Physiogard Touch 7

DEFIGARD 1):4*0GARD
TOUCH 7 TOUCH 7
User guide
* 0-48-0227 *
Art. no.: 0-48-0227 Rev.: g
1
Sales and Service Information
The SCHILLER sales and service centre network is world-wide. For the address of your
local distributor, contact your nearest SCHILLER subsidiary.
In case of difficulty, you can find a complete list of all distributors and subsidiaries on our
Internet site:
http://www.schiller.ch
Sales information can also be obtained from:
sales@schiller.ch
Manufacturer
SCHILLER MEDICAL Phone +33 3 88 63 36 00
4, rue Louis Pasteur Fax +33 3 88 94 12 82
F- 67160 Wissembourg E-mail: info@schiller.fr
Web: www.schiller-medical.fr
Art. no./revision: Date Note

0-48-0227 a 16.12.2014 Version a for testing
0-48-0227 b 3.06.2015 Updated version for validation
0-48-0227 c 1.09.2015 Updated version with minor changes
0-48-0227 d 7.04.2016 Add new feature CO2 and
PHYSIOGARD Touch 7 and other changes.
0-48-0227 e 25.01.2017 Adding correction according to Mantis. Add
IBP and Pacemaker.
0-48-0227 f 3.11.2017 Update to Software revision 6
0-48-0227 g 8.02.2018 Adding correction according to Mantis .
The DEFIGARD Touch7 bears the CE-0459 mark (Notified Body LNE/G-MED), indicating its compli-
ance with the essential requirements of the Annex I of the Medical Device Directive 93/42/EE re-
garding safety, functionality and labelling. The requirements apply to patients, users and third per-
sons who come into contact with this device within the scope of its intended use. First declaration
26.04.2015
The PHYSIOGARD Touch 7 bears the CE-0459 mark (Notified Body LNE/G-MED), indicating its com-
pliance with the essential requirements of the Annex I of the Medical Device Directive 93/42/EE re-
garding safety, functionality and labelling. The requirements apply to patients, users and third per-
sons who come into contact with this device within the scope of its intended use. First declaration
7.04.2016
Article no.: 0-48-0227 Rev.: g

Issue date: 8.02.2018
Translation: original
SW ≥ 6
DEFIGARD/PHYSIOGARD Touch 7 User guide
Table of Contents
1 Safety notes .............................................. 9
1.1 User profiles.......................................................................... 9
1.2 Intended Use ......................................................................... 9
1.3 Contraindication for use .................................................... 10
1.4 Responsibility of the User ................................................ 11
1.5 Organisational Measures ................................................... 11
1.6 Safety-Conscious Operation ............................................. 12
1.7 Operation with other Devices ............................................ 13
1.8 Maintenance........................................................................ 13
1.9 Hygiene................................................................................ 14
1.10 Networks and Internet ........................................................ 14
1.11 Additional Terms ................................................................ 15
1.11.1 Implied Authorisation........................................................................ 15
1.11.2 Terms of Warranty ........................................................................... 15
1.12 Display Symbols/Indicators............................................... 16
1.12.1 Symbols Used in this User Guide .................................................... 16
1.12.2 Symbols used on the device ............................................................ 17
1.12.3 Symbols Used on the Batteries........................................................ 18
1.12.4 Symbols Used on the Electrode Package........................................ 19
2 Components and Operation .................. 20

2.1 Design.................................................................................. 20
2.1.1 Standard unit and options ................................................................ 21
2.1.2 Additional accessories ..................................................................... 21
2.2 Operating Elements............................................................ 22
2.2.1 Front panel DEFIGARD®Touch 7 ................................................... 22
2.2.2 Front panel PHYSIOGARD®Touch 7.............................................. 23
2.2.3 Back Panel ....................................................................................... 24
2.2.4 LEDs ................................................................................................ 24
2.2.5 Display ............................................................................................. 25
3 Initial Operation ...................................... 26

3.1 External DC supply and Battery Operation ...................... 26
3.1.1 External DC Supply Operation ......................................................... 26
3.1.2 Battery Operation ............................................................................. 27
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3.1.3 Operation with external constant voltage source ............................. 28

3.1.4 Operation ambulance charging bracket ........................................... 29
3.1.5 Operation of the desktop charging bracket ...................................... 29
3.1.6 Operation and fixing during intervention .......................................... 30
3.2 Switching off and disconnecting from the external DC supply
31
3.2.1 Lock Touch screen........................................................................... 31
3.2.2 Internal safety discharge .................................................................. 31
3.2.3 Interruption of external power supply ............................................... 31
3.2.4 Ensuring Operational Readiness ..................................................... 32
3.3 Operation............................................................................. 33
3.4 Printing ................................................................................ 34
3.4.1 Pairing Bluetooth devices................................................................. 34
3.4.2 Brother Printer Overview.................................................................. 34
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DEFIGARD/PHYSIOGARD Touch 7
3.5 Connection to a ePCR system........................................... 35

3.5.1 Pairing Bluetooth devices ................................................................ 35
4 Monitoring ...............................................36
4.1 Soft keys, Waveforms and Measurement Fields ............. 36
4.1.1 View selection .................................................................................. 37
4.2 Alarm System...................................................................... 38
4.2.1 Alarm priority.................................................................................... 38
4.2.2 Operator’s position........................................................................... 38
4.2.3 Alarm list .......................................................................................... 38
4.2.4 Physiological alarms ........................................................................ 39
4.2.5 Technical alarms.............................................................................. 39
4.3 Operator-Defined Alarm Thresholds................................. 40
4.3.1 Table of wide/narrow threshold setting ............................................ 41
4.4 ECG and heart rate monitoring ......................................... 43
4.4.1 Quick Diagnosis of the ECG Using Defibrillation Electrodes ........... 43
4.4.2 Connecting a 4- or 10-wire ECG patient cable ................................ 43
4.4.3 Connecting a 4-wire ECG patient cable........................................... 44
4.4.4 Connecting a 10-wire ECG patient cable......................................... 44
4.4.5 Starting ECG monitoring .................................................................. 45
4.4.6 Monitoring a pacemaker patient....................................................... 46
4.4.7 Curve list .......................................................................................... 47
4.4.8 HR Module (ECG)............................................................................ 47
4.4.9 ECG messages................................................................................ 47
4.4.10 Print and pdf formats........................................................................ 48
4.5 Diagnostic ECG (R-ECG).................................................... 49
4.6 SpO2-, SpCO, SpMet monitoring (Option) ........................ 50
4.6.1 Inaccurate or incorrect measurement result .................................... 51
4.6.2 Starting SpO2 monitoring and test................................................... 52
4.6.3 SpO2 Module ................................................................................... 52
4.6.4 SpO2error and information messages .............................................. 53
4.7 NIBP monitoring ................................................................. 55
4.7.1 Starting NIBP monitoring ................................................................. 57
4.7.2 NIBP Menu....................................................................................... 58
4.7.3 NIBP Information and Error Messages ............................................ 58
4.8 IBP Monitoring .................................................................... 59
4.8.1 Preparing an IBP measurement....................................................... 59
4.8.2 Start IPB measurements.................................................................. 60
4.8.3 IBP menu settings............................................................................ 60
4.8.4 IBP zeroing ...................................................................................... 61
4.8.5 IBP alarms/messages ...................................................................... 61
4.9 Temperature monitoring .................................................... 62
4.9.1 Start temperature monitoring ........................................................... 62
Art. no.: 0-48-0227 Rev.: g
4.9.2 Temperature menu settings ............................................................. 62

4.9.3 Temperature alarms......................................................................... 62
4.10 CO2 mainstream ................................................................. 63
4.10.1 IRMA mainstream gas analyser....................................................... 63
4.10.2 Preparing the IRMA sensor.............................................................. 64
4.10.3 Initial operation of the IRMA sensor................................................. 65
4.10.4 Placement of IRMA sensor .............................................................. 65
4.10.5 Zeroing of the IRMA CO2 sensor..................................................... 66
4.10.6 Sensor LED indications.................................................................... 67
4.10.7 Settings etCO2 menu....................................................................... 67
4.10.8 Curve list .......................................................................................... 67
4.10.9 CO2 error messages........................................................................ 68
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4.11 CO2 Sidestream .................................................................. 69

4.11.1 ISA gas analyser (sidestream measurement) .................................. 69
4.11.2 Initial operation of the ISA gas analyser........................................... 71
4.11.3 Sensor LED indications.................................................................... 71
4.11.4 Respiration rate alarms .................................................................... 72
4.11.5 Settings etCO2 menu....................................................................... 73
4.11.6 Curve list .......................................................................................... 73
4.11.7 Zero adjustment of the CO2 sidestream sensor .............................. 73
4.12 Registering events ............................................................. 74
4.13 View Trend, R-ECG and Screenshots ............................... 75
4.13.1 View Trends ..................................................................................... 75
4.13.2 View resting ECG............................................................................. 75
4.13.3 View /Print Screenshots ................................................................... 76
4.14 Transmission ...................................................................... 77
4.14.1 Selecting communication media Wifi or GPRS ................................ 77
4.14.2 Transmission procedure................................................................... 77
5 Defibrillation ........................................... 78
5.1 Application guidelines and safety notes .......................... 78
5.1.1 Additional safety information for AED Mode .................................... 79
5.1.2 Defibrillating children/neonates ........................................................ 80
5.2 General function ................................................................. 81
5.2.1 Activating the manual defibrillation mode......................................... 82
5.2.2 Activating the automated (AED) defibrillation mode......................... 83
5.2.3 Manual defibrillation procedure ........................................................ 84
5.3 Manual Defibrillation Using Pads...................................... 85
5.3.1 Applying the adult and paediatric electrodes ................................... 85
5.3.2 Applying the electrodes.................................................................... 86
5.3.3 Checking the electrodes................................................................... 87
5.3.4 Manual Defibrillation Using Pads Procedure.................................... 88
5.4 Synchronised defibrillation ............................................... 89
5.4.1 Warning erroneous triggering........................................................... 89
5.4.2 Setup switching from synchronized to unsynchronized mode ......... 89
5.4.3 Function of the Synchronized Defibrillation Procedure .................... 90
5.4.4 Synchronised defibrillation procedure .............................................. 91
5.5 Semi-automated defibrillation ........................................... 92
5.5.1 Semi-automated defibrillation (AED) procedure............................... 92
5.5.2 Voice messages in AED Mode......................................................... 93
5.5.3 Defibrillation procedure .................................................................... 94
5.6 CPR Guide........................................................................... 96
5.6.1 SCHILLER LifePoint......................................................................... 96
5.6.2 FreeCPR .......................................................................................... 97
5.6.3 Metronome settings.......................................................................... 97
Art. no.: 0-48-0227 Rev.: g
5.7 Defibrillator Technical Messages...................................... 98
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6 Pacemaker ...............................................99
6.1 Pacemaker Function........................................................... 99
6.1.1 Fixed-rate mode (Fix)....................................................................... 99
6.1.2 Demand mode ................................................................................. 99
6.2 Safety Notes ...................................................................... 100
6.3 Guidelines for the Application of External Pacemakers 100
6.3.1 Attaching the pacer pads ............................................................... 101
6.3.2 Checking the electrodes ................................................................ 101
6.4 Start-up of the Pacemaker ............................................... 102
6.4.1 Pacemaker display......................................................................... 103
6.4.2 Selecting pacemaker mode ........................................................... 103
6.4.3 Pacemaker settings operational mode fix ...................................... 104
6.4.4 Demand Mode ............................................................................... 105
6.4.5 Switching from pacemaker to defibrillation .................................... 105
7 Finishing the Therapy ..........................106
8 Intervention summary ..........................107

8.1 Post-intervention .............................................................. 108
8.1.1 Reviewing intervention file on the device....................................... 108
8.1.2 Transmitting the intervention file .................................................... 108
8.1.3 Autotest.......................................................................................... 108
9 Main Menu .............................................109

9.1 General setup.................................................................... 109
9.1.1 Device Settings Menu ................................................................. 110
10 Maintenance ..........................................112
10.1 Maintenance interval ........................................................ 112
10.1.1 Maintenance Interval Table............................................................ 112
10.1.2 Service/Shelf life ............................................................................ 113
10.2 Functional test .................................................................. 114
10.2.1 Visual inspection of the device and accessories............................ 114
10.2.2 Battery check ................................................................................. 114
10.2.3 Defibrillator key test ....................................................................... 114
10.2.4 Auto Test ....................................................................................... 115
10.2.5 Functional test - measured values ................................................. 115
10.2.6 Alarm tests ..................................................................................... 115
10.3 Update Software .............................................................. 117
10.3.1 Update via USB ............................................................................. 117
Art. no.: 0-48-0227 Rev.: g
10.3.2 Update via Server .......................................................................... 117

10.4 Maintenance interval of the batteries ............................. 118
10.4.1 Replacing the batteries .................................................................. 118
10.4.2 Battery disposal ............................................................................. 118
10.5 Cleaning............................................................................. 119
10.5.1 Detergents ..................................................................................... 119
10.6 Disinfection ....................................................................... 120
10.6.1 Disinfectant .................................................................................... 120
10.6.2 Cleaning and disinfecting the device, cable and sensors .............. 121
10.7 Disposal at the end of the device's useful life ............... 121
10.8 Inspection and Checklist Tables ..................................... 122
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10.8.1 Monthly........................................................................................... 122

10.8.2 Every 12 months ............................................................................ 123
10.8.3 Lifed-item replacement every 5 - 10 years..................................... 123
10.9 Error Detection ................................................................. 124
10.9.1 General errors ................................................................................ 124
10.9.2 Technical Information and Error Messages ................................... 125
10.9.3 Measures to prevent electromagnetic interferences ...................... 126
11 SCHILLER Charging Unit CS-1 ........... 127

11.1 Battery Charging Options ................................................ 127
11.2 Inserting a battery ............................................................ 127
11.3 Control Panel .................................................................... 128
11.4 Battery Calibration ........................................................... 129
11.5 Input and Output Supplies............................................... 130
12 Technical Data ...................................... 131

12.1 System data ...................................................................... 131
12.2 Defibrillation Waveform ................................................... 134
12.2.1 Shock Advisory System ................................................................. 137
12.3 Pacemaker......................................................................... 138
12.4 Technical data - monitoring............................................. 139
12.4.1 ECG ............................................................................................... 139
12.4.2 Features of pacemaker pulse rejection .......................................... 140
12.4.3 NIBP - non-invasive blood pressure............................................... 141
12.4.4 IBP - invasive blood pressure ........................................................ 141
12.4.5 Temperature................................................................................... 141
12.4.6 SpO2 - pulsoximetry....................................................................... 142
12.4.7 etCO2 - Capnography .................................................................... 144
12.5 Telecommunication GSM (option) .................................. 146
12.6 Device Configuration ....................................................... 147
12.6.1 General configuration..................................................................... 147
12.6.2 ECG ............................................................................................... 148
12.6.3 Defibrillator ..................................................................................... 149
12.6.4 Display ........................................................................................... 149
12.6.5 AED................................................................................................ 150
12.6.6 ECG ............................................................................................... 150
12.6.7 IBP ................................................................................................. 150
12.6.8 NIBP............................................................................................... 151
12.6.9 SpO2 .............................................................................................. 151
12.6.10 Temp .............................................................................................. 151
12.6.11 EtCO2 ............................................................................................ 151
Art. no.: 0-48-0227 Rev.: g
12.6.12 Time and date ................................................................................ 152

12.6.13 Event .............................................................................................. 152
12.6.14 SpO2 .............................................................................................. 152
12.6.15 Email configuration......................................................................... 152
12.6.16 Email adresses............................................................................... 153
12.6.17 Transmission.................................................................................. 153
12.6.18 Ethernet.......................................................................................... 153
12.6.19 WIFI................................................................................................ 154
12.6.20 GSM ............................................................................................... 154
12.6.21 SEMA ............................................................................................. 154
12.6.22 SUS (Schiller Update server) ......................................................... 155
12.7 Electromagnetic interferences ........................................ 156
12.7.1 Electromagnetic emissions ............................................................ 156
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12.7.2 Electromagnetic immunity.............................................................. 156

12.7.3 Recommended minimum distances............................................... 158
13 Appendix ...............................................159
13.1 Accessories and disposables ......................................... 159
13.2 Accessories DEFIGARD/PHYSIOGARD Touch 7........... 159
13.3 Literature ........................................................................... 161
13.4 Glossary ............................................................................ 161
14 Index ......................................................163
Art. no.: 0-48-0227 Rev.: g
Page 8
Safety notes 1
DEFIGARD/PHYSIOGARD Touch 7 User guide User profiles 1.1
1 Safety notes
The PHYSIOGARD® Touch 7 is a monitor.
The DEFIGARD® Touch 7 is an emergency monitor / defibrillator.
1.1 User profiles

Physician The DEFIGARD® Touch 7 must only be used by qualified medical or paramedic staff,
if the manual defibrillation mode is activated.
The PHYSIOGARD® Touch 7 must only be used by qualified medical or paramedic

staff.
Other persons The DEFIGARD® Touch 7 can be used by other persons (AED mode only if trained
in early defibrillation).
Training An initial training of at least 30 minutes is necessary and sufficient to use the device.
1.2 Intended Use

Defibrillator
 The DEFIGARD® Touch 7 defibrillation function is used for the treatment of
ventricular fibrillation (VF) and ventricular tachycardia (VT).
Transcutaneous Pacemaker
 The pacemaker pulse is delivered using the same electrode pads (adult or child)
as those used for defibrillation. The frequency and current of the pacemaker
pulses are defined by the user. There are two pacemaker modes as follows:
– Fix: The pacemaker pulse is delivered at a fixed frequency and current level de-
fined by the user.
– On demand: Current level and frequency are defined by the user. The unit mon-
itors the ECG signal and generates pacemaker pulses if the pulse rate falls be-
low the defined value.
 Depending on their configuration, the monitoring function of the
DEFIGARD® Touch 7 & PHYSIOGARD® Touch 7 delivers the most important
parameters – ECG, SpO2, SpCO, SpMet, CO2 – and allows continuous
monitoring of the patient from the beginning to the end of an intervention.
 The devices are intended for single patient use only.
 The devices are designed to meet the specific needs of ground and air rescue
Art. no.: 0-48-0227 Rev.: g
services as well as in-house and inter-hospital transportation.

 The devices can be used for adults, children and neonates with the
corresponding accessories.
ECG
 The ECG is used to diagnose cardiac abnormalities, acute myocardial
ischaemia and infarctions in chest pain patients.
Page 9
1 Safety notes
1.3 Contraindication for use DEFIGARD/PHYSIOGARD Touch 7
NIBP
 The NIBP monitor is intended for use as an aid or adjunct to diagnosis and
treatment when it is necessary to measure an adult, child and neonate patient’s
blood pressure. The NIBP can be used for patients of both sexes and all races.
 This NIBP can be used on pregnant patients or patients suffering from pre-
eclampsia
IBP
 Invasive blood pressure: systolic, diastolic and mean pressure.
SpO2, SpCO, SpMet
 The Masimo Rainbow SET® Pulse CO sensor is indicated for use with adult and
paediatric patients during both no-motion and motion conditions, and for patients
who are well or poorly perfused.
etCO2
 The IRMA mainstream sensor is intended to be connected to a patient breathing
circuit for the continuous non invasive monitoring of breath rate and inspired/
expired gases during anaesthesia, recovery and respiratory care.
 The ISA gas analyser is intended to be connected to a patient breathing circuit
for the continuous non invasive sidestream monitoring of breath rate and
inspired/expired gases during anaesthesia, recovery and respiratory care.
 The CO2 sensors are intended for use with adult, paediatric and infants
populations.
1.3 Contraindication for use

Defibrillation (DEFIGARD® Touch 7)
 The defibrillator of the DEFIGARD® Touch 7 must not be used in automated
mode (AED) when the person:
– is responsiv
– is breathing normally
– has pulse
 Do not use the device in or near magnetic resonance imaging equipment (MRI).
 Danger of explosion! — The device must not be used in areas where there is
any danger of explosion. There might be a danger of explosion in areas where
flammable products (petrol), flammable anaesthetic agents or products for skin
cleaning/disinfection are in use, or where the ambient air's oxygen concentration
is higher than 25 %.
Art. no.: 0-48-0227 Rev.: g
Page 10
Safety notes 1
DEFIGARD/PHYSIOGARD Touch 7 User guide Responsibility of the User 1.4
1.4 Responsibility of the User

 The numerical and graphical results and any interpretation given must be
examined with respect to the overall clinical condition of the patient and the
general recorded data quality.
 The indications given by this equipment are not a substitute for regular checking
of vital functions.
 Always ensure that the screen/alarm LED of the device can be seen in case the
audible alarms cannot be heard or are turned off (see chapter 4.2.2 Operator’s
position page 38).
 The AED of the DEFIGARD® Touch 7 must only be used if the following
symptoms are present:
– not responsive
– not breathing normally
– no pulse
 Make sure that the user has read and understood the user guide, and especially
these safety notes.
 Operating a device with a defective casing, defective cables and sensors
constitutes a danger to the patient or the user! Therefore:
– Immediately replace a damaged unit, damaged cables, sensors and connec-
tions. Damaged or missing components must be replaced immediately.
 The device including sensor and accessories must be serviced on a regular
basis. (see chapter 10.1.1 page 112)
 The DEFIGARD® Touch 7 is an emergency device and must be ready for
operation at any time and in all situations. Ensure that the device is always
equipped with a sufficiently charged battery and keep a spare battery at hand.
 Properly dispose of the package material and make sure it is out of children's
reach.
1.5 Organisational Measures

 Before using the unit, ensure that an introduction regarding the unit functions
and the safety precautions has been provided and understood.
 Always store the user guide at hand near the device. Make sure that the
instructions are always complete and legible.
Art. no.: 0-48-0227 Rev.: g
Page 11
1 Safety notes
1.6 Safety-Conscious Operation DEFIGARD/PHYSIOGARD Touch 7
1.6 Safety-Conscious Operation

 This user guide, and especially these safety notes, must be read and observed.
 Danger of electric shock!
The energy applied to the patient can be conducted through the patient to other
persons, who may suffer a lethal electric shock. Therefore:
– Do not touch the patient, the electrodes or other conducting objects during
defibrillation
– Do not defibrillate the patient in a puddle of water or on other conductive
surfaces
– Switch the device off when it is no longer used.
 To avoid the risk of electric shock, this equipment must only be connected to a
supply mains with protective earth.
 To grant the patient's safety, it must be ensured that neither the electrodes,
including the neutral electrode, nor the patient, or persons touching the patient,
come into contact with conducting objects, even if these are earthed.
 Immediately report any changes that impair safety (including operating
behaviour) to the person responsible.
 Only connect original SCHILLER accessories to the device.
 Before switching on, check if the unit's casing and electrode connection are
undamaged.
 Only operate the device in accordance with the specified technical data.
 Do not expose the device to great temperature variations over a long period of
time. Major temperature variations can cause condensation water on the unit.
Should condensing water nevertheless occur, dry the unit, the defibrillation
electrodes and all connections.
 In case of strong water/liquid spraying onto the device, check the absence of
water/liquid in the battery compartment. If necessary, please remove the battery,
dry water from compartment and replace battery.
 Special caution must always be taken on intracardiac application of medical
equipment. Especially make sure that no conducting parts connected to the
unit's isolated patient input (patient, plug, electrodes, sensor) come into contact
with other, earthed conductive objects, as this might short-out the patient's
isolation and remove the protection of the isolated input.
 Carefully route patient cabling to reduce the possibility of patient entanglement
or strangulation.
 The user shall always remain close to the patient during monitoring.
 Do not place the device where the device can be controlled by the patient.
 Position the device so that there is no possibility of it falling on the patient or
floor.
 Do not reuse disposable accessories marked with the symbol to prevent

cross infection.
If unexpected readings are obtained, the operator should check the connections
Art. no.: 0-48-0227 Rev.: g

and verify the readings according to section 10.2.5 page 115.
Page 12
Safety notes 1
DEFIGARD/PHYSIOGARD Touch 7 User guide Operation with other Devices 1.7
1.7 Operation with other Devices

 Use only accessories and other parts recommended or supplied by SCHILLER.
Use of other than recommended or supplied parts may result in injury,
inaccurate information and/or damage to the unit.
 The patient can be endangered by too high leakage currents (summation of
leakage currents) if:
– several devices are connected to the patient
– other equipment is connected to the DEFIGARD® Touch 7 or
PHYSIOGARD® Touch 7.
For this reason, devices that are not required should be disconnected from the
patient, and only equipment approved by SCHILLER may be connected to the
device.
 Accessory equipment connected to the analogue and digital interfaces must be
certified according to the respective IEC standards (e.g. IEC/EN 60950 for data
processing equipment and IEC/EN 60601-1 for medical equipment).
Furthermore all configurations shall comply with the valid version of the system
standard IEC/EN 60601-1. Everyone who connects additional equipment to the
signal input part or signal output part configures a medical system, and is
therefore responsible that the system complies with the requirements of the valid
version of the system standard IEC/EN 60601-1. If in doubt, consult the technical
service department or your local representative.
 Magnetic and electrical fields of X-ray equipment, tomographs, portable
communication devices, HF radios and devices labelled with the symbol

can affect the operation of this device. (See section 10.9.3 Measures to prevent
electromagnetic interferences page 126.) Avoid using such devices or keep a
sufficient distance from them.
 The charging of energy and the release of the defibrillation impulse can disturb
other devices. Check these devices before their further use.
 Sensors and devices that are not defibrillation proof must be disconnected from
the patient before a shock is triggered.
 If the patient has a pacemaker implanted, do not position the electrode directly
onto the pacemaker. Check the pacemaker after the defibrillation.
 The DEFIGARD® Touch 7 & PHYSIOGARD® Touch 7 can be used together with
high-frequency electrosurgical devices. However, precautions must be
observed when such HF equipment is used. To reduce the risk of burns in the
case of a failure of the neutral HF electrode, a distance of at least 15 cm must
always be kept between the defibrillation electrodes and the HF surgical
electrodes. If in doubt, disconnect the electrodes and sensors from the unit
during use of a HF surgical device. In addition, it may affect the accuracy or
availability of the oximeter measurements.
1.8 Maintenance
Art. no.: 0-48-0227 Rev.: g
 Danger of electric shock! Do not open the device. No serviceable parts inside.
Refer servicing to qualified personnel only.
 No modification of this equipment including sensor and accessories is allowed.
 Before cleaning, switch the unit off and remove the battery.
 Do not use high temperature sterilisation processes
(such as autoclaving). Do not use E-beam or gamma radiation sterilisation.
 Do not use solvent or abrasive cleaners on either the unit or cable assemblies.
 Do not, under any circumstances, immerse the unit or cable assemblies in liquid.
Page 13
1 Safety notes
1.9 Hygiene DEFIGARD/PHYSIOGARD Touch 7
1.9 Hygiene
 For cleaning and disinfection observe the legal requirements applicable.
 Only use cleaning agents and disinfectants recommended by SCHILLER.
Unsuitable agents can damage the device. Clean and disinfect the device in
accordance with the instructions given in this book.
1.10 Networks and Internet

 When the unit is part of a network, (LAN, WLAN, HIS, etc.), transmitting over a
telephone network or any other transmission/reception medium, or if exposed to
the Internet or other insecure networks, appropriate security measures must be
taken to protect the stored patient data.
 SCHILLER takes no responsibility for the configuration of Windows.
 Patient data security and security of the network is the sole responsibility of the
user.
 In order to guarantee the security of the network, Schiller recommends the
following:
– isolating the DEFIGARD® Touch 7 or PHYSIOGARD® Touch 7 network from
other networks
– defining access authorisation for the configuration of the host system, incl.
DEFIGARD® Touch 7 or PHYSIOGARD® Touch 7, so that no unauthorised al-
terations of the system are possible
– limiting the data transmission between the host and other systems/networks to
a minimum
Art. no.: 0-48-0227 Rev.: g
Page 14
Safety notes 1
DEFIGARD/PHYSIOGARD Touch 7 User guide Additional Terms 1.11
1.11 Additional Terms

1.11.1 Implied Authorisation
Possession or purchase of this device does not convey any express or implied license
to use the device with unauthorized sensors or cables which would, alone or in
combination with this device, fall within the scope of one or more of the patents
relating to this device.
1.11.2 Terms of Warranty

Your SCHILLER DEFIGARD® Touch 7 & PHYSIOGARD® Touch 7 is warranted
against defects in material and manufacture according the general term of conditions.
Excluded from this guarantee is damage caused by an accident or as a result of
improper handling. The warranty entitles free replacement of the defective part. Any
liability for subsequent damage is excluded. The warranty is void if unauthorised or
unqualified persons attempt to make repairs.
In case of a defect, send the apparatus to your dealer or directly to the manufacturer.
The manufacturer can only be held responsible for the safety, reliability, and
performance of the apparatus if:
• assembly operations, extensions, readjustments, modifications, or repairs are

carried out by persons authorised by him, and
• the DEFIGARD® Touch 7/PHYSIOGARD® Touch 7 and approved attached
equipment is used in accordance with the manufacturer's instructions.
There are no express or implied warranties which extend beyond the warranties
hereinabove set forth. SCHILLER makes no warranty of merchantability or fitness for
a particular purpose with respect to the product or parts thereof.
Art. no.: 0-48-0227 Rev.: g
Page 15
1 Safety notes
1.12 Display Symbols/Indicators DEFIGARD/PHYSIOGARD Touch 7
1.12 Display Symbols/Indicators

1.12.1 Symbols Used in this User Guide
The safety level is classified according to ISO 3864-2. The following overview
contains the safety symbols and pictorals used in this user guide.
For a direct danger which could lead to severe personal injury or to death.
For a possibly dangerous situation, which could lead to heavy bodily injury or to death.
For a possibly dangerous situation which could lead to personal injury. This symbol is
also used to indicate possible damage to property.
For general safety notes as listed in this section.
Used for electrical dangers, warnings and other notes in regarding operation with
electricity.
NOTE for possibly dangerous situations which could lead to damages to property or
system failure or IMPORTANT for helpful user information.
Reference to other guidelines
Touch-sensitive areas
This symbol is used to designate touch-sensitive areas that might not be self-evident.
Touch (to open/close menus and perform functions)

Art. no.: 0-48-0227 Rev.: g
Move up or down.
Move to the right or left
Page 16
Safety notes 1
DEFIGARD/PHYSIOGARD Touch 7 User guide Display Symbols/Indicators 1.12
1.12.2 Symbols used on the device

BF symbol. The device's signal input is defibrillation protected.
Signal input type CF: Highly isolated port, defibrillation protected. However, it is only
defibrillation protected when used with the original SCHILLER patient cable.
Notified body of the CE certification (G-MED)
Note accompanying documents!
• Symbol for the recognition of electrical and electronic equipment.

