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Newborn HAL

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1. Lab Template E Template Description New Template CBC DIFF Platelets Differential E selected Rem S 1 Metabolic Panel Anion Gap Albumin Alkaline Phos Calcium Choride Neonate Blood test For newborn and premie T o Deee E Newborn HAL User Guide 49 To begin click on Create a New Lab Report from the right panel Details Palette Lab Scenario Speech Log Gaumard Lab Reports z Name Template Description Sent dear Save Cancel Lab Template CBC DIFF is Color Healthy Critical O CE Other Report Name Report Time l p Description CBC Both 4 B Variable NormalRange Value Comment Abs Lymph 0 60 3 10 Abs Netus 1 10 8 00 Basophils 0 00 1 00 Eosinophils 0 00 7 00 Lymphocytes 17 00 45 00 MCH pg 26 00 35 00 MCHC q dL 32 00 36 00 Pepper ee ie Ui l First select a Lab Template from the drop down menu Edit Lab Report Lab Template Lipid Panel CBC DIFF Description Metabolic Panel Neonate Blood test OB Blood test PPT Report Name Prothrombin Time in Provide a Report Name Report Time and Description In addition select a condition color tag for the lab report on the right panel Color tags aid the sorting of lab reports on the report list window A ll e
2. 2 Provider Tasks and performance Physician Provider introduces themselves to the patient How would you rate teamwork during this delivery emergency 5 Communication Perfect N A Overall Communication Rating Orient new members SBAR Transparent thinking Directed communication Closed loop communication 6 Situational Awareness Good Perfect N A Overall Situational Awareness Rating Newborn HAL User Guide 77 After the evaluation template design is complete click Save at the top of the window Evaluation Form Load template Iv Save Gear Delete Evaluation Name Vacuum Delivery On Site Reviewer Category Multiple Choice Entry 6 Finally select the new template from the Load template drop down to use the completed evaluation form Evaluation Form Load template save Gear Delete Breech Vaginal Delivery Evaluation Nan 2 Seizure Forceps Delivery On Site Reviey Postpartum Hemorrhage Shoulder Dystocia Category Umbilical Cord Prolapse Multiple Choice Entry 6 Vacuum Delivery 78 User Guide Newborn HAL Menus Setup Monitors Profile New Session Reset Session Clock Save Report Print Report Import Export Exit This option allows you to change your current profile Clicking New Session in the file menu will e Clear any loaded playing scenario e Clear any load
3. On the virtual monitor window an exclamation icon notifies the provider a file is ready for access Click the SUSIE drop down menu to select the available lab report Once the report is sent the letter Y will be present on the Sent column Use the Stop Sharing button on the right panel to remove any items on the virtual monitors file list Lab Reports SHEEN Temptate Description Sent Create New Lab Report Healthy 2 OB Blood test Healthy Levels Y TER Healthy Neonate Blood test Healthy Levels iiini James Metabolic Panel Session 1 Y a Selected Item Lab 02 CBC DIFF High levels Edit Lab 03 Neonate Blood test High levels Y Delete Lab 04 CBC DIFF Simulation 1 TTY An editable copy of the lab report is also copied onto the Gaumard_UI folder on the laptop s home screen For information on how to access other files from the Gaumard Monitor screen go to page 91 52 User Guide Newborn HAL Drugs Automatic Mode Only The drug tab is available only in automatic operating mode It is used by facilitators to simulate the physiological effects and reactions of medications administered to the patient model The physiologic model processes the drug s properties dosage administration time and interactions then adjusts the patient model vital signs accordingly While operating in the automatic mode select the Meds Profile to load the library of preprogrammed drugs The bu
4. Newborn HAL User Guide 25 To navigate between the vital sign parameter categories click the vertical tabs The tabs divide controls related to airway breathing and circulation among others ma Reset with feta Circula ECG Rhythm Heart Ra Absent P Brach C Brach The HOLD and Auto buttons are unique to the automatic mode Similar to manual mode click an apply button to submit changes Some changes are gradual and even the NOW apply button is pressed The delay results from using a closed loop model that adjusts other related values over time rather than displaying a unique value that is unrelated to other parameters HOLD Allows you to keep a current value constant Recall that in the manual mode to keep a value constant simply leave the control blank Click on the H to change the option from Auto to HOLD Respiration Pattern Resp Rate Hold Inspiration Auto Prio Volume Auto Auto Allow the model to auto adjust the value Click the input field blank to return to the default auto state Respiration Pattern inspiration Auto Efra Volume Auto Manual Input the value of the parameter manually The model automatically adjusts related physiological values Respiration Pattern Eres Rate 17 ib inspiration Auto fria Volume Auto 26 User Guide Newborn HAL The A B vertical details tab includes the airwa
