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Product Overview Sudden Cardiac Arrest Heart Attack OR Cardiac Arrest? How many? Every Second Counts 80% occur outside medical setting Why HeartSine? HeartSine Technologies is a world leader in personal and public access defibrillation, with an impressive pedigree dating back over 40 years HeartSine Technologies are proud to be involved with corporate and other partners the world over such as: Backup Why samaritan PAD? Easy to use Fast shock delivery Compact & Lightweight IP56 Practical Pad-Pak™ CPR Advisor™ Product Demonstration Backup Electrocardiogram Visuals Normal Sinus Rhythm A healthy heart rate is spaced at regular intervals at 60–100 beats a minute Ventricular Tachycardia More rapid heart beating does not allow the ventricles to fill with blood, resulting in falling blood pressure. It can be treated successfully with defibrillation Ventricular Fibrillation A heart attack causes the muscle to “quiver” irregularly; this is the most common initial rhythm associated with cardiac arrest and may also be treated successfully with defibrillation Asystole No electrical rhythm in the heart, a condition that cannot be treated with defibrillation Early Defibrillation Used AC power from a line socket, stepped up • Technique was often ineffective • Studies showed damage to the cells of the heart • Large and hard to transport Early Defibrillation The next major advance was made by Bernard Lown • Studies involved hundreds of dogs • Waveform was more effective and safer • Became standard waveform SCOPE™ Overview Most modern defibrillators use a version of the biphasic waveform. • There is no standard biphasic waveform • Not all waveforms are the same and not all of them perform the same • Extensive experimental and clinical testing Patented Technology HeartSine developed a unique, patent pending, biphasic waveform, called SCOPE™ or Self Compensating Output Pulse Envelope. • This advanced technology energy delivery platform is available on our complete family of AED devices. • Developed through extensive experimental and clinical testing the SCOPE® system gives unrivalled performance and optimizes defibrillation success. SCOPE™ Small patient Low Impedance Large patient High Impedance SCOPE™ Small patient Low Impedance Large patient High Impedance SCOPE™ SCOPE Waveform • SCOPE (Self Compensating Output Pulse Envelope) is HeartSine’s proprietary biphasic waveform. • To account for different patient impedances, the biphasic wave shape is generally modified. • For any particular energy level there are three primary variables for the wave shape: voltage, tilt, and the duration of each phase. • Different manufacturers have adopted different strategies for biphasic waveforms and will adjust one or more of the main variables to compensate for patient impedance. D2 D1 SCOPE™ The HeartSine SCOPE waveform adjusts all four variables for all impedances in the operating range in conjunction with an escalating energy protocol to optimize the efficacy of the samaritan PAD. The HeartSine SCOPE waveform is a low energy waveform, reducing the likelihood of myocardial dysfunction. Waveform D1 D2 Voltage Tilt HeartSine SCOPE Variable Variable Variable Variable Philips SMART Variable Variable Fixed Variable CSC STAR Variable Fixed Variable Variable Zoll Fixed Fixed Variable n/a Physio-Control Variable Variable Limited Variable SCOPE™ Operating impedance range Waveform Min Imp Max Imp HeartSine SCOPE 25 230 Philips SMART 25 180 CSC STAR 25 180 Zoll* 25 175 Physio-Control 25 200 * Delivered energy reduces rapidly after 175 ohms Biphasic versus Monophasic Or … 360 Joules? Really? Schneider, et al published a study in 2000 showing that an appropriately dosed low-energy impedance-compensating Biphasic-waveform strategy results in superior defibrillation performance in comparison with escalating, high-energy monophasic shocks in out-of hospital cardiac arrest. Moreover, the 150-J biphasic-waveform AED results in a higher rate of ROSC and better neurological status at the time of hospital discharge. Mittal S, et al published a comparative study in 1999 demonstrating that 120-J rectilinear biphasic shocks have a greater efficacy than 200-J damped sine wave monophasic shocks for transthoracic ventricular defibrillation, particularly in patients with a high transthoracic impedance. In addition, ventricular defibrillation was achieved with less delivered current. O’Cummins R.O. et al published a statement for healthcare professionals from the American Heart Association Committee on Emergency Cardiovascular Care and the subcommittees on basic life support advanced cardiac life support, and paediatric resuscitation on Low-Energy biphasic waveform defibrillation in 1998. Electrodes Electrode Technology • Electrodes are the primary point of contact between the patient and the defibrillator o Electrode technology uses patented construction method to provide 4 years shelf life without significant increase in cost. o Superior electrical performance Rapid recovery time Very low noise • Electrodes are large and have very low impedance. Pad size and low impedance are critical to success of defibrillation1,2,3 • Electrode technology enables ICG based CPR advisor Electrode Design Rivet Conductive gel Foil conductor (Tin or tin alloy) Conventional Electrode Adhesive foam Corrosion (aging) occurs at tin/hydrogel junction Lead wire Rivet Conductive gel Printed conductor (Silver) HeartSine Electrode Adhesive foam Lead wire Protective layer forms at silver/hydrogel junction substrate samaritan PAD 350P Features • Compact and lightweight. Class leader • Simple to use, 2 button operation. Published study • Exclusive one-change, low maintenance Pad-Pak. Unique to HST • SCOPE technology – Field proven, state-of-the-art, treatment therapy. Unique to HST • Industry leading 10 year warranty. Unique to HST • IP56 – Highest in the industry. Unique