• The device must be disposed of in a municipally approved collection point or
recycling centre when it is no longer required.
• Improper disposal harms the environment and human health due to the presence
of dangerous substances in electrical and electronic equipment.
Manufacturer symbol, manufacturing date
Read the instruction for use
Devices with WLAN or GSM

Attention: Non-ionic electromagnetic environment. The device contains an HF
transmitter.
The DEFIGARD/PHYSIOGARD Touch 7 radiates high-frequency electromagnetic

energy during telemetric ECG data transfer and can disturb other devices if not
installed and operated in accordance with the user guide.
However, even in the case of correct installation/operation, there is no guarantee that

no interferences can occur.
If the DEFIGARD/PHYSIOGARD Touch 7 causes interferences, these can be

prevented by switching off or not sending ECGs.
Art. no.: 0-48-0227 Rev.: g
The user can take the following measures to solve this problem:
• Increase the distance between the disturbed device and the DEFIGARD/
PHYSIOGARD Touch 7. A minimum distance of 20 cm must be kept between the
device and a pacemaker.
• Turn the device to change the antenna's angle of radiation.
• Connect the device to a different mains connector.
For more details, see section 10.9.3 Measures to prevent electromagnetic
interferences page 126.
Page 17
1 Safety notes
1.12 Display Symbols/Indicators DEFIGARD/PHYSIOGARD Touch 7
IP55 The device is protected against dust and spraying water from all directions.
Used for electrical dangers during defibrillation (DEFIGARD® Touch 7)
1.12.3 Symbols Used on the Batteries

Common symbols
The unit/component can be recycled.
Battery may not be disposed of with domestic refuse.
Do not burn, saw up or crash the battery
Do not short-circuit the battery
Expiration date
Power battery (Li-Ion)
Rechargeable battery
Storage temperature for the power battery:

Unlimited: -10...+40 °C
Limited: -20...+65 °C for 48 hours
Safety primary cell (Li/MnO2)
Non rechargeable battery
Storage temperature for the primary cell:

Unlimited: 15...+25 °C
Art. no.: 0-48-0227 Rev.: g
Limited: 0...+60 °C for 48 hours
Read the instruction for use
Page 18
Safety notes 1
DEFIGARD/PHYSIOGARD Touch 7 User guide Display Symbols/Indicators 1.12
1.12.4 Symbols Used on the Electrode Package

This applies only to the DEFIGARD® Touch 7.
• Open clothes
• Open the electrode package
• Peel off the protective foil
Disposable item; Single use only
Do not bend packing
Storage temperature for the electrodes
Expiration date
Read instruction before use
Latex free
Use within 1 day after opening
Keep dry
Keep out of direct sunlight

Art. no.: 0-48-0227 Rev.: g
Page 19
2 Components and Operation
2.1 Design DEFIGARD/PHYSIOGARD Touch 7
2 Components and Opera-

tion
The DEFIGARD® Touch 7 is a lightweight mains and battery powered defibrillator
featuring an ECG monitor, SpO2/SpCO/SpMet, etCO2,Temperature and NIBP
measurements. It is designed for clinical use. Defibrillation is possible in non-
synchronised or synchronised mode.
Moreover, the device can be switched to automated defibrillation (AED operation) by

pressing a single key
The PHYSIOGARD® Touch 7 includes the same features as the DEFIGARD® Touch
7, but without the defibrillation function.
Biocompatibility
The parts of the product described in this user guide, including all accessories, that
come in contact with the patient during the intended use, fulfil the biocompatibility
requirements of the applicable standards. If you have questions in this matter, please
contact SCHILLER.
2.1 Design
Power supply The DEFIGARD® Touch 7 and PHYSIOGARD® Touch 7 is powered by an integrated
rechargeable battery. The capacity of one battery is sufficient for:
DEFIGARD® Touch 7 • 100 shocks with maximum energy or

• >6 hours of monitoring
PHYSIOGARD® Touch 7 • >6 hours of monitoring

The battery is recharged by an external DC supply.
Defibrillator The DEFIGARD® Touch 7 is a defibrillator featuring biphasic pulsed defibrillation

impulse – Multipulse Biowave®. The defibrillation is done using disposable
adhesive electrodes (pads), which also measure the ECG signal for the analysis.
Adhesive electrodes for children and adults are available. The device recognises the
connected electrodes and selects the defibrillation energy levels accordingly. In the
AED mode, the user will be given visual and audible instructions (display/
loudspeaker).
Monitoring According to its configuration, the DEFIGARD® Touch 7 and PHYSIOGARD® Touch
Art. no.: 0-48-0227 Rev.: g
7 monitoring function gives all important parameters – ECG, SpO2/SpCO/SpMet,

etCO2, RR, NIBP, IBP and Temperature. The parameters are indicated in figures and
as waveforms on the large 7” (800x480) LCD display.
Data storage All intervention data – resting ECG data, lead II ECG, defibrillator ECG, SpO2 curves,
trends, events, patient data.
Data transmission • Easy transmission of a 12-lead ECG, trends and screenshots by WLAN or GSM
during intervention
• GSM, WLAN, Ethernet (via USB adapter) Communication, for software and
configuration updates and post-intervention data (PDF or Sema format)
transmissions.
Page 20
Components and Operation 2
DEFIGARD/PHYSIOGARD Touch 7 User guide Design 2.1
• USB to Ethernet connector for software updates

• Import/export device configuration via USB
2.1.1 Standard unit and options
DEFIGARD® Touch 7 Standard

• Defibrillator (AED) with 4-lead ECG cable
• Temp (sensor not included)
Options:
• Manual defibrillation mode
• SpO2
• Pacemaker
• SpCO
• SpMet
• NIBP
• IBP
• CO2 mainstream
• CO2 sidestream
• 12-lead ECG
• GSM/3G
• WLAN
• CPR feedback (FreeCPR)
• CPR feedback (ARGUS LifePoint)
PHYSIOGARD® Touch 7 Standard

• 4-lead ECG cable
• SpO2
• NIBP
• Temp (sensor not included)
Options
• SpCO
• SpMet
• CO2 mainstream
• CO2 sidestream
• IBP
• 12-lead ECG
• GSM/3G
• WLAN
2.1.2 Additional accessories

Art. no.: 0-48-0227 Rev.: g
• SCHILLER Charging Unit CS-1. External charging and calibrating unit for
rechargeable batteries.
• DC/DC or AC/DC ambulance charging bracket. Holds the device securely while
recharging the battery inside the device.
• AC/DC desktop charging bracket. Holds the device while recharging the battery
inside the device.
• AC/DC Nomad charger
• DC/DC Nomad charger
Page 21
2.2 Operating Elements DEFIGARD/PHYSIOGARD Touch 7
2.2 Operating Elements

2.2.1 Front panel DEFIGARD® Touch 7
Loudspeaker Power battery
Battery/DC Supply
Status or Alarm LED
Status LED
TEMP: Check sensor

Touch screen Adult OFF
HR
NIBP
R-ECG Screenshot Event Manual Def Start Menu
On/off key USB USB CPR Shock key

Defi pads Feedback
Monitor ON Key AED ON key
SpO2
ECG patient cable

IBP
Safety primary cell
Temp (not rechargeable)
Optional Trunk
Art. no.: 0-48-0227 Rev.: g
NIBP cable for CO2
SIM card for

GSM option
Fig. 2.1 Control elements at the device’s front
Page 22
DEFIGARD/PHYSIOGARD Touch 7 User guide Operating Elements 2.2
2.2.2 Front panel PHYSIOGARD® Touch 7
Loudspeaker Power battery
Battery/DC Supply
Status or Alarm LED
Status LED
TEMP: Check sensor

Touch screen Adult OFF
HR
NIBP
R-ECG Screenshot Event Start Menu
On/off key USB
SpO2
ECG patient cable

IBP
Safety primary cell
Temp (not rechargeable)
Optional trunk
NIBP cable for CO2
Art. no.: 0-48-0227 Rev.: g
SIM card for

GSM option
Page 23
2.2 Operating Elements DEFIGARD/PHYSIOGARD Touch 7
2.2.3 Back Panel
Replaceable power battery
Dovetail fixing
joint
Safety primary cell

DC input from Docking
compartment for backup
station
during battery change
Fig. 2.2 Control elements at the device´s back
2.2.4 LEDs
The LEDs give the following information:
(1) Flashes while the battery is being recharged

1 2 (2) Unit connected to the external power supply.
Art. no.: 0-48-0227 Rev.: g
Fig. 2.3 LEDs
Page 24
DEFIGARD/PHYSIOGARD Touch 7 User guide Operating Elements 2.2
2.2.5 Display
Filter mode: Monitoring, Rhythm or Diagnostic Patient Information
Network status
Intervention duration
Display field for system and alarm mes-
sages. Touch to show alarm list Battery charging status
Date/time
Alarm Status
Black and white dis-
SpO2: Startup state
play Off
Adult
HR
ECG calibration
impulse 1 mV Heart Rate
NIBP
NIBP
Waveform field
SpO2 and Tempera-
ture
EtCO2 and Respira-

tory Rate
Soft keys R-ECG Event screenshot Manual Def Start Menu

Menu/Home
Resting ECG Event button Start/stop NIBP

measurement
Start Manual
Defibrillation (DEFIGARD Touch
Fig. 2.4 Display elements of the device
The display can vary according to the settings and used options and selected views.
The following screen is displayed when swiping from right to left, see above.
Adult Off
HR
Art. no.: 0-48-0227 Rev.: g
Show ECG curve again:
 swipe from left to right NIBP
R-ECG Event screenshot Manual Def Start Menu
Page 25
3 Initial Operation
3.1 External DC supply and Battery Operation DEFIGARD/PHYSIOGARD Touch 7
3 Initial Operation
 Please read the safety notes in section 1 Safety notes page 9 before initial
operation.
 Danger of explosion! The device is not designed for use in areas where an
explosion hazard may occur. Also, it is not permitted to operate the defibrillator
in an oxygen-enriched environment or in the presence of flammable substances
(gas) or anaesthetics. Oxygenation in the vicinity of the defibrillation electrodes
must be strictly avoided.
 Danger of electrical shock. The DEFIGARD® Touch 7 is a high-voltage therapy
device. Improper use of the device can endanger life. Always follow the
instructions given in this user guide.
 The user must make sure that there are no conductive connections between the
patient and other persons during ECG analysis and defibrillation.
 Avoid defibrillation in very moist or wet surroundings.
 To avoid the risk of electric shock, this equipment must only be connected to a
supply mains with protective earth.
3.1 External DC supply and Battery Operation

3.1.1 External DC Supply Operation
1. Put the device into the docking station. Insert a fully charged battery. Check the
LED 2 is on if placed on the docking station.
2. Press the on/off button.
3. Touch the battery icon (3) to display further battery charging information.
4. Check battery charging LED 1 according to 3.1.2 Battery Operation page 27.
1 3
2
Fig. 3.1 Status LED supply
Art. no.: 0-48-0227 Rev.: g
Page 26
Initial Operation 3
DEFIGARD/PHYSIOGARD Touch 7 User guide External DC supply and Battery Operation 3.1
3.1.2 Battery Operation

Charging the battery
Important
The power battery is automatically recharged when the device is connected to the
external DC supply via the docking station (LED 2). The power battery requires
1 2 approx. 2 hour to be recharged at 90%.
The recharging of the battery is indicated by the LED above the battery symbol.
– LED (1) is continuously on = battery problem

– LED (1) is blinking = battery is charging
– LED (1) is continuously off = battery is fully charged
Fig. 3.2 LED battery operation
If the temperature in the device becomes too high, the charging is stopped. As soon
as the temperature has decreased to an acceptable level, the charging resumes.
Low battery indication

below 20%
When the battery is below 20 %, a red battery symbol with one bar is displayed in the
top right corner of the screen.
below 10%
When the battery is below 10%, a red empty battery symbol is displayed in the top
right corner of the screen and a technical alarm is displayed and a voice prompt
reminds to check the battery.
The device shuts-down automatically when the battery is below 5%.

Fig. 3.3 Battery low indication
Battery status unknown

? • When the battery is unknown, a red battery symbol with a question mark is
displayed in the top right corner of the screen.
• This indicator is also displayed in case of a new battery. Any new battery has to be
placed into the device and fully charged before use.
Fig. 3.4 Battery defect indication
Battery status
Press on the battery icon. The following information will be displayed:
• Charge level in %
• Estimated autonomy in hours and minutes
• Estimated number of shock possible with the remaining capacity
Art. no.: 0-48-0227 Rev.: g
• Safety Cell Voltage level
Page 27
3 Initial Operation
Changing the batteries
• The device does not need to be switched off. Monitoring is continued. The device
is powered by the safety primary cell for another 30 seconds; after that, the device
is switched off automatically.
• The battery can only be inserted in one way.
1. Open the battery cover.
2. To remove the battery, press the two blue catches to release and remove the bat-
tery.
 To replace, proceed as follows:

– Slide the battery into the battery compartment with the markings positioned as
shown.
– Push home until the battery clicks in place with the blue catches.
– Close the battery cover and make sure that the cover is clicked in properly.
Click!
3.1.3 Operation with external constant voltage source
The device can be connected to an external direct-current source via the docking
station.
Operation with an external power source is indicated by the LED on the
device.
Art. no.: 0-48-0227 Rev.: g
Page 28
Initial Operation 3
DEFIGARD/PHYSIOGARD Touch 7 User guide External DC supply and Battery Operation 3.1
3.1.4 Operation ambulance charging bracket
 The charging bracket must be fixed to a stable wall.
Power supply connectors
Power supply
module AC/DC or DC/DC
Click!
2 1
Putting the device on the charging bracket Removing the device from the charging bracket
 Simply put the device back on the wall mounting.  Pull the release lever towards the device (1) and pull
The device is locked automatically. You should the device upwards (2), while keeping the lever in the
clearly hear the click of the locking mechanism release position.
3.1.5 Operation of the desktop charging bracket
 The desktop charging bracket must be screwed on a table or VESA fixing

system.
 The desktop charging bracket is only for indoor use. Do not use it in vehicles.
Art. no.: 0-48-0227 Rev.: g
 The device can easily be slid onto the desktop charging bracket.
Page 29
3 Initial Operation
3.1.6 Operation and fixing during intervention

During intervention, the two positioning bars (1) can be folded out to keep the device
in an ergonomic position.
During transportation, the device can be fixed on a rail (e.g. bed or stretcher rail)
Art. no.: 0-48-0227 Rev.: g
Page 30
Initial Operation 3
DEFIGARD/PHYSIOGARD Touch 7 User guideSwitching off and disconnecting from the external DC supply
3.2
3.2 Switching off and disconnecting from the

external DC supply
1. Press the on/off button.
2. The dialogue No/Yes is displayed.
3. Confirm switch-off or cancel with No.
4. Remove the device from the charging station if you do not want to recharge the
Switch off device? battery.
Yes
Restart The “Restart” function is used to exit the Post-Intervention or the control panel menu
No directly by restarting the device instead of switching it on and off.
Lock touch screen
Forced shutdown procedure

If the device cannot be switched off via the above procedures, press and hold the
green On/Off button until the device is switched off.
3.2.1 Lock Touch screen
Lock the Touch screen In the ON/OFF dialogue, select “ Lock touch screen”.
Unlock Touch screen Press the button twice. The message appears “Touch screen unlocked”
Note: If you touch the locked touch screen, a message prompts you to press the ON/
OFF button twice to unlock the screen.
3.2.2 Internal safety discharge

The DEFIGARD® Touch 7 has an internal safety discharge circuit for internal
discharge of the defibrillator’s stored energy. The defibrillator displays the message
"Internal discharge" during the safety discharge.The energy is internally discharged
when
• the shock is not delivered within 20 s after charging

• a lower energy value is selected while the defibrillator is charging
• the battery voltage is insufficient
• the device is defective
• the device is turned off
Art. no.: 0-48-0227 Rev.: g
Furthermore the residual energy stored in the defibrillator 100 ms after shock release
is always discharged internally.
3.2.3 Interruption of external power supply
If the external DC supply is interrupted, the device automatically switches over to

battery operation. The user settings are maintained.
Page 31
3 Initial Operation
3.2 Switching off and disconnecting from the external DC supply DEFIGARD/PHYSIOGARD Touch 7
3.2.4 Ensuring Operational Readiness
• Do not expose the device to direct sunlight, or extremely high or low temperatures.
The ambient temperature should be in the range of 0°C to 40 °C. Lower or higher
ambient temperatures will have a negative impact on the battery's life.
To ensure its readiness for use, the device runs a self-test to check the unit and the
battery. A self-test can be performed any time. An enhanced periodic test can be
performed in a defined interval (standard setting every 5 weeks) and at a defined time
(standard setting 12:00)
• Status OK: green blinking LED

• Device failure status: LED OFF.
If the device detects an error during the self-test, an alarm sound is activated.
 An auto test can be executed anytime see paragraph 10.2.4 Auto Test.
Art. no.: 0-48-0227 Rev.: g
Page 32
Initial Operation 3
DEFIGARD/PHYSIOGARD Touch 7 User guide Operation 3.3
3.3 Operation
The menus can be accessed as follows:
• Direct access by pressing on the curve or measurement field, or

• by clicking on the menu soft key or any other soft key or
• by clicking on a icon, or
• by moving finger up or down, left or right for scrolling or changing display
---
Adult Off
HR
NIBP
R-ECG Event Screenshot Manual Def Start Menu
---
Adult Off
HR
Select an other view

NIBP
Trends
R-ECG
Art. no.: 0-48-0227 Rev.: g
Screenshots
Stop Intervention
00547_160318_103611
Fig. 3.5 Display with main menu and the touch-sensitive areas
Page 33
3 Initial Operation
3.4 Printing DEFIGARD/PHYSIOGARD Touch 7
3.4 Printing
The following data can be printed on the Bluetooth printer:
• Recorded Resting ECG (incl. patient data, patient vitals, interpretation and ECG
curves)
• Screenshots (+/- 5 sec from the moment of the screenshot that contains all
displayed curves, patient data and vital data)
• Intervention report.
3.4.1 Pairing Bluetooth devices

1. Select the transmission icon to display the Data transmission menu.
2. Select menu Printer to display the pairing menu.
3. Switch on the Bluetooth printer and make sure that Bluetooth is activated.
4. Select “Scan for Printer”. As soon as the printer is found, the printer’s identification
Data Transmission number is displayed e.g. RJ-40304072.
Transmission list 5. As soon as the printer pairing is done, printer status in the Data transmission
Communication media
menu indicates .
6. Select “Printer test page” to check the printing function.
Printer
idle
eCPR system
Data Transmission
In case of communication problem with a Bluetooth device, switch it off and on again.
Scan again for the Bluetooth device.
Scan for printer
Printer test page
3.4.2 Brother Printer Overview
For detailed information, refer to the Brother P4030 printer user guide.
1. Press and hold the (Power) button to switch off the printer.
2. Open the cover (1).
2 3. Insert the RD Roll into the compartment (2).
4. Close the cover.
5. Press and hold the (Power) button to turn the printer on.
Art. no.: 0-48-0227 Rev.: g
6. Press the (feed) button to set the paper in the right starting position.
1
Page 34
Initial Operation 3
DEFIGARD/PHYSIOGARD Touch 7 User guide Connection to a ePCR system 3.5
(1) Power On/OFF

(2) Paper feed
(3) Power On/Off status LED
1 2 3 4 5 6 7 (4) Status LED printer
(5) Battery status LED (blinks every 4 s = battery half, twice every 4 s =battery low,
once every second =battery must be charged.
(6) Bluetooth Status LED
(7) Bluetooth On/Off button
3.5 Connection to a ePCR system

The following data can be transmitted via bluetooth to a ePCR (electronic patient care
report) system:
• Patient vital data

• Patient identification and information
• RECG in pdf format
• Trends
According to the ePCR settings this can be as spot measurement, regulary or for a
defined period of time.
For details information refer to the ePCR manufacturer’s user manual.
3.5.1 Pairing Bluetooth devices
• The DEFIGARD/PHYSIOGARD Touch 7 acts like a slave to the ePCR equipment,

therefore, the pairing must be initiated on the ePCR equipment.
• The pairing is to be perfomed only the very first time that an ePCR equipement is
connected.
1. Select the transmission icon to display the Data Transmission menu

2. Select ePCR
3. Activate the Bluetooth discoverability
Data Transmission
Transmission list
Communication history • Please contact your local SCHILLER distributor for compatible ePCR systems list
or interface request.
Communication media • In case of communication problem with a Bluetooth device, switch it off and on
Printer
again. Scan again for the Bluetooth device.
Art. no.: 0-48-0227 Rev.: g
eCPR system
Enable bluetooth discoverability ON
Page 35
4 Monitoring
4.1 Soft keys, Waveforms and Measurement Fields DEFIGARD/PHYSIOGARD Touch 7
4 Monitoring
Operation and menu access is detailed on page 33.
4.1 Soft keys, Waveforms and Measurement

Fields
The waveform and measurement fields are automatically displayed when the device
is switched on (if options are installed). The device can basically be operated via the
touch screen. The functions of the soft keys vary according to the selected screen.
Adult Off
HR
NIBP
Advanced monitoring view
Settings
The settings that are defined in the menus are set to default when the unit is switched
off.
Art. no.: 0-48-0227 Rev.: g
Page 36
Monitoring 4
DEFIGARD/PHYSIOGARD Touch 7 User guide Soft keys, Waveforms and Measurement Fields 4.1
4.1.1 View selection

The default view after start up can be configured.
Menu 1. Go to menu “Choose another view”.

2. Choose one of the views:
Choose another view
– Advanced monitoring
Trends – Basic monitoring
– 12 leads ECG
R-ECG – Critical care
The display can vary according to the settings and used options. The default views
are displayed as described below:
Basic monitoring
with 2 ECG leads and SpO2 curve, big measurements filed with heart
rate, NIBP and SpO2 values.
Advanced monitoring
with 2 ECG leads, SpO2, EtCo2 curve, measurements filed with heart
rate, NIBP SpO2, ETCO2, RR and Temp values.
Critical care
with 2 ECG leads, SpO2, EtCo2, IBP curve, measurements filed with
heart rate, SpO2, Temp, etCO2, RR, IBP and NIBP values.
Art. no.: 0-48-0227 Rev.: g
12 lead ECG
with all 12 ECG leads.
As the displayed ECG is online and filtered with diagnostic filters the
curves may be sensitive to motion artefacts. For better ECG quality it
is advised to perform a "R-ECG" see paragraph 4.5.
Page 37
4 Monitoring
4.2 Alarm System DEFIGARD/PHYSIOGARD Touch 7
4.2 Alarm System
 In some countries, it is not permitted to disable audio alarms

permanently. Therefore, this function is configurable.
 When pausing or switching off the audio alarm, even high-priority alarms such
as VT/ VF and asystole are paused/switched off!
 Pausing or switching off of the audio alarm system is only allowed if the patient
is permanently observed.
4.2.1 Alarm priority

Alarm type Priority Audible signal Display
• Text display in the alarm status field at the top
• Displaying -?- in the parameter field
Technical alarm Low One beep once
• Orange LED is lit

• Orange flashing parameter field
Physiological alarm Medium 3 signals (beep beep beep)
• Orange LED is flashing

10 signals • Red flashing parameter field
(beep beep beep - beep
Physiological alarm High
beep beep beep beep - beep
beep)
• RED LED is flashing
4.2.2 Operator’s position
 Ensure that the environmental noise is below the alarm sound volume of 65 dB.
The visual alarm LED is visible to a distance of 4 meters and the flashing value is
visible to a distance of 1 meter.
4.2.3 Alarm list

An alarm list can be displayed any time by touching the alarm status line.
Art. no.: 0-48-0227 Rev.: g
Alarm List
08h02m43s: HR out of range (P-ECG03)
HR out of range
08h02m43s:SpO2: Sensor Off Patient (T-SP229)
Page 38
Monitoring 4
DEFIGARD/PHYSIOGARD Touch 7 User guide Alarm System 4.2
4.2.4 Physiological alarms

When a measurement reading exceeds a threshold, an alarm is triggered after 3
Alarm Settings Default
seconds and:
Wide Quick Set
Narrow Quick Set

• the device alarm LEDs are flashing orange (medium) or red (high)
• an interrupted alarm sounds
Audio Pause • the measurement value (2) flashes red
• a message is displayed in the alarm field
Audio OFF
Reset Alarm / Audio On Pausing an audio alarm

 Pause the audio alarm by pressing the button (1) and selecting Audio Pause
– the measurement reading is flashing red until it returns to the permissible range.
– if the measured value does not return to the permissible range within the 2 min-
1 utes, the audible alarm is reactivated automatically.
Switching off audio alarm system

 Press the button (1) and select Audio OFF.
 The audible alarm system is switched off permanently until it is reactivated by
2 selecting Reset Alarm/Audio on or Audio Pause.
A reminder signal (buub-buub) is issued every 2 minutes.
Reactivation of the paused or switched off audio alarm system

 Press the button (1) and select Reset Alarm /Audio On.
Fig. 4.1 Alarm indicators
4.2.5 Technical alarms

When a technical error occurs:
• the orange device alarm LEDs are on

1 • a message is displayed in the alarm field
• one alarm beep once
• 3 dashes (2) are displayed if no sensor is connected before switching on (no LED
or alarm)
• a question mark (-?-) is displayed instead of the measurement reading (3)
Art. no.: 0-48-0227 Rev.: g
Page 39
4 Monitoring
4.3 Operator-Defined Alarm Thresholds DEFIGARD/PHYSIOGARD Touch 7
4.3 Operator-Defined Alarm Thresholds

 Make sure that the patient’s vital parameters are not critical before pressing the
button Wide Quick set or Narrow quick set.
 Make sure that the right patient is selected (adult, child or neonate).
 The defined alarm thresholds are not a substitute for regular checking of vital
functions.
 Setting the Audio OFF is only allowed if the patient is permanently observed.
 Standard or user-defined alarm limits as well as quick settings may vary for
similar or the same devices. Therefore, always check the set alarm limits for the
current patient.
 30 seconds after main battery power interruption, the alarm threshold Wide
Quick set or Narrow quick set is set to default.
Access the threshold menu by pressing the alarm icon and selecting Wide Quick set
or Narrow quick set.
• With the Default key, the default threshold values are activated.
• With the Quick Set selection, all values are derived from the current measured
Alarm Settings Default
values. See table on the following page.
Wide Quick Set
 Make sure that the patient’s vital parameters are not critical before pressing the
Narrow Quick Set button Quick Set.
Audio Pause
Audio OFF
Reset Alarm / Audio On
Fig. 4.2 Alarm Setting menu
• The operator-defined Quick set thresholds will be set to the default values after
switching off the device.
Art. no.: 0-48-0227 Rev.: g
Page 40
Monitoring 4
DEFIGARD/PHYSIOGARD Touch 7 User guide Operator-Defined Alarm Thresholds 4.3
4.3.1 Table of wide/narrow threshold setting

The range values in brackets () are the default values activated when pressing “De-
fault” in the alarm setting menu see Fig. 4.2, page 40. The values before the bracket
“ECG 0-350 (50-150) bpm” are the low/high system limits.
HR [bpm] Pat. value Wide limits Narrow Limits

Range: Low High Low High
ECG 0-350 (50-150) bpm <60 -20 +35 -10 +25
Pleth 25-240 (50-150) bpm 60-79 -25 +40 -20 +30
80-104 -30 +40 -30 +30
>=105 -35 +45 -25 +25
Allowed values [30-150] [100-240] [30-150] [100-240]
RR [rpm] Pat. value Wide limits Narrow Limits

Range: 0-60 (5-30) resp/min Low High Low High
<15 -8 +8 -4 +4
>=15 -15 +15 -8 +8
Allowed values [5-15] [10-60] [5-15] [10-60]
SpO2 [%] Pat. value Wide limits Narrow Limits

Range: 50-100 (85-100) % Low High Low High
>=90 -5 +3 -5 +3
<90 -5 +3 -5 +3
Allowed values [85-100] [90-100] [85-100] [90-100]
SpCO/SpMet [%] Pat. value Wide limits Narrow Limits

Range: Low High Low High
SpCO 0-40 (0-10) % - 0% 10% 0% 10%
SpMet 0-15% - 0% 3% 0% 3%
Temperature [°C] Pat. value Wide limits Narrow Limits
Range: 0-46 (35-39) °C Low High Low High
- -3 +3 -1 +1
Allowed value - [31-41] [31-41] [31-41] [31-41]
EtCo2 [mmHg]/ [%] Pat. value Wide limits Narrow Limits

Range: 5-70 mmHg/0.7-9.2 %
Low High Low High
(15-50 mmHg/2-6.6 %)
<40/5.3 -10/1.3 +15/+2.0 -10/-1.3 +15/+2.0
Art. no.: 0-48-0227 Rev.: g
>=40/5.3 -10/1.3 +15/+2.0 +15/+2.0 +15/+2.0

[5-60] / [20-70] / [5-60] / [20-70] /
Allowed values [mmHg]/ [%]
[0.7-7.9] [2.7-9.2] [0.7-7.9] [2.7-9.2]
Page 41
4 Monitoring
4.3 Operator-Defined Alarm Thresholds DEFIGARD/PHYSIOGARD Touch 7
NIBP SYS [mmHg] Pat. value Wide limits Narrow Limits

Range SYS: 30-255 (50-200) mmHg Low High Low High
<90 -20 +35 -10 +25
90-114 -20 +35 -10 +25
115-140 -25 +35 -10 +20
>140 -25 +35 -10 +20
Allowed values [30-245] [30-245] [30-245] [30-245]
NIBP DIA [mmHg] Pat. value Wide limits Narrow Limits
Range DIA: 15-220 (20-150) mmHg Low High Low High
<65 -15 +25 -10 +25
65-90 -15 +15 -15 +10
>90 -15 +15 -15 +10
Allowed values [12-210] [12-210] [12-210] [12-210]
NIBP MAP [mmHg] Pat. value Wide limits Narrow Limits
Range MAP: 15-223 (20-235) mmHg - - - -
IBP SYS [mmHg] Pat. value Wide limits Narrow Limits

Range SYS: 30-255 (50-200) mmHg Low High Low High
<90 -20 +35 -10 +25
90-114 -20 +35 -10 +25
115-140 -25 +35 -10 +20
>140 -25 +35 -10 +20
Allowed values [30-245] [30-245] [30-245] [30-245]
IBP DIA [mmHg] Pat. value Wide limits Narrow Limits
Range DIA: 15-220 (20-150) mmHg Low High Low High
<65 -15 +25 -10 +25
65-90 -15 +15 -15 +10
>90 -15 +15 -15 +10
Allowed values [12-210] [12-210] [12-210] [12-210]
IBP MAP [mmHg] Pat. value Wide limits Narrow Limits
Range MAP: 15-223 (20-235) mmHg - - - -
Art. no.: 0-48-0227 Rev.: g
Page 42
Monitoring 4
DEFIGARD/PHYSIOGARD Touch 7 User guide ECG and heart rate monitoring 4.4
4.4 ECG and heart rate monitoring

 False diagnosis! Only use silver/silver-chloride electrodes if the patient may
have to be defibrillated while the ECG is being displayed. Other electrodes may
create high polarisation voltages and the ECG trace on the monitor and on the
recording may simulate cardiac arrest.
 Danger of destroying the device during defibrillation! The device is only type CF
protected if the original SCHILLER patient cables are used.
Important
• The guidelines for patient electrode placement are provided as an overview only.
They are not a substitute for medical expertise.
• If an electrode is faulty or has come off, a message indicates the faulty electrode.
4.4.1 Quick Diagnosis of the ECG Using Defibrillation Electrodes

This only applies for the DEFIGARD® Touch 7.
Isoelectric segments are excluded from the corresponding lead arc duration
measurements (Q, R, S waves). Isoelectric parts (I-wave) are also excluded in the
duration measurement of the respective adjacent waveform. (For more detailed
information, see 2.530036c Statement_of_accurracy 3ed_ETM.
For a quick diagnosis, the ECG signal can be recorded from the patient's thorax using
the defibrillation electrodes. In all other situations, we recommend acquiring the ECG
via ECG electrodes and the patient cable.
To apply the electrode pads, see section 5.3.1 Applying the adult and paediatric
electrodes page 85.
Fig. 4.3 Defibrillation electrodes
4.4.2 Connecting a 4- or 10-wire ECG patient cable

4+6-wire ECG patient cable
The 4 + 6 wires cable is a two-part cable that provides the standard four monitoring
(limb) electrode leads with the option of adding the 6 chest leads to provide a full 12-
leads diagnostic ECG without the need to change the cable and remove the limb
electrodes.
4-wire patient cable

Art. no.: 0-48-0227 Rev.: g
Refer to the following pages for the electrode placement of the 4-wire cable. Connect
the blanking connector to the cable junction.
10-wire patient cable
The electrode placement for the 10-wire cable is the same as for the 10-wire standard
cable described on the following pages. The blanking connector must be removed and
the connector for the additional 6 wires placed in the socket on the cable junction.
Page 43
4 Monitoring
4.4 ECG and heart rate monitoring DEFIGARD/PHYSIOGARD Touch 7
4.4.3 Connecting a 4-wire ECG patient cable
Red Yellow
When a patient cable as well as the defibrillation electrodes are connected, you can
select the heart rate signal source by touching the first curve (standard ECG:II) on the
Black Green display and selecting ECG Defi. The first display curve is used to calculate the heart
rate unless the HR source is set to Pleth.
Fig. 4.4 4-wire cable
4.4.4 Connecting a 10-wire ECG patient cable

*Note
C3 green
The electrode positions shown here (O) *Note
are based on the diagnostic ECG. For C4 brown
patient monitoring, the limb electrodes
can be attached on the upper body. C5 black
C1 red
C2 yellow
C6 purple
Right Arm - red Left Arm - yellow
Black Green
Art. no.: 0-48-0227 Rev.: g
Fig. 4.5 10-wire cable
Page 44
Monitoring 4
4.4.5 Starting ECG monitoring

1. Apply the electrodes as shown in Fig. 4.4 or Fig. 4.5.
2. Connect the patient cable to the ECG signal input.
3. Define the ECG settings directly via the Touch screen curve or measurement
field.
4. Open the HR module (ECG menu) and check the settings.
Fig. 4.6 ECG cable
The sweep speed on the screen is fixed to 25 mm/s.