5. AREER Newborn HAL Simulators for Health Care Education Alice s Baby Healthy baby Apply suction and O2 Wait Indefinitely for actions Newborn HAL User Guide 109 G SIT aumar d weaimn Care Eaucation Newborn HAL Asphyxia Baby has an asphyxia attack and the providers need to give ventilations to help bring back the vitals to a healthy state 110 User Guide Newborn HAL Apply suction and O2 Wait indefinitely for actions Ventilate and perform chest compressions Wait indefinitely for actions Newborn HAL Siomulaioes Sor Weal Care ducation Beth s Donna s Baby Baby is born with a mild asphyxia that needs attention Once ventilations are started the baby s vitals go to a healthy state Begin PPV Wait Indefinitely for action Newborn HAL User Guide 111 i Newborn HAL Gaumard simulators for Health Care Education Cynthia s Baby Male infant with central cyanosis limp flaccid and requires immediate resuscitation No spontaneous movement of right arm is noted Stat CXR reveals a fractured right clavicle and right pneumothorax Perform ventilations and needle decompression Wait Indefinitely for actions Perform fluid resuscitation Wait Indefinitely for acti
6. Neck is hyper flexed Return the head to a normal position Recalibrate the Head Position sensor All others See Calibration Wizard section inside User s Manual Artificial ventilations Is the communication indi See solution above in section making are not properly cator panel consistently reference to blinking communication detected or not yellow indicator is consistently yellow detected at all All others See Calibration Wizard section inside User s Manual Simulator s chest Simulator not running In some simulators the trachea is does not rise with disconnected from the lungs when they are artificial ventilation not on e g BVM Disable lung s Enable the lungs from Detail page on the GaumardUI software Low chest rise or no Wrong settings or disabled Make sure lungs are enabled and both chest rise at all respiration rate and inspiration percent are while breathing different than 0 Try changing the respiration rate to a different value and if still nothing happens try turning the restart the simulator Loss of brachial Brachial pulses disabled Make sure to enable brachial pulse on pulse Details tab page Pre built scenarios Select Quick Start Scenarios when don t show up Starting the software Should user forget to do so there s no need to shut down the software and open it again in order to load the pre built scenarios Go to File Profile menu
7. Edit Lab Report Lab Template Lipid Panel g a Cholesterol HDL LDL Triglycerides Description Critical Other Report Time 11 15am 7 Report Name Lab 0i f Description Above normal range Cholesterol LDL Cholesterol 50 User Guide Newborn HAL Input the results of the tests on the Value column Values above the normal range specified will be displayed in bold Include any comments associated with the test performed Finally click Save from the top right menu to create the lab report Description Above normal range Cholesterol LDL Cholesterol Lipid Panel Female Variable Normal Range Value Comment HDL Cholesterol mg dL 35 00 85 00 85 Cholesterold HDL Ratio 0 00 4 40 5 1 Care required Lipid Panel Male Variable Normal Range Value Comment HDL Cholesterol mg dL 29 00 71 00 Cholesterol HDL Ratio Ratio 0 00 4 90 I Lipid Panel Both variable Normal Range value Comment Cholesterol mg dL 0 00 199 00 190 00 I LDL Cholesterol mg dL 0 00 129 00 135 I Triglycerides mg dL 30 00 200 00 100 I The newly created lab report is now listed in the Lab Reports section Sort lab reports by name template description or color tag Details Palette Lab Scenario Speech Log Lab Reports On the right panel click Preview to view
8. Tongue Edema The CPR evaluator feature provides real time feedback on the provider s compression and ventilation performance f Gaumard Scientific CPR Evaluator 0 10 30 Compression Data 26 Ventilation Data Rate ct LE Rate PIP Ti 0 0 2 00 00 0 133 2 4 I E PEEP LV 1 0 6 gt 14 12 Too Many Compressions 242 Too Many Ventilations 9 L 9 OK 129 H 104 L 0 OK 0 H 9 94 User Guide Newborn HAL The provider performance indicator boxes are located on the right The V ventilation and C compression box fill color changes between the following states e Grey No intervention was detected e Yellow Compression was too shallow Ventilation was too weak e Green Compression ventilation was performed correctly e Red Compression was too deep Ventilation was too strong Compression and ventilation data is displayed at the bottom of the window as CPR is performed by the provider 0 10 20 30 40 Compression Data 306 Ventilation Data Rate Ct LC Rate PIP Ti 96 0 3 00 00 0 0 0 5 I E PEEP LV 0 08 57 Too Many Compressions 42 Too Many Ventilations 8 ECI OK 112 Hs 28 L 0 OK 0 H 8 Compression Data e Rate Rate of compressions in real time e Ct Compression time Average length of each compression in seconds e LC Last Compression Time elapsed sin
