 years when stored and maintained according to directions provided  
in this Owner’s Manual.  
training life  
Supports 10 hours of use in training mode.  
HeartStart Adult SMART Pads M5071A and  
Infant/Child SMART Pads M5072A  
category  
specifications  
E
adult pads  
Disposable, adhesive defibrillation pads with a nominal active surface area of 85  
2
cm each, provided in a snap-in cartridge with an integrated 54” (137.1 cm),  
typical, cable.  
infant/child pads  
Disposable, adhesive defibrillation pads with a nominal active surface area of 85  
2
cm each, provided in a snap-in cartridge with an integrated 40 inch (101.6 cm),  
typical, cable. Cartridge incorporates teddy bear icon on cover of seal for ready  
identification.  
defibrillation pad  
requirements  
Use only HeartStart Adult SMART Pads M5071A or Infant/Child SMART Pads  
M5072A with the HeartStart Defibrillator.  
 
E-8  
Environmental considerations  
By complying with your national regulations regarding disposal of electric,  
electronic, and battery waste, you can make a positive contribution to our shared  
environment. Such waste can introduce harmful elements into the environment as  
a whole and may also endanger human health.  
product  
information  
defibrillator  
The defibrillator contains electronic components. Do not dispose of it as  
unsorted municipal waste. Collect such electronic waste separately and dispose  
of it at an appropriate recycling facility according to your country's regulations.  
battery  
pads  
The battery cells contain chemicals. The chemistry used in each battery is  
identified by a symbol on the label; symbols are defined in the defibrillator  
User's Guide/Instructions for Use/Owner's Manual. Recycle the battery at an  
appropriate recycling facility.  
The used pads may be contaminated with body tissue, fluid, or blood. Cut them  
off and dispose of them as infectious waste. Recycle the remaining cartridge  
components at an appropriate recycling facility in accordance with local  
regulations.  
HEARTSTART M5066A  
 
F
Configuration  
Overview  
The Philips HeartStart Defibrillator comes with a factory default configuration  
designed to meet the needs of most users. This configuration can only be  
changed by an authorized person using HeartStart Configure PDA software or  
Event Review software. This software is for use by trained personnel.  
Information about HeartStart data management products is available online at  
Device options  
The following table includes the features of HeartStart Defibrillator operation that  
are not related to patient treatment.  
parameter  
settings  
default  
8
default description  
speaker volume  
1, 2, 3, 4,  
5, 6, 7, 8  
The volume of the HeartStarts speaker is set  
to 8, highest.  
auto send periodic  
self-test (PST) data  
On, Off  
On  
On  
Enables the periodic self-test data to be  
broadcast through the device's infrared data  
port.  
F
ECG out data  
On, Off  
Enables the ECG data to be broadcast  
through the device's infrared data port.  
F-1  
 
F-2  
Patient treatment protocol options  
parameter  
settings  
default  
default description  
“call EMS” voice • At power on (when At the start of  
Provides a voice reminder to make  
sure emergency medical services have  
been called, at the start of the first  
patient care pause.  
reminder timing  
the user turns on  
the HeartStart)  
the first  
patient care  
pause  
• At power on and at  
the start of the first  
patient care pause  
• At the start of the  
first patient care  
pause  
• No reminder  
shock series  
1, 2, 3, 4  
1
The automatic protocol pause for CPR  
is activated each time a shock is  
*
delivered.  
During the protocol pause, the  
HeartStart does not perform rhythm  
analysis.  
The length of the protocol pause after  
a shock series is completed is  
determined by the protocol pause  
timer setting.  
shock series interval  
(minutes)  
1.0, 2.0,  
(infinity)  
1.0  
A delivered shock must occur within 1  
minute of the previous shock to be  
counted as part of the current shock  
series.  
NOTE: This parameter is only applicable  
when the shock series is not configured to  
the default 1 shock.  
* A shock series begins when a shock is delivered after the HeartStart is turned on. A new shock series begins after a  
protocol pause. If shock series is configured for 2 or more, a new shock series also begins if the time since the previous  
shock exceeds the shock series interval setting.  
HEARTSTART M5066A  
 
