# FDA and lifepack 15



## Scout (Apr 23, 2010)

Can anyone say woops?


http://www.dotmed.com/news/story/12444/




> The U.S. Food and Drug Administration issued its most serious product recall on Physio-Control's LIFEPAK defibrillators Thursday, warning that the life-saving machines could shut down or turn on by themselves.
> 
> Once it turns on or off, the machines could then stay that way, the FDA said in a statement announcing the Class 1 recall.
> 
> ...


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## WolfmanHarris (Apr 23, 2010)

And my service has just started purchasing on the LP15's to replace all our 12's. I think we've only got one or two at the moment for our Performance and Development Division to play with.

I was actually hoping for the Phillips monitor myself.


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## 46Young (Apr 23, 2010)

I'm quite happy with our Phillips monitors. My service replaced all of our LP 12's with the Phillips during the same time period that the recalled LP 15's were being issued. 

It was explained to me that Physio was charging an absurd amount for the 15's when compared to Phillips. I don't remember exactly, but I think it was 18 grand a pop or so. I remember thinking what balls this company has charging so much for the new models.


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## WolfmanHarris (Apr 23, 2010)

Apparently the 15's are actually going to have decent battery life too. Lord knows the 12's are frigging awful for that.


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## 46Young (Apr 23, 2010)

The Phiilip's battery is supposed to last 14 continuous hours. The monitor has two. That's 28 continuous hours give or take. No one runs their monitor 24/7. That means that you could get two or three days to a week without needing to change the batteries, assuming that you don't plug it in between calls.

How long does the LP 15 last in comparison?


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## WolfmanHarris (Apr 23, 2010)

46Young said:


> How long does the LP 15 last in comparison?



Couldn't tell ya without looking up the specs on Medtronics site.

All we've been told so far was that we're getting them (along with replacements for all our bags) as part of our equipment replacement cycle this year. I can only hope it's as good as the Phillips.

Specs for a brand-new battery state 360 mins for monitoring = 6 hours. (Initially stated 12, reread the fine print and those numbers were for two batteries)
For defib, 420x 360j discharges.

There's lots of different Nicd models for the LP12 and I'm not sure which we're using at the moment (not at work) but the range for monitoring is from 110-120mins.


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## Shishkabob (Apr 23, 2010)

WolfmanHarris said:


> Apparently the 15's are actually going to have decent battery life too. Lord knows the 12's are frigging awful for that.



I HATED the battery life on LP12s during my internship. I'd have to change out batteries after every call that I used the monitor on, and kept 2 extra batteries in the truck beyond the normal one they required.

I loved using the Phillips in school.


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## zmedic (Apr 24, 2010)

I'm surprised they didn't move the on/off switch on the 15. There have been a number of reports of users who go to shock or charge on the 12 and hitting the off button and turning them off. Not what you want during a cardiac arrest.


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## colafdp (Apr 24, 2010)

zmedic said:


> I'm surprised they didn't move the on/off switch on the 15. There have been a number of reports of users who go to shock or charge on the 12 and hitting the off button and turning them off. Not what you want during a cardiac arrest.



You do have to press and hold the power button on the 15 to turn it off. However, maybe if people are doing this, they should take a second and actually look at which button they're hitting.


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## Shishkabob (Apr 24, 2010)

zmedic said:


> I'm surprised they didn't move the on/off switch on the 15. There have been a number of reports of users who go to shock or charge on the 12 and hitting the off button and turning them off. Not what you want during a cardiac arrest.




You should really be looking at the monitor when you shock someone anyhow...


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## zmedic (Apr 24, 2010)

Adverse Design of Defibrillators: Turning Off the Machine When Trying to Shock
Annals of Emergency Medicine, Volume 52, Issue 5, Pages 512-514
C. Høyer, E. Christensen, B. Eika

", we observed that in 5 of 192 defibrillation attempts by the physicians, the monitor-defibrillator was inadvertently powered off. "

Hey, I've never turned one off during a code, but if the design makes it more likely it's a problem. Arguing that "people should look" doesn't really fix the problem. Moving the button to the other side of the machine does. Safety engineering is the reason why anesthesia is hundreds of times safer than it was 30 years ago. They decided to make the machines smart enough that it won't let you do dumb things like turn up the anesthesia gas so high that the patient doesn't get enough 02. etc etc.