9. im Gaurmard User Interface 4 manikins profiles C Default Profile Quick Stark Scenarios C resources In the GUI program folder is the profiles sub folder e g C Program Files Gaumard Scientific Gaumard User Interface profiles All user information is saved there and it is the only folder that should be modified manually In the example shown notice that there are 2 profiles in this installation Default Profile and Quick Start Scenarios Saved as plt files palette items in each profile are located at the top level of each profile folder To copy palette items from one profile to another copy the plt file found in the source profile folder Newborn HAL User Guide 121 Scenarios are stored as sub folders within profile directories Scenarios can also be transferred between profiles by copying the scenario folder and its contents Modify files in the resources directory or those at the top level of the Gaumard User Interface directory Manipulate files or folders while the GaumardUI software is running Modify or delete dll scn or sys files 122 User Guide Newborn HAL Troubleshooting Use the following table to find causes and solutions to a number of possible problems Communication Battery is discharged Turn off the software and plug charger never gets adapter to the simulator The charger s LED established or is lost
10. menu and select Remote access Via Network Please wait 30 seconds for the feature to initialize 11 Enter the Controller IP and port number as shown on step 7 and click Connect The Non Scenario Automatic Response feature allows the facilitator to _ set preprogrammed responses to electrical therapy events When the electrical therapy IS detected auto responses can automatically load a specific palette item or prompt the facilitator before making preprogrammed changes to the simulator s vital signs Non scenario response settings only detect electrical therapy administered when a scenario is not in progress For information on how to configure auto responses for scenarios go to page 37 To activate the virtual shock panel go to page 85 Warning Do not defibrillate or pace Newborn HAL Preemie with real medical equipment Doing so will result in damage to the simulators internal components Dsplay warning when non shockable Al Auto cardac rhythm is shocked External Pacing Defibrillation Shock Cardioversion Shock Non Syne Shock Prom z i Prom Promot Prom Prompt N ompt He Promp aR ompt lt x Auto i Js i Auto Ta Auto 33 Auto ofa Setting Setting Setting Joules 100 gt Joules 100 x Shocks Shocks Shocks jap convert to NSR g convert to NSR j degrade to 75 bpm BP 75 bpm BP ventricular 120 80 120 80 fibrifiaton me OK bane I The behavior
11. 53010 Gaumard Simulators for Health Care Education Newborn HAL is an interactive educational system developed to assist a certified instructor It is not a substitute for a comprehensive understanding of the subject matter and not intended for clinical decision making Newborn HAL User Guide B12 5 1 Gaumard Scientific Company 2012 All Rights Reserved www Gaumard com 2 User Guide Newborn HAL Contents TM NS aor eae rn eee ec ene era ede E 3 End User License Agreement ccscsccsseceeseeeseeeesesenseneneeenseeensenesesenseeeaseneaes 4 Gal and Caution iscscssccssscosvasccecsccacssesvascocsarccussenteasescarcosssessesvetesracsssesucesutersress 6 Overall VV AUIS lh os eases eas a a ee a scene acta R E veience r EICCUICAN MCKAY cessen a aa a e N a EN 7 G tting Started s aedini nedin e iaa haaha e ha a 8 OY COW noce e a E A A TO 9 TEMNO O V cesna a e ee tert er meen a e a S 10 als UT ela t gies UDa 11 Conte Tablet COMPU zaan tetas tea ois Renae A 12 NEWDOrN FAL BAWO Geen ee erence re roe r re err SOT eee 12 i GL gi 8 FUN Vo a de aan a a r E E r O ee Pe re eT 14 WOrking WIth GaUmMaraU siioni a aa aiaia aaa 15 MUINO NEWDOT FAL siririn ie S 16 Protil s and Operating Mod ES isnie aiaa aaeei 16 lah 10 a1 a 8 21 g osina N a a Raia 18 BUNS ec aca cenit pest eile rede he E EO ere ta asset ceed aie ua sate adic Dale aerate acronis ented 22 Fd UG cree easter A EIEE EAE Dall caste warmed OA E A
12. 9 Terminology lt is wise to spend a moment familiarizing yourself with some of the terminology that will be used to discuss simulation with the Newborn HAL system Automatic Mode In this mode vital signs respond automatically to caregiver participation instructor specifications and pharmacologic intervention The model used in this operating mode was developed based on physiologic principles Features unique to this mode include a comprehensive list of drugs for easy administration a drug profile editor for adding new drugs or editing existing ones among other things Facilitator the person conducting the simulation an instructor or lab staff member GUI the Gaumard User Interface is the software application used to control the simulator and evaluate care providers Palette a collection of Palette Items Each profile has its own palette Palette Item Any full or partial set of physiological parameters that have been grouped and saved together under a single name Profile a unique Newborn HAL software configuration including custom Palette Scenarios and options Each Profile acts as a separate program in that changes made to one profile have no effect on the others Provider a person participating in the simulation as a healthcare provider Scenario a saved sequence of physiological states like a playlist Scenarios provide a level of automation that unburdens the facilitator and al