F-3  
parameter  
settings  
default  
2.0  
default description  
protocol pause timer  
(minutes)  
0.5, 1.0, 1.5,  
2.0, 2.5, 3.0  
A 2-minute protocol pause for CPR  
automatically starts after voice  
instruction is given when a shock  
series is completed. After the protocol  
pause, the defibrillator returns to  
rhythm analysis.  
If the user presses the i-button for  
optional CPR coaching, the HeartStart  
provides coaching for 5 cycles of CPR,  
starting and ending with compressions,  
when the CPR Coaching parameters  
are also set to their default values. The  
number of CPR cycles varies for other  
protocol pause timer and CPR  
Coaching parameter settings.  
Note: Because the protocol pause ends  
upon completion of a CPR cycle in order  
to maximize the benefits of CPR, the  
actual duration of the pause may differ  
slightly from the timer setting.  
NSA pause type • Standard NSA  
pause: HeartStart  
does not perform  
rhythm analysis  
SMART NSA  
pause  
During a SMART NSA pause, the  
defibrillator conducts background  
monitoring. If a potentially shockable  
rhythm is detected in a motionless  
patient, the defibrillator terminates the  
SMART NSA pause and resumes  
rhythm analysis.  
during the NSA  
pause.  
• SMART NSA pause:  
HeartStart con-  
ducts background  
monitoring during  
the SMART NSA  
pause. If a poten-  
tially shockable  
rhythm is detected,  
HeartStart termi-  
nates the SMART  
NSA pause and  
resumes rhythm  
analysis.  
NOTE: If the HeartStart detects CPR in  
progress or if the responder has pressed  
the i-button for CPR Coaching, the SMART  
NSA pause will be converted to a  
standard NSA pause. During the standard  
NSA pause, the defibrillator does not  
perform rhythm analysis.  
F
 
F-4  
parameter  
settings  
default  
2.0  
default description  
NSA pause timer  
(minutes)  
0.5, 1.0, 1.5,  
2.0, 2.5, 3.0  
A 2-minute NSA pause for CPR  
automatically starts after voice  
instruction is given when no shock is  
*
advised (NSA).  
If the user presses the i-button for  
optional CPR coaching, the HeartStart  
provides coaching for 5 cycles of CPR,  
starting and ending with compressions,  
when the CPR Coaching parameters  
are also set to their default values. The  
number of CPR cycles varies for other  
NSA pause timer and CPR Coaching  
parameter settings.  
Note: Because the NSA pause ends upon  
completion of a CPR cycle in order to  
maximize the benefits of CPR, the actual  
duration of the pause may differ slightly  
from the timer setting.  
CPR prompt • CPR1: Instructs the CPR4:  
The CPR reminder voice instructions  
provided at the beginning of a pause  
interval assures the user that it is safe  
to touch the patient, instructs the user  
to begin CPR, and invites the user to  
user to begin CPR.  
Instructs the  
user that it is  
safe to touch  
the patient, to  
• CPR2: Instructs the  
user that it is safe  
to touch the  
patient and to begin  
CPR.  
begin CPR, and press the i-button for guidance in the  
to press the  
i-button for  
basic steps of CPR.  
Note: CPR Coaching is available only with  
the CPR3 and CPR4 settings.  
• CPR3: Instructs the  
user to begin CPR  
and to press the  
i-button for CPR  
Coaching.  
CPR Coaching.  
• CPR4: Instructs the  
user that it is safe  
to touch the  
patient, to begin  
CPR, and to press  
the i-button for  
CPR Coaching.  
* If the shock series is configured to 2 or more, and a shock has been delivered as part of a series, the length of the first  
NSA pause within that shock series is determined by the protocol pause timer setting. Otherwise, the length of an NSA  
pause is determined by the NSA pause timer setting.  
HEARTSTART M5066A  
 
F-5  
parameter  
settings  
Yes, No  
default  
Yes  
default description  
CPR Coaching  
adult ventilation  
instruction  
Optional CPR Coaching includes  
rescue breaths at the rate determined  
by the CPR Coaching  
compression:ventilation ratio for  
adults when an adult pads cartridge is  
installed.  
NOTE: if this parameter is configured to  
NO, CPR Coaching will always be  
compressions-only when an adult pads  
cartridge is installed.  
CPR Coaching  
infant/child ventilation  
instruction  
Yes, No  
Yes  
Optional CPR Coaching includes  
rescue breaths at the rate determined  
by the CPR Coaching  
compression:ventilation ratio for  
infants and children when an infant/  
child pads cartridge is installed.  
NOTE: if this parameter is configured to  
NO, CPR Coaching will always be  
compressions-only when an infant/child  
pads cartridge is installed.  
CPR Coaching • 30:2 adult and  
30:2 adult and  
30:2 infant/  
child  
If the user presses the i-button for  
optional CPR Coaching during a  
protocol pause or NSA pause, the  
HeartStart provides coaching in basic  
CPR for cycles of 30 compressions and  
2 ventilations for adults, children, and  
infants. Pauses begin and end with  
compressions.  
compression:ventilation  
ratio  
30:2 infant/child  
• 30:2 adult and  
15:2 infant/child  
• 15:2 adult and  
15:2 infant/child  
F
 