The screen
QRS complexes are represented by green vertical dashes above the top ECG curve,
pacemaker pulses by red vertical dashes.
Curve list with a 10-wire cable
---
Adult Off
Curve List HR
ECG: Defi
ECG: I NIBP
ECG: II
ECG: III
ECG: aVr
Curve list with a 4-wire cable
Curve List
ECG: II R-ECG Event Screenshot Manual Def Start Menu
ECG: Defi
ECG
Back to Default
HR source
Art. no.: 0-48-0227 Rev.: g
Auto Scale OFF
Amplitude
ECG filters
QRS sound level
Page 45
4 Monitoring
4.4.6 Monitoring a pacemaker patient
 Erroneous HR displayIn the monitoring of pacemaker patients, the possibility

of pacer pulses being counted as QRS complexes cannot be excluded.
Therefore, pacemaker patients should always be watched closely. It is
recommend monitoring pacemaker patients by means of the plethysmogram HR
source = Pleth in the ECG or SpO2 menu).
 This device can reject double pacemaker pulses having amplitudes from ± 2 mV
to ±700 mV (± 70mV) and pulse widths from 0.1 ms to 2.0 ms ( ± 0.3 ms)
synchronized with an ECG or without ECG.
 Patients with a pacemaker must be observed continuously because the heart
rate from the pacemaker might still be registered in case of a cardiac arrest or
some arrhythmias.
 Pacemaker signals from different pacemakers vary. In the case of cardiac
arrests or some arrhythmias, pacemaker signals might still be measured,
especially signals from pacemakers generating high amplitudes (> 20 mV) or
overshoot. Pacemaker patients need to be monitored very closely.
When monitoring the heart rate of pacemaker patients, it is important that the device
will only count the QRS complexes and reject the pacer pulses.
Randomly, some pacemaker pulses could be missing on the display.
Pacemaker impulses are represented by red vertical dashes above the top ECG
curve.
The device has an electronic pacer pulse suppression algorithm which rejects the
pacer pulses so that they are not counted as QRS complexes. Depending on the
pacemaker model used and on the position of the electrodes, the compensation pulse
following every pacer pulse may be considered as a QRS complex. In this situation
and when the pacer pulse is ineffective, the displayed heart rate may lead to a
misinterpretation, and the device will not issue an alarm in the case of bradycardia or
asystole. Whether or not the compensation pulse is counted as a QRS complex
depends on the pacer pulse parameters.
For pacemaker patients, the ECG signal amplitude should be greater that 1 mV.
If the source of the heart rate is SpO2, this is indicated by the blue HR (Pleth)
measurement field instead of the green HR measurement field.
Art. no.: 0-48-0227 Rev.: g
Fig. 4.7 Indication HR source SpO2
Page 46
Monitoring 4
4.4.7 Curve list

MENU Parameter Description Value
Selection of the displayed first curve. The
first display curve is used to calculate the II or Defi
Curve list Touch first curve
Heart rate unless the HR source is set to Default:
Pleth.
Defi/I, II, III, aVR, aVL, aVF, SpO2
Touch the curves 2,3,4 Selection of the displayed curve plethysmograph, EtCO2:Respiration.
IBP
4.4.8 HR Module (ECG)
The sweep speed on the screen is fixed set to 25 mm/s.

Auto, Defi, ECG or Pleth
aSource If set to Auto, the device will
ECG HR Source based on which the heart rate automatically select the source with
should be determined. the following priorities: DEFI > ECG >
Pleth.
Auto Scale Automatic scale of the ECG amplitude OFF/ON
ECG Curve amplitude ECG amplitude setting 0.25 / 0.5 / 1 / 2 cm/mV
EMG ON/OFF (electromyogram)
BLW ON/OFF (baseline wandering)
ECG Filter Filter settings
Detailed information see ECG
amplifier band pass page 140.
QRS sound Volume of the systolic sound Off/Low/Medium/High
a. When the patient has a cardiac pacemaker, the HR source must be set to Pleth (see page 46).
4.4.9 ECG messages

Alarm Cause Remedy
• Electrodes not attached to the  Check the contact between the electrodes and the pa-
patient; come off; bad contact tient.
Cable not detected  Check the ECG cable and electrodes
• Electrodes defective; line break
• The device is defective  Have the device repaired
No Patient • Unable to calculate heart rate  Check the ECG cable and electrodes
 Check patient
Art. no.: 0-48-0227 Rev.: g
• Heart rate is out of set alarm lim-

HR out of range  Check narrow/wide HR alarm limit and adjust it if neces-
its.
sary.
Asystole • No heart rhythm  Physiological alarm! Check Patient.
• Ventricular fibrillation or tachy-  Physiological alarm! Check Patient.

VF/VT
cardia
Page 47
4 Monitoring
4.4.10 Print and pdf formats

The device can generate the following formats according to its configurations:
PDF resting ECG format • 12 averages + 6 leads, 12.5 mm/s (1 page)

• 1x12 leads, 50 mm/s (2 pages)
• 4x3 leads + 1 rhythm lead, 25 mm/s (1 page)
• 2x6 leads, 25 mm/s (1 page)
• 1x12 leads, 25 mm/s (1 page)
Print resting ECG format • 12 averages + 4*3 leads, 25 mm/s (7 pages)

• 4x3 leads + 1 rhythm lead, 25 mm/s (2 pages)
• 4x3 leads + 1 rhythm lead, 50 mm/s (3 pages)
• 2x6 leads, 25 mm/s (2 pages)
Art. no.: 0-48-0227 Rev.: g
Page 48
Monitoring 4
DEFIGARD/PHYSIOGARD Touch 7 User guide Diagnostic ECG (R-ECG) 4.5
4.5 Diagnostic ECG (R-ECG)

1. Apply the electrodes of the 10-wire ECG cable as shown in Fig. 4.5.
2. Connect the patient cable to the ECG signal input.
R-ECG 3. Press the button R-ECG and:
– the icon on the top changes from “Rhythm” to “Diagn.”
– the lead placement screen appears, showing leads off with red circle.
4. Press Next:
– the patient information dialogue is displayed for entering patient data if required
Diagn. 5. Press Next:
– the “ECG acquisition in progress” screen appears.
6. It takes about 15 seconds to record the ECG. After acquisition, the “Send” and
“Print” buttons are active. After about 8 seconds, the button “NEW R-ECG” is dis-
played so that another resting ECG can be recorded, if necessary.
Send New R-ECG Print Interpr. Measur. Close
7. It is now possible to scroll the R-ECG in the x-y axis for reviewing.
8. Transmit the ECG with following options:
 Press ”Send” to transmit the file via the defined transmission path e.g GSM/3G/
Wi-Fi, Bluetooth to:
– SEMA
– e-mail
– USB storage
 Press “Print” to print the ECG to an external Bluetooth printer.
 Press “Interpr.” to open the interpretation information.
 Press ”Measur.” to open the measurement information
Art. no.: 0-48-0227 Rev.: g
• If transmission of the data fails, the error icon appears in the top right status bar.
The failed transmitted data can be re-sent in the main menu “R-ECG”.
• If you close the R-ECG Window without sending the data, the data can be re-sent
via the main menu “R-ECG”.
For detailed information about the transmission, see chapter 4.6 page 50.45
• The resting ECG speed displayed on the recording depends on the configured
printout- or pdf format (see chapter 4.4.10 Print and pdf formats, page 48).
• To display all 12 ECG leads see chapter 4.1.1 View selection, page 37.
Page 49
4 Monitoring
4.6 SpO2-, SpCO, SpMet monitoring (Option) DEFIGARD/PHYSIOGARD Touch 7
4.6 SpO - SpCO SpMet monitoring (Option)

2 , ,
• The pulse oximeter enables the continuous, non invasive monitoring of functional
oxygen saturation of arterial haemoglobin as well as the pulse rate. The signal
received from the patient sensor is used to calculate the patient's functional oxygen
saturation and pulse rate.
• The Masimo Rainbow SET® technology for SpCO and SpMet measurements is
based on the same principles as pulse oximetry. The Masimo Rainbow SET
technology uses a multi-wavelength sensor to distinguish between oxygenated
blood, deoxygenated blood, blood with carbon monoxide, blood with oxidized
haemoglobin and blood plasma. Once the Masimo Rainbow SET technology
receives the signal from the sensor, it calculates the patient's functional oxygen
saturation (SpO2), fractional concentration of carboxyhaemoglobin (SpCO),
fractional concentration of methaemoglobin (SpMet) and pulse rate.
• The display shows the continuous progress of the numeric SpO2 value, pulse rate,
plethysmographic waveform and signal quality.
• The displayed plethysmographic curve is not proportional to the pulse volume.
• The update period of the measurement readings on the display is 0.2 seconds.
• According to the relevant standards, the temporary alarm suppression must not
exceed 2 minutes.
• Equipment used to perform functional tests cannot be used to give an indication as
to the accuracy of the SpO2 module.
• SpO2, SpCO and SpMet are empirically calibrated in healthy adult volunteers with
normal levels of carboxyhaemoglobin (COHb).
• The peak wavelength and maximum optical power of the light emitted by the pulse
oximeter probes has to be considered in certain cases, e.g. when performing
photodynamic therapy. They are as follows:
– Range of peak wavelengths: 600 nm to 900 nm
– Maximum optical power output LNCS sensor: <15 mW
– Maximum optical power output Rainbow sensor: <25 mW
• Masimo sensors use LEDs that are non-laser with the SpO2 module.
• High-intensity extreme lights (such as pulsating strobe lights) directed on the
sensor, may not allow the pulse co-oximeter to obtain vital sign readings.
Art. no.: 0-48-0227 Rev.: g
Page 50
Monitoring 4
DEFIGARD/PHYSIOGARD Touch 7 User guide SpO2-, SpCO, SpMet monitoring (Option) 4.6
 Only use SpO2, SpCO and SpMet sensors listed in the order information for the
DEFIGARD/PHYSIOGARD Touch 7. Other oxygen transducers (sensors) may
lead to improper performance.
 The information in this user guide does not overrule any instructions given in the
sensor's user guide, which must be consulted for full instructions.
 Never use the pulse oximeter as the sole means of monitoring a patient or as an
apnoea monitor- always use the pulse oximeter in combination with an ECG
trace.
 Never use a pulsoximeter during MR imaging. Induced current could potentially
cause burns and the pulse oximetry may affect the image and accuracy of the
measurements.
 Tissue damage can be caused by incorrect application or use of a sensor.
Inspect the sensor application location as described in the sensor directions to
ensure skin integrity and correct positioning and adhesion of the sensor.
 Do not use damaged patient cables, damaged sensors or sensors with exposed
optical components.
 Change the position of the sensor at least every 4 hours, and every 2 hours if
the perfusion is low.
 When patients are undergoing photodynamic therapy, they may be sensitive to
light sources. Pulse oximetry may be used only under careful clinical supervision
for short time periods to minimize interference with photodynamic therapy.
4.6.1 Inaccurate or incorrect measurement result
 Inaccurate measurements can be caused in general by:

– Improper sensor application
– Low arterial perfusion
– Motion artefact
– Elevated levels of bilirubin
– Intravascular dyes such as indocyanine green or methylene blue
 Inaccurate measurements SpCO and SpMet can be caused by:
– Abnormal haemoglobin levels
– Low arterial oxygen saturation levels including altitude induced hypoxaemia
 Inaccurate SpO2 measurements can be caused by:
– Elevated levels of COHb or MetHb: High levels of COHb or MetHb may occur
with a seemingly normal SpO2. When elevated levels of COHb or MetHb are
suspected, laboratory analysis (co-Oximetry) of a blood sample should be per-
formed.
– Externally applied colouring and texture, such as nail polish, acrylic nails, glitter,
etc.
– Severe anaemia
 Interfering substances: Dyes or any substance containing dyes that change
usual blood pigmentation may cause erroneous readings.
 If SpO2 values indicate hypoxaemia, a laboratory blood sample should be taken
Art. no.: 0-48-0227 Rev.: g
to confirm the patient’s condition.
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4 Monitoring
4.6.2 Starting SpO2 monitoring and test
1. Apply the SpO2 sensor to the patient. Insert the patient's forefinger into the probe
as far as it will go, and make sure that the finger tip covers all of the probe window.
This is to prevent that extraneous light reaches the photodetector.
2. Connect the SpO2 sensor to the device and secure the cable with the two velcro
fasteners.
3. Check the bar graph for signal quality (1).
4. Check Perfusion Index PI level (3).
5. Set the narrow SpO2 alarm limit see page 40.
6. When the SpO2 value exceeds the alarm limit (2), an alarm is issued.
Set the alarm limit to narrow or wide when the vital data are not critical.
Perfusion Index PI (3) with trending capability indicates arterial pulse signal strength
and may be used as a diagnostic tool during low perfusion.
2 1 PI display ranges from 0.02% (very weak pulse strength) to 20% (very strong pulse
strength).
Display “-?-” or “---” instead of the value:

3
 --- Sensor not connected to the device
 -?- Sensor not attached to finger
Fig. 4.8 SpO2 measurement field
4.6.3 SpO2 Module

Auto, Defi, ECG or Pleth
aSource If set to Auto, the device will
SpO2 HR Source based on which the heart rate
should be determined. automatically switch sources with
following priority: DEFI > ECG > Pleth
Definition of the integration time for the
Average 4/6/8/10/12/14/16 seconds
calculation of the displayed average value.
Normal, Maximum, Adaptive Probe
Select the measurement sensitivity. Select Off detection
High when the pulse is weak. APOD If set to “Maximum” and the sensor
(Adaptive Probe off detection) is optimised becomes dislodged from the patient,
Sensitivity
for the detection of “Sensor has come off”, the potential for false readings may
regardless of the signal quality. The setting occur due to environmental "noise"
"High" must not be set as default setting. such as light, vibration, and excessive
air movement.
Set to match regional power line frequency
Line Frequency to allow for cancellation of noise introduced 50 or 60 Hz
by fluorescent lights and other sources.
Art. no.: 0-48-0227 Rev.: g
Set the pulse tone. The pitch of the pulse

SpO2 Sound level tone also indicates if the saturation level is OFF, low, medium, high
high (high pitch) or low (low pitch).
a. When the patient has a cardiac pacemaker, the HR source must be set to Pleth (see page 46).
Page 52
Monitoring 4
DEFIGARD/PHYSIOGARD Touch 7 User guide SpO2-, SpCO, SpMet monitoring (Option) 4.6
4.6.4 SpO2error and information messages
Alarm (measurement field) Code Cause Remedy

SpO2: Low Perfusion Index I.SP214  Check the patient
 Check the sensor and reapply. If
The same accounts for: • Weak pulse this message is displayed repeat-
Low SpCO perfusion I.SP206 • Sensor not properly applied edly, the oxygen saturation needs
Low SpMet perfusion I.SP209 to be verified by means of another
method.
SpO2: Low SpO2 confidence I.SP203  Check the patient
 Check the sensor and reapply or
The same accounts for: • Low pulse signal quality, measurements replace sensor
Low HR (pleth) Confidence I.SP211 are based on a poor signal quality. The  If this message is displayed re-
Low SpCO confidence pulse tone, if activated, is low. peatedly, the oxygen saturation
I.SP205
Low SpMet confidence needs to be verified by means of
I.SP208
another method
Invalid functional SpO2 I.SP204 • Value is not plausible  Check the patient
 Check the sensor and reapply
The same accounts for:
Invalid HR (pleth) I.SP212 • SpCO readings may not be provided if
Invalid SpCO I.SP207 there are low arterial saturation levels or
Invalid SpMet I.SP210 elevated methaemoglobin levels.
T.SP230  Make sure that the sensor is well
Pulse Search • Device is searching for the pulse
connected to the patient
T.SP229 • Sensor not connected to the patient or  Check the contact between the
Sensor Off patient sensor and the patient
off
I.SP231  Check sensor, compatibility
Check sensor • SpO2 sensor failed or disconnected
 Replace the sensor
T.SP201  Module not installed or defective
T.SP202
T.SP203
T.SP204
T.SP205
Board inoperative T.SP206 • No SpO2 module installed
T.SP207
T.SP208
T.SP209
T.SP210
& T.SP232
Interference detected T.SP226  Check the sensor on the patient,
Art. no.: 0-48-0227 Rev.: g
check the cable connector, elimi-

nate sources of interferences, e.g.
• Interferences detected high frequency devices or strong
light sources.
 Check Line frequency setting 50 or
60 Hz
T.SP211 • No cable connected  Check/replace cable
T.SP212 • Cable life expired
Check cable T.SP213 • Incompatible cable
T.SP214 • Unrecognised cable
T.SP215 • Defective cable
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4 Monitoring
Alarm (measurement field) Code Cause Remedy

T.SP216 • No sensor connected  Check/replace the sensor
T.SP217 • Sensor life expired
T.SP218 • Incompatible sensor
T.SP219 • Unrecognised sensor
T.SP220 • Cable and sensor fault  Check cable and sensor fault
Check sensor T.SP221 • No adhesive sensor connected
T.SP222 • Adhesive sensor life expired
T.SP223 • Incompatible adhesive sensor
T.SP224 • Unrecognised adhesive sensor
T.SP225 • Defective adhesive sensor
T.SP227 • Defective sensor
Art. no.: 0-48-0227 Rev.: g
Page 54
Monitoring 4
DEFIGARD/PHYSIOGARD Touch 7 User guide NIBP monitoring 4.7
4.7 NIBP monitoring

The non-invasive blood pressure is measured by the oscillometric method.
The module performs single measurements and automatic measurements at

selectable intervals.
The automatic measurements are suitable also for pregnant or pre-eclamptic patient.
Make sure that the cuff is on a level with the heart during blood pressure
measurements. If this is not ensured, the hydrostatic pressure of the liquid column in
the blood vessels will lead to incorrect results. When the patient is sitting, standing or
supine during measurements, the cuff is automatically at the correct level.
Factory default cuff pressure adult = 180 mmHg, children = 150 mmHg,
neonates = 50 mmHg
The initial cuff pressure is configurable. The maximum cuff pressure configuration in
neonatal mode is 150 mmHg.
 To prevent extensive pressure on the extremity, it is very important to choose

the correct cuff size and to check the setting patient type adult, children or
neonates.
 On neonatal patient, it is imperative to selected first the neonatal MODE. A
erroneous MODE selection will lead to higher pressure which can cause
haematoma or an osseous deformation.
 When neonatal MODE is selected the maximal pressure is lowered and the time
measure is shorter. An erroneous MODE selection on neonatal patients would
engender inadequate pressure and time measure.
 In case of long-term monitoring or automatic operation, the connected body
areas of the patient and the extremity to which the cuff is attached must be
checked regularly for signs of ischaemia, purpura and/or neuropathy, especially
in patients with decreased pain sensitivity (due to medication), or with older
patients with decreased blood circulation of the extremities.
 The cuff must not be attached to a limb that is already used for interventions
such as:
– infusions or
– SpO2 measurement (loss of data can occur during cuff inflation) or
– if an arterio-venous shunt is present.
 To prevent extensive pressure on the extremity and incorrect measurement
results, make sure that the tube is not kinked or compressed.
 To achieve correct arterial pressure measurement, the cuff must always be
installed on the level of the right atrium.
 In order to reduce interferences and the danger of burns for the patient, keep the
Art. no.: 0-48-0227 Rev.: g
cuff and hose as far away as possible from the operated area and the
electrosurgical cables. Make sure that the electrosurgical return conductor
(neutral) is well attached to the patient and that a good contact is guaranteed.
 In some patients petechiae, haemorrhages or subcutaneous haematomas may
occur. All patients must be told when putting on the cuff that if they experience
pain during the recording they should switch off the equipment and inform the
doctor.
 When an automated measurement interval is defined, bruising or decreased
blood circulation can occur in the arm. Only carry out recordings with automated
measurement intervals under constant medical supervision.
 It must be certain that, according to the health of the patient, the use of the
device will not damage blood circulation in the arm.
Page 55
4 Monitoring
4.7 NIBP monitoring DEFIGARD/PHYSIOGARD Touch 7
 As with occasional blood pressure measurement, petechial bleeding can occur

in patients with coagulation disorders or having anticoagulant treatment even
with the correct cuff size.
 In patients who have had a single mastectomy, the cuff can be placed on the
opposite arm.
 The cuff must not be placed over or near a wound that could cause further injury.
 To prevent incorrect measurement results, ensure that the tube is not pinched
or compressed.
 A cuff that is applied to a patient in the recumbent or sitting position is normally
located at the same level as the heart. However, if the cuff is located at a level
higher than the heart (for instance if the arm of a patient in bed is lifted), this may
result in lower-than-actual measurement readings (approx. 7.5 mmHg per 10 cm
rise).
 The measurement may be inaccurate or impossible:

– if a regular arterial pressure pulse is hard or impossible to detect, e.g. with car-
diac arrhythmias, severe shock, hypothermia or with obesity or an edematous
extremity
– with excessive and continuous patient movement such as shivering or convul-
sion.
Art. no.: 0-48-0227 Rev.: g
Page 56
Monitoring 4
DEFIGARD/PHYSIOGARD Touch 7 User guide NIBP monitoring 4.7
4.7.1 Starting NIBP monitoring

1. Note the cuff size for the respective patient type see chapter.13.2 Accessories
DEFIGARD/PHYSIOGARD Touch 7 page 159.
2. The cuff is attached to the left or right upper arm, about 4 cm above the elbow (on
children a little closer).
3. Connect the cuff tubing to the connection sleeve (1) and make sure it properly
locks into place.
1 4. Define the NIBP settings directly via the Touch screen NIBP measurement field.
– Patient type - adult, child or neonate (indicated at the top right)
5. Open the NIBP menu and check the settings.
– Setting of the Automatic cycle time or manual measurement
6. Start the NIBP measurement by pressing the soft key “Start”.
 To disconnect the cuff tube, press the milled shell of the connecting sleeve
backwards.
Neonate
 Clean and disinfect the cuff after each use see chapter 10.5 Cleaning page 119
and
NIBP Module
10.6 Disinfection page 120.
Automatic Cycle
Manual
The following settings are available for the cycle time:
Venous Block
Automatic Cycles 2/3/5/10/30 minutes
Manual The measurement is manually initiated by pressing the soft key.
Venous Block The venous block is used to apply an intravenous access. The
pressure is exactly 40 mmHg. The blockage time is limited to 80
second. You can stop anytime the blockage by the NIBP Stop
key.
Off
Adult
HR
START
NIBP
V. BLOCK
1:30
Art. no.: 0-48-0227 Rev.: g
Bar graph applied pressure Remaining time till to the next

NIBP measurement
Fig. 4.9 NIBP soft key
• When the measurement is started, the increasing cuff pressure is displayed on the
bar graph.
• The last four measurements are displayed in the window.
Page 57
4 Monitoring
4.7 NIBP monitoring DEFIGARD/PHYSIOGARD Touch 7
4.7.2 NIBP Menu

Automatic cycle of 2/3/5/10/30
NIBP Automatic cycles Cycle time setting
minutes
The measurement is manually initiated by
Manual soft key = Start
pressing the soft key.
4.7.3 NIBP Information and Error Messages

NIBP Alarm Code Cause Remedy
T.NIBP01  Replace device
T.NIBP02
T.NIBP03
Module inoperative T.NIBP04 • NIBP module failed
T.NIBP05
T.NIBP06
T.NIBP07
• No pressure can be measured  Check cuff and connection.

Unable to inflate cuff T.NIBP08
• The device is defective  Replace device
T.NIBP09  Check cuff and connection for leaks

• Pressure/pulse below/above
Invalid measurement T.NIBP10
limits
T.NIBP11
• No signal/pulse detected at 50  Check patient, cuff and hose

Unable to measure T.NIBP12
mmHg
• Pressure in the cuff remains too  Check cuff and connection for leaks
Cuff not present T.NIBP13
low < 10 mmHg during 10 s
• Pressure too high because  Check cuff and connection.

Wrong cuff T.NIBP14 - Too small cuff applied
- Tube buckled
T.NIBP15 • Measurement disturbed by ex-  The patient must not move during meas-
Artefacts detected urement
T.NIBP16 ternal influences
• Measurement time exceeded  Check cuff and connection.

Measurement timeout T.NIBP17
with no results  Make sure that the cuff is well applied
T.NIBP18 • Pumping running time exceed-  Check cuff and connection for leaks.
Inflate timeout
T.NIBP19 ed
• Pressure below/above accept-  Check patient, cuff and hose

Pressure out of range T.NIBP20
able range
• No pulse detected  Make sure that the cuff is well applied
Art. no.: 0-48-0227 Rev.: g
No pulse I.NIBP01
 Check patient, cuff and hose
Page 58
Monitoring 4
DEFIGARD/PHYSIOGARD Touch 7 User guide IBP Monitoring 4.8
4.8 IBP Monitoring

 Carefully read the manufacturer's instructions before using the invasive blood
pressure kit.
 When applying the kit to the patient, make sure that absolutely no air penetrates
the system.
 To achieve correct arterial pressure measurement, the pressure sensor must be
installed on the level of the right atrium.
 If the pressure sensor's position is changed after calibration, this might lead to
wrong low or high values.
 If an invasive catheter for blood pressure measurement is introduced into an
arterial vessel, the circulation in the terminal vessels must be checked in regular
intervals.
 Single-use sensors and valves must not be reused.
 Do not use IBP kit if packaging is opened or damaged.
 To grant the patient's safety, it must be ensured that neither the electrodes nor
the patient, or persons touching the patient, come into contact with conducting
objects, even if these are earthed.
 Special care must be exercised when the unit is used with high-frequency
equipment. To prevent incorrect IBP measurements, only use sensors that are
protected against high-frequency radiation.
• The kit and operating procedure vary according to manufacturer. Please consult
the manufacturer's documentation for connection.
• For warm-up time/ready for measurement and displacement for invasive
transducers, refer to the documentation of the transducer manufacturer.
4.8.1 Preparing an IBP measurement
The rinse must be contained in a flexible container. This container must be

surrounded by a pressure bag which should exert a pressure of 300 mmHg ± 30
mmHg on the container. This is in order to ensure a minimum flow of rinse of
approximately 6 ml per hour to prevent occlusion of the catheter tip.
1. Unpack the disposable measuring kit and check all tube connections for tight-
ness.
2. Secure the infusion bag and connect the infusion tube to the bag.
3. Fill up the system with liquid so it is completely void of air.
4. Hang the measuring kit in the holder and secure the holder.
5. Connect the cable of the transducer to the adaptor cable.
6. Connect the adapter cable to the DEFIGARD/PHYSIOGARD Touch 7 IBP input.
Art. no.: 0-48-0227 Rev.: g
Page 59
4 Monitoring
4.8 IBP Monitoring DEFIGARD/PHYSIOGARD Touch 7
4.8.2 Start IPB measurements
1. Select the IBP measurement field (1) to open the IBP menu.
2
2. Select OFF/ON button (2) to start the measurement.
3. Zeroing the IBP (see Zeroing)
4. Check the IBP curve on the display to see if the connections have been made
Start measurement ON correctly and the IBP value is in the expected range.
Zeroing 1
Curve amplitude (mmHg)
IBP curve display
HR
IBP curve IBP measurement field with

Systolic/Diastolic and mean
arterial pressure
4.8.3 IBP menu settings

Access the IBP menu via the IBP measurement field as described on page 33.
The default settings are printed bold.
Menu item Parameter Description

Art. no.: 0-48-0227 Rev.: g
IBP parameter Start measurement Starts the IBP measurement

Zeroing Zero adjustment of the IBP
Limits see Alarm limits

Set the range for the IBP measurement:
Curve amplitude (mmHg)
0-30, 0-60, 0-150, 0-300 mmHg
Page 60
Monitoring 4
DEFIGARD/PHYSIOGARD Touch 7 User guide IBP Monitoring 4.8
4.8.4 IBP zeroing
• Zeroing must be carried out before every application.