13. Click CANCEL to stop checking every minute the Cardiac Rhythm Click Yes to degrade the cardiac rhythm to ventricular fibrillation Click No to maintain the cardiac rhythm and recheck after 1 more minute Click Cancel to stop the software from checking the cardiac rhythm every minute To use virtual electrical therapy click the shock panel shortcut near the top of the screen If the Shock Panel shortcut is not displayed click Setup gt Options gt General and check mark Show defibrillation cardioversion pacer panel on the menu bar Shock Panel ah 34 Shock Pace Panel aannamen S Virtual Pace 2 3 5 7 10 20 30 50 E The Details page is also used to create Palette Items A Palette Item is any full or partial set of physiological parameters that have been grouped and saved together under a single name A collection of these palette items applied in succession are referred to as a Scenario For more information about scenario building navigate to page 31 To create a Palette Item choose the desired parameters on the Details page and click the Save as Palette Item button near the top of the page You will be prompted to name the palette specify a description and color code Click Save to create the new palette Item Navigate to the Palette tab to view a collection of all the palette items in the current profile Save as Palette Item Palette Item Name Palette Item Description
14. Use this feature as a troubleshooting tool to verify the status of the simulator s features For more information on using the diagnostics screen for troubleshooting go to page 126 Ado Thoat voc V 5 M 5 R 0 Heart V 5 M 5 R 0 Lung Front Upper Right Vol NA carotid Lung Front Upper Left V 1 M 5 R 0 Radial Right Radial Lot K Right v 5 M 5 R 0 KK Left v 5 M 5 R10 Bowe upoe Right Vol NA Newborn HAL User Guide 97 Working with Newborn HAL 98 User Guide Newborn HAL Disclaimer The section below describes all possible features in the Newborn HAL simulator Please use the table below to identify which features are standard and which ones are optional before you complete reading Section Error Reference source not found The content of this table are subject to change without prior notice Please ontact Gaumard Scientific for the most current information Legend Y Yes N No O Optional Category Simulator Feature Nasal Intubation Airway Oral Intubation Breathing Airway Sounds Independent Chest Rise Breathing Lung Sounds Heart Sounds Cardiac ECG generated in real time Bilateral IV Bilateral virtual BP Circulation Pulses Cyanosis Disable Pulses Bowel Sounds Male Female Catheterization Systemic Head Position Sensor Seizures Intraosseous access Physiologic Model Instructor control data change Other ETC Pro Gaumard Virtu
15. palette if a virtual defibrillation shock of 200 Joules or greater is detected AUTOMATIC MODE NON SCENARIO AUTOMATIC RESPONSES The additional auto responses listed below are unique to the automatic mode Link All Auto Response to Cardiac Irritability Auto responses will work only if the cardiac irritability option on the details page matches the selection on this window Non scenario automaticresponses settings alloff Link All Auto Response to Cardiac Irritability Modeling E A O off great random On if Cardiac Irritability is multichoice is enabled External Pacing Defibrillation Shock Prompt Prompt ee Auto 2 Auto SS Auto The following message is displayed if electrical therapy is detected and the cardiac irritability on the details page does not match the selection on the responses window NX Defibrillation shock detected Shock 3 300 Joules But current cardiac irritability does NOT allow rhythm to change Drug Model Effect Configure the auto response behavior when the administration of a medication is detected e Auto Apply the drug effects based on medication s programmed properties and dosage e Prompt Display a confirm prompt before applying the drug s effects Proceed Drug 2 0ug of Naloxone Narcan through IV_Push has just been Administered This dose will be treated as StandardDose Do you want this drug to take the foll
16. ts Evaluations Organize A Open v Share with Print E mail Burn New fold we Favorites Documents library Evaluations Libraries See zal Eclamptic Seizure Session 3 xps Ctrl O Ctri Ctrl P Properties Alt Enter Exit Alt F4 ptic Seizu On Site Reviewer James C Date 08 08 2011 74 User Guide Newborn HAL Select the printer device from the list box and click print Select Printer Add Printer mh Canon IR C4080 C4580 PCL5c 4 1 Status Ready E Print to file Location Comment Page Range All Selection Current Page Pages 1 3 Enter either a single page number or a single pe 2 2 3 3 page range For example 5 12 It is recommended that documents are first saved as XPS files before being printed into hard copies Each evaluation is based on an evaluation template Facilitators can create new evaluation templates to tailor specific assessment needs Template design and creation is done in the evaluation form edit mode To enter the edit mode toggle the Go To button located on the top right of the evaluation form window In edit mode enter the name of the evaluation template in the Evaluation Name field Evaluation Form Load template w Save Clear Delete Evaluation Name Vacuum Deliveryl On Site Reviewer From the Category menu click Add Load template Evaluation Name Vacuum Delivery On Site Revi
