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What This Guide Helps With
This guide assists Clinical Engineering in troubleshooting ECG display errors or artifacts on a LIFEPAK 20 / 20e defibrillator. Symptoms may include unusual waveforms, baseline wander, noisy signal, intermittent ECG display, or distorted readings. The focus is on external and easily verifiable factors before considering internal failure.
Step-by-Step Troubleshooting
Check Patient Connection
- Verify electrodes are correctly placed and fully adhered to the patient’s skin.
- Ensure proper skin preparation (clean, dry, and free from oils or gels).
Why: Poor contact or loose electrodes are the most common cause of artifacts.
Inspect ECG Cables
- Check for visible damage, kinks, or breaks in the cables.
- Ensure connectors are fully seated in the device.
- Swap with a known-good ECG cable if available.
Why: Damaged or loose cables can introduce intermittent or noisy signals.
Check Electrode Quality and Expiration
- Confirm electrodes are within their expiration date and compatible with LIFEPAK 20 / 20e.
- Replace old or dried-out electrodes.
Why: Electrodes lose conductivity over time, causing artifacts.
Verify Device Settings
- Confirm proper ECG lead configuration is selected (e.g., 3-lead vs. 5-lead).
- Ensure filters (if available) are correctly set for the patient and monitoring needs.
Why: Incorrect configuration can produce abnormal display or baseline wander.
Assess Environmental Interference
- Remove sources of electromagnetic interference (EMI) such as mobile phones, infusion pumps, or nearby electrical equipment.
- Check that the patient is not shivering or moving excessively.
Why: EMI or motion artifacts can distort the ECG waveform.
Perform Device Self-Test
- Run the built-in ECG test or device self-test function.
Why: Confirms whether the device circuitry and display are functioning correctly.
If the Problem Persists
Common external causes have been ruled out; the ECG module or internal circuitry may be faulty.
- Remove the device from service.
- Label as Out of Service.
- Send to the biomedical repair bench or authorized service center for evaluation.
Reminder: Knowing when to escalate is part of proper troubleshooting.
Clinical Use Tip
- Do not troubleshoot on an active patient if ECG signal is unreliable.
- Move patient monitoring to another device first to ensure patient safety.
- Only perform detailed troubleshooting when it does not compromise patient care.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
“ECG waveform is showing baseline wander and intermittent noise.”
Cause
What was observed during troubleshooting.
Example:
Electrodes were partially detached, and the ECG cable showed minor wear. Environmental EMI from nearby infusion pumps was also present.
Resolution
What action was taken.
Example:
Replaced electrodes, secured ECG cable connections, minimized nearby EMI. Device self-test passed after corrections.
Helpful Details to Include
- Outlet or power source checked
- ECG cable swapped and inspected
- Electrode placement and skin prep confirmed
- Device self-test results recorded
- Final waveform quality noted
Final Thought
Patient safety and accurate monitoring are paramount. Logical, stepwise troubleshooting prevents unnecessary internal repairs and ensures the device is safe for use. Proper documentation helps track recurring issues and supports cost-effective maintenance.
That is successful troubleshooting.