Notes  
HEARTSTART M5066A  
 
G
Testing and troubleshooting  
Testing  
As long as a battery is installed, the HeartStart Defibrillator automatically tests  
itself every day and alerts you if it finds a problem. The self-test includes pads  
readiness testing. In addition, it runs a pads self-test each time a pads cartridge is  
inserted. It alerts you if it finds a problem. See the Technical Reference Manual,  
tests.  
You can also test the defibrillator at any time by removing the battery for five  
seconds then reinstalling it. This test takes about one minute. Because the battery  
insertion self-test is very detailed and uses battery power, running it more often  
than necessary will drain the battery prematurely. It is recommended that you run  
the battery insertion self-test only:  
when the defibrillator is first put into service.  
after each time the defibrillator is used to treat a patient.  
when the battery is replaced.  
when the defibrillator may have been damaged.  
If you need to use the defibrillator in an emergency while you are running a  
battery self-test, pull the SMART Pads cartridge handle to stop the test and to turn  
on the HeartStart for use.  
Troubleshooting  
The HeartStarts green Ready light is the signal that tells you if the defibrillator is  
ready for use. The defibrillator also uses chirps and the i-button flashes to alert  
you to a problem.  
G
Recommended action during an emergency  
If for any reason the HeartStart does not turn on when you pull the SMART Pads  
cartridge handle, press the On/Off button.  
If that does not turn on the defibrillator, remove the battery and replace it with a  
new battery if available and press the On/Off button to turn on the defibrillator. If  
G-1  
 
G-2  
no spare battery is available, remove the installed battery for five seconds, then  
reinsert it and run a battery insertion self-test.  
If the problem continues, do not use the HeartStart. Attend to the patient,  
providing CPR if needed, until Emergency Medical Services Personnel arrive.  
Troubleshooting while the HeartStart is in use  
(green Ready light is solid)  
HeartStart tells you:  
possible cause  
recommended action  
... to replace the battery The battery is nearly depleted. The  
immediately defibrillator will turn off if a new  
battery is not inserted.  
Replace the battery with a new battery  
immediately.  
... there is no cartridge • The pads cartridge has been  
Insert a new pads cartridge.  
installed, and  
... to insert a pads cartridge  
removed.  
• The pads cartridge has been  
damaged.  
... to press the pads firmly to • The pads are not properly applied  
• Make sure that the pads are sticking  
completely to the patient’s skin.  
• If the pads are not sticking, dry the  
patient's chest and shave or clip any  
excessive chest hair.  
the skin  
... to make sure the pads  
have been removed from  
the liner  
... the pads should not be  
touching the patients  
clothing.  
to the patient.  
• The pads are not making good  
contact with the patient's bare  
chest because of moisture or  
excessive hair.  
• The pads are touching each other.  
• The pads may not have been  
removed from the liner or may be  
on the patient’s clothing.  
• Reposition the pads.  
• Make sure the pads are not on the  
liner or the patient’s clothing.  
If the voice instruction continues after  
you do these things, insert another  
pads cartridge.  
... to insert new The pads cartridge has been opened  
pads cartridge and the pads peeled off the liner, but  
the pads have not been successfully  
Replace the damaged pads cartridge.  
Pull up the handle on the cartridge  
cover, and replace pads on patient  
with new pads to continue with the  
attached to the patient. There may  
be a problem with the pads cartridge. rescue.  
HEARTSTART M5066A  
 
