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ZOLL Medical Corporation Sales Training

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Title: ZOLL Medical Corporation Sales Training


1
ZOLL Medical CorporationSales Training
M Series Monitor, Defibrillate, Pace
2
M Series Agenda
  • Monitor
  • Defibrillator
  • Clinically superior biphasic technology
  • External Pacing
  • Clinically superior pacing technology
  • Solutions for Customer Goals

3
M Series Overview
  • The Fuel Behind the Fire
  • Compare ZOLLs growth to the launch of the M
    Series..
  • Smaller
  • Lighter
  • Brighter
  • Better
  • Superior biphasic waveform
  • Superior pacing waveform
  • Easy
  • Intuitive
  • Uniform Operating System
  • Dynamic Error Correction
  • Configurable
  • Upgradeable

4
ZOLL M Series Monitor
5
M Series Monitor KNOWLEDGE
  • Basic ECG Monitoring
  • Attach electrodes
  • Select MONITOR
  • Press LEAD button to get desired lead
  • Press SIZE button to get desired size

6
M Series Monitor KNOWLEDGE
  • 5-Lead Monitoring
  • Disconnect 3-lead cable
  • Connect 5-lead cable
  • Attach electrodes
  • Select MONITOR
  • Press LEAD button to get desired lead
  • Press SIZE button to get desired size
  • Printing 3 leads - Set configuration
  • PRINT 3 LEADS WHEN LEADS ARE SEL YES

7
M Series Monitor KNOWLEDGE
  • Recorder
  • Start Press RECORDER
  • Stop Press RECORDER
  • Note there is always a 6 second delay
  • Strips include
  • Date Time ECG Lead
  • Size Heart Rate

8
M Series Monitor KNOWLEDGE
  • Vital Signs Trending
  • HR, SpO2, EtCO2, Respiration Rate, Systolic BP,
    Diastolic BP, Mean BP
  • Trending ENABLED in Configuration
  • Data sampled 1/minute for max 24 hrs, plus with
    any alarm, and with any NIBP measurement

9
M Series Monitor KNOWLEDGE
  • Viewing Vital Signs Trends
  • Press SUMMARY
  • Press TREND
  • Press SELECT to highlight SET TRACE 2 or SET
    TRACE 3
  • Press ZOOM to change the interval period
  • All, 60 min, 30 min, 15 min, 10 min, 5 min
  • To print report, press PRINT on trend screen

10
M Series Monitor KNOWLEDGE
Vital Signs Trend Report
11
M Series Monitor KNOWLEDGE
  • Clearing Vital Signs Trends
  • Press hold SUMMARY
  • Erase Summary, Erase Trend, Erase All is
    displayed
  • Press ERASE TREND

12
M Series Monitor UNDERSTANDING
  • Practice Monitor In-Service

13
M Series Monitor UNDERSTANDING
  • Key Differentiators/Key Selling Points
  • Uniform operating system
  • Benefit Increases operator confidence and
    reduces training costs by utilizing same user
    interface in all generations of product and in
    every model of the M Series platform
  • Question Have you ever had a situation where
    youve arrived at an arrest and the equipment is
    unfamiliar?
  • Question How often are you trained on
    equipment?
  • Question Would it be beneficial to have your
    crash cart devices work the same as your
    transport devices?
  • Error correcting messages
  • Benefit Audibly and visually suggests
    corrective action (ie. Attach ECG Lead vs ECG
    Lead Off)
  • Question How does your equipment currently
    notify you of problems?

14
M Series Monitor UNDERSTANDING
  • Key Differentiators/Key Selling Points
  • Intuitive design
  • Benefit Put an M Series in front of a
    clinician, and theyll be able to use it with
    very little training
  • Question Have you ever been confused about how
    to operate a piece of equipment?
  • Question How often have equipment challenges
    prevented you from treating a patient in a timely
    manner?
  • Large, bright LED display
  • Benefit Ability to see screen from every angle
  • Question What do you currently do to see your
    screen when youre standing to the side / at an
    angle?

