Answer: Septic Shock is an infection in the bloodstream, associated with fluid accumulation and hypotension.

Because of fluid accumulation and the fact that fluid is also conductive, sepsis can alter the normal path of the electrical current transmission used to measure the thoracic bioimpedance, which can affect the ability of ICG technology systems to detect pulsatile changes in the delta Z waveform. Sufficient data has not been acquired to quantify the effect of this condition on the validity of ICG technology data.

Answer: ICG technology cannot obtain impedance data during the electrocautery procedure. However, when electrocautery ceases, ICG technology software will recover and provide values.

Answer: ICG technology devices are not designed for use during exercise. Heavy respiration and/or motion, such as encountered during exercise, can not be filtered and will affect the impedance signal, thus causing invalid measurements of ICG parameters.

Answer: Atrial fibrillation is when the normal rhythmical contractions of the cardiac atria are replaced by rapid irregular twitching of the muscular wall, which causes the ventricles to respond irregularly to the dysrhythmic bombardment from the atria1 .

Answer: There are two common sources of possible interaction between ICG technology systems and pacemaker or implantable defibrillator systems, Pacemaker Programmer interference and Minute Ventilation Pacemaker interference. Most programmers include internal ECG recording capability, to allow a physician to assess implanted device function without the need for a separate ECG machine or monitor.

Answer: MV pacemakers work on a principle similar to ICG, with low amplitude (in the hundreds of micro-amps) constant current pulses sent out at a rate of 20-30 per second between the pacemaker can and the electrodes in the heart. The pacemaker reads the resultant voltage from a different electrode and determines both the rate and tidal volume of respiration. The pacemaker then uses that information to determine the pacing rate of the implanted device.

Answer: The standard equation for estimating body surface area is not appropriate for these individuals. Consequently, indexing these parameters may not be valid (over or under-estimation of indexed parameters). Therefore, ICG technology should only be used to get a baseline and for trending on these patients. Enter in patient's height before the amputation occurred.

Answer: LBBB is a condition in which the heart does not conduct electrical signals properly through the left branch of the Bundle of His. Depending on the ECG vector, LBBB is manifested in the ECG waveform by marked prolongation of the QRS complex (see Figure 1).

Answer: Internal Cardiac Defibrillators are specialized devices designed to directly treat a cardiac tachydysrhythmia. If a patient has a ventricular ICD and the device senses a ventricular rate that exceeds the programmed cut-off rate of the ICD, the device performs cardioversion/defibrillation. Alternatively, the device, if so programmed, may attempt to pace rapidly for a number of pulses, usually around 10, to attempt pace-termination of the ventricular tachycardia.

Answer: AEDs are external devices that can be used by minimally trained laypersons in emergency situations. They not only administer an electrical shock, but also read the heart rhythm patterns of the patient. This significantly reduces the amount of training needed for their effective use and allows people with minimal training to perform defibrillation in emergency situations with little risk of additional injury to the patient.

ICG technology looks at the relationship between the mechanical activity (the ICG waveform) and the electrical activity (the ECG waveform) in order to determine the stroke volume on a beat-by-beat basis. For an ICG beat to be determined valid, certain proprietary acceptance criteria are applied. A-fib is a condition that often causes irregular beat-to-beat electrical and mechanical activity.

AED (Automatic External Defibrillator, Automatic External Cardioverter). 2001. Available: http://www.heartcenteronline.com Answer: When the BioZ NIBP method is the source for determining BP, the Oscillometric method is used. This method measures the pressure pulse within the cuff in incremental steps and has a maximum value of approximately 1 mmHg, which occurs at the MAP. A sophisticated algorithm is then applied to plot the Oscillometric Envelope of pulse pressure measurements vs.

Answer: In most instances ventilators and chest tubes cause no interference with ICG technology. However, in situations where the inflation rate of the ventilator is excessive, it may cause excessive motion of the patient. Heavy respiration and/or motion can not be filtered and will affect the impedance signal, thus causing invalid measurements of ICG parameters.

Hyperdynamic Phase (Warm shock): Characterized by a normal to high cardiac output and systemic vasodilation (decreased SVR). Hypodynamic Phase (Cold Shock): Characterized by an inadequate or falling cardiac output, hypotension, and, in some cases, vasoconstriction.

Weinberger, B.M. Pacemaker and Automatic Internal Cardiac Defibrillator. (7/25/2001). Available: http://www.emedicine.com/emerg/topic805.htm

ICG technology looks at the morphology of the ECG waveform to detect the R wave. The R wave is used to calculate HR, and serves as a marker for identifying the systolic portion of the impedance waveform. Hence, if enough R waves are missed, no numerical data will be displayed.

Water conservation is very important for septic systems because continual saturation of the soil in the drain field can affect the quality of the soil and its ability to naturally remove toxins, bacteria, viruses, and other pollutants from the wastewater. Most households find that the greatest use of water is in the bathroom, and there are a lot of little things that can be done to conserve water there. Assess water usage in your house and look for ways to reduce wasted water.

Sit down, if you’re not already sitting or lying down! If the first shock doesn’t correct the problem you may receive another. You want to avoid further injury as you may fall onto something. Your doctor should have given you instructions on how to proceed. Generally, if you have received multiple shocks they will want to see you immediately. If you have a single shock and you feel fine, you should still give your EP office a call.

Doctors define shock as "circulatory collapse," when blood pressure dips too low to maintain an adequate supply of blood to the body's tissues. Symptoms include cold and sweaty skin, weak and rapid pulse, irregular breathing, dry mouth, dilated pupils, and reduced flow of urine.