G-3  
HeartStart tells you:  
possible cause  
recommended action  
... to stop all motion • The patient is being moved or  
jostled.  
• Stop CPR; do not touch the patient.  
Minimize patient motion. If the  
patient is being transported, stop  
the vehicle.  
• The environment is dry and  
movement around the patient is  
causing static electricity to  
interfere with ECG analysis.  
• Radio or electrical sources are  
interfering with ECG analysis.  
• Responders and bystanders should  
minimize motion, particularly in dry  
environments that can generate  
static electricity.  
• Check for possible causes of radio  
and electrical interference and turn  
them off or remove them from the  
area.  
... the shock was not • The pads may not be making good  
• Press the pads firmly to the patient's  
chest.  
• Make sure the adhesive pads are  
correctly positioned on the patient.  
• Replace the pads if necessary.  
delivered  
contact with the patients skin.  
• The pads may be touching each  
other.  
• The pads may be damaged.  
... the shock button was not Shock has been advised but the shock When next prompted, press the Shock  
pressed button has not been pressed within  
30 seconds.  
button to deliver shock.  
G
 
G-4  
Troubleshooting while the HeartStart is not in use  
(green Ready light is not on)  
behavior  
possible cause  
recommended action  
chirps or • The battery power is low or the  
• Press the blue i-button. Replace the  
battery or pads cartridge if  
instructed.  
i-button flashes  
SMART Pads cartridge needs to be  
replaced.  
• The defibrillator may have been  
turned off without a pads cartridge  
installed, or the installed pads  
cartridge may not have its hard  
cover in place.  
• Make sure the pads cartridge is  
properly installed with the hard  
cover in place. (See Chapter 5,  
“Maintaining the HeartStart,” for  
directions on installing the pads  
cartridge.)  
• The training pads cartridge has been • Remove the training pads cartridge  
left in the defibrillator.  
and replace it with an Adult or  
Infant/Child Pads Cartridge.  
• Remove the battery for five  
seconds then reinstall it to start  
the battery insertion self-test. If it  
fails, insert a new battery to repeat  
the test. If it fails again, do not use  
the defibrillator. If it passes, store  
the defibrillator within the  
• The defibrillator has been stored  
outside the recommended  
temperature range.  
recommended temperature range.  
• Contact Philips for service if  
needed.  
• The defibrillator has detected an  
error during a self-test or cannot  
perform a self-test, or the Shock  
button is damaged.  
no chirping and/or • The battery is missing or completely Remove the battery for five seconds  
i-button does not flash  
depleted.  
then reinstall it to start the battery  
insertion self-test. If it fails, insert a  
new battery and repeat the test. If it  
fails again, do not use the defibrillator.  
Contact Philips for service.  
• The defibrillator may have been  
physically damaged.  
HEARTSTART M5066A  
 
H
Additional technical information required for European  
conformity  
Electromagnetic conformity  
Guidance and manufacturer’s declaration: The HeartStart is intended for use in the  
electromagnetic environment specified in the tables below. The customer or user  
of the HeartStart should assure that it is used in such an environment.  
Electromagnetic emissions  
emissions test  
compliance  
electromagnetic environment – guidance  
RF  
CISPR 11  
Group 1  
Class B  
The HeartStart 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.  
The HeartStart is suitable for use in all establishments,  
including domestic establishments and those directly  
connected to the public low-voltage power supply network  
that supplies buildings used for domestic purposes.  
H
H-1  
 
H-2  
Electromagnetic immunity  
IEC 60601  
electromagnetic environment -  
guidance  
immunity test  
compliance level  
test level  
electrostatic discharge  
(ESD)  
6 kV contact  
8 kV air  
6 kV contact There are no special requirements  
8 kV air  
with respect to electrostatic  
a
IEC 61000-4-2  
discharge.  
power frequency  
(50/60 Hz) magnetic field  
IEC 61000-4-8  
3 A/m  
3 A/m  
Power frequency magnetic fields  
should be at levels characteristic of a  
typical location in a typical  
commercial/hospital environment.  
There are no special requirements for  
non-commercial/non-hospital  
environments.  
radiated RF  
IEC 61000-4-3  
10 V/m  
80 MHz to 2.5  
GHz  
20 V/m  
Portable and mobile RF  
communications equipment should be  
used no closer to any part of the  
HeartStart, including cables, than is  
b,c  
absolutely necessary. The  
recommended separation distances  
for various transmitters and the AED  
are shown in the following table.  
Interference may occur in the  
vicinity of equipment marked  
with the following symbol:  
NOTE 1. At 80 MHz and 800 MHz, the higher frequency range applies.  
NOTE 2. These guidelines may not apply in all situations. Electromagnetic propagation is affected by absorption and  
reflection from structures, objects and people.  
a. Generally, AEDs are sometimes susceptible to interference generated by patient and/or responder motion in environments in which a high  
static electric field is present (e.g., low humidity, synthetic carpets, etc.). As a safety measure, Philips AEDs incorporate a patented method  
to sense possible corruption of the ECG signal by such interference and to respond by directing the user to stop all motion. In these cases,  
it is important to minimize movement in the vicinity of the patient during rhythm analysis in order to ensure that the signal being analyzed  
accurately reflects the patient’s underlying heart rhythm.  
b. The ISM (industrial, scientific and medial) 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.  
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  
HeartStart is used exceeds the applicable RF compliance level above, the HeartStart should be observed to verify normal operation. If  
abnormal performance is observed, additional measures may be necessary, such as re-orienting or relocating the HeartStart.  
HEARTSTART M5066A  
 