to HST • Field upgradeable • Lowest total cost of ownership - Initial purchase and 10 year maintenance fees • Rescue ready - Preconected battery/pads and no lid to open • Visual & verbal prompts • Adult & pediatric care • Free carry case with every unit samaritan PAD 350P “Call for Medical Assistance” “Remove Clothing from Patient’s Chest to Expose Bare Skin” “Pull ‘Green Tab’ to Remove Pads” “Peel Pads from Liner” “Apply Pads to Patient’s Bare Chest as Shown in Picture” “Press Pads Firmly to Patient’s Bare Skin” “Assessing Heart Rhythm – Do Not Touch the Patient” samaritan PAD 350P If a shock is not required… If a shock is required… “Stand Clear of Patient – Shock not Advised” “Stand Clear of Patient – No shock advised” “Stand Clear of Patient – Shock Advised” “Stand Clear of Patient – Press the Orange Shock Button Now” “Begin CPR” “Shock Delivered “It Is Safe to Touch the Patient” “Place overlapping hands on centre of chest” “Press down in time with the metronome” “Remain calm” “Begin CPR” “It Is Safe to Touch the Patient” “Place overlapping hands on centre of chest” “Press down in time with the metronome” “Remain calm” samaritan PAD 360P Features • Compact and lightweight. Class leader • Simple to use, 1 button operation. Published study • Exclusive one-change, low maintenance Pad-Pak. Unique to HST • SCOPE technology – Field proven, state-of-the-art, treatment therapy. Unique to HST • Industry leading 10 year warranty. Unique to HST • IP56 – Highest in the industry. Unique to HST • Field upgradeable • Lowest total cost of ownership - Initial purchase and 10 year maintenance fees • Rescue ready - Preconected battery/pads and no lid to open • Visual & verbal prompts • Adult & pediatric care • Free carry case with every unit samaritan PAD 500P Features • CPR Advisor. Unique to HST • Compact and lightweight. Class leader • Simple to use, 2 button operation. Published study • Exclusive one-change, low maintenance Pad-Pak. Unique to HST • SCOPE technology – Field proven, state-of-the-art, treatment therapy. Unique to HST • Industry leading 10 year warranty. Unique to HST • IP56 – Highest in the industry. Unique to HST • Field upgradeable • Lowest total cost of ownership - Initial purchase and 10 year maintenance fees • Rescue ready - Preconected battery/pads and no lid to open • Visual & verbal prompts • Adult & pediatric care • Free carry case with every unit CPR Advisor™ NOT JUST A SHOCK BOX! Why is a ‘CPR Advisor’ function important? “The quality of unprompted CPR in both in-hospital and out-of–hospital cardiac arrest events is often poor, and methods should be developed to improve the quality of CPR delivered to victims of cardiac arrest.“ 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Part 5: Adult Basic Life Support “In order to maintain high-quality CPR, feedback to rescuers is important. The use of prompt/feedback devices during CPR will enable immediate feedback to rescuers, and the data stored in rescue equipment can be used to monitor the quality of CPR performance and provide feedback to professional rescuers during debriefing sessions.” European Resuscitation Council Guidelines for Resuscitation 2010. Section 2. Adult basic life support and use of automated external defibrillators CPR Advisor With two standard defibrillation electrodes, HeartSine Technologies’ patented impedance cardiography (ICG) analysis technology is able to provide feedback on the quality and rate of compressions during CPR. CPR Advisor™ CPR Advisor “Begin CPR” Uses ICG analysis technology to provide feedback on the effectiveness of CPR using measurements of impedance changes in the thorax. Other devices offering CPR support simply measure the depth of compressions on an electronic device placed on the chest. "Push Harder”, “Push Faster”, “Good Compressions" “Push Faster/Push Slower” Clear and direct feedback on CPR For technical data on the SAM 500P please refer to the manual (CPR Advisor is deactivated when a paediatric Pad-Pak is inserted) “Good Compressions” Competitive Sheets Other Controls Data Port for downloading patient data PC Current status & self-test indicator. If flashing red, battery is low and needs replacement. A blinking green light indicates all systems operational and self test passed Saver EVO® Data Management • Saver EVO ® is an optional data management software designed to store & display event data for later analysis • Software is available and downloadable at no-charge from the official HeartSine website • Saved records include: 90 minutes of… o Time, date, ECG waveform, logged events, timing and shocks delivered (with output level), pads on/off and CPR interval • Saver EVO also provides Erase feature, Time synchronization, Diagnostics testing , Volume control, Language changes and CPR metronome On/Off capability • Data is downloadable from the cable directly into your PC Saver EVO Data Management HeartSine samaritan PAD Trainer • Includes System, Charger, & Trainer pads • Operator selectable scenarios – All scenarios current with 2010 AHA guidelines • Remote control for all functions including a pause button to explain procedures while interrupting the automatic prompts • Provides 7 hours of use on each battery charge • Trainer pads can be disconnected and replaced for subsequent training sessions. HeartSine samaritan PAD Trainer • Scenario One – No Pads attached. – Shock advised. – Two minutes CPR. – No Shock advised. – Two minutes CPR. Scenario Three Check Pads. Shock advised. Two minutes CPR. No Shock advised. Two minutes CPR. • Scenario Two – No Pads attached. – No Shock advised. – Two minutes CPR. – Shock advised. – Two minutes CPR. Scenario Four Shock Advised. Two minute CPR pause. Shock Advised. Two minute CPR pause. No shock advised. Scenario 5 & 6 – Same as one & two but with indicator for rescue breaths Endorsement by Scouting Ireland HeartSine Mobile Rescue Kit HeartSine Accessories SCOPE® Biphasic Backup