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## BLSBoy (Apr 24, 2010)

No sh*t it turns itself off and on.....its designed to do it at 0300 to do its self check...


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## Shishkabob (Apr 24, 2010)

zmedic said:


> Adverse Design of Defibrillators: Turning Off the Machine When Trying to Shock
> Annals of Emergency Medicine, Volume 52, Issue 5, Pages 512-514
> C. Høyer, E. Christensen, B. Eika
> 
> ...




If they aren't taking the extra half second to look at the monitor and confirm what they are doing, then the problem lies on them.


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## WolfmanHarris (Apr 24, 2010)

Linuss said:


> If they aren't taking the extra half second to look at the monitor and confirm what they are doing, then the problem lies on them.



While the provider has ultimate responsibility, pt. safety and the prevention of medical errors is too important to take that tack. With everything going on during a call would it not make more sense to identify and mitigate areas where mistakes are likely. Wouldn't you rather have one less thing to worry about?

I'm also in favour of checklists for high risk, low instance procedures (i.e. RSI's, cric's). Lessons to be learned from the airline industry abound. I believe that not only have checklists found their way into various hospital units, but that forms of Crew Resource Management (CRM) are also being used in surgery in some areas.


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## Markhk (Apr 25, 2010)

Linuss said:


> If they aren't taking the extra half second to look at the monitor and confirm what they are doing, then the problem lies on them.



It's a human factors design issue. Infrequently used skill (the people in the study were Junior Internal Med Physicians in Europe getting ready to work on the ambulance) coupled with a system that wasn't designed with the idea that "to err is human". 

Several AED brands try to address this by requiring the user push and hold the on/off button for several seconds if the user really wants to turn it off. I do recall one brand that states, "warning power button pushed" or something like that when the AED is recommending a shock. 

This kind of reminds me how no one can find the Heartstart MRx "SYNC" button.


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## zmedic (Apr 25, 2010)

Linuss; said:
			
		

> If they aren't taking the extra half second to look at the monitor and confirm what they are doing, then the problem lies on them.



By that logic pilots should just look at their instruments so they don't run out of gas, nurses should just not give the wrong meds, surgeons should know what foot they are operating on. And you can yell at people till you are blue in the face but those were all system problems that were vastly improved by doing things like having alarms sound when low on gas, changing drug packaging to deal with look alike/sound alike meds, having patients sign their operative site etc. etc. 

I'd rather have it work right because it was well designed than worry that a rookie is going to kill my patient.  Much better than have the satisfaction that "oh, I wouldn't have done what they did."


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## colafdp (Apr 25, 2010)

zmedic said:


> By that logic pilots should just look at their instruments so they don't run out of gas, nurses should just not give the wrong meds, surgeons should know what foot they are operating on. And you can yell at people till you are blue in the face but those were all system problems that were vastly improved by doing things like having alarms sound when low on gas, changing drug packaging to deal with look alike/sound alike meds, having patients sign their operative site etc. etc.
> 
> I'd rather have it work right because it was well designed than worry that a rookie is going to kill my patient.  Much better than have the satisfaction that "oh, I wouldn't have done what they did."



maybe it should have that annoying security feature that comes with Windows. A popup saying "are you sure you want to do this?" lol


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## ceej (Apr 26, 2010)

LP12 battery life is atrocious. Nothing like changing your batteries in the middle of a code.

I have had nothing but positive experiences with the LP15, though. Worked three codes back to back to back with defib and went on to finish the shift on the same batteries.

The bluetooth integration is pretty neat and convenient, too. Nothing like typing my run report and having the code summary already attached.


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## lightsandsirens5 (Apr 28, 2010)

colafdp said:


> You do have to press and hold the power button on the 15 to turn it off. However, maybe if people are doing this, they should take a second and actually look at which button they're hitting.


 
I don't know about the LPs, but on the Zolls it is the big round flashing orange button. Kind of hard to miss. Then again, it is tough to confuse a shock button with an "on-off" dial. I suppose the LP has an "on-off" button as opposed to a switch.

I would think though that it would be standard to have the shock button be different, bigger, flashing orange or red, etc.


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## ceej (Apr 28, 2010)

The LP 12 and 15 Shock button is red and the same size as the Charge and On/Off button.

Thinking back to the Lifepak 11, the defib side of that machine had two shock buttons which were small and round and required you to hold them both down simultaneously to discharge. Granted that was some time ago and that machine is lovingly referred to as the "Shockasaurus" now.