17. 305 971 3790 Fax 305 667 6085 Before contacting Tech Support you must 1 Have the simulator s Serial Number located in the left leg under the IM site 2 Access to the simulator and the control computer if troubleshooting is needed Post Gaumard Scientific 14700 SW 136 Street Miami FL 33196 5691 USA Office hours Monday Friday 8 30am 4 30pm EST GMT 4 Summer Time Gaumard and HAL are trademarks of Gaumard Scientific Company Inc Fe CE Newborn HAL User Guide 129 Gaumard Scientific Company 2012 All rights reserved All rights reserved
18. An additional advantage is it can be easily calibrated for your personal comfort The calibration utility found in the control panel will present the user with crosshair targets at each of the four corners of the screen Position yourself and the tablet as if you are working and carefully touch the exact center of each of the targets After calibration the pointer should be displayed directly beneath the stylus tip Significant changes to viewing angle should be followed by calibration for best performance 12 User Guide Newborn HAL Communications Module Connect the RF communication module to an available USB port on the tablet s PRO left side Secure the RF communication module to the tablet or PRO computer using the Velcro patch The tablet is now ready to communicate with simulator For information about the signal strength indicator go to page 20 WARNING Never disconnect the communications module while the Newborn HAL software is running Doing so can seriously damage the module Newborn HAL Battery Newborn HAL S N B1010788 or higher includes two separate power adapters labeled Newborn HAL Charger and Newborn HAL Power Supply Before using the simulator for the first time reference the use for each adapter below To charge the battery connect the adapter labeled Newborn HAL Charger to the battery port and charge Newborn HAL for 2 3 hours or until the charger dis
19. Breathing Resp Pattern normal Rate 15 bom Inf o Active Feature Volume Control OSat Preductal 73 OSat Postductal 73 EtCO2 36 mmHg Circulation on Cardiac Rhythm Value Undergoing Change Sinus Arrhythmia Inactive Heart Sound Feature Newborn HAL User Guide 19 The communication indicator shows the status of the radio link between the control computer and the simulator Full bars indicate excellent communication between the computer and the simulator i e normal operation The indicator is clear when no attempts to communicate with the simulator are being made for example when the module is not connected to the computer or the system is in STAND BY mode Status AGL W of ccc cca ol The warning icon indicates a signal conflict with another simulator Click the exclamation icon for more information To configure individual communication channels for each simulator manually go to 84 RF Communication ge There is currently another Gaumard Simulator on the same channel For optimal communication performance switch to another channel Note Use Setup gt Scan RF Channels for a recommended channel The battery status indicator progresses as the battery in the simulator is used Newborn HAL has a maximum battery runtime of approximately 3 hrs Total runtime is dependent on factors such as breathing sounds seizures and muscle tone bbl A je The exclamation mark indicator is s
20. computer and simulator is reaching its limit Get simulator closer to computer or move away from obstructions or there are too many ob structions between walls etc There s too much RF inter ference either from another Gaumard tetherless simulator in the vicinity or an RF radiator Try changing the RF channel by going to the menu for Setup gt Options gt Environment Select Auto change to channel number from 1 11 The battery on the simulator is depleted Turn off the software and plug charger adapter to the simulator The chargers LED will turn green when the simulator is completely charged Do not turn on the GaumardUl software until the charging process is complete The adapter labeled Power Supply does not recharge the battery RF module not connected Connect the RF module to any USB port Close the software and disconnect the RF module for at least five seconds then plug it back in and restart the software RF module not identified by the computer Is the communication indi cator panel consistently yellow See solution above in section making reference to blinking communication indicator is consistently yellow Is the respiratory rate set to 0 min Chest com pressions are only detected when the respiratory rate is set to 0 per minute 0 min Otherwise they are ignored Set respiration rate to zero 124 User Guide Newborn HAL
