ZOLL X SERIES SKILLS PATIENT MONITORING ASSESSMENT FORM

Participant Name: Employee No: Date:

Assessor Name: Employee No: Date:

This purpose of this assessment is to ensure competency in the basic use and maintenance of the
Zoll X Series defibrillator/ monitor whilst working as an Ambulance Community Officer (ACO).

The participant should be able to competently complete the following skills:

Assessment
Summary of Assessment Criteria Outcome
Please circle
Section 1: Maintenance and Test relevant outcome

▪ Check battery level (as per CWI/OPS/166) S NS

▪ Change battery (as per CWI/OPS/166) S NS

▪ Change paper roll (as per CWI/OPS/166) S NS

▪ Turn on monitor and identify all soft key buttons S NS

▪ Locate, check and restock contents (as per layout guide and contents list) S NS

▪ Perform Defibrillation Test (as per CWI/OPS/166)

- Select pads as the waveform source, Confirm “Check Pads” message is displayed
- Connect multifunction lead to test, Confirm “Check Pads” message is replaced by “Short Detected” message.
- Use “Energy Select” arrows to select 30 Joules S NS
- Press Charge
- Once device is charged and the “Shock” button is illuminated, Press “Shock”.
- Ensure “Defib Short Test Passed” message is displayed. Disconnect test connector and reconnect multifunction pads.
Section 2: Vital Signs Monitoring
▪ Locate the 3 blood pressure cuffs (Adult, X Large Adult, Paediatric) and the 2 SPO2 sensors (Adult & Infant)
▪ Attached blood pressure cuff and SPO2 sensor to the patient
S NS

▪ Inflate blood pressure cuff for measurement

▪ Identify blood pressure measurement, Heart Rate, SPO2 and SPO2 pleth waveform
S NS

▪ Silence alarms temporarily using soft button on front of monitor S NS

▪ Select and change monitor parameters between Adult, Paediatric and Infant modes S NS

▪ Print trend summary for handover S NS

Section 3: AED & Defibrillation

▪ Identify criteria for using paediatric mode using AED (<8 years Old/ <25Kg). No use on child less than 1 year old / <10kg
▪ Select adult defibrillator pads (not HPCPR feedback pads) for paediatric patient S NS
▪ Change monitor to paediatric mode
Section 4: Assisting the Paramedic (ACO Supported Only)
▪ Attach 4 lead ECG electrodes to patient (as per CWI/OPS/163)
▪ Select between Lead I, II, III S NS
▪ Print ECG for paramedic analysis
▪ Once the paramedic has applied the chest lead electrodes, Select 12 lead capture (as per CWI/OPS/172)
▪ Enter patient details S NS
▪ Print ECG for paramedic analysis
▪ Attach CO2 monitoring hose
▪ Select CO2 analysis S NS
▪ Identify CO2 measurement
End Assessment