That was extremely annoying. That was one of the most annoying bugs I've ever seen on YouTube. Absolutely annoying. Because it stopped the data stream, and when it stopped the data stream, it also kept the old live session going. So I had to delete the old session in order for it to even allow me to start a new session, even though there's no data stream. So I had no rights. I couldn't do anything.

Wow, that was an absolute nightmare, but welcome back, guys. That's craziness. I have no idea what happened. It was probably like a neighborhood internet outage because it seemed to also affect my telephones and it affected this laptop. Just a bunch of stuff. You know, stuff happens, right? I'll give everybody just a minute. Man, I had like 15 people watching when it just dropped the stream. It's unfortunate.

Anyway, I'll give everybody just a moment before I try and regain my train of thought here. Good to see some of you guys. All right, guys. So as I was saying, you can monitor the heart through either your cable or through your ECG leads, which I have currently hooked up. And you switch between those using the lead button. Now I can tell you for a fact that I have gone into a surgical room when the anesthesiologist

is tripping out, the cardiologist is tripping out because they can't pull up the patient. It's just a flat line and this patient is very much so not a flat line. And it's the lead button. They bump it. They do whatever. And if it's not on the correct setting, then you're not going to get the correct results. There we go. So here's the crazy thing about these older analyzers. So you see how it's got these adapters.

Normally you want them color coded or something because if you put them on wrong, you can see what you get on your defib. You get an inverted waveform. So the polarity is backwards. So normally there is apex and sternum and sometimes they're labeled. But if you ever walk up to a defib and you see that the waveform when it's on paddles is upside down, disconnect your adapters and get a standard waveform. That happens so often, you guys, very, very often.

So there's a couple of things that I really want to talk with you guys about when it comes to these defibs. Very important stuff, all right? So these defibs, all modern defibs do something called CardioSync or Sync. You can see the button right here, it says Sync. And what that does is it monitors your R of your QRS, which is that tiny or is that really high point. It's the peak. And it's going to put a dot next to it.

You see that? Let's see if I can get it on camera a little bit better. So what it's doing is it's monitoring for the peak. And when it senses the peak, it's going to discharge energy as soon as it can after the peak. And sometimes, I mean, given like right now, it's not very difficult. But when it's on, let's say, an arrhythmia to atrial flutter, that's a little more reasonable. So it's looking for the R wave.

And in order for it to be an effective defibrillation, a more effective defibrillation, it has to be a discharge of energy right after the peak. And you have 60 milliseconds from that peak for it to discharge. And that is something that we actually measure with our analyzer. And it's one of the most important measurements that we take when we do our PM is the cardio sync time. So we measured the amount of time it takes for it to energize all the way up to its maximum

energy, which for this one is 200 joules. So what I'm going to do is put my analyzer, I don't know if I can show this, I'm going to put it on defib. No, I don't want to do that. And it gives me three settings. One of them is energy, one of them is cardio, and one of them is max. I've never done max. It's energy or cardio. Energy is when you want to take measurements and make sure that it's not off. Cardio is going to measure the timing between your ECG leads when it senses the pulse and

on your other cable when it discharges the pulse. So that's what you're measuring. It's going to place that little triangle at the top when it senses the peak on this cable. And on this cable here, it's going to discharge within 60 milliseconds, which is not a lot of time, guys. It's a real short duration. You can sense one of my cable connections here is funky because it's acting like it. So you can see the triangle.

And what happens in cardio sync mode is you press charge. You're going to count the amount of seconds it takes to get up to the maximum energy. And here's where people mess up. When you're in cardio sync mode, you press and hold the button. You don't just press it. You press and hold. And what it does is it waits to the next triangle, and then it discharges your energy. So press. So you press and hold. And when it senses the next peak, that's when it discharges.

And over here on my analyzer, it tells me some very important information. The most important is the amount of milliseconds between the sense and the discharge. And on this one, it's 24 milliseconds on this LifePak right here. Now the older LifePaks, they used to get easily up around 50 to 55 milliseconds because the LifePak 12s, the LifePak 10s, the larger giant models, those ones, they just took their sweet

time to do what they got to do. These newer ones, they're way faster. The Zolls, Zoll defibs, are even faster than this. They're like 10 milliseconds, 12 milliseconds. milliseconds. This one here is at 24. It's well within the spec. So the American Heart Association suggests 60 milliseconds. The other important thing that my analyzer here tells me, up here in the corner, it says the amount of energy that it measured. So I told it to kick out 200 joules. Over here it

measures 205.6. So in my work order notes, I'm going to annotate that 200 joule CardioSync. I registered 205.6 joules at 24 milliseconds. And all defibrillator analyzers will have this CardioSync analyzer function. I can tell I got some bad cables here or something. But that's one of the most important things that we test on this. And then after that is going to be your other standard tests. One of the important things that we have