• To prevent incorrect measurement readings due to the sensor's physical null drift,
calibrate the sensor every 24 hours.
Note
If the pressure sensor's position is changed after or during calibration, this might lead
to wrong low or high values.
1. In accordance with the manufacturer's instructions, open the relevant valve(s) to

equalise the system pressures as is shown in this example.
Rinse 1. Select the IBP measurement field to display the IBP menu.
2. Select the parameter Zeroing to carry out the zeroing.
Touch
Sens
Set three-way
valve to
ambient
Patie
4.8.5 IBP alarms/messages

Alarm Code Cause Remedy
No sensor T_IBP01 • Cable not connected to the device  Check cable connection to the device.
• Catheter disconnected  Check catheter

Catheter
T_IBP02  Check catheter valve
disconnected • Catheter valve closed
• No zeroing has been done

• Zero-point sensor too high/low by  Check tube system, sensor and valves.
Zero required T_IBP03
more than 30 mmHg or unsteady  Perform zeroing.
pressure
• Try to zeroing during valid patient  Check catheter valve is closed during zeroing
measurement
Zero not possible I_IBP01
Art. no.: 0-48-0227 Rev.: g
• Try to zeroing without sensor con-  Connect sensor

nected
• Systolic pressure higher/lower

IBP SYS LOW/HIGH P_IBP01  Check the patient and alarm limits.
than the alarm limits
• Diastolic pressure higher/lower

IBP DIA LOW/HIGH P_IBP01  Check the patient and alarm limits.
than the alarm limits
Page 61
4 Monitoring
4.9 Temperature monitoring DEFIGARD/PHYSIOGARD Touch 7
4.9 Temperature monitoring

• Depending on the sensor type, the sensor can be applied to the ear, the skin or per
rectum.
• To achieve a reliable measured value, independent of the measuring site, the
measurement duration must be at least 2 minutes.
• The temperature measurement method is “Direct mode”.
4.9.1 Start temperature monitoring

1. Connect the sensor to the temperature input.
2. Select the TEMP measurement field to open the Temp menu.
3. Select OFF/ON button to start the measurement.
4.9.2 Temperature menu settings

Access the temperature menu via the TEMP measurement field as described on 33.

Start measurement On or OFF
Calibrate Calibration of the sensor
4.9.3 Temperature alarms

Alarm Cause Remedy
• Temperature sensor not connect-
Check sensor  Connect sensor.
ed to the device
 Check patient
• Temperature is out of set alarm lim-
TEMP: Out of range  Check narrow/wide alarm limit and adjust it if neces-
its.
sary.
Art. no.: 0-48-0227 Rev.: g
Page 62
Monitoring 4
DEFIGARD/PHYSIOGARD Touch 7 User guide CO2 mainstream 4.10
4.10 CO2 mainstream

4.10.1 IRMA mainstream gas analyser
IRMA mainstream gas analyser is intended to be connected to a patient breathing
circuit for monitoring of inspired/expired gases during anesthesia, recovery and
respiratory care.
 The IRMA gas analyzer is intended for use by authorized healthcare

professionals only.
 Risk of cross infection!
– Disposable airway adapters must not be re-used.
– Used disposable airway adapters must be disposed of in accordance with local
regulations for contaminated and biologically hazardous fluids.
 Airway Adapters are non-sterile devices. Do not sterilise.
 Use only Masimo manufactured IRMA airway adapters.
 Use the correct adapter:
– Do not use the IRMA Paediatric/Adult airway adapter for infants because the
adult adapter adds 6 ml dead space to the patient circuit.
– Do not use the IRMA Infant airway adapter for adults because this may cause
Paediatric airway adapter excessive flow impedance.
– Do not use the airway adapter with metered dose inhalers or nebulized medica-
tions as this may affect the light transmission of the airway adapter windows.
 The IRMA sensor is not intended to be used as the only means of monitoring a
patient.
 Never sterilise or immerse the sensor in liquid.
 Do not apply tension to the sensor cable.
 Do not place the IRMA airway adapter between the endotracheal tube and an
elbow as this may allow patient secretions to block the adapter windows and
result in incorrect operation.
Adult airway adapter  To keep secretions and moisture from pooling on the windows, always position
the IRMA probe in a vertical position with the LED pointing upwards.
 Replace the airway adapter if rainout/condensation occurs inside the airway
adapter.
Art. no.: 0-48-0227 Rev.: g
Page 63
4 Monitoring
4.10 CO2 mainstream DEFIGARD/PHYSIOGARD Touch 7
4.10.2 Preparing the IRMA sensor

1. Insert the airway adapter.
1 2. Connect the 15 mm airway adapter end to the ventilator Y piece.
3. Connect the patient side of the airway adapter to the tube.
IMPORTANT
4. To keep moisture from pooling on the windows, position the airway adapter with
its windows in a vertical position.(LED pointing upwards)
2  To prevent the windows' soiling by secretions of the patient or condensing water,
position the adapter in a slightly angled position between the endotracheal and
the respiration tubes.
adapter window
3
HME
 Alternatively; connect a HME (Heat Moisture Exchanger) between the patient’s

endotracheal tube and the IRMA probe. Placing a HME in front of the IRMA probe
protects the airway adapter from secretions and effects of water vapor and
eliminates the need of changing the adapter. It allows free positioning of the IRMA
probe as well. Unless the IRMA probe is protected with a HME always position
the IRMA probe with the LED pointing upwards.
Art. no.: 0-48-0227 Rev.: g
Page 64
Monitoring 4
4.10.3 Initial operation of the IRMA sensor
• The sensor requires a warm-up time of around ten seconds to provide fully
accurate measurements.
• A correction related to O2 usage is available in the menu setting EtCO2>Type of
ventilation. If patient is ventilated with Air and O2, set Type of ventilation to =
“Air + O2” if ventilated only with air set it to “Air”.
1. Connect the sensor cable to the main cable (1). Snap the sensor head on top of
the airway adapter. Make sure it clicks into place.
2. A green LED indicates that the sensor is ready for use.
3. Select the EtCO2 measurement field (2) to open the EtCO2 menu. “
1 4. Select OFF/ON button (3) to start the measurement.
5. Check if the etCO2 value is zero.
6. If needed, carry out a zeroing (see page 66).
7. Connect the narrower end of the airway adapter to the breathing circuit Y-piece.
2
8. Connect the end of the airway adapter to the patient’s endotracheal tube.
9. Check the CO2 curve on the display to see if the connections have been made
correctly and the CO2 value is in the expected range. The curve rises during ex-
piration.
3
Start measurement ON
Curve amplitude (%)
Perform zeroing
Type of ventilation
Air
4.10.4 Placement of IRMA sensor
 The IRMA probe is not intended to be in patient contact.
 When connecting the IRMA sensor to an infant patient circuit, it is important to

avoid the direct contact between the IRMA sensor and the infant’s body. Use
insulation material between the body and the IRMA sensor to avoid contact.
Art. no.: 0-48-0227 Rev.: g
Page 65
4 Monitoring
4.10.5 Zeroing of the IRMA CO2 sensor
 An incorrect zeroing leads to wrong measurement results.

 Therefore, make sure that the IRMA adapter is filled with ambient air (21% O2
and 0% CO2) during the zeroing.
 After start-up or changing of the adapter, wait for at least 10 seconds until the
sensor has reached its operating temperature.
 During zeroing, no breathing air must enter the adapter.
Zeroing intervals for • When the message “CO2 calibration is required” is displayed
CO2 IRMA sensor • When an offset in gas readings is discovered (0-offset)
Zeroing procedure 1. Snap a new airway adapter onto the sensor without connecting the airway adapt-
er to the breathing circuit.
2. After start-up or changing of the adapter, wait for at least 10 seconds until the
sensor has reached its operating temperature.
3. In the "etCO2 settings" menu, select the menu item “Perform zeroing”.
4. Carry out the zeroing by pressing the parameter “Perform zeroing” in the "et-
CO2 settings" menu. Make sure that no exhaled air enters the airway adapter.
The green LED on the probe will be blinking for approximately 5 seconds while
zeroing is in progress.
5. If the message “CO2 calibration is required” is again displayed, perform the
zeroing again.
6. If the message “CO2 calibration is required” is no longer displayed, the zero-
ing has been performed.
7. Reconnect the airway adapter with the sensor to the breathing circuit.
8. Check the CO2 curve on the display to see if the connections are correct and if
the CO2 value is in the expected range. The curve rises during expiration.
Art. no.: 0-48-0227 Rev.: g
Page 66
Monitoring 4
4.10.6 Sensor LED indications

Apart from the indications on the screen, the LED on the sensor gives the following
indications:
Steady green: System OK

Steady red: Sensor error
Flashing red: Check the adapter
Flashing green: Zeroing in process
4.10.7 Settings etCO2 menu

Access the etCO2 menu via the etCO2 display field as shown on page 65.

Curve amplitude (%) 8, 12 or 15 %
Perform zeroing Zeroing the sensor to ambient air
Air = patient ventilated only with air
Type of ventilation
Air + O2 = patient ventilated with Air and O2
4.10.8 Curve list

Selection of the displayed first curve. The II or Defi
first display curve is used to calculate the
Heart rate unless the HR source is set to
Pleth. Default:
Defi/I, II, aVR, aVL, aVF, SpO2
Touch the curves 2,3,4 Selection of the displayed curve plethysmograph,
EtCO2:Respiration
Art. no.: 0-48-0227 Rev.: g
Page 67
4 Monitoring
4.10.9 CO2 error messages

P.ETCO201  Check patient
• Respiration rate out of set alarm  Check narrow/wide etCO2 alarm limit and
RR out of range
limits. adjust it if necessary.
 Check ventilation settings
 Check narrow/wide alarm limit and adjust it if
Apnoea • Apnoea out of set alarm limits.
necessary.
 Check narrow/wide etCO2 alarm limit and
etCO2 out of range • etCO2 is out of set alarm limits.
adjust it if necessary.
I.ETCO201 • an offset in gas readings is dis-  Perform zeroing
CO2 calibration required
covered
T.ETCO201 • No Sensor connected, defective  Connect sensor, check cable
Check Sensor
cable
Zeroing in progress T.ETCO202 • Zeroing process started  Wait till zeroing process ends
T.ETCO204 • Adapter polluted with patient  Replace CO2 adapter if polluted

Replace adapter
secretions
T.ETCO205 • No or incorrect CO2 adapter  Check if IRMA CO2 adapter is properly
No adapter
• Adapter not properly connected connected
T.ETCO214 • Temperature sensor too high/low  Check standard operating condition if
Internal temp out of range normal:
 Replace sensor
T.ETCO215 • Pressure to high/low  Check standard operating condition if
Ambient pressure out of normal:
range
 Replace sensor
T.ETCO216 • This alarm is due to Zeroing  Check standard CO2 condition if normal:
Inaccurate zero reference required message from the probe.  Perform zeroing
Software error T.ETCO218 • Sensor failure  Check sensor, replace sensor
Hardware error T.ETCO219 • Sensor failure  Check sensor, replace sensor
Motor speed out of bounds T.ETCO220 • Sensor failure  Check sensor, replace sensor
Factory calibration lost T.ETCO221 • Sensor failure  Check sensor, replace sensor Art. no.: 0-48-0227 Rev.: g
Page 68
Monitoring 4
DEFIGARD/PHYSIOGARD Touch 7 User guide CO2 Sidestream 4.11
4.11 CO Sidestream
2
4.11.1 ISA gas analyser (sidestream measurement)
• ISA sidestream gas analyser is intended to be connected to a patient breathing

circuit for monitoring of inspired/expired gases during anaesthesia, recovery and
respiratory care.
• A correction related to O2 usage is available in the menu setting EtCO2>Type of
ventilation. If patient is ventilated with Air and O2, set Type of ventilation to =
“Air + O2” if ventilated only with air set it to “Air”.
 The ISA sidestream gas analyzer is intended for use by authorized healthcare
professionals only.
 Disposable sampling lines must not be reused. Used sampling lines should be
disposed of in accordance with local regulations for contaminated and
biologically hazardous fluids.
 Only use Masimo´s Nomoline sampling lines.
 Do only use sample lines intended for anaesthetic agents if N2O and/or
anaesthetic agents are being used.
 Make sure to select the correct configuration:
– Do not use T-adapter sampling line configurations for infants because these
will add 7 ml dead space to the patient circuit.
– Do not use the Nomoline Airway Adapter Set Infant with adult/paediatric pa-
tients.
 Use only airway T-adapters with the sampling point in the centre of the adapter,
see picture on the left.
 Do not use the sampling lines with metered-dose inhalers or nebulized
medications as this may clog the bacteria filter.
 The ISA sensor is not intended to be used as the only means of monitoring a
patient.
 Excessive positive or negative pressure in the patient circuit (e.g. excessive
scavenging suction pressure) might lead to incorrect readings.
 Exhaled gases should be returned to the patient circuit or scavenging system;
do not apply negative pressure to the Nomoline (i.e. by means of a syringe) to
remove condensed water.
 Always use a bacteria filter on the evacuation side if sampled gas is intended to
be re-breathed.
 Use of high frequency electrosurgical equipment in the vicinity of the ISA sensor
may produce interference and lead to incorrect measurements.
 Exhaust gases should be returned to the patient circuit or to a scavenging
system.
Art. no.: 0-48-0227 Rev.: g
 The Nomoline sampling line and its interface are non-sterile devices. To avoid
damage, do not autoclave any part of the sampling line.
 Do not operate the device at temperatures outside the specified operating
environment.
 Make sure that the ISA sensor is properly secured in order to prevent damages
to the sensor.
 The use of a sampling line with an inner diameter of more than 1 mm can lead
to a change in the response and rise time of the CO2 measurement. When the
respiration rate is higher than 130/min, this might lead to a lower etCO2 value
being displayed.
Page 69
4 Monitoring
4.11 CO2 Sidestream DEFIGARD/PHYSIOGARD Touch 7
 The Nomoline sampling line is designed for single use only; do not reuse.
Art. no.: 0-48-0227 Rev.: g
Page 70
Monitoring 4
4.11.2 Initial operation of the ISA gas analyser
• The sensor requires a warm-up time of around ten seconds.
 1. Connect the sensor cable (1).

Nomoline
sampling line 2. Connect the Nomoline sampling line (2) to the ISA gas analyser.
3. A green LED (2) indicates that the sensor is ready for use.
4. Select the EtCO2 measurement field (3) to open the EtCO2 menu. “
5. Select OFF/ON button to start the measurement.
6. Breathe briefly into the sampling line and check that the CO2 curves and values
are displayed correctly.
7. Occlude the sampling line with your fingertip and wait for 10 seconds.
8. Check that an occlusion alarm is displayed and that the gas analyser shows a
flashing red light.
1
 Replace the sampling line if the sampling line input connector (2) starts flashing
red or the message “Sampling line clogged” is displayed on the device.
 Connect the gas sample exhaust port to the gas exhaust of the bag to prevent
Green/Red LED that CO2 enriched gas in the bag influences the zeroing of the ISA gas analyser
2 Nomoline sampling line
Start measurement ON
Curve amplitude (%)
Perform zeroing
Type of ventilation
Air
4.11.3 Sensor LED indications

Art. no.: 0-48-0227 Rev.: g
In addition to the information given on the screen, the sensor LED indicates the
following:
Steady green: System OK

Flashing green: Zero reference calibration in process
Steady red: Sensor error
Flashing red: Check/replace the sampling line
Page 71
4 Monitoring
4.11 CO2 Sidestream DEFIGARD/PHYSIOGARD Touch 7
4.11.4 Respiration rate alarms

• Respiration rate out of set  Check narrow/wide etCO2 alarm limit and
RR out of range
alarmlimits. adjust it if necessary.
Apnoea • Apnoea out of set alarm limits.
CO2 out of range • ETCO2 is out of set alarm limits.
I.ETCO201 • An offset in gas readings is dis-  Perform zeroing
CO2 calibration required
covered
T.ETCO201 • No Sensor connected, defective  Connect sensor, check cable
Check Sensor
cable
Zeroing in progress T.ETCO202 • Zeroing process started  Wait till zeroing process ends
Sampling line clogged T.ETCO207 • Indicates sampling line occlusion.  Replace sampling line
T.ETCO208 • Indicates that a sampling line  Check if IRMA CO2 adapter is properly
No sampling line
needs to be fitted. connected
Internal O2 port failure T.ETCO209 • Sensor failure  If persistent, replace sensor
T.ETCO214 • Temperature Sensor to hight/low  Check standard operating condition if
Internal temp out of range normal:
 Replace sensor
T.ETCO215 • Pressure to high/low  Check standard operating condition if
Ambient pressure out of normal:
range
 Replace sensor
T.ETCO216 • This alarm is due to Zeroing  Check standard CO2 condition if normal:
Inaccurate zero reference
required message from the probe.  Perform zeroing
Software error T.ETCO218 • Sensor failure  Check sensor, replace sensor
Hardware error T.ETCO219 • Sensor failure  Check sensor, replace sensor
Motor speed out of bounds T.ETCO220 • Sensor failure  Check sensor, replace sensor
Factory calibration lost T.ETCO221 • Sensor failure  Check sensor, replace sensor
Art. no.: 0-48-0227 Rev.: g
Page 72
Monitoring 4
4.11.5 Settings etCO2 menu

Access the etCO2 menu via the etCO2 display field as shown on page 71.

Curve amplitude (%) 8, 12 or 15 %
Perform zeroing Zeroing the sensor to ambient air
Air = patient ventilated only with air
Type of ventilation
Air + O2 = patient ventilated with Air and O2
4.11.6 Curve list

Selection of the displayed first curve. The II or Defi
first displayed curve is used to calculate the
Heart rate unless the HR source is set to
Pleth. Default:
Defi/I, II, aVR, aVL, aVF, SpO2
Touch the curves 2,3,4 Selection of the displayed curve plethysmograph, EtCO2,
Respiration and IBP
4.11.7 Zero adjustment of the CO2 sidestream sensor
 Incorrect zero adjustment leads to erroneous measurement results.

 Therefore, make sure that the calibration is performed in a well-ventilated room.
Avoid breathing near the gas analyser before or during the calibration.
 If the ISA gas analyser is stowed in the transport bag, ensure good ventilation of
the bag or check that the gas exhaust is connected before calibration.
• The ISA sidestream gas analyser performs zeroing automatically by switching the
gas sampling from the respiratory circuit to ambient air. The automatic zeroing is
performed after startup and 1 to 3 times per day and it takes less than 3 seconds.
• During zeroing, if ISA’s exhaust gas is returned to the patient circuit, the returned
gas level will be different from the gas level at the sampling site.
Calibration intervals for ISA CO2 • When the message “CO2 calibration is required” is displayed
sensor • When an offset in gas readings is discovered (0-offset)
Art. no.: 0-48-0227 Rev.: g
Zeroing procedure 1. Select the menu CO2 > ETCO2 and then the menu item “Perform zeroing”. The
green LED on the ISA sensor is blinking and the Zeroing process is displayed
on the DEFIGARD/PHYSIOGARD Touch 7.
2. When the green LED on the sensor stops blinking, the calibration is finished.
3. Check the etCO2 curve in the display to see if the connections have been made
correctly and if the etCO2 value is in the expected range. The curve rises during
expiration.
Page 73
4 Monitoring
4.12 Registering events DEFIGARD/PHYSIOGARD Touch 7
4.12 Registering events

When the event button is pressed, the pre-defined event texts are displayed. Select
one of these texts; this text will be recorded in the data report together with the time.
Events
 Select "Cancel last" to indicate that an incorrect event was selected. A "Cancel
Last" event and time stamp are stored in the event list.
Fig. 4.10 Event button
Data (ECG, automatic and manual events) can be displayed on a PC by use of the
Schiller data reviewing Software.
Art. no.: 0-48-0227 Rev.: g
Page 74
Monitoring 4
DEFIGARD/PHYSIOGARD Touch 7 User guide View Trend, R-ECG and Screenshots 4.13
4.13 View Trend, R-ECG and Screenshots

All recorded trend data, resting ECGs and screenhots can be viewed during
intervention. Additionally, the viewed resting ECG can be transmitted as described in
chapter 4.6 page 50.
4.13.1 View Trends

1. Enter the main menu and select Trends.
2. Use the function buttons to navigate in the trend screen.
Menu
Trends
14/09/15 12:00 12.02 12:04
Menu HR
b/min 80 85 81 79
HR (Pleth)
Choose an other view b/min --- --- --- ---
SpO2
% 98 98 97 96
Trends SpCO
%
2.0 1.9 1.7 2.1
Spmet
R-ECG % 1.5 1.4 1.6 1.3
Temp 36.8 36.8
°C
36.8 36.8
Screenshots NIBP 120/80(88) 125/81(89) ---/---(--) ---/---(--)

mmHg
Stop Intervention Beginning Backward Forward End Close

00547_160318_103611
3. Close the Trends screen with the button or “Close” button.
Fig. 4.11 Trends screen
4.13.2 View resting ECG

1. Enter the main menu and select R-ECG.
2. Select one of the R-ECG records on the R-ECG list
R-ECG List 3. The following screen appears.
Art. no.: 0-48-0227 Rev.: g
Send New R-ECG Print Interpr. Measur. Close
4. Exit the viewing mode by pressing the “Close” button.

5. To print the resting ECG, click on "Print"
Page 75
4 Monitoring
4.13 View Trend, R-ECG and Screenshots DEFIGARD/PHYSIOGARD Touch 7
4.13.3 View /Print Screenshots

1. Enter the main menu and select Screenshots.
2. Select one of the screenshot on the list.
3. The screenshot appears with a watermark.
4. Exit the viewing mode by pressing the Red X button on the top left corner.
 To print a screenshot, tick the box on the right and click on "next".
Several screenshots can be selected and printed.
 The screenshot is available for printout only when the icon has switched from
camera to camera + printer
 The printout files may take some time to be generated.
Art. no.: 0-48-0227 Rev.: g
Page 76
Monitoring 4
DEFIGARD/PHYSIOGARD Touch 7 User guide Transmission 4.14
4.14 Transmission
Various data are available for transmission via several communication channels e.g.
GSM/3G, Wi-Fi, USB-Ethernet and USB storage.
4.14.1 Selecting communication media Wifi or GPRS
To change the transmission media select the transmission icon Wifi or GPRS and
select menu Communication media. Select Wifi or GPRS and the corresponding
search for icon will be displayed on the top right status bar.
Network
4.14.2 Transmission procedure
Ensure that a transmission line is connected to the device and that the required
Menu configurations in the Control panel menu have been made.
Transmitting R-ECG or Sreenshots
1. Enter the main menu and select R-ECG or Sreenshots.

Menu 2. Select one of the R-ECG records as example.
R-ECG List Next
Trends

R-ECG
Screenshots
Stop Intervention
00547_160318_103611
Post-Intervention
Transmission in progress
3. Press the button next and select the desired transmission channel (GSM/3G, Wifi,
USB/Ethernet or USB storage).
4. The transmission icon on the top right status bar shows the progress of the trans-
Transmission failed mission.
5. Select the transmission icon to open the Transmission list.
Art. no.: 0-48-0227 Rev.: g
Transmission successful Transmission list Cancel
Transmission successful
No connection to the WLAN
or GPRS transmission
channel. Transmission only
to USB stick possible
If transmission of the data fails, the ECG/Screenshot file can be re-sent via the Menu>
ECG or Screenshots
Page 77
5 Defibrillation
5.1 Application guidelines and safety notes DEFIGARD/PHYSIOGARD Touch 7
5 Defibrillation
This chapter applies only to the DEFIGARD® Touch 7.
5.1 Application guidelines and safety notes

Observe the following guidelines to ensure successful and safe defibrillation.
Otherwise the lives of the patient, the user and bystanders are in danger.
 The patient must:

– not come into contact with the operator or other persons during defibrillation.
– not come into contact with metal parts, e.g. bed or litter, or be positioned on wet
ground (rain, accident in swimming pool), to prevent unwanted pathways for the
defibrillation current, which may endanger the operator or assistants.
 Do not allow the defibrillation electrodes to come into contact with other
electrodes or metal parts which are in contact with the patient.
 The patient's chest must be dry, as moisture causes unwanted pathways for the
defibrillation current. For safety, wipe off flammable skin cleansing agents.
 Owing to the high currents, there is a risk of skin burns at the site of the
electrodes. This is why the electrodes must not be placed on or above:
– the sternum, clavicle or mamillas
 Immediately prior to the shock, the heart massage (CPR) and artificial
respiration must be stopped and bystanders must be warned.
 Defibrillating a patient with an implanted pacemaker is likely to impair the
pacemaker function or cause damage to the pacemaker. For this reason, do not
apply the defibrillation electrodes in the vicinity of the pacemaker, have an
external pacemaker at hand, and check the implanted pacemaker for proper
functioning as soon as possible after the shock.
 Equipment damage! Sensors and devices that are not defibrillation proof must
be disconnected from the patient before a shock is triggered.
Art. no.: 0-48-0227 Rev.: g
Page 78
Defibrillation 5
DEFIGARD/PHYSIOGARD Touch 7 User guide Application guidelines and safety notes 5.1
5.1.1 Additional safety information for AED Mode

In addition to the guidelines set forth in section 5.1, the following rules must be
observed when using an AED, as failure to do so may compromise the success of the
defibrillation or endanger the patient's life.
 The user is committed to verify the prerequisites for the use of the AED by
checking for lack of consciousness, lack of breathing and lack of circulatory
signs using the ABCD system (BLS algorithm).
 The device must only be used if the following symptoms are found:
– non-responsive
– no respiration
– no pulse
 If, in the course of treatment, a patient spontaneously regains consciousness, a
defibrillation shock that may have been advised just before must not be
delivered.
 To ensure correct analysis of the heart rhythm, the patient must lie as still as
possible and must not be touched, as artefacts may otherwise lead to incorrect
analysis results.
 If the ECG signal changes such that the shock is not recommended, the shock
delivery is automatically blocked in the AED mode.
Art. no.: 0-48-0227 Rev.: g
Page 79
5 Defibrillation
5.1 Application guidelines and safety notes DEFIGARD/PHYSIOGARD Touch 7
5.1.2 Defibrillating children/neonates
 Please note that less energy is needed for children:

For the first defibrillation of infants and small children using biphasic shock,
approx. 1 joule/kg body weight is released. An increase of 2 joules/kg body
weight is possible when the defibrillation is repeated.
 For the defibrillation of children, the paediatric pads should be used.
 If no paediatric pads are available adult electrodes can be used when patient
type “Child/Neonate” has been selected. Warning! Double check that the patient
type setting and type of electrodes is “Child/Neonate”. (see illustration 1 & 2
below).
Defibrillation on neonates
 When using the defibrillator on neonates, follow the local guidelines.
 Follow the energy setting for infants and small children as described above.
 The automatic energy setting for neonates is the same as for children.
When paediatric pads are used, the patient type setting Adult or Child/Neonate on
the screen does not overrule the energy setting: when paediatric pads are connected
to the device, the energy setting is always paediatric.
Paediatric Patient type Electrode/energy setting
electrode information
50/50/50Joule
If no children electrodes are available, adult electrodes can be used. When adult pads
are used, the patient type setting “Child/Neonate” on the screen does overrule the
energy setting Adult to “Child/Neonate”.
Adult Patient type Electrode/energy setting
electrode information
150/200/200 Joule
50/50/50Joule
Art. no.: 0-48-0227 Rev.: g
2 50/50/50Joule
Neonate
Page 80
Defibrillation 5
DEFIGARD/PHYSIOGARD Touch 7 User guide General function 5.2
5.2 General function

• The DEFIGARD® Touch 7 works with biphasic truncated exponential chopped
defibrillation waveform impulse. Depending on the factory settings, the device
either switches automatically from synchronised to non-synchronized defibrillation
or the mode has to be changed manually using the Sync button.
• When a patient cable is connected, you can select in the ECG menu if the ECG
should be displayed via the separate ECG electrodes or the defibrillation
electrodes.
• You can select a higher energy value while the defibrillator is charging. The device
will charge to the new level. It is not possible, however, to reduce the charged
energy. In this case, the stored energy will be discharged internally and you will
have to recharge the defibrillator.
• The required energy for a successful defibrillation depends on several parameters
(body constitution, etc.). For emergency medical treatment, AHA/ERC recommend
a biphasic impulse. Depending on configuration settings, the energy of the 3 first
shocks can be increasing.
Shock Adults Children
1 150 joules 50 joules

from 3 200 joules 50 joules
Art. no.: 0-48-0227 Rev.: g
Page 81
5 Defibrillation
5.2 General function DEFIGARD/PHYSIOGARD Touch 7
5.2.1 Activating the manual defibrillation mode

Depending on start-up configuration (performed by the administrator see
12.6.1 General configuration), the device can start in Monitoring, AED or Manual
Defibrillation mode and confirmation is needed or not. Proceed as follows to activate
the Manual defibrillation mode when the device does not directly start in manual
defibrillation mode:
When the device starts in Monitoring or AED mode:

Manual def
 Switch to manual mode by pressing the soft key Manual Def and confirm with
Yes.
Number of released shocks
Elapsed time since the last shock Electrode impedance
Indication of pads type Child or

Adult Manual adults. Low OK
Switching operational modes:

asynchronous or synchronous
Charging progress bar
CPR Event Screenshot
Opening CPR menu to activate/ Selection of energy Charging button

deactivate metronome and activating via - or + button
the Schiller feedback advisory system
when using the Schiller LifePoint
sensor or FreeCPR (based on
impedance).
Art. no.: 0-48-0227 Rev.: g
Page 82
Defibrillation 5
DEFIGARD/PHYSIOGARD Touch 7 User guide General function 5.2
5.2.2 Activating the automated (AED) defibrillation mode

 Depending on start-up configuration (performed by the administrator see
12.6.1 General configuration) the device can start in Monitoring, AED or Manual
Defibrillation mode. Proceed as following to activate the AED mode when
device does not start direct in AED:
Monitoring and Manual Defibrillation Manual def
 Switch to AED mode by pressing the AED key.
In the AED operational mode, the alarm system remains active in the same state as
in the monitoring operational mode.
Number of released shocks

Elapsed time since the last
shock Electrode impedance
ECG curve displayed when soft key

“ECG curve” is pressed
Indication of pads type
Text instruction
30 CHEST COMPRESSIONS
THEN 2 RESCUE BREATH
CPR Event Screenshot Manual Def Analyse Close
Action picture
Opening CPR menu to activate/deactivate metronome and activating
the Schiller feedback advisory system when using the Schiller
Analyse soft key
LifePoint sensor or FreeCPR (based on impedance).
Art. no.: 0-48-0227 Rev.: g
Same AED display as above but with

parameter displayed at the right side.
This view is defined by administrator
configuration.
DO NOT TOUCH THE PATIENT
ANYLYSING
CPR Event Screenshot Manual Def Analyse Close
 Switching from the AED mode to Monitoring mode must be confirmed with Yes
. This depends on the device’s configuration (see 12.6.1 General
configuration)
Page 83
5 Defibrillation
5.2 General function DEFIGARD/PHYSIOGARD Touch 7
5.2.3 Manual defibrillation procedure