15
M Series Monitor APPLICATION
  • Practice Monitor Demo

16
M Series Monitor APPLICATION
  • Customer Goals
  • ZOLL Solutions

Uniform Operating System Error Correcting
Messages Intuitive design Large, Bright LED
Display
Fast Response Times Confident Responders JCAHO
Compliance Effective Patient Care
?
17
ZOLL M Series Defibrillator
18
M Series Defibrillate
  • Catherine Prophet
  • April 2005

19
M Series Defibrillation KNOWLEDGE
  • Manual Defibrillation
  • Attach MFE Electrodes to patient
  • Recommend ZOLL electrodes customized for
    optimal performance with ZOLL M
    Series
  • Select DEFIB
  • Unit automatically defaults to first shock
    setting determined in Configuration (typically
    120J, 150J, 200J)
  • To change energy setting, use UP/DOWN ARROWS.
    Selected energy is displayed as DEFIB XXXJ SEL
  • Press CHARGE
  • Make sure everyone is clear
  • When SHOCK button lights, press SHOCK
  • If so configured, the M Series automatically
    increments the energy setting after the first
    shock according to configuration. Manually
    changing the energy setting disables this
    function.
  • Note Changing the energy level or switching to
    MONITOR after CHARGE is pressed results in
    defibrillator being disarmed

20
M Series Defibrillation KNOWLEDGE
  • Manual Defibrillation with Paddles
  • Select DEFIB
  • Unit automatically defaults to first shock
    setting determined in Configuration
    (typically 120J, 150J, 200J)
  • To change energy setting, use UP/DOWN ARROWS
  • Press CHARGE on the panel or on the apex handle
  • Apply electrolyte gel to the paddles and apply
    paddles to chest
  • Make sure everyone is clear
  • When SHOCK button lights, place paddles on chest
    with 25 lb pressure and simultaneously press
    SHOCK on both paddles
  • Note Changing the energy level or switching to
    MONITOR after CHARGE is pressed results in
    defibrillator being disarmed

21
M Series Defibrillation KNOWLEDGE
  • Advisory Defibrillation
  • Attach MFE Electrodes to patient
  • Select DEFIB
  • Press ANALYZE. ANALYZING ECG will be
    displayed for about 9 seconds.
  • If unit displays SHOCK ADVISED, defibrillator
    automatically charges to first shock setting
    determined in Configuration (typically 120J,
    150J, 200J)
  • If automatic charge is disabled, SHOCK ADVISED
    and PRESS CHARGE will be alternately displayed.
  • To change energy setting, use UP/DOWN ARROWS.
    Selected energy is displayed as DEFIB XXXJ SEL
  • Make sure everyone is clear
  • When SHOCK button lights, press SHOCK
  • If so configured, the M Series automatically
    increments the energy setting after the first
    shock according to configuration. Manually
    changing the energy setting disables this
    function.
  • Note Changing the energy level or switching to
    MONITOR after CHARGE is pressed results in
    defibrillator being disarmed

22
M Series Defibrillation KNOWLEDGE
  • Automatic Defibrillation (AED)
  • Attach MFE Electrodes to patient
  • Turn unit ON
  • Unit automatically defaults to first shock
    setting determined in Configuration
    (typically 120J, 150J, 200J)
  • To change energy setting, use UP/DOWN ARROWS.
    Selected energy is displayed as DEFIB XXXJ SEL
  • Press CHARGE
  • Make sure everyone is clear
  • When SHOCK button lights, press SHOCK
  • If so configured, the M Series automatically
    increments the energy setting after the first
    shock according to configuration. Manually
    changing the energy setting disables this
    function.
  • Note Changing the energy level or switching to
    MONITOR after CHARGE is pressed results in
    defibrillator being disarmed

23
M Series Defibrillation KNOWLEDGE
  • Synchronized Cardioversion
  • Press LEAD to select desired ECG lead
  • Select DEFIB
  • Select desired energy level
  • Press SYNC softkey. Verify presence of SYNC
    marker ?
  • Press CHARGE
  • Verify everyone is clear of patient
  • Press SHOCK
  • Note Use of ZOLL electrodes is strongly
    recommended. Clinical results for AF
    cardioversion are based on 3 part system ZOLL
    Biphasic Waveform, ZOLL electrodes pad
    placement

24
M Series Defibrillation KNOWLEDGE
  • Code Markers
  • Pressing CODE MARKER softkey during
    defibrillation displays the following options
  • CPR B-block Fentanyl
  • Intubate Atrovent Digoxin
  • EPI Mag Sulf Vasopr
  • LIDO Procain
  • Narcan Adenosin
  • Pressing the softkey for a specific code marker
    will cause that action to be recorded along with
    a date and time stamp in the Summary Report Memory