21. indicated by the product s documentation WIRELESS AD HOC CONNECTIVITY The tablet and virtual monitor computer automatically establish an ad hoc computer to computer wireless connection at startup The wireless connection between both systems allows GaumardUI to update the vital signs information displayed on the Gaumard Monitors program To verify the connection between the computers click on the wireless icon located on the task tray of both the tablet and virtual monitor For troubleshooting information on the ad hoc connectivity navigate to page 123 Currently connected to See Unidentified network No Internet access Wireless Network Connection 2 A Connected A GaumardNet gaumard os Other Network ail Open Network and Sharing Center eto G yl 2 54PM 14 User Guide Newborn HAL Gaumard Monitors After the ad hoc connection is established double click or tap the Gaumard Virtual Monitors icon located on the virtual monitor s home screen The Gaumard Virtual Monitor software is now ready to receive vital sign information To learn more about the Gaumard Monitors features and functionality click then V menu and select Help to open a digital copy of the Gaumard Virtual Monitor User Guide Working with GaumarduI Newborn HAL User Guide 15 Initializing Newborn HAL After reading the Care and Cautions and Equipment Set Up section of the guide double click the Gau
22. the vital signs for the target state the transition time will handle trending the values lt is recommended that the first vital signs palette includes instructions for all of the physiological parameters sound types and volumes By specifying each parameter at the beginning of the scenario you will ensure that no vital signs are inherited from a previous exercise Enter the vital signs for the first physiological state in the scenario and click the Save as Palette Item button Shock Panel Pme PTEE Sg a y a J inch Details Palette Scenario Lab Speech D Tongue Edema Pharyngeal Swelling Laryngospasm Upper Airway Sound Resp Pattern Apnea x Left Lung Right Lung i heer KISA TES Newborn HAL User Guide 33 The Save as Palette Item dialog box is displayed Type in the palette item name and a brief description assign a color tag and click Save q Palette Item Name Initial state Palette Item Description f Patient s initial state Color Healthy Care Required After the first palette is saved create the next palette item by saving only those vital sign parameters that simulate the second stage in the patient s condition Repeat this process to create palettes for the third and final stage in the scenario If you are creating scenarios for the automatic operating mode recall that the physiologic model s calculations are base
23. A E AAAA S a eartites Nal sated AA O 30 EESE AE S eee none es Oa Pe Nene ee an EN ee eR aT Pe RR 31 PAN iu eat ett Sa reams de ace eect rie cattle cadet oe ac Na sasha ata AAE E EA amen O 47 Drugs Automatic Mode Only sacs cei ue ectide evan deb sneiou ee fo oeetiaetdak eadboeelade ace ee 53 Modeloa nite aoe mens eer eRe Pater cre ea eae romero e a oe tee eee on ara te ere eae neem rere eee eee 67 LANG ase sha crpace eaten ah eae a a E qa ea iaiadn E aah otaaatmnaniaes 68 EVON E ON aa oa ceactesei ese a a aa sacemeosan cbs aeeasoe a eemeen aes 72 OVS ME E EAS TE TEE AO A A AN O AT ANAE ae 79 Working with Newborn HAL ccccssecseseseeseeeseeeeseeeneseeseeeaseeesesenseneaseoeeenons 98 RIWAN aa sw tn tes N cana Renee E OE 100 EPS AU MN Geanina A aos unahoansnertne whuctastent glut sae 100 521 0 eee er ee ee CR Or ee eR nee come ete ere ele eR tee ee ree ee eee ee ner me cr ae eee 101 GOA ON sss g acetone A A O E I 101 Cepa een eee errata a Pe ee Ree en a S 103 2 CS Coe ere E a ee eee 103 TA ai hea hike tha ek el ah a hed oe 104 Jae o aLe lD APEE T E E E T E E E 106 M re about Scenaro enn aa aaa aa aAA AEEA RAKA ENEAK ENAERE 107 AR fo 8 1 t o1 e109 6 a a a te net ares rte sen te at A a ARENE nee ee 123 Consumables Replacements and Optional Parts cccccccsseeeeeeeeeeeeeeeesaeeeeeeeeaaeess 127 MI AA UNAM setae gee cence cain tage Sct el es lee tae teste aerate E 128 0 91216 a a ee enema cet at rere eee
24. Do not expose the tablet computer to water or excessive dust unless it is protected by a rugged case available separately Mouth to mouth resuscitation without a barrier device is not recommended as it will contaminate the airway Treat Newborn HAL with the same precautions that would be used with a real patient The use of needles larger than 22 gauge will reduce the lifetime of the lower arms skin and veins When the arm veins require replacement contact Gaumard to arrange for a lower arm exchange Refer to the Consumables and Replacement Parts section of this guide and contact customer service for more information Do not inject fluids into the intramuscular sites Intramuscular sites are for placement exercises only Do not remove or replace the umbilical cord while Newborn HAL is in operation Doing so will cause damage to the system Do not pull or carry the simulator by the limbs Handle Newborn HAL with the same care as a human patient Electrical Therapy One of Newborn HAL s most exciting features is the accommodation of real monitoring and electrical therapy devices In most cases no special instruction is necessary to use such devices Newborn HAL s conductive skin sites allow the attachment of real EKG electrodes This feature permits the user to track cardiac rhythms with their own equipment just like with a human patient A few special concerns are described below Newborn HAL does not accept r