1. Select manual defibrillation (see 5.2.1, page 82)
 Confirm switching to manual defibrillation (This depends on the device’s
configuration see 12.6.1 General configuration)
Manual def
2. Select the required energy via the touch screen (button - or +).
3. Charge the energy using the “Charge” button.
4. Release the shock with shock button on the device.
CPR Event Screenshot
Fig. 5.1 Defibrillator window
Art. no.: 0-48-0227 Rev.: g
Page 84
Defibrillation 5
DEFIGARD/PHYSIOGARD Touch 7 User guide Manual Defibrillation Using Pads 5.3
5.3 Manual Defibrillation Using Pads

 Delivering a shock to a patient with normal heart rhythm may induce ventricular
fibrillation. For this reason, first read the general rules and safety information in
sections 5.1 and 5.2.
 Electric shock hazard. Turn off the device before exchanging the defibrillation
electrodes; exchanging the electrodes on a charged defibrillator initiates an
internal safety discharge.
5.3.1 Applying the adult and paediatric electrodes
 Only use the pads up to their expiration date. Please note that the indicated
expiration date only applies if the vacuum pack is intact.
 The pads are pre-gelled, so there is no need to use extra contact agent.
 Do not reuse the pads.
Adult electrodes The adult electrodes with the blue connector are used for adults and children from
25 kg.
The adult electrode can be used for children when the patient type is set to “Child”
(see 5.1.2 Defibrillating children/neonates page 80).
Paediatric electrodes  The paediatric electrodes with the yellow connector are used for children
weighing less than 25 kg.The energy setting is automatically reduced (default 50
Joule) with the paediatric electrodes. The default can be set in the device’s
configuration see 12.6.3 Defibrillator)
Art. no.: 0-48-0227 Rev.: g
Page 85
5 Defibrillation
5.3 Manual Defibrillation Using Pads DEFIGARD/PHYSIOGARD Touch 7
5.3.2 Applying the electrodes
 Good contact between the skin and the adhesive electrodes must be ensured.
Suntan oil, sand or salt reduce the adhesive quality.
 The applied pads must have good contact with the patient's skin, and air bubbles
under the pads must be avoided. To do so, stick on one end of the pad then
smooth it out to the other end.
Adults and children from 25 kg

Electrode placement is the same for adults and for and children weighing 25 kg or
more (see Fig. 5.2 Adult electrode application sites and Fig. 5.3 Electrode application
sites for children weighing 25 kg or more).
 The safety distance between the two electrodes should be approx. 3 cm.
1. Clean and dry the application points for the electrodes (see Fig. 5.2 Adult elec-
trode application sites page 86/Fig. 5.3 Electrode application sites for children
weighing 25 kg or more page 86). Only clean the skin by vigorously rubbing it with
a dry cloth.
2. Apply one electrode above the right nipple. Do not apply it on the clavicle (une-
ven).
3. Apply the other electrode slantwise below the left breast as illustrated in Fig. 5.2
Adult electrode application sites page 86/Fig. 5.3 Electrode application sites for
children weighing 25 kg or more page 86).
Fig. 5.2 Adult electrode application sites 4. Make sure that the connections are positioned on the outside so that the cables
do not hinder cardiopulmonary resuscitation (CPR).
Fig. 5.3 Electrode application sites for

children weighing 25 kg or more
Children weighing less than 25 kg
The energy setting is automatically reduced with the Paediatric electrodes.
1. Clean and dry the application points for the electrodes (see Fig. 5.4 Application
sites for children less than 25 kg page 86). Only clean the skin by vigorously rub-
bing it with a dry cloth.
Art. no.: 0-48-0227 Rev.: g
2. Apply one electrode on the left of the right nipple as illustrated in Fig. 5.4 Applica-
tion sites for children less than 25 kg page 86
3. Apply the second electrode on the back on the same level as the chest electrode
as illustrated in Fig. 5.4 Application sites for children less than 25 kg page 86.
Make sure that the connections are positioned on the outside so that the cables do not
hinder cardiopulmonary resuscitation (CPR).
Fig. 5.4 Application sites for children less

than 25 kg
Page 86
Defibrillation 5
DEFIGARD/PHYSIOGARD Touch 7 User guide Manual Defibrillation Using Pads 5.3
5.3.3 Checking the electrodes

If the resistance between the skin and the electrodes is too high, the message
“CONNECT THE ELECTRODES” (AED mode) or (Manual mode) is

BAD
issued.
Proceed as follows:
1. Alternately press the electrodes/pads down firmly and check when the message
disappears. Carefully press that pad onto the patient's skin once again.
If the message does not disappear,
2. remove both defibrillation electrodes
3. wipe rests of contact agent off with a cloth
4. shave both application areas to remove the uppermost layer of skin
5. apply new defibrillation pads to these points.
Art. no.: 0-48-0227 Rev.: g
Page 87
5 Defibrillation
5.3 Manual Defibrillation Using Pads DEFIGARD/PHYSIOGARD Touch 7
5.3.4 Manual Defibrillation Using Pads Procedure

1. Connect the electrode cable to the pads connector.
2. If the device starts in Monitoring or AED mode, proceed according to the descrip-
tion in chapter 5.2.1 Activating the manual defibrillation mode, page 82.
3. Select the energy via the touch screen +-.

4. Initiate the energy charging by pressing "Charge".

Metronome CPR Guide Event
• Do not, under any circumstances, touch the patient during shock delivery.
• Make sure that the patient does not touch any conducting objects.
5. Trigger the shock by pressing the button .
6. Finish the therapy (see 7 Finishing the Therapy page 106).

Fig. 5.5 Manual defibrillation
Art. no.: 0-48-0227 Rev.: g
Page 88
Defibrillation 5
DEFIGARD/PHYSIOGARD Touch 7 User guide Synchronised defibrillation 5.4
5.4 Synchronised defibrillation

5.4.1 Warning erroneous triggering
 Erroneous triggering, interpretation hazard

– For synchronised defibrillation, the ECG electrodes should be applied as far
from the defibrillation electrodes as possible (e.g. on the limbs).
– Use only silver/silver-chloride electrodes, if you acquire the ECG via separate
ECG electrodes. These electrodes prevent polarisation voltages which may be
caused by the defibrillation shock, resulting in an ECG trace on the monitor
screen or recording that simulates cardiac arrest.
 Disturbed ECG trigger signal! Signal noise may disturb the ECG signal and
cause artefacts. This must be considered chiefly in the synchronised mode and
in demand pacing. For this reason, the following should be observed:
– Do not touch the device during defibrillation to prevent electrostatic noise
– Keep the patient cable away from power cords, transformers etc.
 To achieve adequate ECG signal quality for reliable triggering, ensure that
– the ECG signal is free of artefact
– there are no major fluctuations in amplitude
– the displayed trigger pulses are positioned exactly above the R-wave
5.4.2 Setup switching from synchronized to unsynchronized mode
The synchronized mode (1) is manually activated (Sync ON/OFF). Depending on the
factory setup, the synchronized mode stays activated after delivering the shock (Sync
after sync shock =Yes) or switches back to unsynchronized shock (Sync after sync
shock = No). The current setting must be communicated to the user.
1
 The default setting is “Sync after sync shock = No”:
 the manual activated synchronized mode will be deactivated after delivering a
synchronized shock. To deliver a second synchronized shock, it is important to
activate it again.
 If the admin setting is “Sync after sync shock = YES”:
 the manual activated synchronized mode is maintained after delivering a
synchronized shock. To deliver a unsynchronized shock, it is important to
deactivate it again.
Art. no.: 0-48-0227 Rev.: g
Page 89
5 Defibrillation
5.4 Synchronised defibrillation DEFIGARD/PHYSIOGARD Touch 7
5.4.3 Function of the Synchronized Defibrillation Procedure
For synchronised defibrillation, the defibrillation shock is delivered in synchronisation

with the heart action, as the heart is still working. As a prerequisite, the patient's ECG
signal must be supplied to the defibrillator. After the physician has triggered the
defibrillation shock, the trigger signal for the actual shock delivery will be derived from
1 the subsequent QRS complex 25 ms after the trigger mark on the monitor screen (1).
Pulse triggering Shock release
Keep shock button pressed

In case of absence of QRS, an internal discharge will occur in a delay of 20 – 30
seconds.
Fig. 5.6 Synchronised defibrillation
 Be aware that after initiation of the shock, the actual shock will be released with
the next trigger signal (QRS) derived from the ECG. This may lead in a shock
delivery delay time of 30 second.
Art. no.: 0-48-0227 Rev.: g
Page 90
Defibrillation 5
DEFIGARD/PHYSIOGARD Touch 7 User guide Synchronised defibrillation 5.4
5.4.4 Synchronised defibrillation procedure

2. If the device starts in Monitoring or AED mode, proceed according description
chapter 5.2.1 Activating the manual defibrillation mode, page 82.
3. Select synchronised defibrillation via the touch screen (1).

4. The setting ON (2) is displayed below the Sync label.
5. Check ECG rhythm:
– the QRS beep sounds
– the trigger pulses above the R-wave
Metronome CPR Guide Event 6. Select the desired energy with the +/- button.
7. Charge the desired energy with the button Charge.
1
As soon the defibrillator is ready for shock an audio signal sounds and the LED
below the shock button is on.
 You have now 20 seconds to work through the points 8 to10, before the internal
safety discharge is activated because of exceeding the time limit.
8. Check ECG curve, SYNC (1) ON and energy setting.
2
Fig. 5.7 Switching to synchronised defi-

brillation
9. Warning, electric shock!

10. Deliver the shock by pressing the button ,
 Keep the button pressed until the shock is delivered.
 Be aware that after initiation of the shock, the actual shock will be released with
the next trigger signal (QRS) derived from the ECG. This may lead in a shock
delivery delay time of 30 second.
11. After the shock is delivered, monitor the patient and the ECG signal.
 If the default setting is “Sync after sync shock = No” the synchronized
defibrillation mode is switched back to OFF after delivering the shock.
12. If a second attempt is contemplated, return to step 4.

Art. no.: 0-48-0227 Rev.: g
If an unsynchronized shock is required while in synchronized mode, it is possible at

any time to switch the synchronized mode to OFF and deliver the shock immediately
(unsynchronized).
Page 91
5 Defibrillation
5.5 Semi-automated defibrillation DEFIGARD/PHYSIOGARD Touch 7
5.5 Semi-automated defibrillation

 Delivering a shock to a patient with normal heart rhythm may induce ventricular
fibrillation. For this reason, first read the general rules and safety information in
section 5.1, page 79.
 Electric shock hazard. Turn off the device before exchanging the defibrillation
electrodes; exchanging the electrodes on a charged defibrillator initiates an
internal safety discharge.
 According to AHA/ERC guidelines, even children under 8 year old may be
defibrillated in semi-automated mode.
 In the semi-automated mode, the electrodes should be applied in the common
anterior-anterior positions. With infants, anterior-posterior placement can be
advised to prevent a short-circuit between the two defibrillation electrodes.
 If, in the course of treatment, a patient spontaneously regains consciousness, a
defibrillation shock that may have been advised just before must not be
delivered.
 During HF surgical interventions, ECG analysis is not permitted in the semi-
automated mode.
5.5.1 Semi-automated defibrillation (AED) procedure
• In the AED operational mode, the patient is not under monitoring conditions.
• The switched off device can be started directly in AED mode by pressing the AED
button .
Depending on start-up configuration (performed by the administrator) the device can

start in Monitoring, AED or Manual Defibrillation mode. Proceed as follows to
activate the AED mode when the device does not directly start in AED mode:
 Switch to AED mode by pressing the AED key and confirm with the check box.
When the AED mode starts, the spoken and visual instructions for the defibrillation are
issued and the analyses will be running automatically as soon as the pads are applied.
Closely follow the instructions.
 Press the Monitor button to leave the AED mode.
 Switching from the AED mode to Monitoring mode must be confirmed with Yes
.
Metronome CPR Guide ECG curve Analyse
Art. no.: 0-48-0227 Rev.: g
For qualified physicians only

The analysis can be repeated at any time during CPR by pressing the analysis button
. CPR needs to be interrupted while the analysis is performed.
Page 92
Defibrillation 5
DEFIGARD/PHYSIOGARD Touch 7 User guide Semi-automated defibrillation 5.5
5.5.2 Voice messages in AED Mode
 The sequencing of AED instructions might be very fast and could cause
confusion to the user because:
 The “Anteriority Analyse” feature pre-analyses the heart rhythm before the
actual analysis. This feature can substantially reduce the duration of the
analysis.
The following instructions will be spoken by the device:
Spoken instructions Display Note

Illustration for electrode
connection
Technical alarm:
Electrodes not yet applied. The message
Plug and apply electrodes disappears as soon as the electrodes are
PLUG AND correctly applied and the resistance is between
APPLY ELECTRODES 25 to 250 Ohm.
DO NOT TOUCH THE

Do not touch the patient. Analysing
PATIENT ANALYSIS
Movement detected -
Movement detected - Analysis Technical alarm: Patient was moved during
Analysis cancelled, resume
cancelled, resume CPR analysis and device could not run analysis.
CPR
Device recommends a shock
Shock advised
Stand clear of patient, press
Stand clear of patient; press orange
orange button
button
TO SHOCK
Device does not recommend a shock
No shock advised No shock advised.
Immediately resume CPR: 30 chest 30aCHEST

compressions, then 2 rescue breaths – COMPRESSIONS
continue until patient is breathing THEN 2 RESCUE
normally. BREATHS
a.When paediatric electrodes are used, CPR is carried out in the ratio of 15:2 if 2 rescuers are on the spot, otherwise 30:2.
A “continuous compressions" option is also available (i.e. no rescue breaths)
Art. no.: 0-48-0227 Rev.: g
Page 93
5 Defibrillation
5.5 Semi-automated defibrillation DEFIGARD/PHYSIOGARD Touch 7
5.5.3 Defibrillation procedure

When the device is switched on, spoken and displayed instructions are issued
regarding the defibrillation. Closely follow the instructions.
Step 1 Switching on and preparing the device

1. Switch on the device by pressing the green button or the AED button directly.
2. Check the state of the patient.
4. You are prompted to continue the resuscitation and to apply the electrodes.
5. Apply the defibrillation electrodes (see section 5.3.1 Applying the adult and pae-
diatric electrodes page 85, page 85).
The message CONNECT THE ELECTRODES is switched off as soon as the de-
vice measures an acceptable electrode resistance. If it is not switched off, see
section 5.3.1 Applying the adult and paediatric electrodes page 85.
Fig. 5.8 Switch unit on
Step 2 Analysis
6. The analysis starts automatically when the electrodes are detected.
7. You are prompted not to touch the patient any more.
8. The analysis key can be pressed any time during CPR to start a new analysis.
If the device detects ventricular fibrillation or ventricular tachycardia with a heart rate
exceeding 150 pulse/min, Step 3 shock delivery follows; otherwise continue with Step
4, Cardiopulmonary resuscitation, page 95.
Fig. 5.9 Analysis
Art. no.: 0-48-0227 Rev.: g
Page 94
Defibrillation 5
DEFIGARD/PHYSIOGARD Touch 7 User guide Semi-automated defibrillation 5.5
Step 3 Step 3 shock delivery

As soon as the energy for a shock is charged, the device prompts the user to deliver
the shock by pressing button 3.

9. Deliver the shock by pressing the button .
After the shock delivery, step 4 follows.
The following default energy values are programmed:
Shock Adults Children

Step 4 Cardiopulmonary resuscitation

10. Carry out cardiopulmonary resuscitation. Alternate between 30 chest compres-
sions and 2 breaths1 for 2 minutes2. After 2 minutes, the device begins again with
Step 2, Analysis.
11. Finish the therapy (see page 106).
The CPR duration may vary according to country-specific standards (see page 110
Defibrillator ERC Protocol).
Art. no.: 0-48-0227 Rev.: g
1. A "continuous compressions" option is also available (i.e. no rescue breaths)

2. CPR cycle duration can vary depending on the "CPR cycle configuration" settings.
Page 95
5 Defibrillation
5.6 CPR Guide DEFIGARD/PHYSIOGARD Touch 7
5.6 CPR Guide

The manual and AED defibrillation mode offers three functions for a guided CPR:
CPR
• CPR Guide with SCHILLER LifePoint sensor

CPR • CPR Guide with FreeCPR based on the impedance measurement by the
METRONOME OFF defibrillation electrodes
• Metronome
CPR GUIDE ON
5.6.1 SCHILLER LifePoint

The LifePoint measures the compression depth and rate after each compression.
COMPRESSION
FREQ. 78 Measured value from

LifePoint sensor
DEPTH 4.9
RECOIL good
MESSAGE
Advice to improve the

30 CHEST COMPRESSIONS
THEN 2 RESCUE BREATH PRESS FASTER CPR quality
CPR Event Screenshot Manual def Analyse Close
1. Connect the LifePoint USB cable to the adapter cable.

2. Switch on the device and select manual or AED defibrillation.
3. Open the CPR menu and activate the CPR guide.
4. Place the LifePoint on the patient chest and start CPR.
5. The displayed measurements on the right side of the screen informs you about
your CPR quality.
6. The following limits are set for speed and depth:
Metronome speed Press Faster Press Slower
[/min]
100  90 120
110 100 130

120 110 140
Art. no.: 0-48-0227 Rev.: g
Depth [mm] Press Deeper Press Shallower

1-127 45 62
Page 96
Defibrillation 5
DEFIGARD/PHYSIOGARD Touch 7 User guide CPR Guide 5.6
5.6.2 FreeCPR
• The FreeCPR measures the compression rate based on the impedance
measurement by the defibrillation electrodes.
1. Switch on the device and select manual or AED defibrillation.

CPR
2. Apply the defibrillation electrodes.
3. Open the CPR menu and activate the CPR guide.
CPR
4. The displayed measurements on the right side of the screen inform you about the
METRONOME OFF
CPR quality and frequency.
CPR GUIDE ON
5.6.3 Metronome settings

1. Open the CPR menu.
CPR
2. Activate the metronome.
3. The following settings are available:
CPR
– 30:2
METRONOME ON
– 15:2
– Continuous
Continuous
CPR GUIDE OFF

Art. no.: 0-48-0227 Rev.: g
Page 97
5 Defibrillation
5.7 Defibrillator Technical Messages DEFIGARD/PHYSIOGARD Touch 7
5.7 Defibrillator Technical Messages

T.ECG11  Contact technical service
T.DEFI01
T.DEFI02
T.DEFI03
T.DEFI04
T.DEFI05 • CPU peripheral board defective
Defibrillator inoperative
T.DEFI06 • Defi board defective
T.DEFI07
T.DEFI10
T.DEFI13
T.DEFI14
T.DEFI15
• Internal discharge while releasing  Check electrodes, if necessary re-

shock “on impedance higher than apply electrodes
T.DEFI08
Incorrect electrodes 250 ohm” or if the current during the
T.DEFI12
shock is 0 or above 105 A, because
of poorly placed electrodes
• A shock that is not delivered within  Do not exceed the time of 20 sec-
Internal discharge duration onds till releasing the shock
T.DEFI09 the specified duration causes an in-
too long
ternal discharge.  Contact technical service
• Internal discharge because of select-  Normal safety discharge

Internal discharge smaller
T.DEFI11 ing lower energy after the device
energy
charged the selected higher energy
Art. no.: 0-48-0227 Rev.: g
Page 98
Pacemaker 6
DEFIGARD/PHYSIOGARD Touch 7 User guide Pacemaker Function 6.1
6 Pacemaker
6.1 Pacemaker Function
The pacemaker is the module for external transcutaneous stimulation of the heart.
The pacemaker offers two modes of operation, demand and fixed-rate pacing. In
demand mode, the pacemaker requires an ECG signal for synchronisation.
The same, large adhesive electrodes used for defibrillation are also employed for
pacing. They ensure good electrical contact with the skin. These electrodes and a 20
ms square-wave pulse reduce painful muscle contractions provoked by excessive
current density.
Pacer rate, pulse width and current are checked when the device is turned on and
during operation; therefore, a functional test of the pacemaker module is not
necessary.
6.1.1 Fixed-rate mode (Fix)

In this operating mode, the module delivers pacing impulses with the user-defined
current at a user-defined rate. The selected rate remains constant and is not affected
by intrinsic actions of the patient's heart. This mode is mainly used in the case of
asystoles.
6.1.2 Demand mode

In demand mode, the pacemaker does not deliver pacing pulses as long as the
patient's intrinsic heart rate exceeds the set pacing rate. When the heart rate drops
below the pacing rate, the pacemaker starts emitting stimulation pulses. This can only
be ensured by continued monitoring of the ECG with a 4- or 10 -lead patient cable.
The pacemaker reads the necessary ECG signal via the pads. If the module is not
able to reliably identify QRS complexes, it will stimulate the heart permanently in
demand mode.
The demand mode is the recommended pacing mode when the patient is at risk of
developing bradycardia or even asystole as a result of a critical event. As the
pacemaker function is controlled by the patient's ECG, the harmful competition
between intrinsic and external stimulation, which could induce ventricular fibrillation,
is excluded.
Art. no.: 0-48-0227 Rev.: g
Page 99
6 Pacemaker
6.2 Safety Notes DEFIGARD/PHYSIOGARD Touch 7
6.2 Safety Notes

 Shock hazard!
Never touch the pads or the patient's body near the pads while the pacemaker
is in use.
 Patient hazard, equipment failure

Equipment delivering electrical energy to the patient at the same time as the
pacemaker can disturb the pacemaker function. Particularly HF surgery
equipment used on a pacemaker patient may cause interference, preventing the
detection of QRS complexes. In this situation, the pacemaker must be set to
fixed-rate pacing (FIX). Also please note that leakage currents could be
transferred to other electric circuits, interfering with the functioning of devices
connected to these circuits.
 For safety reasons, the external pacemaker should be disconnected from the
patient in this situation and an internal pacemaker should be used.
 Accessories, wearing parts and disposables that affect the safe use of the
pacemaker and that are to be used in conjunction with the pacemaker must be
tested for safety and approved by an authorised test laboratory.
6.3 Guidelines for the Application of External

Pacemakers
These guidelines apply to all pacemakers, irrespective of type and manufacturer.
All electrical devices that deliver energy to patients in any form or have an electrically
conductive connection to the patient are a potential source of danger.
As the user is responsible for the safe application of the devices, observance of the
instructions given in the user manual and of the guidelines below is of utmost
importance.
 Pacemakers must only be used under the supervision of trained, qualified and
authorised staff.
 Observe the user guide for the pacemaker's operation.
 The patient must not be left unattended during pacing.
 It is assumed that the patient's ECG and plethysmogram is being monitored to
be able to assess the effect of pacing.
 When positioning the patient, take care that no electrically conductive
connections exist between the patient and earthed metal parts (puddles of
Art. no.: 0-48-0227 Rev.: g
water, for instance, are capable of conducting the electrical current). Although
the pacer current output is required to be floating, this is an additional safety
precaution to ensure that the pacemaker current pulse flows only between the
pacemaker electrodes.
 Set all values for the pacemaker to position 0, or the lowest value.
 Position stationary pacemakers close to the patient.
 After each defibrillation, check that the pacemaker is functioning properly.
Page 100
Pacemaker 6
DEFIGARD/PHYSIOGARD Touch 7 User guide Guidelines for the Application of External Pacemakers 6.3
6.3.1 Attaching the pacer pads
• The same adhesive electrodes used for defibrillation are also employed for pacing.
The electrodes are designed for:
• 1 hour of pacing using 140mA / 120p/min (pulse duration 20ms)

• 8 hours of pacing using 70mA / 60p/min (pulse duration 20ms) with inspection of
pads every 30 minutes
• 10 minutes of pacing using maximum energy and frequency output (150mA / 210p/
min)
A detailed application of electrodes is given in section 5.3.1 Applying the adult and
paediatric electrodes page 85.
Anterior-posterior placement
1. Apply the dorsal electrode (+) to the left scapular area and the precordial elec-
trode (-) near the left lower sternal edge.
2. Connect the pads to the device.
If the dorsal electrode cannot be used, apply anterior-anterior placement.
Fig. 6.1 Anterior-posterior placement
Anterior-anterior placement
1. Apply the "+" electrode on the right side below the clavicle and the "-" electrode
to the left of the axillary line on a level with the 5th intercostal space so they do not
hinder heart massage.
2. Connect the pads to the device.
Fig. 6.2 Anterior-anterior placement
6.3.2 Checking the electrodes

If the resistance between the skin and the electrodes is too high, the message
“CONNECT THE ELECTRODES” is issued.

BAD
Proceed as follows:
Art. no.: 0-48-0227 Rev.: g
1. Alternately press the electrodes/pads down firmly and check when the message
disappears. Carefully press that pad onto the patient's skin once again.
If the message does not disappear,
2. remove both defibrillation electrodes
3. wipe rests of contact agent off with a cloth
4. shave both application areas to remove the uppermost layer of skin
5. apply new defibrillation pads to these points.
Page 101
6 Pacemaker
6.4 Start-up of the Pacemaker DEFIGARD/PHYSIOGARD Touch 7
6.4 Start-up of the Pacemaker

 Shock hazard!
Pacing is started immediately when the pacemaker is switched ON and the
current is set.
In order to be able to operate the pacemaker, the following conditions must be met:
• the pacemaker (optional) needs to be activated.

• Pads must be connected to the device.
• When the pacemaker is switched on, the current value is set to 10 mA.
• The device can be switched from pacing to defibrillation mode at any time. The
pacemaker is stopped by confirming the switchover.
• The device can be switched from pacing to monitoring mode at any time. In this
case, the pacemaker screen is displayed as small measurement field at the top
OFF Close right.
• If the pacemaker function is OFF and closed by pressing the Close key, the
frequency and current settings are reset.
• Pressing the monitoring or Close key will minimize the pacemaker

window (pacing is still running).
• When pacemaker is started only "Monitoring advanced" and "Critical care" views
are available.
Art. no.: 0-48-0227 Rev.: g
Page 102
Pacemaker 6
DEFIGARD/PHYSIOGARD Touch 7 User guide Start-up of the Pacemaker 6.4
6.4.1 Pacemaker display

• Select the Pacer measurement field at the top right to display the pacemaker
function.
The pacemaker menu with the pacemaker parameter is displayed.
The pacemaker default mode at switchover is “Demand” mode; the “Fix” mode has
to be selected manually.
6.4.2 Selecting pacemaker mode

1. Press the Pacer measurement field (1) to open the Pacer menu (2).
2. Press operational mode Fix or Demand (3)
3. The operational mode is displayed in the pacer measurement field (1)
Running time 2 Impedance OK/ Pacer pulse

of pacer High/Low
HR
Type of used
electrodes
Frequency
Fixed
3
Current
Demand
Event Screenshot Manual def Start Close 4
4. When the pacemaker is running, press Close (4) or switch to monitoring with the
monitoring key.
In this case, the pacemaker values are displayed as small measurement field (1) at
the top right and the curve field shows again all curves.
Art. no.: 0-48-0227 Rev.: g
Page 103
6 Pacemaker
6.4.3 Pacemaker settings operational mode fix

1. Attach the pacer pads (see 101).
2. Display pacemaker and select operational mode Fix.
3. Select (1) Frequency +- to set the impulse frequency.
Frequency
Fixed
Current
Demand
2
3
 Shock hazard!
current is set.
 Never touch the pads or the patient's body near the pads while the pacemaker
is in use.
4. Starting the pacemaker!

Press the Pacer OFF/ON (2) to activate the pacemaker.
5. Press the (3) Current +- mA to set the impulse current until the heart reacts to
the stimulation.
6. The pacemaker can be interrupted and restarted by selecting the Pacer OFF/ON.
7. Finish the therapy as described in section 7 Finishing the Therapy page 106.
Art. no.: 0-48-0227 Rev.: g
Page 104
Pacemaker 6
6.4.4 Demand Mode
To determine when a pacemaker pulse is required, the patient ECG must be

monitored with a 4- or 10-lead ECG cable.
1. Attach the pacer pads (see 101).

2. Display pacemaker and select operational mode Demand.
3. Select (1) Frequency +- to set the impulse frequency.
Frequency
Fixed
Current
Demand
2
3
 Shock hazard!
current is set.
 Never touch the pads or the patient's body near the pads while the pacemaker
is in use.
4. Starting the pacemaker!

Press the Pacer OFF/ON (2) to activate the pacemaker.
5. Press the (3) Current +- mA to set the impulse current until the heart reacts to
the stimulation.
6. The pacemaker can be interrupted and restarted by selecting the Pacer OFF/ON.
7. Finish the therapy as described in section 7 Finishing the Therapy page 106.
6.4.5 Switching from pacemaker to defibrillation

Art. no.: 0-48-0227 Rev.: g
1. Press the AED key.

2. Use the same key to confirm stopping the pacemaker and switching to defibrilla-
tion mode.
Page 105
7 Finishing the Therapy
7 Finishing the Therapy

1. Switch the device off as soon as the therapy is finished by pressing the button
.The dialogue No/Yes is displayed.
2. Confirm switch-off.
3. Disconnect the electrode cable.
Adhesive electrodes – Carefully remove the electrodes from the patient's skin.
– Discard the disposable pads immediately after use to prevent their reuse (hos-
pital waste).
– Clean the device, ECG cables and sensors as described in section 10.6.2 page
119).
Art. no.: 0-48-0227 Rev.: g
Page 106
Intervention summary 8
8 Intervention summary
In order to document the intervention, the intervention data is saved.
The information can be read and displayed with the Schiller reviewing software or
viewed directly on the device
• If the memory is full, the oldest data will be overwritten.