25
M Series Defibrillation KNOWLEDGE
  • Printing Reports
  • Summary Report triggered by six events
  • VF Alarm HR Alarm
  • Defibrillator Shock Turn Recorder ON
  • Selecting PACER Pressing ANALYZE
  • Memory stores up to 65 defibrillation or 140
    recorder activated ECG events
  • Press SUMMARY to print report, then select
    softkey
  • Print Config Configuration settings
  • Print Chart Select from All or Range of Events
  • Print Log Incident log
  • To add patient name and ID, press ID softkey and
    enter information

26
M Series Defibrillation KNOWLEDGE
  • Biphasic Waveform
  • Fixed Flat design
  • Fixed duration, constant current
  • Current defibrillates ZOLL has the most
  • Only biphasic waveform cleared by the FDA
    to be labeled superior to monophasic for
    cardioversion of AF defibrillation of high
    impedance VF
  • Controls for variations in patient impedance
    through series of digital equipment resistors so
    that the low impedance patient is not overdosed
    and the high impedance patient gets the most
    current of any defibrillator
  • Defibrillation protocol 120J 150J 200J
  • Cardioversion protocol 75J 120J 150J 200J

27
M Series Defibrillation KNOWLEDGE
  • ZOLL Multifunction Electrodes
  • Always mention electrodes during defib product
    overviews and in-services
  • Validated as part of the system high quality
    performance guaranteed
  • Question Do you want to use electrodes not
    validated and proven on your defib system? Not
    all have equivalent performance.
  • Critical success factor for biphasic in clinical
    studies biphasic electrode and proper pad
    placement
  • Optimized product line for resuscitation and
    therapy
  • statpadz speed pack, center energy feed
  • Question Do you want to lose precious response
    time by using pads without a preconnect feature
    on your defibrillator?
  • propadz liquid gel and specialized electrodes
  • Question Would you like to reduce the risk of
    dermal damage? Do you have needs for radiolucent
    or sterile electrodes in your OR and Cath/EP
    labs?
  • pedipadz liquid gel reduces dermal damage
  • Question Would you like to offer your pedi
    patients the best care for their delicate skin?
  • CPR-Dpadz one piece, CPR feedback
  • ZOLL only defib company to own electrode
    manufacturing control over quality, innovation,
    service and inventory
  • Question Third party branded electrodes my save
    pennies, but why risk integrity of life saving
    therapy?
  • Best reputation in the industry
  • No need for adaptors or special connectors

28
M Series Defibrillation UNDERSTANDING
  • Practice Defibrillation In-Service

29
M Series Defibrillation UNDERSTANDING
  • Key Differentiators/Key Selling Points
  • Clinical superiority with rectilinear biphasic
    technology
  • Benefit Better patient outcomes and reduced
    costs through increased efficacy of rectilinear
    biphasic waveform
  • Question What have your experiences been with
    defibrillation during a code/cardioversion? How
    many times do you typically have to shock a
    patient?
  • Low Energy Defibrillation
  • Benefit Provides the ability to use lowest
    effective dose of therapy for defibrillation and
    cardioversion
  • Question Are you aware of the AHAs statements
    on biphasic defibrillation?
  • Question Are you aware of the Mittal AF or VF
    studies on the rectilinear biphasic waveform?
  • AED, Advisory or Manual on the same platform
  • Benefit One machine can be used for various
    clinical applications throughout the hospital
  • Question Are you familiar with AHA Guidelines
    regarding code response time?
  • Question Describe what happens when you have a
    code called on a Med/Surg floor?
  • Configurable Auto-escalation
  • Benefit Eliminates one step in an already
    hectic environment and reduces the necessity to
    remember new energy protocols
  • Question What is your current procedure for
    energy escalation?
  • Uniform Operating System
  • Error correcting messages
  • Large, bright LED display

30
M Series Defibrillation APPLICATION
  • Practice Defibrillation Demo

31
M Series Defibrillation APPLICATION
  • Customer Goals
  • ZOLL Solutions

Uniform Operating System Error Correcting
Messages Large, Bright LED Display Superior
clinical technology AED, Advisory or Manual
Fast Response Times Confident Responders JCAHO
Compliance Effective Patient Care Keep up with
therapeutic advances Cost effective
standardization
?
32
ZOLL M SeriesExternal Pacing
33
M Series Pace
  • Catherine Prophet
  • April 2005