to remember is these defibrillators also come with paddles. You can see they're labeled Apex and Sternum. So when we check out these defibs, we also are going to plug in the paddles. And that's why we pull these adapters off. And we put these defib paddles immediately on the analyzer. Direct contact. No gel, no nothing like that. Just put them straight on there. But the first thing that we're going to test is the paddles themselves to make sure that the wiring and all the

circuitry here is good. Because paddles get dropped, they get slammed around. A lot of stuff happens to paddles and they do go bad. So the way that you test your paddles is you stick them together. You see that nice perfect flat line that happens? So what you are doing is you are instantly verifying all the cabling and everything in between these two paddles is perfectly good. You can see I can move them around. You're not

seeing any blips. See that blip? See that stuff there? That's what happens when you have a poor wiring connection. Either here at the paddles or here at the connector. So if you wiggle this connector around and you start seeing those lines blipity blip like that, that is when you either have a bad connector or you have bad paddles. So your first test when you walk up and you're going to test your paddles, put them together, wiggle your cabling around and check

that bad boy and see if it's okay. And then from there we're going to go, I'm going to set my analyzer back to defib and I'm going to put on energy this time and I'm going to measure the amount of output that my paddles are giving me. So one of the best ways to test your defib is to pull the power cord. When you walk up to a defib and you start checking it out, pull your power cord and I leave it dangling right over in front like this. I don't know, you can't see it. Leave

it dangling right in plain view. That way there you know that, hey, I left it unplugged, right? So I'm doing all my energy output tests and everything. I'm doing a lot of shocks. I'm going to do it all on battery because I want to test out that battery to see how good it is. Now the defibs, they know how old their battery is that's inserted. And after a certain date and time, it's going to give you an error code and you have to go and change out the battery. But we still don't

know of the battery. So that's what we're testing by testing it all on battery. So I'm going to go ahead and set the defib. Guys, I stand corrected. This is the first time I've been messing around with the LifePak 20E and this guy does biphasic to 360 joules. That's crazy. I have never seen a biphasic defibrillator go that high. It's always monophasic. So more power to them, I guess. That's cooking a patient. That's a lot of energy. That's okay. We're going to test it out anyway. Let's

see. I'm going to set this guy to paddles. Okay. You can see I've got a good connection here. It's a flat line. We're ready to go. I'm charging it at 360 joules. Remember guys, we're doing this completely on battery power. You want to know the amount of time it takes to charge to the maximum energy. And if I remember right, it's less than nine seconds. So if it takes you longer than nine seconds, it means your internal batteries are going bad. Okay. So you can see it tells you to

press your buttons. You have to press two of them. Notice I press that one, nothing happens. Notice this one, nothing happens. If I press them together, they're going to discharge. Do not discharge into air. Always discharge through your analyzer. Ready? Go. So you can see. All right. So it's looking for heart rate right now. So I discharged at 360 joules over here on my analyzer. It's reading 369.2 joules. That one's good. And from here, you're going to select a different energy range. So set

it at 300. Charge. You want to make sure that you got good contact on this because you don't want pitting or anything like that to happen. You got to make sure that these two surfaces are perfectly defect free because if there's any pitting, any rust or anything like that, it's going to create hot spots on your patient. When you go to energize, hot spots will cause burns. And it's, you know, if somebody looks at your defib and they see that, you know, that's what caused the problem and you

were the last person to touch it and it's got rusty paddles, that's on you, man. And that's not going to be good. Whenever you're dealing with life support equipment, make sure you document everything. And if it's got bad paddles, if they're chipped, cracked, whatever, replace them, replace them, or suggest to your customer that they get them replaced. Document that you suggested it needs to be replaced. Okay. So let's see. That is testing with paddles. I think you guys get it,

the paddles. Now, the only other thing that's very important is when you are done with your tests, make sure that your paddles are stowed correctly. Make sure that they're stowed correctly. The users almost never have the paddles plugged in. They always use it with this cable here. Never with the paddles, almost never. But make sure that the cable isn't tangled up. Make sure it's nice and organized, that your paddles are actually

connected properly. All right. When I leave a defib, I make sure that all the cables are done up nice and neat, tucked in where they need to be tucked in. It's especially important with defibrillators. They grab them and they just run. They take off with them. All right. So let's put this guy back on so I can show you some of the other tests that we do. So I have nothing on it, so I'm going to select paddle. Escape, escape, escape, go back. I really like these raised

buttons on this analyzer. It allows me to go through these tests really quickly. So normally 60. Okay, guys. You can see right here, these aren't labeled, but I have an inverted sinus rhythm which tells you I have the polarity wrong. So I'm going to switch them back around. All right. Here we go. So now that I got the correct polarity, everything's set back up. Now I can continue on with some of my other tests.