• The intervention data is stored as soon the device is switched off or the intervention
has been stopped with the function “Stop Intervention” in the main menu.
• “Stop Intervention” is also used to start a new intervention.
• The data will be stored until the data has been transmitted via the menu “Post-
Intervention”.
Menu
• All intervention data (R-ECG, Screenshots and Trends) can be reviewed and
transmitted on the device via the menu <Post-Intervention> see next page.
Menu
Trends
R-ECG
Screenshots
Stop Intervention
00547_160318_103611
Post-Intervention
Overview of events documented with date and time in the “rescue.file”:
• Power on
• Start of analysis
• Analysis result
• Defibrillator charging
• Defibrillation shock
• Internal discharge
• Switchover to manual operation
• Electrode alarm
Art. no.: 0-48-0227 Rev.: g
• "Battery low" alarm

• Activation of a vital signs module
• Deactivation of a vital signs module
• Asystole alarm (manual mode)
• Fibrillation/flutter alarm (manual mode)
• Event button
• ECG curve
The “RestingECG.file” includes the resting ECG data.
Page 107
8 Intervention summary
8.1 Post-intervention DEFIGARD/PHYSIOGARD Touch 7
8.1 Post-intervention
Exiting this menu is only possible by switching off-on the device.
8.1.1 Reviewing intervention file on the device
1. To review the intervention data directly on the device, go to the main menu and
select “Post-intervention.
Menu 2. Stop the patient monitoring. The Post-Intervention menu is displayed.
3. Select “Memory” to display the intervention list.
4. Select desired intervention.
Menu 5. For each intervention you can review, print or send the following data:
Choose an other view Data Review Print Send

R-ECG X X X
Trends Screenshot X X X
Trends X - -
R-ECG Intervention
- X -
report
Screenshots
For each intervention it is also possible to printout a full intervention report composed
Stop Intervention of patient data, Trend table, first ECG, auto screenshots (Pacer ON/OFF, shock), last
00547_160318_103611 ECG.
Post Intervention
Intervention report contains following elements:

Transmission/Clear memory • Intervention and patient details
Memory • Trends table (15 columns max with adaptive intervals)
• ECG events (25 max)
Autotest – 1st ECG
Update config from SEMA – Issued shocks (1st, 2nd, 3rd and last shock)
NLA_conf2 – Pacemaker On/Off
– Last ECG
Update software from SEMA
soft06.B05_L01
8.1.2 Transmitting the intervention file

1. To review/sending the post intervention data go to the main menu and select
Art. no.: 0-48-0227 Rev.: g
“Post-intervention.
2. Stop the patient monitoring. The Post-Intervention menu is displayed.
3. Select Transmit/Clear the memory to send all intervention data via Network or di-
rect to USB memory stick.
8.1.3 Autotest
An autotest can be executed after a finalised intervention to check the performance
of the device. Additionally, the autotest report can be viewed or sent via Network or
directly to a USB memory stick.
Page 108
Main Menu 9
DEFIGARD/PHYSIOGARD Touch 7 User guide General setup 9.1
9 Main Menu
9.1 General setup
For the monitoring of vital parameters, physiological alarm thresholds are preset in the
DEFIGARD/PHYSIOGARD Touch 7, which are activated when the device is turned
on. The operator-defined thresholds (wide/narrow) can be set in the respective menus
(see page 40, section 4.3);
1. Press the Menu soft key. The menu is displayed.
---
Adult Off
HR
Menu
Choose another view
NIBP
Trends
R-ECG
Screenshots
Stop Intervention
00547_160318_103611
R-ECG Screenshot Event Manual Def Start Menu
Fig. 9.1 Main menu

Art. no.: 0-48-0227 Rev.: g
Page 109
9 Main Menu
9.1 General setup DEFIGARD/PHYSIOGARD Touch 7
9.1.1 Device Settings Menu Menu
Access the device settings menu via the menu button.
Menu Sub-menu/Parameter Description Note

Choose another view • Advanced monitoring
• Basic monitoring Selection of different view The selection is depending on
• 12 leads ECG according users needs the configuration of the device
• Critical care
Trends • ---- Shows the trend since the start
see page 75, section 4.13.1
of the intervention
R-ECG • Selecting R-ECG List of the recorded R-ECG
see page 75, section 4.13.2
since the interventions starts
Screenshots • Selecting Screenshot List of the screenshots done
since the start of the
intervention. The screenshot see page 76, section 4.13.3
can be displayed, transmitted
or printed.
Stop Intervention • Yes/No The stopped intervention can
Yes stops the recording of all
be reviewed/transmitted in the
data, saves data under the
Post-intervention menu. The
intervention file and resets the
number under the Stop
Stop-watch on the screen to
Intervention parameter shows
zero. A new intervention is
the Intervention ID with date
started.
and time.
• Transmission/Clear memory Transmission/Clears memory
of all intervention files.
• Memory Memory of all intervention files
since the last clearing. The file see page 107, section 8.
can be reviewed via this menu.
• Autotest Running an autotest to confirm
the functionality after finishing
an intervention.
Post- Intervention • Update config from SEMA Download the configuration
Exiting “Post-Intervention from the Schiller update server.
menu” only by switching The line below the parameter
off the device possible. shows the current configuration
file name.
• Update software from SEMA Download the software from
the Schiller update server. The
line below the parameter
shows the current software.
Art. no.: 0-48-0227 Rev.: g
• Current version information Shows actual installed

software versions and
configured options
Control panel • Device Name Entering of the a device name Exiting “ Control panel menu”
(Password protected) only by switching off the device
Default password: schiller possible.
• Import/export Config
Exiting “ Control panel menu”
– import from USB
only by switching off the device
– Import config. from SEMA possible.
– Export to USB
Page 110
Main Menu 9
DEFIGARD/PHYSIOGARD Touch 7 User guide General setup 9.1
Menu Sub-menu/Parameter Description Note

• Software update
– Update from USB Exiting “ Control panel menu”
– Search on server only by switching off the device
– Current version informa- possible.
tion
• Maintenance Once the safety cell has been
– Safety cell replaced changed, press this button.
– RFID Flasher
– RFID Tag info Exiting “ Control panel menu”
– Export log to USB only by switching off the device
possible.
– Format log file
– Format memory
– Start auto test Manual start of the Auto Test
• Ethernet config. If set to OFF:
– DHCP ON/OFF IP address
Netmask
Gateway
DNS1-3 Server
– Radius ON/OFF If DHCP is set to ON
• Check connectivities Select one of the desired
communication channels GSM/
3G or Wi-Fi for checking.
– Check SEMA  Activates the connectivity

connectivities check for SEMA
– Check SUS connectivities  Activates the connectivity
check for SUS
• List of available languages The language setting here is
only for the current use. Once
Select the desired language for
Language the device is switched off, it
the current use.
will use again the default
configuration.
Art. no.: 0-48-0227 Rev.: g
Page 111
10 Maintenance
10.1 Maintenance interval DEFIGARD/PHYSIOGARD Touch 7
10 Maintenance
10.1 Maintenance interval
Note
The unit must be serviced on a regular basis. The test results must be recorded and
compared with the values in the accompanying documents.
Maintenance work described in this chapter may be performed by a qualified

technician or by the user according to the Maintenance and Interval Table below.
The following table indicates the intervals and responsibilities of the maintenance
work required. Local regulations in your country may stipulate additional or different
inspection intervals and tests.
10.1.1 Maintenance Interval Table

Interval Maintenance Responsible
Before or after each use, Life-saving functions - check the following:  User
respectively • Visual inspection of the device and accessories (see section 10.2.1)
• Switch on the device and make sure that both batteries are
sufficiently charged (see section 10.2.2).
After every intervention
• Visual inspection of the device and accessories (see section 10.2.1).
• Battery check (see section 10.2.2)
• Button test (see sections 10.2.3)
• Auto Test in the Post intervention menu (see section 10.2.4)
Monthly • Functional test charging capacitor (see section 10.2.4)  User
Every 12 months • Measuring and safety checks and inspections according to the  Service staff
instructions in the service handbook authorised by
• NIBP check SCHILLER
• ECG check
• SpO2 check
• IBP check
• EtCO2 Gas span check
• Defibrillator function check (only DEFIGARD® Touch 7)
Lifed item replacement The following parts must be checked and replaced if necessary  Service staff
• Replace the power battery, see section 10.4.1. authorised by
• Replace the safety cell (see expiring date or when device switches of SCHILLER
Art. no.: 0-48-0227 Rev.: g
immediately when replacing power battery)

• Replace the internal button cell (every 10 years)
• Replace the defibrillation capacitor (if the released energy [Joule]
deviates more than 15 % from the intended value) only
DEFIGARD® Touch 7
Page 112
Maintenance 10
DEFIGARD/PHYSIOGARD Touch 7 User guide Maintenance interval 10.1
10.1.2 Service/Shelf life

Device The device has a lifetime of 10 years.
Accessories shelf life Power battery (approx. 5 years), safety cell (approx. 7 years), button cell (approx. 10
years) and electrodes (approx. 2 years), see expiring date on the battery or electrodes
pouch. EtCO2 accessories see expiring date on the packaging.
Art. no.: 0-48-0227 Rev.: g
Page 113
10 Maintenance
10.2 Functional test DEFIGARD/PHYSIOGARD Touch 7
10.2 Functional test

A detailed description of the maintenance steps is listed in table 10.8. Enter the results
in the check list on page 122.
10.2.1 Visual inspection of the device and accessories

Check the device and accessories for the following:
 Sufficient number of all required disposables available?

 Device housing undamaged?
 Electrode connection undamaged?
 Defibrillator / pacemaker pads available?
 Check the expiration date on the electrode package, battery and safety cell.
 Check the expiration date invasive blood pressure kit
 Defective units or damaged cables and damaged or expired accessories must
be replaced immediately.
10.2.2 Battery check

 Connect the unit to the power supply (docking Station) and switch it on. The start
screen is displayed.
 The external DC voltage indicator is lit.
– When the battery indicator is flashing, the battery is being charged.

Check the charging status once the indicator goes off.
– The battery indicator is off when the battery is fully charged - the full bat-
tery symbol is displayed. The charging process can be reactivated and
checked by disconnecting shortly from the external DC supply; indicator

is flashing.
Battery status
 Click on the Battery icon and check the following status:
– Charge level
– Estimated autonomy
– Estimated numbers of shocks
– Safety Cell Voltage Level
10.2.3 Defibrillator key test

1. Switch on the device. If the device starts in AED mode press the button Manual
Def.
Art. no.: 0-48-0227 Rev.: g
2. Use the button “-” to set the energy to 2 joule; then use the button “+” to set the
energy to 4 joule.
3. Press the Charge button. Device is charging. Shock key is lit.
4. Press the Shock key - a safety discharge is triggered.
5. Press the AED key - spoken instructions are issued and the pads connector LED
is flashing.
Page 114
Maintenance 10
DEFIGARD/PHYSIOGARD Touch 7 User guide Functional test 10.2
10.2.4 Auto Test

The Auto Test can be executed any time and checks the most important function of
the device.
1. Switch on the device

2. Select Menu > Post-Intervention > Auto Test
3. Start the auto test.
4. If message “Press shock button” appears, press the button to continue and
finalizing the test.
Previous tests are listed in the sub-menu “Review/send previous tests”.
10.2.5 Functional test - measured values
Heart rate  Perform the functional test according to section 4.4.5 page 45 and verify the heart
rate with the measured pulse rate of the SpO2.
SpO2  This test is performed on a volunteer (finger measurement; section 4.6.3, page
52).
NIBP  This test is performed on a volunteer (arm measurement; section 4.7.1, page 57)
Manometer Test
See technical manual 0-48-0245_NT_DGTouch7_ANG
IBP This test only includes the connection between the sensor and the Touch 7, and the
Zeroing function.
1. Connect the sensor to the Touch 7 according to section 4.8.1 page 59.
2. Perform a “zeroing according to section 4.8.4 page 61.
3. Zeroing is shown on the display.
CO2 Mainstream Perform the functional test according to section 4.10.3 page 65.
CO2 Sidestream Perform the functional test according to section 4.11.2 page 71.
10.2.6 Alarm tests
Alarm volume Check during the following tests that the alarm sound is higher than 65 dB.
Heart rate 1. Start the ECG monitoring (see section 4.4.5, page 45).
2. Set the alarms with the narrow quick set function (see section 4.3, page 40).
3. When the measured value exceeds the alarm thresholds, an alarm is issued.
4. Reset the alarm limits to their original values.
Art. no.: 0-48-0227 Rev.: g
SpO2 See section 4.6, page 50.
NIBP 1. Start the NIBP monitoring (see section 4.7.1, page 57).
2. Set the NIBP alarm limits below/above the measured values and take a new
measurement.
CO2 1. Start the CO2 monitoring according to section 4.10.3 page 65 or 4.11.2 page 71
2. Set the alarms with the narrow quick set function (see section 4.3, page 40).
Page 115
10 Maintenance
10.2 Functional test DEFIGARD/PHYSIOGARD Touch 7
If the device does not behave as described in this user guide, there is an error that
must be repaired by the after-sales service.
Art. no.: 0-48-0227 Rev.: g
Page 116
Maintenance 10
DEFIGARD/PHYSIOGARD Touch 7 User guide Update Software 10.3
10.3 Update Software
 Software updates must only be performed by authorized personnel.
Select Menu > Control Panel > Software update.
This function is only used for updating the software.The software can be updated via
Wifi (update Server) or USB interface (memory stick).
10.3.1 Update via USB

The USB stick needs to have a memory of at least 32 MB.
1. Connect the USB stick.

2. Switch on the device and make sure that it is connected to the DC supply or that
the battery is charged sufficiently. The device must not switch off during the up-
date!
3. Select the parameter Software update and start the update by selecting the de-
sired update source. During update, a progress bar is displayed.
4. As soon as the update is finished, the device switches off.
5. Switch the device on again and enter the Menu > Control Panel > Software up-
date > Current software version to verify that the software has been installed.
10.3.2 Update via Server
The device initiates by itself regularly or on schedule a connection to the server to

check for available updates.
Required accessories • Wifi or GSM/3G connection to the update server.
Update 1. Switch on the device and make sure that it is connected to the DC supply or that
the battery is charged sufficiently. The device must not switch off during the up-
date!
2. Select the parameter Software update and start the update by selecting the de-
sired update source. During update, a progress bar is displayed.
3. As soon as the update is finished, the device switches off.
4. Switch the device on again and enter the Menu > Control Panel > Software up-
date > Current software version to verify that the software has been installed.
Art. no.: 0-48-0227 Rev.: g
Page 117
10 Maintenance
10.4 Maintenance interval of the batteries DEFIGARD/PHYSIOGARD Touch 7
10.4 Maintenance interval of the batteries

Important
• The battery's performance and life largely depend on how and under which
ambient conditions the battery is used.
Power Battery
• The rechargeable power battery is maintenance-free during its normal life.
• The battery must be replaced according the expired date on the battery, regardless
of whether or not the unit has been used.
• Only store fully charged batteries. If a battery is not used, recharge it every 6
months.
Safety primary cell
• The safety primary cell is maintenance-free during its normal life.
• The safety primary cell must be replaced according the expired date on the Cell,
regardless of whether or not the unit has been used.
10.4.1 Replacing the batteries

Replacing the power battery:
The power battery needs to be replaced if the operating time in monitoring mode is
less than 1 hour with a fully charged battery (see chapter 10.2.2 Battery check)
Replacing safety primary cell:

Check in the menu if safety cell is OK. (see chapter 10.2.2 Battery check)
10.4.2 Battery disposal
 Danger of explosion! Battery may not be burned or disposed of with domestic

refuse.
 Danger of acid burns! Do not open or heat up the battery.
The battery is to be disposed of in municipally approved areas or sent back to

SCHILLER Médical.
Art. no.: 0-48-0227 Rev.: g
Page 118
Maintenance 10
DEFIGARD/PHYSIOGARD Touch 7 User guide Cleaning 10.5
10.5 Cleaning
Cleaning removes dust, dirt and stains; however, this does not constitute a
disinfection. Use commercially available detergents intended for clinics, hospitals
and practices.
10.5.1 Detergents
Please refer to the manufacturer's information regarding the detergents.
Admissible detergents • 70 % isopropyl alcohol

• Neutral detergents
• Soap water
• All products that are suitable for ABS plastic
Non-admissible detergents Never use products containing the following:
• Ethyl alcohol
• Acetone
• Hexane
• Abrasive cleaning powder
• Plastic-dissolving products
Art. no.: 0-48-0227 Rev.: g
Page 119
10 Maintenance
10.6 Disinfection DEFIGARD/PHYSIOGARD Touch 7
10.6 Disinfection
Use commercially available disinfectants intended for clinics, hospitals and
practices to disinfect the device.
Wipe disinfection removes certain bacteria and viruses. Please refer to the
manufacturer's information.
10.6.1 Disinfectant
Admissible disinfectants • Isopropyl alcohol 70%

• Propanol (70-80 %)
• Ethyl hexanal
• Aldehyde (2-4 %)
• Ethanol (70-80 %)
• all products that are suitable for ABS plastic
Non-admissible disinfectants Never use products containing the following:
• Organic solvents
• Ammonia-based detergent
• Abrasive cleaning agents
• 100% alcohol, Virex, Sani-Master
• Sani-Cloth®, Ascepti® or Clorox® wipes
• HB Quat®
• Conventional cleaner (e.g. Fantastic®, Tilex® etc.)
• Conductive solution
• Solutions or products containing the following ingredients:
– Acetone
– Ammonium chloride
– Betadine
– Chlorine, wax or wax compound
– Ketone
– Sodium salt
Art. no.: 0-48-0227 Rev.: g
Page 120
Maintenance 10
DEFIGARD/PHYSIOGARD Touch 7 User guide Disposal at the end of the device's useful life 10.7
10.6.2 Cleaning and disinfecting the device, cable and sensors
 Remove the battery and close the cover before cleaning. See section 3.2
Switching off and disconnecting from the external DC supply page 31.
 Do not immerse the unit nor the cable or sensors in liquid and do not sterilise
them!
 Do not use aggressive cleaners.
 Do not use any phenol-based agents or peroxide compounds for cleaning.
 Reusable sensors must be treated as biologically dangerous material after
usage and sterilised according to the manufacturer's instructions.
 Observe the manufacturer's notes when cleaning the sensors and cables.
1. Disconnect the device from the mains and remove the plug and sensors.
2. Wipe the equipment, cable and sensors with a dampened cloth and a mild clean-
ing solution. The manufacturer recommends using 70% alcohol.
3. Dispose of single-use sensors and protective coverings according to the relevant
regulations.
Notes on the cleaning and disinfection
NIBP cuff The manufacturer recommends using 70% alcohol to clean and disinfect the NIBP
cuff and tube.
SpO2 sensor The manufacturer recommends using 70% alcohol to clean the cable and sensor. Dry
the sensor before reuse.
ECG cable The cable can be wiped with a mild cleaning agent or with 70% alcohol.
CO2 sensors The IRMA probe can be cleaned using a cloth moistened with ethanol or isopropyl
alcohol (< 70 %).
The ISA sidestream gas analyzers and the Nomoline Adapter may be cleaned using
a cloth moistened (not wet) with max 70% ethanol or isopropyl alcohol.
To prevent cleaning liquids and dust from entering the ISA gas analyzer through its
sampling gas inlet connector, keep the Nomoline Family sampling line fitted while
cleaning the analyzer.
10.7 Disposal at the end of the device's useful life

This unit must be disposed of in a municipally approved collection point or recycling
centre when no longer used.
Art. no.: 0-48-0227 Rev.: g
If no such collection point or recycling centre is available, you can return the unit to
your distributor or the manufacturer for proper disposal. In this way, you contribute to
the recycling and other forms of utilisation of old electrical and electronic equipment.
Improper disposal harms the environment and human health due to the presence of
dangerous substances in electrical and electronic equipment.
Page 121
10 Maintenance
10.8 Inspection and Checklist Tables DEFIGARD/PHYSIOGARD Touch 7
10.8 Inspection and Checklist Tables

In accordance with the maintenance interval detailed previously, the following check
list should be copied and followed.
Checking life-saving functions

The following tests (sections 10.8.1 to 10.8.3) need to be performed before or after
each intervention, respectively. Enter the results in the check list.
• Visual inspection of the device and accessories (see section 10.2.1).

• Battery charging status (see section 10.2.2).
• Button test (see sections 10.2.3)
• Auto Test in the Post intervention menu (see section 10.2.4)
Year Month 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Jan.
Feb.
Mar.
Aprl.
May
June
July
Aug.
Sept.
Oct.
Nov.
Dec.
10.8.1 Monthly
• Functional test charging capacitor with maximum energy. This is done with the
Auto test function (see section 10.2.4)
Month Date Periodic test results OK Periodic test results NOT OK
1 o o
2 o o
3 o o
4 o o
5 o o
6 o o
Art. no.: 0-48-0227 Rev.: g
7 o o
8 o o
9 o o
10 o o
11 o o
12 o o
Page 122
Maintenance 10
DEFIGARD/PHYSIOGARD Touch 7 User guide Inspection and Checklist Tables 10.8
10.8.2 Every 12 months

Inspection Results Inspection
Functional, safety checks and in-
spections
 Confirm the date of the last • Return the unit to your nearest
factory inspections and tests authorised service point or your
o o o o o
SCHILLER agent for safety and
functional checks.
Date of inspection:
Inspector:
10.8.3 Lifed-item replacement every 5 - 10 years

Inspection Results Replacement
Battery
 Replace battery • The battery needs to be replaced:
– when the operating time is less
o o o o o
than 1 hour, see section 10.4.1.
– Replace the safety primary cell o o o o o
(see expiring date or when de-
vice switches of immediately
when replacing power battery) o o o o o
– Replace the internal button pri-
mary cell (every 10 years)
Date of replacement:
Inspector:
Defibrillation capacitor
 Replace defibrillation capacitor • Send the unit to your nearest
SCHILLER service centre for
capacitor replacement if the
defibrillation capacitor deviates
more than 15 % [joule] from the o o o o o
intended value.
Date of replacement:
Inspector:
Art. no.: 0-48-0227 Rev.: g
Page 123
10 Maintenance
10.9 Error Detection DEFIGARD/PHYSIOGARD Touch 7
10.9 Error Detection

 If a technical alarm is still present at shut down a reminder is displayed.
 If it is not possible to get the device back into operating condition within a
reasonable period of time, continue cardiopulmonary resuscitation.
Forced shutdown procedure

 If it is not possible to get the device back into operating condition, follow this
procedure:
 Press and hold the green button until the device has switched off. Then
switch on again.
10.9.1 General errors

Error Cause Remedy
 Insert battery correctly or replace it
• Battery not inserted correctly or
The screen is not lit when defective
the device is switched on  Connect to the power supply (docking Station) and
• Battery empty
charge battery
• The device is defective
 Replace device
Device cannot be switched • Software hangs  Keep the green button pressed for at least 10 seconds.
off • The device is defective  Replace device
• ECG signal too weak  Perform cardiac massage again

• ECG signal interference through  Turn off source of signal interference. e.g. radio equip-
electromagnetic waves ment or cell phone, or move patient outside field of inter-
No analysis ference
• Patient moved or touched dur-
ing analysis  Do not move or touch patient during analysis
• Battery too low  Change batteries

• Electrode error caused by re-  Reapply electrodes
Unable to deliver shock
suscitation measures
(DEFIGARD® Touch 7)  Run new analysis
• Heart rhythm has changed
Battery is not being • Temperature in the device or  Let device cool down, if possible; charging is continued
charged battery too high once the temperature has reached an acceptable level. Art. no.: 0-48-0227 Rev.: g
Page 124
Maintenance 10
DEFIGARD/PHYSIOGARD Touch 7 User guide Error Detection 10.9
10.9.2 Technical Information and Error Messages

Alarm Cause Remedy
• T.CPU01  Replace device
• T.CPU02
• T.CPU03
CPU BOARD INOPERATIVE • T.CPU04
• T.CPU05
• T.CPU06
• T.CPU07

BACKUP BATTERY EMPTY
• T.CPU09

SAFE BATTERY EMPTY
• T.CPU11
LOW POWER BATTERY • T.CPU12  Replace device
POWER BATTERY EMPTY • T.CPU13  Replace device
POWER BATTERY CHARGE FAILURE • T.CPU14  Replace device
• T.ECG01  Replace device

• T.ECG02
• T.ECG03
• T.ECG04
• T.ECG05
ECG INOPERATIVE
• T.ECG06
• T.ECG07
• T.ECG08
• T.ECG09
• T.ECG10
DEFI INOPERATIVE(DEFIGARD® Touch 7) • T.ECG11  Replace device

Art. no.: 0-48-0227 Rev.: g
Page 125
10 Maintenance
10.9 Error Detection DEFIGARD/PHYSIOGARD Touch 7
10.9.3 Measures to prevent electromagnetic interferences

The user can help avoid electromagnetic disturbances by keeping the minimum
distance between portable and mobile RF telecommunication devices (transmitters)
and the DEFIGARD/PHYSIOGARD Touch 7. The distance depends on the output
performance of the communication device as indicated below.
“Non-ionic electromagnetic radiation"
HF source Transmitter fre- Power P Distance d

quency [W] [m]
[MHz]
Radio telephone (microcellular) CT1+, CT2, 885-887 0.010 0.23
CT3
Cordless DECT telephone, WLAN, UMTS 1880-2500 0.25 1.17
phone
Mobile phone USA 850/1900 0.6 1.8
Mobile phone
- GSM900, 900 2 3.3
- GSM850, NMT900, DCS 1800 850,900,1800 1 2.3
Walkie-talkie (rescue service, police, fire 81-470 5 2.6
brigade, service)
Mobile telephone system (rescue service, 81-470 100 11.7
police, fire brigade)
RFID (active and passive transponders and 433 0.5 0.85
reading devices) 865-868 1.62
It can be deducted from the table that portable RF telecommunication devices must
not be used within a radius of 3 m from the device and its cables.
 However, there is no guarantee that no interference can occur in certain

installations. If the DEFIGARD/PHYSIOGARD Touch 7 causes interferences,
these can be prevented by switching off the device.
Further measures to prevent electromagnetic interferences:
The user can take the following measures to prevent electromagnetic interferences:
• Increase distance to the source of interference.
• Turn the device to change the angle of radiation.
• Connect the device to a different mains connector.
• Only use original accessories (especially patient cables)
• The device should not be used adjacent to or stacked with other equipment.
Art. no.: 0-48-0227 Rev.: g
For more detailed information, please refer to page 156.
Page 126
SCHILLER Charging Unit CS-1 11
DEFIGARD/PHYSIOGARD Touch 7 User guide Battery Charging Options 11.1
11 SCHILLER Charging Unit

CS-1
 The batteries supplied are rechargeable Lithium-Ion 4.65 Ah batteries. Only use
rechargeable batteries supplied by SCHILLER.
 We recommend that the batteries are replaced every 1000 charge / discharge
cycles.
In battery slot 1, the battery can also be calibrated.
The charging unit is optional.
11.1 Battery Charging Options

The following options are available to charge the batteries:
• Batteries can be removed and charged using the optional charging unit SCHILLER
CS-1 (see following).
• The DEFIGARD/PHYSIOGARD Touch 7 batteries are also charged when the
DEFIGARD/PHYSIOGARD Touch 7 is connected to the external power supply.
11.2 Inserting a battery

• Insert the battery in the charger unit and push home until the battery clicks in place
with the blue catches.
• To remove a battery, press the two blue catches to release it.
2 1 3
Art. no.: 0-48-0227 Rev.: g
The charger has double contacts and a battery can be inserted in either way.
(1) Control/indicator panel

(2) Battery slot 1 - only this slot can be used for battery calibration.
(3) Battery slot 2.
Page 127
11 SCHILLER Charging Unit CS-1
11.3 Control Panel DEFIGARD/PHYSIOGARD Touch 7
11.3 Control Panel
Power connected
indicator
Battery slot 1 Battery slot 2

indicators indicators
Calibration button
The LED indicators give the following information:
LED Function
No LEDs lit - No battery inserted.
Constant display for 5 seconds - When a battery is first
inserted, one, two or three LEDs are lit for 5 seconds.
This indicates the battery charge state (1 LED = 1/3
capacity, 2 LEDs = 2/3 capacity and 3 LEDs = 100%
capacity).
LEDs are flashing in sequence (left to right)- After 5
seconds of a battery being inserted, the charge
sequence starts.
All LEDs lit - battery fully charged.
LEDs are flashing in sequence (right to left) - battery
being calibrated (see page129).
LEDs blink two/one in sequence - faulty battery.
Art. no.: 0-48-0227 Rev.: g
Page 128
SCHILLER Charging Unit CS-1 11
DEFIGARD/PHYSIOGARD Touch 7 User guide Battery Calibration 11.4
11.4 Battery Calibration

Every battery has an individual calibration and capacity circuit. The DEFIGARD/
PHYSIOGARD Touch 7 uses this information to display the battery capacity. New
batteries are factory calibrated before use and should not need recalibrating during
their normal life cycle. If a battery seems to have a low capacity or is near the end of
its life, it may need recalibrating.
Calibrate a battery as follows:
1. Place the battery in the left battery slot of the charger.

2. Press the Cal key to start the calibration procedure. The stages to calibrate a bat-
tery are as follows:
– The battery is completely discharged.1
– The battery is charged and calibrated.
The calibration cycle takes approximately 2.5 - 5 hours to complete - the full charge
cycle (after full discharge) takes approximately 2.5 hours. During the calibration
process:
– The LED above the calibration key is lit.