34
M Series Pacing KNOWLEDGE
  • Value of External Pacing
  • 60 of codes do not require defibrillation
  • Survival rates for non-VT/VF rhythms is less than
    10

35
M Series Pacing KNOWLEDGE
  • External Pacing
  • Apply electrodes and ZOLL MFE pads
  • Select PACER
  • Turn PACER RATE knob clockwise to set rate 10-20
    ppm higher than intrinsic rate or 100 ppm
  • Turn PACER OUTPUT knob clockwise to increase mA
    until capture
  • Press and hold 41 button to deliver pacing
    impulse for 1 out of 4 beat to determine
    underlying rhythm

36
M Series Pacing KNOWLEDGE
  • Pacing Pad Placement
  • Apply EKG electrodes
  • Identify your Heart Rate
  • Pad Placement Back Pad First between scapula
    spine
  • Front Pad V2-V5
  • Take pulse on the right side
  • Apply Back Pad First
  • Dont shave patient

37
M Series Pacing UNDERSTANDING
  • Practice Pacing In-Service

38
M Series Pacing UNDERSTANDING
Pacing Historical Background 1952
39
M Series Pacing UNDERSTANDING
  • NTP 1000 1983
  • Marketed in 1983
  • Pacemaker/Monitor
  • Price 7200
  • Always sold at list
  • Never did evaluations
  • Pacing Electrodes only

40
M Series Pacing UNDERSTANDING
  • ACLS Guidelines 2000
  • Transcutaneous pacing is a Class I intervention
    for all symptomatic bradycardias.
  • If clinicians are concerned about the use of
    atropine in higher level blocks, they should
    remember TP is always appropriate..If the
    bradycardia is severe and the clinical condition
    is unstable, implement TP immediately p.I-155

41
M Series Pacing UNDERSTANDING
  • LARGER SURFACE AREA ELECTRODES
  • CONSTANT CURRENT-RECTILINEAR WAVEFORM
  • HIGH IMPEDENCE GEL
  • LONG PULSE DURATION-UP TO 40 MS

Pacing Evolution
42
M Series Pacing UNDERSTANDING
  • Different Pacing Waveforms
  • ZOLL- Rectilinear
  • Physio- Truncated Exponential
  • Philips- Truncated Exponential

43
M Series Pacing UNDERSTANDING
Pacing Waveform Comparisons
44
M Series Pacing UNDERSTANDING
Clinical Research on External Pacing ZOLL Pacing
(40 msec pulse duration) Capture Rate Mean
Threshold 1PM ZOLL (Circulation
5/85) 96 56mA 2Madsen (American Heart Journal
7/88) 94 55mA 3Dunn (Heart and Lung
1/89) 91 43mA 4Heller (Prehospital Disaster
7/89) 80 67mA 5Worley (Acute Coronary Care
1987) 96 67mA 6Falk (New England Journal
11/83) 94 56mA Competitive Pacing (20 msec pulse
duration) 7Heller (Prehospital Disaster
7/89) 50 105mA 8Knowlton (American Journal
Cardiology) 46 95mA 9Crockett (Experience in
Coronary Care) 25 142mA 10Crockett (Experience
in Emergency Department 50 88mA 11Falk (J.
American College of Cardiology 1993) ---- 78mA
45
M Series Pacing UNDERSTANDING
  • Key Differentiators/Key Selling Points
  • Clinically superior pacing waveform
  • Twice the rate of capture
  • Benefit Potential for higher survival rates
  • Question What do you do when there is not shock
    advised? What are your criteria for using
    external pacing? What has your experience been
    with external pacing?
  • Question What is your understanding of the
    differences between pacing technologies?
  • Question Where might your approach change if
    you could capture more patients?
  • Half the current for capture
  • Benefit Ability to maintain external pacing at
    a comfortable level for longer periods of time
  • Question How might capturing at lower energy
    levels benefit the patient?
  • High efficacy with 35 pads
  • Benefit Cheaper to than floating internal wires
  • Question When do you float wires to establish
    internal pacing?
  • Uniform operating system
  • Error correcting messages
  • Large, bright LED display