25. It is best to think of controlling the simulator in terms of three levels of complexity Details then the Palette and finally Scenarios From the details tab facilitators can manually control the simulator s vitals enable disable features or complications and create palette items later used to build labor scenarios Changing controls directly from the details page is the simplest form of control available to the facilitator Details Palette Lab Scenario Model Log Legend Glear Settings LoadPaletteItem Save as Palette Item on of lost Cyanosis Muscle Tone Appearance Airway Upper Airway Sound iv O Crying general t ductal Breathing Resp Pattern isl dian Left Lung Right Lung OSat Respiratory Rate Etco2 _ Chest Rise Chest Rise breaths min as change Sound Sound change change g Inspiratory Time Circulation Rhythm i Heart Rate re Blood Pressure Absent Pulses beats min Heart Sound Systolic Diastoli Brachial Right change isl ystolic Diastolic mmHg g Sinus Arrhythmia shila iat Ol cette Other Temperature C Blood Glucose ann 10sec 30sec imin 2min 5min 10 00min Vital controls are divided in several categories For each vital control on the details tab there is a corresponding entry on the status panel providing real time information Set the changes on the available fields and then use th
26. Normal Vital Signs Color O Healthy Care Required 24 User Guide Newborn HAL When operating in automatic mode the physiologic model calculates physiologic responses from student interaction facilitator input drug administration chronic conditions and programed environmental factors The automatic mode is an optional upgrade To enable the automatic mode option click Setup gt Options gt Other and enter the code included with your upgrade in the Model Activation Code field To switch between operating modes without restarting the software click File gt Profile The physiologic model assists the instructor by automatically changing related vital signs parameters For example if the instructor increases the heart rate the physiologic model will calculate a realistic response to the event and automatically adjust the blood pressure values The physiologic provides a more advanced level of automation and accuracy during simulation The instructor can control which parameters the physiologic model cannot change by using the hold controls shown in the automatic mode controls section Click the pause button located on the right panel to freeze the model calculations during lectures and then to resume To return the patient to the initial state click Reset In the automatic mode patient files store general information such as weight height and age The physiologic model factors in the patient s weight a
27. R More Appear ance Skin Color 0 Muscle Tone reduced irwa crying a Throat Sound Breathing Lung Condition Resp Pattern Rate 35 In 17 Yo Tidal Volume 15 Right Lung bpm EtcO2 46 mmHg 18 User Guide Newborn HAL File Setup Status s fl B Monitors Appearance Skin Color Patient State Heart Sound Cardiac Heart Rate 140 bpm Sinus arrhythmia Blood Pressure L a R m 63 48 mmHg via Absent Pulses R Brachial Other Temperature 36 8 C B Glucose 70 mgldL Cardiac Tricuspid alve Regurgitation Resistance Pulmonary alve Regurgitation Resistance Mitral alve Regurgitation Resistance Aortic alve Regurgitation Resistance Contractility R4 100 RY 100 LA 100 Lv 100 Cardiac Irritability Circwdatory assel Diameter essel Stiffness Blood Yolume 225 ml Respiratory Amb Pressure 1 00 47 Inspire 02 21 Inspire CO2 0 PH 7 38 Shunt Flow 8 Dead Space 5 mil Status panel entries and features mirror the simulators hardware configuration Light blue icons show active features and values undergoing changes are highlighted yellow Click on the volume bars to adjust the volume of each sound Some status panel entries and features might not be visible depending on the simulator s hardware configuration Battery Indicator Signal Strength
28. Wireless tablet PC with stylus control 3010 205 Bump Case R Bump case for tablet PC 3010 206 RF Module R Radio Frequency Module with USB connector 3010 EXW Two Year Extended Warranty A Extended warranty for years Two AND Three 3010 INST In Service Training A Day of in service training and installation C Consumables R Replacements A Accessories U Upgrades M Replace in Miami Factory ONLY Newborn HAL User Guide 127 Warranty Gaumard warrants that if the accompanying Gaumard product proves to be defective in material or workmanship within one year from the date on which the product is shipped from Gaumard to the customer Gaumard will at Gaumard s option repair or replace the Gaumard product This limited warranty covers all defects in material and workmanship in the Gaumard product except Damage resulting from accident misuse abuse neglect or unintended use of the Gaumard product Damage resulting from failure to properly maintain the Gaumard product in accordance with Gaumard product instructions including failure to property clean the Gaumard product and Damage resulting from a repair or attempted repair of the Gaumard product by anyone other than Gaumard or a Gaumard representative This one year limited warranty is the sole and exclusive warranty provided by Gaumard for the accompanying Gaumard product and Gaumard hereby explicitly disclaims the implied warranties of merchantability satisfactory quality and fitn