– To indicate the discharge cycle the three indicators LEDs blink in sequence -
right to left.
– When the discharge cycle is finished, the three indicators LEDs blink in se-
quence left to right to indicate the charge cycle.
– When the calibration is successfully completed, all LEDs are lit and the LED
above the calibration key is extinguished.
If for any reason the battery cannot be calibrated, the LED above the CAL key is
flashing. This indicates that the battery cannot be calibrated and the battery should
not be used any longer.
The calibration process can be stopped at any time, by again pressing the Cal key.
Art. no.: 0-48-0227 Rev.: g
1. The power stored in the battery to be calibrated is transferred by ‘dynamic pow-

er distribution’ to the battery in the other slot, or used for any connected device,
so that no energy is wasted.
Page 129
11 SCHILLER Charging Unit CS-1
11.5 Input and Output Supplies DEFIGARD/PHYSIOGARD Touch 7
11.5 Input and Output Supplies

The SCHILLER CS-1 Charging Unit has the following input and output power
supplies:
2 3 4 5 6 7 1
(1) On / Off switch

(2) Potential equalisation (to vehicle common earth).
Yellow/Green Cable.
(3) Power output (do not use) 15 V
(4) Spare power output to docking station 8...48 VDC
19 V
(do not use)
(5) Spare power output to docking station 8...48 VDC 19 V fix or
(do not use) 12 V to 48 V
(6) DC IN from vehicle power supply 12 V to 48 V DC
(7) Fuse 5 x 20 mm, 20 A
Art. no.: 0-48-0227 Rev.: g
Page 130
Technical Data 12
DEFIGARD/PHYSIOGARD Touch 7 User guide System data 12.1
12 Technical Data
Data refer to standard testing conditions.
Technical data about the defibrillation (chapter 12.2) applies only to the
DEFIGARD® Touch 7.
12.1 System data

Manufacturer SCHILLER MEDICAL
Device type DEFIGARD® Touch 7 & PHYSIOGARD® Touch 7
Dimensions 160 x 250 x 70 mm (h x l x w) without bag
Weight 3.3 kg with battery and bag for DEFIGARD® Touch 7

2.9 kg with battery and bag for PHYSIOGARD® Touch 7
Protection case IP 55
Power supply DC/DC Ambulance bracket
Input 10.8 till 17.6 VDC

Output 15 VDC/4.0 A
Power supply AC/DC (desktop Type XP Power Model: AHM85PS15

charger and ambulance bracket) Medical grade switching power supply, protection class I.
Input 100 - 240 VAC, max. 1.0 A, 50-60 Hz

Output 15 VDC, max. 5.67 A
Power battery
Battery type Lithium/ion 11.1 V, 4.65 Ah, 51.6 Wh
Autonomy 100 shocks with maximum energy or >6 hour monitoring
Charging time 90 %: 2 hours after full discharge and device switched off
Safety primary cell Ensures continued monitoring for approx. 30 seconds when replacing the power
battery
Art. no.: 0-48-0227 Rev.: g
Battery type Lithium/MnO2, 6 V, 1.4 Ah
Environmental conditions
For operation • 0 ºC ... 40 ºC relative humidity at 15 - 95 % (non condensing)
Atmospheric pressure 700...1060 hPa
• If higher or lower temperatures prevail during use, a limited operation time of up
to 1 hour is possible, if device has been stored previously at room temperature.
See next page “environmental conditions for transient operation”
Page 131
12 Technical Data
12.1 System data DEFIGARD/PHYSIOGARD Touch 7
Environmental conditions Operation in NORMAL USE for a period not more than 20 min under the
For transient operation following environmental operating conditions:
• a temperature range of - 20 °C to + 50 °C;
• a relative humidity range of 15 % to 90 %, non-condensing, but not requiring a
water vapour partial pressure greater than 50 hPa.
Operation in NORMAL USE for a period of 1 hour under a temperature range of
- 10°C to + 50°C;
For Transport and storage • - 40 °C to + 5 °C without relative humidity control;
between uses • + 5 °C to + 35 °C at a relative humidity up to 90 %, non-condensing;
• > 35 °C to 70 °C at a water vapour pressure up to 50 hPa;
after having been removed from its protective packaging and subsequently
between uses.
Time for warming up/cooling • 30 minutes;

down Time required for the DEFIGARD/PHYSIOGARD Touch7 to warm or cool from
the minimum/maximum storage temperature between uses until the DEFIGARD/
PHYSIOGARD Touch7 is ready for its intended use when the ambient
temperature is 20 °C.
MIL STD 810G Device was tested in accordance with:
• MIL STD 810G Method 501.5 Procedure III
• Tactical-standby to Operational (+60°C)
• MIL STD 810G Method 502.5 Procedure II Operation (-26°C).
Defibrillation electrodes
Storage • 0 ºC...50 ºC
Storage max. 10 days • -40 ºC...75 ºC
Display
Type • High-resolution colour LCD capacitive touch screen, protected by tempered glass
Dimensions • 7 “ (154 x 85.92 mm)
Alarm sound level 65 dBA for medium and high priority alarms
Connections ECG patient cable, SpO2, NIBP, Temperature, CO2, IBP
Interfaces USB
Art. no.: 0-48-0227 Rev.: g
Page 132
Technical Data 12
DEFIGARD/PHYSIOGARD Touch 7 User guide System data 12.1
Memory 24 hours memory (FIFO)

Recording of Defi, ECG Lead II, Impedance curves, Events, CPR feedback,
patient data, patient vitals, screenshots
Safety standard IEC/EN 60601-2-4

The device is designed for intensive use
EMC • IEC/EN 60601-1-2

• IEC/EN 60601-2-4
• CISPR 11 class B
The device can be exposed to the following interferences without any impairment:
• Static discharges up to 15 kV
• Field strength up to 20 V/m in the radio frequency range of (80...2500 MHz, 5 Hz
modulated)
• Magnetic fields of 100 A/m, 50 Hz
Conformity CE according to directive 93/42/EEC class IIb
Protection class Class I according to IEC/EN 60601-1

Art. no.: 0-48-0227 Rev.: g
Page 133
12 Technical Data
12.2 Defibrillation Waveform DEFIGARD/PHYSIOGARD Touch 7
12.2 Defibrillation Waveform

The chapter 12.2 applies only to the DEFIGARD® Touch 7.
Form • Biphasic pulsed defibrillation waveform with fixed physiological optimum phase
durations
• Near stabilisation of the emitted energy in function with the patient resistance
using pulse-pause modulation depending on the measured patient resistance
(duty cycle 80%).
Curve at an impedance of 100 Ω Printout: Current – left y-axis, (--- mean current calculated for each cycle)
Condenser voltage – right y-axis.
Current [A]
Voltage [V]
time [ms]
Overview on the measured values with regard to the impedance
200 joule released in: 25 Ω 40 Ω 50 Ω 60 Ω 75 Ω 80 Ω 100 Ω 125 Ω 150 Ω 175 Ω

First phase
Max. current [A] 99.5 62.2 49.8 41.5 33.26 31.1 24.9 19.9 16.6 14.2
Mean current [A] 55.9 38.4 31.1 26.2 21.5 19.2 15.6 12.7 9.7 8.8
Art. no.: 0-48-0227 Rev.: g
Duration [ms] 1.8 2.25 2.7 3.15 3.6 4.5 5.4 6.3 9.45 9.86
Second phase
Max. current [A] 36.6 28.5 23.5 20 17.1 14.3 11.8 9.9 6.6 6.5
Mean current [A] 18.6 16.4 14.7 12.6 11.5 9.4 8.2 7.1 4.9 4.9
Duration [ms] 2.25 2.700 2.700 3.150 3.150 3.600 3.600 4.050 4.050 4.050
Total shock duration [ms] incl. 0.5 ms of 4.55 5.45 5.9 6.8 7.25 8.6 9.5 10.85 13.55 14.4
pause between first and second phase.
Energy delivered [J] 196 192 189 188 182 187 182 179 184 177
Note: In the case of high patient impedance or some other specific usage cases, the energy delivered to the patient might be
lower than expected(e.g If patient impedance >= 150 Ohms, the rated energy level is set to 190J when 200J is selected)
Page 134
Technical Data 12
DEFIGARD/PHYSIOGARD Touch 7 User guide Defibrillation Waveform 12.2
Standard energy settings Deviation at 50 3 J or 15 % (the higher value is assumed)
AED
Adult 150/200/200 joules (configurable see page 149)
Paediatric 50/50/50 joules (configurable see page 149)
(automatic selected when the paediatric or adult electrodes are connected)
Manual mode
Adult 150 joules (configurable see page 149)
Paediatric 50 joules (configurable see page 149)
(default energy settings when starting in manual mode, adjustable anytime during
intervention)
Charging time for shock (Time used to charge the storage capacitor to the max. energy of 200 J in manual
mode)
• with fully charged battery

• with 15 VDC mains voltage after 15
discharges with max. energy 8 seconds
• from switch-on of the device with 9 seconds
pads
19 seconds
Cycle Time Rhythm Analysis –

Shock Standby in AED Mode
• with fully charged battery 1st shock = 11 s max.
• with 15 VDC mains voltage after 15 1st shock = 11 s max.
discharges with max. energy
• from switch-on of the device to 1st shock = 23 s
charge at max. energy
Cycle time shock – shock <15 s
Operating Modes • Synchronised with heart action < 60 ms after R wave

• Non synchronised
• AED
Charge control and monitoring • Automatic shock recommendation of analysis in AED mode
• Direct via touch screen
• Display of selected energy
Patient resistance 25 ...250 
Indication when ready to shock

LED below is lit
Art. no.: 0-48-0227 Rev.: g
Shock delivery
Using key
Page 135
12 Technical Data
12.2 Defibrillation Waveform DEFIGARD/PHYSIOGARD Touch 7
Safety discharge when: • the battery voltage is insufficient

• the shock is not released within 20 seconds
• a lower energy value is selected while the defibrillator is charging
• the device is defective
• the device is turned off
• a non shockable rhythm is detected
Shock delivery • Via applied disposable adhesive defibrillation electrodes
Defibrillation electrode Type BF, defibrillation-protected >5 kV

connection
Defibrillation electrodes Electrode cable, 2 m long
Deviating from the compliance statement according to 201.108.1.10 (IEC60601-2-

4, 201.1.108.7. and 201.1.108.6), the following features have been measured for the
universal electrode:
• 80 cm2 active surface

Measurements after 60 minutes of pacemaker at maximum setting, followed by a
Adult and Paediatric electrode shock at 200 Joule:
• Defibrillation recovery 720 mV after 4 s and 710 mV after 60s

• DC offset voltage 785 mV after 1 minute of stabilisation
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Technical Data 12
DEFIGARD/PHYSIOGARD Touch 7 User guide Defibrillation Waveform 12.2
12.2.1 Shock Advisory System

The Shock Advisory System (SAS) validation test set consists of 17,803 ECG
waveforms coming from the PhysioNet databases [1]. These files (MIT-VFDB) are
subsets of the general PhysioNet databases recognised as standard in ECG tests.
PhysioNet databases are ECG Holter recordings with full diagnostic bandwidth [0.05
- 125] Hz. The bandwidth of the devices that recorded the signals is larger than that
of the DEFIGARD® Touch 7. However, when the analogue signals of the database are
run the the electrode connector, the rhythm detector signal-processing
characteristics are applied. Moreover, these signals are of appropriate length to allow
decisions to be made by the detector system.
[1]: The MIT-BIH Malignant Ventricular Arrhythmia The validation test set database used to establish compliance with the AHA
Database http://physionet.org/physiobank/data-
base/vfdb/
requirements [2] and the IEC Standards [3] is independent from the one used to
[2]: Automatic External Defibrillators for develop the rhythm recognition detector.
Public Access Defibrillation : The SAS validation test set contains the following ECG samples (see test sample size
Recommendations for Specifying and in Table 1):
Reporting Arrhythmia Analysis
Algorithm Performance, Incorporating • coarse ventricular fibrillation (VF) (>200 μV peak-to-peak amplitude)
New Waveforms and Enhancing • shockable ventricular tachycardia (VT hi) (HR >150 bpm, rushes that last more
Safety ; Circulation, 1997 ; 95 :1677- than 8s)
1682. • asystole (≤100 μV peak-to-peak amplitude)
• normal sinus rhythm (NSR) (PQRS-T waves visible, HR 40-100 bpm)
[3]: Standard IEC 2010 60601-2-4, ed 3. • other organized rhythm (N) (includes all rhythms except those in other listed
categories)
[4]: Shock advisory system with minimal delay trig-
gering after end of chest compressions: Accuracy For each test sample, in function of the expert rhythm annotation and the SAS
and gained hands-off time. Jean-Philippe Didon, decision (shock/no shock), an interpretation table is built and shows the true positive
Vessela Krasteva, Sarah Ménétré, Todor Stoyanov,
Irena Jekova, Resuscitation 82S (2011) S8-S15 (correct classification of a shockable rhythm), true negative (correct classification of a
non-shockable rhythm), false positive (non-shockable rhythm incorrectly classified as
[5]: Circulation. 2011; 124: A219, Resuscitation Sci- a shockable rhythm), false negative (shockable rhythm incorrectly classified as non-
ence Symposium Abstracts, Best Original Resusci-
tation Science Poster Session, Abstract 219: Com- shockable). Finally, the results of the detector performance are reported in terms of:
bination of Algorithms to Decrease Preshock Pause specificity-Sp (TN/(TN+FP)), true predictive value (TP/(TP + FP)), sensitivity-Se (TP/
for Automated External Defibrillators. Jean-Philippe
Didon, Irena Jekova, Sarah Ménétré, Todor Stoy-
(FN + TP)), false positive rate (FP/(FP + TN)).
anov, Vessela Krasteva.
[6]: Circulation. 2010; 122: A253, Resuscitation Sci-

Table 1: DEFIGARD® Touch 7 SAS performance by rhythm category meets AHA
ence Symposium Abstracts, Best Original Resusci- recommendations [2] and IEC Standards [3] for adult defibrillation on artefacts-free
tation Science Poster Session, Abstract 253: Meth- MIT-VFDB signals:
od for Minimal Delay Triggering of VF Detection
During Cardio Pulmonary Resuscitation. Jean-
Philippe Didon; Sarah Ménétré, Irena Jekova, Ves-
sela Krasteva. »
Rhythms Test sample Performance goal Observed perfor-

size mance
Shockable Coarse VF 308 Sensitivity > 90% Meets [2-3]
VT hi 202 Specificity > 75% Meets [2-3]
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Non Shockable NSR 1023 Sensitivity > 99% Meets [2-3]

Asystole 4798 Sensitivity > 95% Meets [2-3]
Other rhythms 1425 Sensitivity > 95% Meets [2-3]
Total NS 7246 Sensitivity > 95% Meets [3]
The DEFIGARD® Touch 7 SAS when configured as “Analysis with anteriority to ON”
uses a combination of algorithms which are launched in two-stages [4-6] to deliver a
shock advisory decision at minimal delay after actual CC stoppage. The SAS
configured as “Analysis with anteriority to OFF” starts a chest compression-free VF
detection at an analysis request, without trying to optimize hands-off time. In both
configurations, the SAS does not continue analyzing after a shock advised decision
is reached.
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12 Technical Data
12.3 Pacemaker DEFIGARD/PHYSIOGARD Touch 7
The DEFIGARD® Touch 7 SAS test has been completed with a validation database
consisting of 2,475 couples of ECG and transthoracic Impedance Cardiogram (ICG)
from out-of-hospital cardiac arrest (OHCA) interventions, recorded with Automated
External Defibrillators (FredEasy, Schiller Medical SAS, France) used by the fire
brigade of Paris.
This supplementary test completes the validation of both SAS configurations and
provides performance fully in accordance with these summarized in Table 1. A report
of the global validation test results is available on request.
12.3 Pacemaker
Operating Modes • Demand
• Fixed frequency (FIX)
Stimulation pulse
Form Rectangle mono-phase with constant current source
Pulse duration 20 ms ± 5%
Pulse rate Configurable in steps of 40, 45, 50, 60, 70 ... 240 beats/min, ± 1.5%
Pulse current Configurable to 0 (pacemaker Off) and then from 10 ...200 mA, ± 10 % or 5 mA (the
higher value is applied)
Refractory period
• 340 ms 80 b/min
Signal connection • 240 ms >80 b/min
Readiness for operation Type BF, defibrillation-protected >5 kV
Immediately
Pacer electrodes Electrode cable, 2 m long

(same as defibrillation electrodes)
Deviating from the compliance statement according to 201.108.1.10 (IEC60601-2-
4, 201.1.108.7. and 201.1.108.6), the following features have been measured for the
universal electrode:
Adult and Paediatric electrode

Duration 80 cm2 active surface
• For up to 1 hour of pacing using 140mA / 120ppM (pulse duration 20ms)
• For up to 8 hours of pacing using 70mA / 60ppM (pulse duration 20ms) inspection
of pads every 30 minutes
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Technical Data 12
DEFIGARD/PHYSIOGARD Touch 7 User guide Technical data - monitoring 12.4
12.4 Technical data - monitoring

12.4.1 ECG
Leads Simultaneous, synchronous recording of all 9 active electrodes giving 12 leads
Patient cable 4-, 10-wire cable (4+6), type CF
Heart rate
Range • 15 – 350 beats/min
Accuracy • ±10 % or 5 beats/min, whichever is greater
Lead display Selection of 1 or 12 leads
Sensitivity 0.25, 0.5, 1, 2 cm/mV programmable
Blockage caused by defibrillation Max. 5 seconds

shock
Input impedance > 2.58 M
Current electrode test < 0.5 A
Suppression of large T-waves max. amplitude of T-wave according to IEC 60601-2-27 section 201.12.1.101.17:
0.8 mV
HR averaging method The heart rate calculation is done using a user-defined number of previous RR
intervals (minimum 4, maximum 16).
The RR intervals are reset and the heart rate is set to zero whenever an asystole
condition has been detected
Response time HR measurement Change from 80 to 120 beats per minute: 2.56 s
Change from 80 to 40 beats per minute: 8 s
Reaction to an irregular rhythm • A1: 80/min

• A2: 60/min
• A3: 120/min
• A4: 90/min (except for triggers no. 6 and 7, HR < 90/min)
(according to IEC specifications 60601-2-27, 6.8.2.bb)
Duration until alarm is triggered in B1 and B2: 3 s (according to IEC specification 60601-2-27, 6.8.2.bb)
the case of tachycardia
ECG amplifier
Sampling rate 500 Hz
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Pacemaker detection ± 2 mV to ± 700 mV0.1 till 2.0 ms

QRS detection range Duration: 70 to 120 ms, amplitude: 0.5 to 5.0 mV
Protection Fully isolated, defibrillation-protected >5kV
Mains filter Distortion-free suppression of superimposed 50 / 60 Hz sinusoidal interferences by
means of adaptive digital filtering.
Frequency range The ECG frequency range depends on the ECG cable, the ECG view and the
selected settings (see table next page).
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12 Technical Data
12.4 Technical data - monitoring DEFIGARD/PHYSIOGARD Touch 7
ECG amplifier band pass The band pass depends on the ECG source.
Patient cable BLW EMG Display Display “R-ECG” display

Filter Filter
Monitoring Rhythm Diagnostic
4 & 10 leads OFF OFF 0.05 – 42 Hz - 0.05 – 150 Hz

4 & 10 lead ON ON -- 0.6 – 25 Hz -
4 & 10 lead ON OFF - 0.6 – 42 Hz -
4 & 10 lead OFF ON 0.05 – 25 Hz -
Defibrillator - - 1 – 25 Hz 1– 25 Hz -
To pass distortion test according IEC 60601-2.25, Clause 201.12.4.107.1, use the 4
or 10 lead patient cable to set the ECG amplifier band pass to 0.05-150 Hz (see table
above).
12.4.2 Features of pacemaker pulse rejection

According to IEC 60601-2-27 Clause 201.12.1.101.13
Single pacemaker pulse • Duration 2.0ms, amplitude > 2mV and a overshoot of <0.25mV
• Duration 0.1ms, amplitude > 2mV and a overshoot of <0.8mV
followed by a QRS complex • Duration 2ms, amplitude > 4mV

• Duration 0.1ms, amplitude > 25 mV
Pacemaker pulse followed by an • Duration 2.0ms, amplitude between 4mV and 300mV
identical pulse within 150 ms • Duration 0.1ms, amplitude between 25mV and 300mV
followed by a QRS complex • Duration 2.0ms, amplitude between 4mV and 300mV
• Duration 0.1ms, amplitude between 25mV and 700mV without overshoot
• Duration 0.1ms, amplitude between 25mV and 300mV with overshoot
Pacemaker pulse followed by an • Duration 2.0ms, amplitude between 4mV and 400mV
identical pulse within 250 ms • Duration 0.1ms, amplitude between 25mV and 400mV
followed by a QRS complex • Duration 2.0ms, amplitude between 4mV and 300mV
• Duration 0.1ms, amplitude between 25mV and 700mV without overshoot
• Duration 0.1ms, amplitude between 25mV and 300mV with overshoot
Note: pacemaker signals from different pacemakers vary. In the case of cardiac
arrests or some arrhythmias, pacemaker signals might still be measured, especially
signals from pacemakers generating high amplitudes ( > 20mV) or overshoot.
Pacemaker patients need to be monitored very closely.
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Technical Data 12
12.4.3 NIBP - non-invasive blood pressure
Measurement Automatic or manual
Measuring method Oscillometric
Connection Type CF
Measurement range
Adults(Child • Sys 30...255 mmHg, dia 15...220 mmHg
Neonate • Sys 30...135 mmHg, dia 15...110 mmHg
Accuracy ± 3mmHg and ± 2 beats/min
12.4.4 IBP - invasive blood pressure
Measuring range -150...400 mmHg
Accuracy 1 mmHg or ± 1% (whichever is greater)
Sampling rate 500 Hz
Amplifier Type CF, defibrillation-protected >5 kV
Zeroing Manual
12.4.5 Temperature
Measuring method Direct
Sensor YSI 401, rectal, oesophageal, skin
Amplifier Type CF, defibrillation-protected >5 kV
Sampling rate 2 Hz
Measurement interval 1x per second
Measuring range 15 °C to 45 °C
Resolution 0.1 °C
Accuracy ± 0.1 °C from 25 to 45 °C

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12 Technical Data
12.4.6 SpO2 - pulsoximetry
Amplifier Masimo™
Patent see web site www.masimo.com/patents.htm for detailed patent information
Operation Normal and sensitive
Measuring range
SpO2 0 % to 100 %
PP 25 to 240 /min
SpCO 0 to 99 %
SpMet 0 to 99.9 %
PI 0.02 to 20 %
Accuracya
SpO2 (no movement) • 60 to 80 % ± 3 % adults/children (10 -50 kg)/infants (3-20 kg)
• 70 to 100 % ± 2 adults/children/infants; ± 3 neonates
SpO2 (movement) 70 to 100 % ± 3 adults/children/infants/neonates
SpO2 (low perfusion) 70 to 100 % ± 2 adults/children/infants/neonates
PP (no movement) 25 to 240/min ± 3 digits adults/children/infants/neonates
PP (movement) 25 to 240/min ± 5 digits adults/children/infants/neonates
PP (low perfusion) 25 to 240/min ± 3 digits adults/children/infants/neonates
SpCO 1 to 40 % ± 3 adults/children/infants
SpMet 1 to 15 % ± 1 adults/children/infants/neonates
Resolution
SpO2 1%
PP 1 /min
SpCO 1%
SpMet 0.1 %
Calibration range 70 ... 100 %
Connection Type CF
Displayed range 1 ... 100 %
Blockage caused by defibrillation Max. 10 seconds

shock
Skin surface temperature less than 41°C in a minimum 35°C environment

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Technical Data 12
a.
SpO2, SpCO and SpMet accuracy was determined by testing on healthy adult volunteers in the range of 60-100% SpO2, 0-40% SpCO, and 0-15%
SpMet against a laboratory CO-Oximeter. SpO2 and SpMet accuracy was determined on 16 neonatal NICU patients ranging in age from 7-135
days old and weighing between 0.5-4.25 kg. Seventy-nine (79) data samples were collected over a range of 70-100% SpO2 and 0.5-2.5%
MetHb with a resultant accuracy of 2.9% SpO2 and 0.9% SpMet.
The Masimo sensors have been validated for motion accuracy in human blood studies on healthy adult male and female volunteers with light to
dark skin pigmentation in induced hypoxia studies in the range of 70-100% SpO2 against a laboratory CO-oximeter and ECG monitor. This
variation equals plus or minus one standard deviation which encompasses 68% of the population.
The Masimo SET Technology has been validated for low perfusion accuracy in bench top testing against a Biotek Index 2 simulator and Masimo’s
simulator with signal strengths of greater than 0.02% and transmission of greater than 5% for saturations ranging from 70 to 100%. This vari-
ation equals plus or minus one standard deviation which encompasses 68% of the population.
The Masimo sensors have been validated for pulse rate accuracy for the range of 25-240 bpm in bench top testing against a Biotek Index 2 simu-
lator. This variation equals plus or minus one standard deviation which encompasses 68% of the population.
The following substances may interfere with pulse CO-Oximetry measurements:
- Elevated levels of Methaemoglobin (MetHb) may lead to inaccurate SpO2 and SpCO measurements
- Elevated levels of Carboxyhaemoglobin (COHb) may lead to inaccurate SpO2 measurements.
- Very low arterial Oxygen Saturation (SpO2) levels may cause inaccurate SpCO and SpMet measurements
- Severe anaemia may cause erroneous SpO2 readings.
- Dyes, or any substance containing dyes, that change usual blood pigmentation may cause erroneous readings.
- Elevated levels of total bilirubin may lead to inaccurate SpO2, SpMet, and SpCO readings.
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12 Technical Data
12.4.7 etCO2 - Capnography
The IRMA and ISA sensors are equipped with an automatic barometric pressure
compensation.
Extremely compact infrared mainstream and sidestream gas analyser.
Trademarks Masimo IRMATMMasimo ISATM, NomolineTM
Masimo AB patents SE519766; SE519779; SE523461; SE524086
Standards MDD 93/42/EEC, EN ISO 80601-2-55:2011, IEC 60601-1:2005, IEC 60601-1-

2:2007, EN ISO 5356-1:2004, EN 1789:2007
Modules Masimo IRMA mainstream and Masimo ISA sidestream
Cable length 2.5 m (IRMA)

0.5 m (ISA)
Surface temperature IRMA Max. 39 °C

(at environment temp. of 23° C)
Accuracy The following specifications are valid for a dry gas at 22 ± 5°C and 1013 ± 40 hPa
(standard conditions).
• 0...15 % (± 0.2 vol % + 2 % of reading)

• 15... 25 % (no information on accuracy)
in standard conditions
• ± (0.3 kPa + 4 % of reading)
Specification of accuracy in all conditions is valid for all specified ambient conditions (see
in all conditions page 131). Deviating from these, influences are specified in the table “Interfering gas and
vapour effects” and in section “Effects from water vapor partial pressure on gas readings”.
These technical specification can be found in the IRMA/ISA user guide chapter 2.
Breath detection Adaptive threshold value, min. 1 vol% change in CO2 concentration
Respiration rate 0-150 /min. The respiration rate is displayed after three breaths and the average
value is updated after every breath.
Rise time IRMA: CO2 < 90 ms
ISA: CO2 < 500 ms

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Technical Data 12
Total system response time IRMA: < 2 second

ISA: < 4 seconds (using 2 m long sampling line)
Protection class IP44 (IRMA)

IP4X (ISA)
Airway adapter IRMA

Adults/children adapter Increases dead space by less than 6 ml
Pressure drop less than 0.3 cm H2O @ 30 LPM
Infant adapter Increases dead space by less than 1 ml

Pressure drop less than 1.3 cm H2O @ 10 LPM
Sampling rate 1 second
Sampling flow rate ISA 50 (±10) ml/min

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12 Technical Data
12.5 Telecommunication GSM (option) DEFIGARD/PHYSIOGARD Touch 7
12.5 Telecommunication GSM (option)

Frequency range Quad band GSM/GPRS/EDGE 850/900/1800/1900 MHz
UMTS/HSPA+ 850/900/AWS1700/1900/2100 MHz
Supported SIM cards 3 and 1.8 V
Data transmission GPRS class B
Max. transmitting power • UMTS/HSPA – Class 3 (0.25 watt)

• GSM 850/900 MHz – Class 4 (2 watt)
• GSM 1800/1900 MHz – Class 1 (1 watt)
• EDGE 850/900 MHz – Class E2 (0.5 watt)
• EDGE 1800/1900 MHz – Class E2 (0.4 watt)
FCC identification R17HE910

IC 5131A-HE910
Standards • FCC, IC
• PTCRB
• R&TTE
• GCF
• RoHS/WEEE
• CE
• ANATEL
• KCC
• CCC
• JATE
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Technical Data 12
DEFIGARD/PHYSIOGARD Touch 7 User guide Device Configuration 12.6
12.6 Device Configuration

12.6.1 General configuration
Parameter Values Description
This option shall be activated if artefacts are detected on ECG signals
when the device is plugged to the mains. The notch filter must be
• None* chosen according the location.
Notch filter • 50Hz • 50Hz: Europe, Africa, Middle- East (except Saudi Arabia), Asia-
• 60Hz Pacific (except Japan, Taiwan and Philippines), Australia
• 60Hz: The American continent (except Chile, Argentina, Uruguay,
Paraguay, Bolivia, French Guyana)
• AED
Boot mode by Sets the mode your device shall start in when pressing the On/Off
• Monitoring*
default button
• Manual def
• Monitoring no curve
• Advanced monitoring Sets the desired default view in monitoring.
Monitoring display
• Basic monitoring • Monitoring without curve: No curves are displayed by default, only big
mode
• 12 leads ECG monitoring values
• Critical care
Sets the behaviour of the HR parameter box between following
possibilities:
• Auto: The device automatically detects the HR source with
• Auto*
Default heart rate predefined priorities level. DEFI higher than ECG higher than SpO2
• Defi ECG (pulse)
source
• Pleth • Defi: Always force the HR calculation on DEFI
• ECG: Always force the HR calculation on ECG lead II SpO2: Always
force the HR calculation on SpO2 (pulse)
• 2min* When this option is activated, the device will always remain silent for 2
Audio pause at start
• Off minutes at start, even if an alarm occurs
• Daily* The device wakes up by default weekly to perform a self test. Is is

Periodic test
possible to set a daily test.
frequency • Weekly Hereafter, the details of content of the automatic and manual self test
This parameter specifies when the device will automatically wake up to
perform its self test. This field must be specified in hours in 24 hours
Time of test • 12 format.
Always specify time in HH and not in HH:mm
Example: 13 refers to 1PM Example: 13:30 is not allowed
Technician
• schiller Sets the password that will be asked to enter the Control Panel
password
If this option is activated, the device will ask a confirmation in following
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Confirmation • True* situations

required on mode - Switch from AED to monitor
change • False - Switch from AED to manual def
- Switch from monitor to manual def
• True* Activating this option will allow to pair a Bluetooth printer and will make
Enable printer
• False the printer button available
• 0.5mm*
Curve thickness • 0.7mm Sets the thickness of the curves printed on the Bluetooth printer.
• 0.9mm
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12 Technical Data
12.6 Device Configuration DEFIGARD/PHYSIOGARD Touch 7

• English* German Sets of the language in which the device will always start by default.
Default language French Spanish Italian Even if the language is modified during the use on the device, it will
etc… start again with the language specified here
• Low
Selection of the overall sound level applied to technical and
Alarm sound level • Medium
physiological alarms
• High*
• False If this option is activated, the user will have the possibility to shut down
Audio off allowed
• True* totally sound alarming
12.6.2 ECG
• 1p avg 1x6 10sec 12.5mms
• 2p 1x12 5sec 50mms Sets the PDF layout for the resting ECG
PDF Format • 1p 2x6 5sec 25mms* report. This layout will be used for the PDF
• 1p 4x3+1 2sec 25mms sent by Email
• 1p 1x12 10 sec 25mms
PDF encryption
• True If this option is activated, every Resting ECG
Encrypt PDF sent by the device will be password
• False* protected with the password specified in the
setting PDF password
Sets the wished password to protect the
PDF password • schiller
PDF of Resting ECG
R-ECG Low pass • 40Hz Sets the low pass filter frequency for the
filter • 150Hz* resting ECGTrue False*
• 4x3 10sec 25mms + avg 7p