46
M Series Pacing APPLICATION
  • Practice Pacing Demo

47
M Series Pacing APPLICATION
  • Customer Goals
  • ZOLL Solutions

Uniform Operating System Clinically superior
pacing waveform 55 codes NO SHOCK High
efficacy with 35 pads
Fast Response Times Effective Patient
Care Cost effective options
?
48
Selling PacingWho to talk toWhat to say
49
ZOLL M SeriesPutting it All Together
50
User Goal
With staff changes, we need to know everyone can
operate any defibrillator in any area!
51
M Series Offers Solutions
  • Tools for Everyone and Every Environment
  • Extensive range of M Series options and
    configurations to meet every clinical need.
  • Crash Cart
  • ED
  • EMS
  • Flight Service
  • Transport
  • Cath Lab/EP
  • OR
  • Low Acuity Units

52
M Series Offers Solutions
Consistency that Builds Confidence and Minimizes
Training
A 20-Year Commitment D900 PD1200 PD1400,
D1400 PD1600, D1600 PD1700 PD2000, D2000 M
Series M Series CCT
53
M Series Offers Solutions
Dynamic Error Correction
  • Driven by design principles of cockpit safety.
  • Issues corrective prompt instead of describing
    error
  • ECG LEAD OFF

54
User Goal
These days we need defibrillators everywhere
from the ICU to theparking lot, from BLSto ALS
levels
55
M Series Offers Solutions
Early Defibrillation
The goal of early defibrillation by first
responders is a collapse-to-shock interval, when
appropriate, of lt3 minutes in all areas of the
hospital and ambulatory care facilities (Class
I). Guidelines 2000
The ZOLL family of AEDs is designed to help
clinical professionals deliver early
defibrillation.
56
User Goal
We want to measure the quality of our
resuscitation program, but we cant find the
resources.
57
M Series Offers Solutions
A Better Way to Collect Performance Data
  • Data transfer via PC card technology to RescueNet
    Code Review for case review and reporting.
  • Unit does not have to be removed from service

58
M Series Offers Solutions
Automated Compliance with Standards and
Recommendations
  • JCAHO Standard TX.8
  • Effective resuscitation services are
    systematically available through the hospital.
  • d. Appropriate data collection related to the
    processes and outcome of resuscitation and
  • Ongoing review of outcomes related to
    resuscitation in the aggregate to identify
    opportunities for improvement of resuscitation
    efforts.
  • AHA Guidelines 2000
  • Organized collection and review of patient data
    can identify system wide problems and allow
    assessment of each link in the Chain of Survival
    for the adult victim of sudden cardiac death.

59
User Goal
Keeping all our defibrillators up-to-date and
ready for emergencies is a challenge.
60
M Series Offers Solutions
Products that Adapt Over Time
Easy to add options as needed.
12-lead
61
User Goal
We cant afford downtime for the equipment we
depend on.
62
M Series Offers Solutions
Uptime Beyond a Quick Fix
All ZOLL repairs, modifications and upgrades are
tested to the same quality standards as new
factory defibrillators.
63
User Goal
We need a long-term partner whos 100 focused
on us.
64
Customer-Driven Success
  • Driven by unmatched focus on customer needs
  • Ranked 11th on Forbes listing of 100 Fastest
    Growing Small Companies
  • Fastest growing hospital defibrillator company
  • Growth driven by customers switch to ZOLL from
    other suppliers


65
Top 15 Cardiac Hospitals All Use ZOLL
  • Cleveland Clinic, Cleveland OH
  • Mayo Clinic, Rochester MN
  • Brigham Woman's Hospital, Boston MA
  • Duke University Medical Center, Durham NC
  • Mass General Hospital, Boston
  • Johns Hopkins Hospital, Baltimore MD
  • Emory University Hospital, Atlanta GA
  • Texas Heart Institute-St. Luke's Episcopal
    Hospital, Houston TX
  • Stanford University Hospital, Stanford CA
  • Barnes-Jewish Hospital, St. Louis MO
  • New York Presbyterian Hospital
  • UCLA Medical Center, Los Angeles CA
  • Washington Hospital Center, Washington DC
  • William Beaumont Hospital, Royal Oak MI
  • Methodist Hospital, Houston

66
M Series Configuration
  • Critical Questions?
  • Review configuration options on your own

67
M Series Summary
  • Standardization Tools for everyone in every
    environment
  • Consistency that Builds Confidence Uniform
    operating system Dynamic error correction
  • Superior clinical results with patented biphasic
    and pacing waveforms
  • Upgradeable to adapt to changing needs over time
  • ZOLL partner focused on resuscitation
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