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## colafdp (Apr 28, 2010)

lightsandsirens5 said:


> I would think though that it would be standard to have the shock button be different, bigger, flashing orange or red, etc.



On the 15, the shock button is round instead of that oblong shape, and it's slightly larger. Oh how I remember the zoll's...very easy to use, but a pain in the *** on the highways around here. lol.

and to the poster directly above me, the shock buttons on the 12 and the 15 are different.


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## ceej (Apr 28, 2010)

You're right! Thanks for correcting me!


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## lightsandsirens5 (Apr 28, 2010)

Oh, I see. Yea, I guess you could punch the wrong button. Here is the Zoll M. The "On-Off" switch is the center black dial. The shock button is the round button at two o'clock to the on-off. Kind of tough to get them confused.









> ...very easy to use, but a pain in the :censored::censored::censored: on the highways around here. lol.


 
How so are they a pain?


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## lightsandsirens5 (Apr 28, 2010)

HOLY COW THAT IS A BIG PICTURE!!!! Sorry about that!


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## spike91 (Apr 28, 2010)

Linuss said:


> I HATED the battery life on LP12s during my internship. I'd have to change out batteries after every call that I used the monitor on, and kept 2 extra batteries in the truck beyond the normal one they required.
> 
> I loved using the Phillips in school.



Our squad uses the 12s, and I personally don't mind them. Battery wise, we always keep quite a few spares around, but its never really been an issue with us yet.


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## MonkeySquasher (May 1, 2010)

Markhk said:


> This kind of reminds me how no one can find the Heartstart MRx "SYNC" button.



Is that an important button?     -snicker-


My Volly company runs LP12s, along with an LP11.
My paid company runs Zolls.
At school, we have LP12, LP10, and Zoll.


I must say, I like the Zolls better.  I just feel the layout is better.  However, I don't like that I have to switch between Defib/Pace/Monitor.  Also, I'm not as big of a fan of the buttons for selecting things...  Though I admit, they're more straight-forward than the dial on the LP12.

Anyone here like the LP10/11?  Personally, I love the 10 in training, especially the ability to easily QuickLook, and the audible tone to note changes in rate.

Also, what exactly has LP updated from the 12-15?  Was it really that massive of an upgrade?


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## Markhk (May 1, 2010)

MonkeySquasher said:


> Is that an important button?     -snicker-



Alternate sync cardioversion technique: Shock it till you recognize it!


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## colafdp (May 1, 2010)

MonkeySquasher said:


> .....especially the ability to easily QuickLook, and the audible tone to note changes in rate.
> 
> Also, what exactly has LP updated from the 12-15?  Was it really that massive of an upgrade?



You can do a quick look with the 12 and 15 too if you have the paddles. Also, you can turn up the volume on the 12\15 so you can hear every QRS, unless i'm mistaken, i think that's what you meant. lol.

the 15 is tougher, more robust and secure cable connections, SpCO on the finger probe, and I can't think of anything else. That's just off the top of my head.


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## MonkeySquasher (May 1, 2010)

Markhk said:


> Alternate sync cardioversion technique: Shock it till you recognize it!



HAHAHA   If I shock every second, it looks like a normal rhythm, right??  :wacko:




colafdp said:


> You can do a quick look with the 12 and 15 too if you have the paddles. Also, you can turn up the volume on the 12\15 so you can hear every QRS, unless i'm mistaken, i think that's what you meant. lol.
> 
> the 15 is tougher, more robust and secure cable connections, SpCO on the finger probe, and I can't think of anything else. That's just off the top of my head.



Yeah, true, I didn't think that our LP12 doesn't have the paddles.  Can we still do it with defib pads?  Should be able to...    Where is the volume button?  Others have said it has it too, but I've never found it.

Also, the LP15 has an SpCO?  Like a RAD57?  (-researches it-)  Oh snap, you're right.  That's sweet.


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## BLSBoy (May 1, 2010)

It also does CO monitoring, and will do BGL through the fingertip probe.


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## colafdp (May 1, 2010)

MonkeySquasher said:


> Where is the volume button?  Others have said it has it too, but I've never found it.



When on the main screen, rotate the dial so it highlights the HR in the top left corner. Click it in, and then scroll down to volume, click, and turn that puppy up.


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