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What This Guide Helps With
Troubleshoots pacing problems involving pad contact, cable recognition, ECG sensing, user settings, patient factors, or pacing-output verification.
Step-by-Step Troubleshooting
1. Protect the Patient and Maintain Pacing Capability
If transcutaneous pacing is clinically required and the DEFIGARD Touch 7 is not producing effective therapy, immediately provide another verified pacing-capable device or alternate treatment as directed by the clinical team.
Do not troubleshoot uncertain pacing output while the patient depends on the unit.
Expected outcome: Required pacing support continues using reliable equipment.
2. Distinguish No Capture From No Pacing Output
Clinical noncapture does not automatically indicate equipment failure.
Determine whether the device:
- Does not enter pacing mode.
- Does not recognize therapy pads.
- Shows pacing markers but no clinical capture.
- Produces no apparent pacing output.
- Fails output verification on test equipment.
Expected outcome: The symptom is separated into a device-output problem, accessory problem, or patient-capture concern.
3. Inspect Therapy Pads and Placement
For a patient-related report, clinical staff should verify pad condition and placement according to their approved clinical procedure.
For bench troubleshooting, inspect pads, adapters, and therapy cables for damage and secure connection.
Expected outcome: Approved therapy accessories are correctly connected and recognized.
4. Substitute Known-Good Therapy Accessories
Use approved known-good pads and therapy cables for bench evaluation.
Expected outcome: The device recognizes the replacement accessory and pacing behavior becomes stable if the original accessory was defective.
5. Verify ECG Signal Quality
Demand pacing depends on reliable ECG sensing.
Check for:
- Lead-off conditions.
- Excessive ECG artifact.
- Poor electrode contact.
- Unstable heart-rate detection.
Use an approved simulator during bench testing.
Expected outcome: The device receives a stable ECG signal suitable for pacing evaluation.
6. Verify User-Accessible Pacing Controls
Confirm that the appropriate pacing mode, rate, and output controls respond normally during an approved bench test.
Do not use service-level calibration adjustments unless authorized.
Expected outcome: Pacing controls respond predictably and the device generates pacing indications as expected.
7. Verify Output With an Approved Analyzer
Connect the defibrillator to an approved defibrillator/pacer analyzer using the manufacturer-appropriate test setup.
Measure pacing output according to approved manufacturer and facility procedures.
Expected outcome: Pacing output meets the applicable specified requirement. If output passes, the device fault is not reproduced and troubleshooting can stop after documenting the result.
8. Verify Demand/Fixed Pacing Behavior as Applicable
Using a simulator and analyzer, verify the pacing mode involved in the original complaint and any additional pacing functions required by the return-to-service procedure.
Expected outcome: Pacing output and sensing behavior are reliable and repeatable.
If the Problem Persists
Known-good therapy accessories, ECG sensing, normal controls, and analyzer testing have been completed. If pacing output remains absent, erratic, or outside the applicable manufacturer specification, an internal therapy-control or output fault may exist.
The device should be:
- Removed from service.
- Labeled Out of Service.
- Sent for repair or bench evaluation.
- Evaluated using appropriate manufacturer documentation and approved defibrillator/pacer test equipment.
- Repaired or calibrated only by qualified personnel.
Do not adjust internal pacing circuitry without authorized procedures. Complete required pacing, defibrillation, monitoring, alarm, and electrical-safety testing before return to service.
Knowing when to stop external troubleshooting is proper troubleshooting.
Clinical Use Tip
Clinical noncapture can occur even when pacing output is normal, so separate patient response from device output using approved test equipment.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
"Clinical staff reported that transcutaneous pacing from the DEFIGARD Touch 7 did not appear to produce capture."
Cause
What was observed during troubleshooting.
Example:
"Clinical Engineering verified normal pacing output on an approved analyzer and found that the equipment fault could not be reproduced with known-good therapy accessories."
Resolution
What action was taken.
Example:
"Completed pacing and ECG functional verification, documented normal device output, and returned the unit to service after successful testing."
Helpful Details to Include (If Known)
- Whether pacing mode was entered.
- Therapy accessory recognition.
- ECG quality.
- Pacing mode used.
- Rate and output settings observed.
- Known-good cable or pad result.
- Analyzer measurements.
- Whether the complaint was reproduced.
- Final device status.
Final Thought
Separate patient capture from electrical pacing output before diagnosing a device failure. Verify the complete therapy and ECG sensing paths with approved analyzers, and remove the defibrillator from service whenever pacing output cannot be confirmed.
That is successful troubleshooting.