H-3  
Recommended separation distances between portable and mobile RF  
communications equipment and the HeartStart  
The HeartStart is intended for use in an electromagnetic environment in which  
radiated RF disturbances are controlled. The customer or the user of the  
HeartStart can help prevent electromagnetic interference by maintaining a  
minimum distance between portable and mobile RF communications equipment  
(transmitters) and the HeartStart as recommended below, according to the  
maximum output power of the communications equipment.  
separation distance according to frequency of transmitter (m)  
rated maximum output  
power of transmitter (W)  
80 MHz to  
800 MHz  
d = 0.6P  
800 MHz to  
2.5 GHz  
d = 1.15P  
0.01  
0.1  
1
0.06  
0.19  
0.6  
0.115  
0.36  
1.15  
3.64  
11.5  
10  
1.9  
100  
6.0  
For transmitters rated at a maximum output power not listed above, the recommended separation distance d  
in meters (m) can be determined using the equation applicable to the frequency of the transmitter, where P is  
the maximum output power rating of the transmitter in watts (W) according to the transmitter manufacturer.  
NOTE 1. At 80 MHz and 800 MHz, the separation distance for the higher frequency range applies.  
NOTE 2. The ISM (industrial, scientific and medial) 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.  
H
 
H-4  
Important warnings and reminders  
Do not allow the pads to contact other electrodes or metal parts that are in  
contact with the patient.  
Before delivering a shock, it is important to disconnect the patient from other  
medical electrical equipment, such as blood-flow meters, that may not  
incorporate defibrillation protections. In addition, make sure the pads are not  
in contact with metal objects such as a bedframe or stretcher.  
Check supplies, accessories, packaging, and spares for damage and expiration  
dating.  
Environmental considerations  
The defibrillator contains electronic components. Dispose of it at an  
appropriate recycling facility.  
The battery cells contain chemicals. Recycle the battery at an appropriate  
recycling facility.  
The used pads may be contaminated. Cut them off and dispose of them  
properly. Recycle the remaining cartridge components at an appropriate  
recycling facility.  
Shock cycle timing  
The HeartStart Quick Shock feature allows it to deliver a shock within 8 seconds,  
typical, following the prompt ending a CPR Interval. From shock to shock, the  
HeartStart takes <20 seconds, typical, including analysis. After 15 shocks, the  
HeartStart takes <30 seconds from analyzing to ready-to-shock. After 200 shocks,  
the HeartStart takes <40 seconds from initial power-on to ready-to-shock.  
HEARTSTART M5066A  
 
Intentionally blank.  
 
Intentionally blank.  
 
Intentionally blank.  
 
Intentionally blank.  
 
Intentionally blank.  
 
P O W E R T O S A V E  
A
L I F E  
Philips Medical Systems  
Philips Medical Systems is part of  
Royal Philips Electronics  
United States  
Philips Medical Systems  
2301 Fifth Avenue, Suite 200  
Seattle, WA, USA 98121  
(800) 263-3342  
Canada  
Philips Medical Systems  
281 Hillmount Road  
Markham, Ontario  
L6C 2S3  
(800) 291-6743  
Europe, Middle East, and Africa  
Philips Medizin Systeme Boeblingen GmbH  
Cardiac and Monitoring Systems  
Hewlett-Packard Strasse 2  
71034 Boeblingen, Germany  
+49 7031 463 2254  
Latin America  
Philips Medical Systems  
1550 Sawgrass Corporate Parkway, Suite 300  
Sunrise, FL 33323, USA  
(954) 835-2660  
Asia Pacific  
Philips Electronics Hong Kong Ltd.  
30th Floor, Hopewell Centre  
17, Kennedy Road, Wanchai  
Hong Kong  
(852) 2821 5888  
REF: M5066-91901  
 

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