So let's see. I had it at 200. Put it back into defib analyzer mode energy high Okay, so one of the things that we do have to test on these is whether or not it can detect that it's got a Good sinus rhythm, and if it does have a good sinus rhythm, then it should not shock so that is AED mode I can do it here, or I can close this fancy little door, so I currently have defib Okay, so I press the defib button, and I press analyze, and it should not shock you can see it's all over the place

There's not a defined R wave for the QRS complex You see it's just that wavy pattern Good not shock It should shock my bad It should shock my bad So it's gonna tell you to go ahead and shock and Then over here. I have two hundred and seven point one joules over here I wanted this charge 200 well within spec. We're good, so you go through the rest of the energy ranges, right? The other thing that we are going to do is we're going to set it to ECG

Normal 60 and we want to make sure that it does not shock with a normal sinus rhythm Okay there we go So we've tested the sink we have tested the The AED mode and the analyze function one of the next things that we are going to check Is we do like 10 to 12? One We do 10 to 12 discharges at maximum energy to make sure that the battery can handle it So we just take it all the way back up Okay again you got to make sure that charges in less than nine seconds

Three 373 joules I'm not going to run through all of them But this is putting a drain on the battery so we're testing the battery and at the same time We're making sure that the the defib is consistent Discharge 372 joules So anyway that That is how you test that function The next most important check that we do after cardio sync and after our energy discharges We are going to test the pacer function the pacer sends out a pulse

To the heart and it tells it when to beat so when the heart cannot establish its own Cardiorhythm or let's say it can't keep a steady heart rate Then you can use the pacer function to tell it how to beat at a consistent interval So let's go ahead and turn it on I'm gonna press the pacer button You can see it defaults to 60 Pulses per minute, that's the PPM and you also set the current okay, so you can you can crank the current way up

And and this is a pretty powerful pulse 200 milliamps When I test these things out I run it all the way up And I run the rate all the way up It should be what 180 170 okay, and on the analyzer The second next to defib is pacer. So we go into pacing function. No We are going to use internal 50 ohm resistive load and We're gonna check for pulses So the little analyzer, let's see if I can pull this in the frame So you can see the pulses that it's detecting and it kind of does a graphical representation right here

And at the same time it shows you how many PPM you have along with how many milliamps? So these are all things that you're going to document in your work order So you want to make sure that the pacing mechanism can keep up to its maximum load its maximum load is 200 milliamps at a hundred To 70 ppm. So you're gonna start there. I'm at 203 milliamps at a 170 Then I'm gonna take the current down Let's take it down to 150

Take the ppm down to 150 Okay, I'm at a hundred and fifty two hundred and fifty one ppm so I will document this 151 ppm and over on the amount of current I have 153.6 milliamps, so I'm off by 3.6 milliamps Let's take it down even further I Like doing things in a hundred Is that tells you in a real percentage wise what your deviation is? So we're at a hundred milliamps a hundred ppm over here I'm at a hundred ppm, and I have a hundred and two point eight milliamps. That means I'm off by two point eight percent

Okay so Generally when you're working with like issues with Defibs whatever if you need a percentage always take it to a hundred and then from there you instantly know what your percentages of deviation So that's the main punk The main functionality of the pacer now. There are a couple other really important things So we have this Let's see you see this little pulse right here. I hope that's picking up Whoa, she's temperamental folks. She is temperamental

This guy I'll tell you what. I didn't check this analyzer before I brought it home Oh, that's interesting so as soon as it sense a fault it will instantly stop the discharge I Didn't know that good to know Let's take it back to a hundred and one hundred Okay, I have a hundred ppm. I have one or two point eight so again two point eight percent off Now the other things do Over here you have a pause button and in some deep edge

You have a one in four button and what it does is it allows it to stop? pulsing so the doctor can get a quick glimpse at what the hearts trying to if it's trying to Or if you know it's just failing completely So that's one of the things that we do we press pause and you see See how it does one beat and then it goes for a period of time and then another beat because your heart still has to beat so the pause is doing a one in four so a

One in four means that for every four beats that you tell it to do. It's it's going to do one pulse and When you release the button it goes back to its regular rate So I have it set at a hundred ppm. So one in four Is basically what? 25 p.m. And That's all the doctor is gonna do is he wants to see the heart rate He's gonna hold the button Look and see what the hearts doing and then you let go of it and it goes back to beating the heart for the patient

So that's that's the pause function Now, let's see. This this one is a little different Some of the defibs have a async sync for pacing and Async or sync is asynchronous Which means that if the heart is trying to beat at a certain Certain amount of beat