• 4x3 +1 2.5sec 25mms 2p* Sets the layout for the resting ECG printed
Printout format
• 4x3 +1 2.5sec 50mms 3p out on the external thermal printer
• 2x6 5sec 25mms 2p
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Technical Data 12
12.6.3 Defibrillator
Default energy for • 2, 4, 8, 15, 30, 50, 70, 90, Sets the energy which will be displayed by default when entering
adults in manual def. 120, 150*, 200 Joule manual defibrillation mode in adult mode
Default energy for • 2, 4, 8, 15, 30, 50*, 70, 90, Sets the energy which will be displayed by default when entering
children in manual def. Joule manual defibrillation mode in child mode
• True If this option is activated, the device remains in sync. mode after
Sync. after sync shock
• False* a synchronized shock in manual defibrillation
• 2, 4, 8, 15, 30, 50, 70, 90, Sets the energy which will be delivered for the first shock in AED
First shock for adults
120, 150, 200 Joule in adult mode
• 2, 4, 8, 15, 30, 50, 70, 90, Sets the energy which will be delivered for the second shock in
Second shock for adults
120, 150, 200 Joule AED in adult mode
• 2, 4, 8, 15, 30, 50, 70, 90, Sets the energy which will be delivered for the third shock in AED
Third shock for adults
120, 150, 200 Joule in adult mode
• 2, 4, 8, 15, 30, 50*, 70, 90, Sets the energy which will be delivered for the first shock in AED
First shock for children
Joule in child mode
Second shock for • 2, 4, 8, 15, 30, 50*, 70, 90, Sets the energy which will be delivered for the second shock in
children Joule AED in child mode
• 2, 4, 8, 15, 30, 50*, 70, 90, Sets the energy which will be delivered for the third shock in AED
Third shock for children
Joule in child mode
12.6.4 Display
• False* Enables the analysis with anteriotity (part of the signal analysis is done
Anteriority Analysis
• True on the signal before the device mentions the start of the analysis).
• False If this option is activated, the analysis key will be displayed to allow
Analysis key
• True* additional manual analysis in AED mode.
Alarm on Vfib or • False* High priority alarm will be issued if Vfib or Vtach is detected during
Vtach detection • True* monitoring on both ECG cable and Defi pads.
Precognitive • False*
Not used at the moment, has no impact on the unit.
Analysis • True
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12 Technical Data
12.6.5 AED
Display curve in • False
If enabled, ECG lead Defi is displayed in AED mode
AED • True*
• High
Metronome default behaviour in adult mode
AED voice level • Medium*
This behaviour can be changed during intervention on the device
• Low
• 30:2*
Metronome Metronome default behaviour in adult mode
• 15:2
behaviour adult This behaviour can be changed during intervention on the device
• Continuous Off
• 30:2
Metronome Metronome default behaviour in child mode
• 15:2*
behaviour child This behaviour can be changed during intervention on the device
• Continuous Off
• 100cpm*
Metronome rate • 110cpm Sets the frequency of the metronome
• 120cpm
• High
Metronome audio
• Medium* Sets the audio level of the metronome
level
• Low
• cm* Sets the unit in which the chest compression depth value will be
CPR depth unit
• inch displayed
• 1min
CPR cycle duration • 2min* Sets the duration of the CPR cycle
• 3min
12.6.6 ECG
• 0.25mv
• 0.5mv Sets the default ECG curve amplitude, If Auto is selected, the
ECG curve
• 1mv* displayed amplitude will be automatically adapted depending on the
amplitude
• 2mv signal amplitude
• auto
• False*
ECG 16,7 Hz filter Not used at the moment, has no impact on the unit
• True
• Off
• Low*
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QRS sound level Sets the audio level of the QRS sound issued by the ECG
• Medium
• High
12.6.7 IBP
IBP curve amplitude • 30, 60, 100, 300mmHg Sets the default IBP curve amplitude
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Technical Data 12
12.6.8 NIBP
Deflation rate • 3, 4, 5, 6, 7, 8, 9 mmHg/s Sets the cuff deflation rate
• mmHg*
NIBP unit Sets the unit in which the NIBP values will be displayed and stored
• kpa
Automatic cycles at • False* Automatic NIBP measurement cycle starts once a first measurement is
start • True initiated manually
Initial pressure for • 90, 120, 150, 180*, 210,

Sets the initial cuff pressure for measurement in adult mode
adults 240, 270mmHg
Initial pressure for • 90, 120, 150*, 180, 210,
Sets the initial cuff pressure for measurement in child mode
children 240, 270mmHg
Initial pressure for • 50*, 70, 90 110,130,
Sets the initial cuff pressure for measurement in neonate mode
neonate 150mmHg
12.6.9 SpO2
Sets the integration time for the calculation of the displayed average
SpO2 average • 4, 6, 8, 10,12*,14, 16sec
value.
• Normal* Sets the measurement sensitivity.
SpO2 sensitivity • Automatic Probe Off De- Adaptive Probe Off Detection is optimised for the detection of Sensor
tection has come off, regardless of the signal quality.
• Off
• Low
SpO2 sound level Sets the audio level of the pulse sound
• Medium*
• High
12.6.10 Temp
• Celcius* Sets the unit in which the temperature value will be displayed and
Temperature unit
• Fahrenheit stored
12.6.11 EtCO2
Respiration curve
• 50*, 75, 100mmHg Sets the respiration curve amplitude to be displayed by default
amplitude
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• vol%
EtCO2 unit Sets the unit in which the EtCO2 value will be displayed and stored
• mmHg*
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12 Technical Data
12.6.12 Time and date

• DD/MM/YY*, MM/DD/YY
Date format Sets the format in which the date will be displayed
YY/MM/DD
• AM/PM
Time format Sets the time format
• 24H*
• Europe/Berlin
• Europe/Paris*
• Europe/London
Time zone Sets the time zone to calculate appropriate date & time
• GMT-12...-1
• GTM 0
• GTM 2....+12
12.6.13 Event
Enter an event name (for example a medication).
This event can be selected on the device in the events list during
Event (from 1 to 20) • Event(1 to 20) intervention. Once selected it is stored in the memory and flagged in
the intervention report
(20 customisable fields)
12.6.14 Email configuration

Any hostname of SMTP provider
Email server -
(example: smtp.myinternetprovider.com)
Email address The email from which the Emails are going to be sent (example:
-
source mymail@myinternetprovider.com)
The port that is used to communicate with the SMTP server
Server port -
(example: 25, 465, 587)
• False* Enables TLS/SSL encryption for communication with the SMTP

TLS Server. This setting must be done according to SMTP Server
• True requirements.
Authentication • False* Enables authentication for communication with the SMTP Server. This
required • True setting must be done according to SMTP Server requirements
Login - The login used for SMTP server authentication
Password - The password used for SMTP server authentication
12.6.15 Email adresses

Art. no.: 0-48-0227 Rev.: g

Email address (from The Email address must be correctly entered
-
1 to 30) Example: user@myinternetprovider.com
This text will be displayed on the device for a better recognition of the
Alias (from 1 to 30) -
recipient.Example: Dr USER
Page 152
Technical Data 12
12.6.16 Transmission
If this option is activated, the device will automatically send over the
• False* media selected in configuration Transmission media during
Automatic R-ECG
intervention to the address specified for SEMA Server
transmission • True There will be no preview of the resting ECG on the device, after
acquisition, it will be automatically sent
The device is capable of transmitting automatically its memory after an
intervention using the media selected in Transmission media by
• When device plugged on automatic wake up, with the following scenario:
Automatic docking station - Never (Off)
intervention data
• At device power off - 10 minutes after the device has been shutted down (After device
transmission
• Off* power off)
- When a external power supply is detected (When device plugged on
docking station)
• Wi-Fi* The selected media will always be selected by default at manual start
Transmission media
• GSM/3G of the device.
during intervention
• USB/Ethernet This media can always be changed by the user during the intervention
Transmission media • Wi-Fi* The selected media will always be selected by default during automatic
by automatic wake • GSM/3G wake up of the device (automatic intervention data transmission,
up • USB/Ethernet automatic self test results transmission...)
12.6.17 Ethernet
Sets the IP that will be used to test the connectivity of the device over
Ethernet. Usually, it's recommended to use either common DNS
Ethernet ping serve • 8.8.8.8
server(e.g.
8.8.8.8), or the public SEMA Server IP address
Art. no.: 0-48-0227 Rev.: g
Page 153
12 Technical Data
12.6.18 WIFI
SSID - SSID of the Wi-Fi Network that shall be used for data transmission
• WEP
• WPA
• WPA2* Type of encryption from the Wi- Fi Network that shall be used for data
Encryption type
• WPA-EAP transmission
• WPA2-EAP
• None
Security key of the Wi-Fi Network that shall be used for data
Security key -
transmission
Wi-Fi Login - Login used for EAP authentication
Wi-Fi Password - Password used for EAP authentication
WIFI. Usually, it's recommended to use either common DNS
Wi-Fi ping server -
server(e.g.
8.8.8.8), or the public SEMA Server IP address
12.6.19 GSM
Sets the PIN code to unlock SIM card
PIN - It's recommended to either use the same PIN for all devices, or to
disable PIN on all SIM cards. Both are accepted by the device
Sets the APN of the M2M Internet provider
APN name -
Example: orange.m2m.spec or MATOOMA, or A1.net
APN port - Sets the APN port (if required by the APN)
APN user - Sets the APN user (if required by the APN)
APN password - Sets the APN password (if required by the APN)
APN extra
- If required by the APN, extra commands can be specified here
commands
GSM ping server 8.8.8.8 GSM. Usually, it's recommended to use either common DNS
server(e.g. 8.8.8.8), or the public SEMA Server IP address
12.6.20 SEMA
Sets the IP address or the hostname of the SEMA Server
Art. no.: 0-48-0227 Rev.: g
Should the device be able to send data to SEMA over Internet (typically
through GSM), the public IP address or hostname must be specified
SEMA server -
and not the private
Example: 188.165.287.137
(public IP) and not 192.168.200.32 (private IP)
Sets the port with which SEMA Server is reachable. This port might be
different whether the device tries to connect with or without SSL
SEMA server port 8181 encryption
Example: By default, 8080 is used for HTTP and 8181 is used for
HTTPS
• False Sets SSL encryption. It's recommended to activate this option to

SEMA SSL
secure the communication, especially if transmission are done over the
encryption • True* Internet
Page 154
Technical Data 12

Sets device login to SEMA. To be able to transmit data to SEMA, a
SEMA login - login and password must be specified for each device (it can be the
same login/password for all device though)
Sets device password to SEMA. To be able to transmit data to SEMA,
SEMA password - a login and password must be specified for each device (it can be the
Sets Technician ID. This field is only necessary if Multi-tenancy is used
SEMA Attending
- in SEMA in order to split recordings belonging. Typically the Attending
name
name is a specific login in SEMA Server
12.6.21 SUS (Schiller Update server)

Sets either the IP address or the hostname of the SUS Server
Should the device be able to update itself over Internet (typically
through GSM), the public IP address or hostname must be specified
SUS server -
and not the private
Example: 188.165.287.137
(public IP) and not 192.168.200.32 (private IP)
Sets the port with which SUS Server is accessible. This port might be
different whether the device tries to connect with or without SSL
SUS server port 8181 encryption
Example: By default, 8080 is used for HTTP and 8181 is used for
HTTPS
• False Sets SSL encryption. It's recommended to activate this option to

SUS SSL
secure the communication, especially if transmission are done over the
encryption • True* Internet
Sets device login to SUS. To be able to retrieve data from SUS, a login
SUS login - and password must be specified for each device (it can be the same
login/password for all device though)
Sets device password to SUS. To be able to retrieve data from SUS, a
SUS password - login and password must be specified for each device (it can be the
Art. no.: 0-48-0227 Rev.: g
Page 155
12 Technical Data
12.7 Electromagnetic interferences DEFIGARD/PHYSIOGARD Touch 7
12.7 Electromagnetic interferences

The DEFIGARD/PHYSIOGARD Touch 7 is intended to be used in the
electromagnetic environments listed in the following tables. The user of the
DEFIGARD/PHYSIOGARD Touch 7 has to ensure that the device is operated in an
adequate environment.
12.7.1 Electromagnetic emissions

Compliance with the regula-
Emission measurement Electromagnetic environment - explanations
tions
HF emissions Group 1 DEFIGARD/PHYSIOGARD Touch 7 only uses HF energy for
CISPR 11 internal functions. Therefore, HF emissions are very low and
interferences with electronic devices nearby are unlikely.
HF emissions Class B
CISPR 11 DEFIGARD/PHYSIOGARD Touch 7 is suitable for use in all
Harmonics IEC 61000-3-2 Class B establishments, including domestic establishments and those
directly connected to the public low-voltage power supply network
Voltage fluctuations Compliant
that supplies buildings used for domestic purposes.
IEC 61000-3-3
12.7.2 Electromagnetic immunity

Interference testing IEC 60601 test level Conformity level Electromagnetic environment - explanations
Electrostatic discharge ± 8 kV contact IEC 60601-1 Floors should be made of wood, concrete or ceramic
IEC 61000-4-2 ± 8 kV air conformity tiles. If floors are covered with synthetic material, relative
humidity should be at least 30%.
Electrical fast transient/ ± 2 kV for power supply lines IEC 60601-1 Mains power quality should be that of a typical
burst ± 1 kV for input/output lines conformity commercial and/or hospital environment.
IEC 61000-4-4
Surge ± 1 kV between conductors IEC 60601-1 Mains power quality should be that of a typical
IEC 61000-4-5 ± 2 kV conductor-earth conformity commercial and/or hospital environment.
Voltage dips, short 0 % nominal voltage during 0.5 period IEC 60601-1 Mains power quality should be that of a typical
interruptions and voltage 40 % nominal voltage during 100 ms at conformity commercial and/or hospital environment. If the user of
variations on power 50/60 Hz the DEFIGARD/PHYSIOGARD Touch 7 is reliant on
supply input lines 70 % nominal voltage during 500 ms at permanent operation even in the case of a power failure,
IEC 61000-4-11 50/60 Hz it is suggested connecting the DEFIGARD/
0% nominal voltage during 5 s at 50/60 PHYSIOGARD Touch 7 to an uninterruptible power
Hz supply or use it with a battery.
Power frequency (50/60 30 A/m 30 A/m Power frequency magnetic fields should be that of a
Hz) magnetic field typical commercial and/or hospital environment.
IEC 61000-4-8
Note: UT indicates the AC voltage of the mains before the test level.
Interference testing IEC 60601 test level Conformity lev- Electromagnetic environment - explanations
Art. no.: 0-48-0227 Rev.: g
el
Recommended minimum distances

Portable and mobile HF telecommunication devices must
keep the recommended minimum distance from the
DEFIGARD/PHYSIOGARD Touch 7 and all its
components, incl. cables; the recommended minimum
distance is calculated based on the transmitter's frequency.
Page 156
Technical Data 12
DEFIGARD/PHYSIOGARD Touch 7 User guide Electromagnetic interferences 12.7
Interference testing IEC 60601 test level Conformity lev- Electromagnetic environment - explanations
el
Conducted HF 3 Veff between 150 kHz and 3 V 3 ,5
IEC 61000-4-6 80 MHz outside of the ISM d = -------  P
3
frequency bandsa
10 Veff between 150 kHz and 10 V 12

d = ------  P
80 MHz within the ISM frequency 10
bandsa
Radiated HF 10 V/m 80 MHz to 2.5 GHz 10 V/m SpO2 monitor:
IEC 61000-4-3 12
d = ------  P between 80 MHz and 800 MHz
10
23
d = ------  P between 800 MHz and 2.5 GHz
10
20 V/m ECG, Temp, NIBP monitoring and defibrillator:

12
d = ------  P between 80 MHz and 800 MHz
20
23
d = ------  P between 800 MHz and 2.5 GHz
20
where P is the maximum transmitting power of the transmitter

in Watt (W) according to manufacturer data, and d the
recommended minimum distance in metres (m)b.
The field strength of stationary HF transmitters (according to

c)
an on-location measurement must not exceed the
conformity level for each frequency range d.
When operating the device near devices bearing the

symbol “ionising radiation”, interferences can occur.
Note 1 For 80 MHz to 800 MHz, the higher frequency range applies.
Note 2 These guidelines might not always be applicable. Electromagnetic radiation is influenced by absorption and reflection on
structures, objects and people.
a. The ISM frequency bands (ISM = industrial, scientific, medical) between 150 kHz and 80 MHz are 6.765 MHz to 6.795 MHz;
13.553 MHz to 13.567 MHz; 26.957 MHz to 27.283 MHz; and 40.66 MHz to 40.70 MHz.
b. The conformity levels within the ISM frequency bands between 150 kHz and 80 MHz and between 80 MHz and 2.5 GHz
serve to minimise the probability of interferences caused by mobile/portable communication equipment that accidentally happens to be in the
patient environment. The formula for the calculation of the recommended distance has been adapted by the factor 10/3 for transmitters in this
frequency range.
c. The field strength of stationary transmitters, e.g. base stations for radio telephones (mobile or cordless) and portable radio
equipment, amateur radios, AM and FM radios and TV signals cannot be predicted accurately in a theoretical way. In order to analyse
electromagnetic environments caused by stationary HF transmitters, an electromagnetic analysis on site should be considered. If the measured
field strength exceeds the HF conformity level, it needs to be checked whether the DEFIGARD/PHYSIOGARD Touch 7 can be used in this
environment. If an abnormal behaviour is detected, additional measures need to be taken, e.g. reorientation or change of location of the
DEFIGARD/PHYSIOGARD Touch 7.
Art. no.: 0-48-0227 Rev.: g
d. For the frequency range between 150 kHz and 80 MHz, the field strength must be lower than 3 V/m.
Page 157
12 Technical Data
12.7 Electromagnetic interferences DEFIGARD/PHYSIOGARD Touch 7
12.7.3 Recommended minimum distances

The DEFIGARD/PHYSIOGARD Touch 7 is intended to be used in electromagnetic
environments in which it is possible to control radiated HF interferences. The user of
the DEFIGARD/PHYSIOGARD Touch 7 can prevent electromagnetic interferences
by always keeping a minimum distance between portable/mobile HF communication
devices (transmitters) and the DEFIGARD/PHYSIOGARD Touch 7. The
recommended minimum distances are listed in the following table according to the
transmitters' max. transmitting power.
Distances according to the transmitter's frequency (m)
Max. transmitting 3 ,5 12
d = -------  P d = ------  P 12 23
power of the 3 10 d = ------  P d = ------  P
10 10
transmitter (W) between 150 kHz and 80 between 150 kHz and
between 80 MHz and between 800 MHz and
MHz outside of the ISM 80 MHz within the ISM
800 MHz 2.5 GHz
frequency band frequency band
0.01 0.12 0.12 0.12 0.23
0.1 0.37 0.38 0.38 0.73
1 1.17 1.2 1.2 2.3
10 3.69 3.79 3.79 7.27
100 11.67 12 12 23
For transmitters with a max. transmitting power that is not listed in the above table, the recommended minimum distance d in metres (m) can
be calculated using a formula based on the transmitter's frequency, where P is the max. transmitting power of the transmitter in Watts (W)
(according to manufacturer data).
Note 1 These guidelines might not always be applicable. Electromagnetic radiation is influenced by absorption and reflection on structures,
objects and people.
Note 2 To calculate the recommended minimum distance of transmitters in the ISM frequency bands between 150 kHz and 80M
Hz and in the frequency band between 80 MHz and 2.5 GHz, the additional factor 10/3 is used to minimise the probability of interferences caused
by mobile/portable communication equipment that accidentally happens to be in the patient environment.
Art. no.: 0-48-0227 Rev.: g
Page 158
Appendix 13
DEFIGARD/PHYSIOGARD Touch 7 User guide Accessories and disposables 13.1
13 Appendix
13.1 Accessories and disposables
 Always use SCHILLER replacement parts and disposables, or products
approved by SCHILLER. Failure to do so may endanger essential performance,
life and/or invalidate the warranty.
Your local representative stocks all the disposables and accessories for the
DEFIGARD® Touch 7. A full list of all SCHILLER representatives can be found on the
SCHILLER website (www.schiller.ch).
13.2 Accessories DEFIGARD/PHYSIOGARD

Touch 7
Article no. Article description
Device
3.940100 Battery Li/ion 11.1V, 4.65 Ah, 51.6 Wh(rechargeable)
4-07-0022 Battery Li/MnO2, 6 V, 1,4 Ah
ECG
0-05-0051 4- or 10-lead set, press stud, IEC (4+6-lead press stud patient cable)
0-21-0033 ECG electrodes pouch of 4 (box of 10 pouches)
0-21-0034 ECG electrodes pouch of 6 (box of 10 pouches)
0-05-0052 6-pol. leadset, press stud, IEC 4-lead patient cable "6in4" P/N 0-05-0051
is necessary
NIBP
0-04-0012 Cuff for neonatal soft, 4 cm (Arm circumference 6-12 cm)
0-04-0016 Cuff for Child, 8 cm (Arm circumference 11-22 cm)
0-04-0014 Cuff for Child, 11 cm (Arm circumference 16-28 cm)
0-04-0013 Cuff for Adult, 13 cm (Arm circumference 26-33 cm)
0-87-0006 Hose assembly NIBP, 2 m
SpO2
2.310301 Connection cable SpO2 Masimo 1.2 m
2.100598 Adult (> 30 kg) reusable finger clip sensor, 1m, M-LNCS DCI
2.100565 Adult (> 30 kg) soft reusable finger clip sensor, 1m, M-LNCS DBI
Art. no.: 0-48-0227 Rev.: g
0-13-0031 Paediatric/slender (10-50 kg) reusable finger clip sensor, 1 m, M-LNCS

DCIP
2.100627 Disp. adult (> 30 kg) adhesive finger sensor, 1m, 20/box, M-LNCS ADTX-
3
2.100628 Disp. paediatric (10-50 kg) adhesive finger sensor, 1m, 20/box, M-LNCS
PDTX-3
2.100629 Disp. infant (3-20 kg) adhesive sensor, 1m, 20/box, M-LNCS INF-3
2.100630 Disp. neonatal/adult (< 3 kg or > 40 kg) SpO2 adhesive sensor, 1m, 20/
box, M-LNCS NEO-3
SpCO, SpMet, SpO2
2.310301 Connection cable SpO2 1.2 m
2.100599 Adult (>3 0 kg) reusable finger clip sensor, 1m, Rainbow DCI
Page 159
13 Appendix
13.2 Accessories DEFIGARD/PHYSIOGARD Touch 7 DEFIGARD/PHYSIOGARD Touch 7
Article no. Article description

0-13-0033 Paediatric (10-50 kg) reusable finger sensor, 1m, Rainbow DCIP
Temp
2.101108 Reusable temperature probe rectal / oesophageal, adult, 2m
2.101109 Reusable temperature probe rectal / oesophageal, child, 2m
2.101104 Temperature probe skin adult
2.310298 Reuseable connecting cable for disposable temperature probe
CO2 IRMA/ISA
2.100571 IRMA CO2 sensor
6-17-0015 Trunk cable IRMA/ISA etCO2 with adapter plate
2.100567 ISA sidestream etCO2 sensor
IBP
2.310285 IBP cable assembly Braun
2.310297 IBP cable assembly Baxter
2.310299 IBP cable assembly Transpac IV
2.310164 IBP cable assembly Utah, Mallinckrodt
2.310308 IBP cable assembly PCB Combitrans
2.310296 IBP cable assembly Ohmeda
2.310246 IBP cable assembly Medex
DEFI DEFIGARD® Touch 7
0-21-0040 Disposable adhesive defibrillation electrode pads for adults
(preconnectable) with detection of shelf life by RFID
2.155067 Disposable adhesive defibrillation electrode pads for children
2.100860 ARGUS LifePoint (CPR feedback sensor)
6-17-0012 Adapter cable for LifePoint CPR feedback sensor
2.100519 Adhesive pad set of 5 pcs
General
accessories
0-80-0023 Carrying bag
3.940100 Li/Ion 11.1 V, 4.65 Ah, 51.6 Wh (rechargeable)
1-128-5080 Ambulance bracket with AC/DC charging module. The battery is charged
in the device via ambulance bracket.
1-108-5181 Ambulance bracket with DC/DC charging module. The battery is charged
in the device via ambulance bracket.
1-128-5180 Desktop bracket with AC/DC charging module. The battery is charged in
the device via Desktop bracket.
1-128-5181 Nomad AC/DC charging module
1-128-5182 Nomad DC/DC charging module
2.100018 Charging unit CS-1, external battery charger
Art. no.: 0-48-0227 Rev.: g
Page 160
Appendix 13
DEFIGARD/PHYSIOGARD Touch 7 User guide Literature 13.3
13.3 Literature
European Resuscitation Council Guidelines 2015 for Cardiopulmonary Resuscitation and Emergency Cardiovascular
(2015) Care (
American Heart Association (2015) Guidelines 2015 for Cardiopulmonary Resuscitation and Emergency Cardiovascular
Care
Cansell A. (2000) Wirksamkeit und Sicherheit neuer Impulskurvenformen bei transthorakaler

Defibrillation – Biphasische Impulskurvenformen – Notfall- & Rettungsmedizin,
Springer-Verlag 3: 458 – 474.
Clinical experience with a low-ener- Jean-Philippe Didon, Guy Fontaine, Roger D. White, Irena Jekova, Johann-Jakob
gy pulsed biphasic waveform in out- Schmid, Albert Cansell; Clinical experience with a low-energy pulsed biphasic
of-hospital cardiac arrest waveform in out-of-hospital cardiac arrest, Resuscitation (2008) 76, pp 350—353.
13.4 Glossary
AED Automated external defibrillator
BLS Basic Life Support (artificial respiration and cardiac massage)

CPR is frequently used synonymously
CPR Cardiopulmonary resuscitation
VT Ventricular tachycardia
VF Ventricular fibrillation
Art. no.: 0-48-0227 Rev.: g
Page 161
13 Appendix
13.4 Glossary DEFIGARD/PHYSIOGARD Touch 7
Art. no.: 0-48-0227 Rev.: g
Page 162
Index 14
14 Index
A I V
Accessories and disposables .............. 125 IBP Voice support ......................................... 93
Activating the audio alarm ..................... 39 IBP calibration .................................. 61
Alarm indicators ..................................... 39 IBP settings ...................................... 60
Alarm messages .................................... 38 Preparing IBP measurement ............ 59 W
Auto ..................................................... 115 Zeroing ............................................. 60 Warranty ................................................ 15
Internal defibrillation .............................. 89
B
Battery L
Battery life ...................................... 131 LEDs ..................................................... 24
Battery disposal ................................... 118
Battery type ......................................... 131
Biocompatibility ..................................... 20 M
Maintenance
Lifed Item Replacement ................. 123
C Maintenance interval ........................... 112
Charge control and monitoring ............ 135 Maintenance interval for the battery .... 118
Charging time ...................................... 135 Manual defibrillation .............................. 83
Charging Unit CS-1 Manual defibrillation using pads ............ 85
Input and Output Supplies .............. 130
Cleaning .................................. 119, 121
Cycle time shock – shock .................... 135 N
NIBP Menu ............................................ 58
NIBP softkey ......................................... 57
D
Danger of electric shock! ....................... 12
Danger of explosion .............................. 26 O
Default energy settings ........................ 135 Operating elements ............................... 22
Defibrillation - procedure ....................... 94 Operational readiness ........................... 32
Defibrillation pulse ............................... 134
Demand mode ....................................... 99
P
Pacemaker
E Fixed-rate mode (Fix) ....................... 99
ECG error messages ............................. 47 Pacemaker patients .............................. 46
ECG Menu ............................................. 50 Patient resistance ................................ 135
ECG, quick diagnosis ............................ 43 Physiological alarms ............................. 39
Error Detection .................................... 125
etCO2
etCO2 settings .................................. 67
S
Safety discharge ................................. 136
LED on the sensor ............................ 67
O2 concentration .............................. 67 Semiautomatic defibrillation .................. 92
Shock delivery ..................................... 136
Preparation ....................................... 67
SpO2 error messages ........................... 53
Sensor LED ...................................... 71
Zeroing ............................................. 66 SpO2 Menu ........................................... 52
SPO2 monitoring ................................... 50
Event marks .......................................... 85
Step 2 Analysis ..................................... 94
Art. no.: 0-48-0227 Rev.: g
Step 3 shock delivery ............................ 95

F Step 4 Cardiopulmonary resuscitation .. 95
Functional test Suppressing an alarm sound ................ 39
Auto Test ........................................ 115 Symbols on the device .......................... 17
Battery charging status ................... 114 Symbols used on the battery ................. 18
Button test in SAED automatic operation . Symbols used on the electrode package 19
114 Synchronised defibrillation .................... 89
Button test in SAED manual operation .....
114
Charging condenser (monthly) ....... 115
T
Technical alarms ................................... 39
Visual inspection of the device and
accessories .................................... 114 Transport support ........................ 29, 30
Page 163
14 Index
Art. no.: 0-48-0227 Rev.: g
Page 164

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DEFIGARD 1):4*0GARD

Art. no./revision: Date Note

Article no.: 0-48-0227 Rev.: g

2 Components and Operation .................. 20

3 Initial Operation ...................................... 26

3.1.3 Operation with external constant voltage source ............................. 28

3.5 Connection to a ePCR system........................................... 35

4.9.2 Temperature menu settings ............................................................. 62

4.11 CO2 Sidestream .................................................................. 69

5.7 Defibrillator Technical Messages...................................... 98

7 Finishing the Therapy ..........................106

8 Intervention summary ..........................107

9 Main Menu .............................................109

10.3.2 Update via Server .......................................................................... 117

10.8.1 Monthly........................................................................................... 122

11 SCHILLER Charging Unit CS-1 ........... 127

12 Technical Data ...................................... 131

12.6.12 Time and date ................................................................................ 152

12.7.2 Electromagnetic immunity.............................................................. 156

Art. no.: 0-48-0227 Rev.: g

The DEFIGARD® Touch 7 is an emergency monitor / defibrillator.

1.1 User profiles

The PHYSIOGARD® Touch 7 must only be used by qualified medical or paramedic

1.2 Intended Use

services as well as in-house and inter-hospital transportation.

1.3 Contraindication for use

Art. no.: 0-48-0227 Rev.: g

1.4 Responsibility of the User

1.5 Organisational Measures

1.6 Safety-Conscious Operation

 Do not reuse disposable accessories marked with the symbol to prevent

1.7 Operation with other Devices

communication devices, HF radios and devices labelled with the symbol

1.10 Networks and Internet

Art. no.: 0-48-0227 Rev.: g

1.11 Additional Terms

1.11.2 Terms of Warranty

• assembly operations, extensions, readjustments, modifications, or repairs are

1.12 Display Symbols/Indicators

For general safety notes as listed in this section.

Reference to other guidelines

Touch (to open/close menus and perform functions)

Move to the right or left

1.12.2 Symbols used on the device

Notified body of the CE certification (G-MED)

Note accompanying documents!

• Symbol for the recognition of electrical and electronic equipment.

Manufacturer symbol, manufacturing date

Read the instruction for use

Devices with WLAN or GSM

The DEFIGARD/PHYSIOGARD Touch 7 radiates high-frequency electromagnetic

However, even in the case of correct installation/operation, there is no guarantee that

If the DEFIGARD/PHYSIOGARD Touch 7 causes interferences, these can be

Used for electrical dangers during defibrillation (DEFIGARD® Touch 7)

1.12.3 Symbols Used on the Batteries

The unit/component can be recycled.

Battery may not be disposed of with domestic refuse.

Do not burn, saw up or crash the battery

Do not short-circuit the battery