29. automatically Always remember to specify a new respiratory rate Respiration Pattern Biles Rate s nien Ei inspiration To Efri Volume ml If the respiratory rate goes to zero the model does not restore it automatically Always remember to specify a new respiratory rate Each cardiac rhythm has a specific effect on the blood pressure wave forms The pressure wave forms include ABP CVP PAWP and Pulse Mild cyanosis is activated when the oxygen saturation is less than 92 and or the temperature is less than 35 C Values under these thresholds will cause the cyanosis to get progressively worse Similar to O2Sat and EtCOz blood pressure can be changed indirectly when using the modeling mode You can do so by selecting one of four options e Vascular profiles vessel diameter and vessel stiffness e Heart Rate e LV Contractility e Total Blood Volume There are three controls on this tab unique to the automatic mode e Patient status Selecting one of the two available options affects heart rate temperature respiratory rate tidal volume metabolism rate and carbon dioxide formation rate indirectly Excited state after exercise increases heart rate temperature respiratory rate tidal volume O2 CO2 diffusion capacity metabolism rate and CO2 formation rate Circulation Patient Status ECG Rhythm Sinus resting jexcited e Bleed Click the bleed button to simulate internal bleeding
30. between the simulator and the control computer On the menu bar click Setup gt Remote Access via Network to open the configuration window To use this alternate configuration first install the USB RF module drivers on the virtual monitor computer Navigate to www Gaumard com to download the USB RF module drivers and then transfer them to the virtual monitor computer using a USB flash drive 1 Exit the GaumardUI software and disconnect the RF module on the control computer 2 Connect the RF module to the virtual monitor computer 3 Verify that both computers are connected to the ad hoc network e g GaumardNet 4 Initialize the GaumardUI software on the tablet computer and on the menu bar click Setup gt Remote Access via Network The Remote Access via Network Window is displayed 5 Select the Remote access via network option Standard RF Communication Remote Access Via Network EJ Remote Access Via Network m DESEN 6 On the adapter list select Wireless Network Connection If the option is greyed click the Stop button first 7 Click Find available to auto assign a port for this connection 8 Write down the Controller IP and Port number then click the Connect button The status will not show connected until the last step of this guide Open the Gaumard Monitors software on the virtual monitor computer 10 Click the V
31. connection between the GaumardUI and Gaumard Virtual Monitor software For detailed instructions on how to configure and connect the Gaumard Vital Signs Monitors refer to the Gaumard Monitors User Guide CPR Monitors Help Sensors File sharing Custom numbers Que Ede Configuration Fit neal eal 1 If the Monitors menu option is not shown go to Setup gt Options gt Newborn HAL Add Ons and enter the virtual monitors activation code For more information go to page 85 Use the sensors option to enable or disable any of the waveforms displayed in the vital signs monitor Select the waveform and click ON to display the readings on the virtual monitor screen To disable a parameter reading click OFF The vital signs monitor sensors defaults to All On Setup Monitors CPR Help SpO2 Probe ECG Leads Resp Monitor File sharing Custom numbers Thermometer hue Ede Configuration yngeal s ery NIBP Cuff gt Ingospasm _ ABP cannula und Capnography normal I z All ON All OFF Window Some sensors such as NIBP and Thermometer are equipped with a STAT control that will allow the facilitator to activate readings on the virtual monitors from the controller software The sensor control window is a floating panel with on off toggle controls Click Monitors gt Sensors gt Window to
32. drugs directly into the bone marrow of the tibia Remove the skin and the bone inserts to drain the fluid infused during an exercise To get more uses from every bone insert reseal the needle holes using cement glue Control and program the cyanosis visible on the simulator Use the Model tab to automate the change in cyanosis as the provider performs CPR intervention For more information on the Model feature go to page 94 Control the movement of the simulator s arms by enabling any of the available muscle tone settings limp reduced active left arm only right arm only jittery or seizures For a more pronounced movement effect lay the simulator on a flat surface with the arms parallel to the ground Systemic Perform catheterization exercises via exchangeable male and female genitalia To fill the urine reservoir remove the white cap and use the modified syringe to fill the bladder reservoir Newborn HAL User Guide 103 UMBILICAL CORD SYSTEM S N B0906424 OR HIGHER Catheterize or inject the umbilical cord To fill the umbilical cord with fluid inject any of the three blood vessels with 2 mL of water using the syringe For catheterization exercises use a 6 Fr urethral round tip catheter lubricated with silicon oil The replaceable umbilical cord can be trimmed or cut Before removing or replacing the umbilical cord after an exercise turn off the simulator by exiting the software Fil
33. final lab report on the facilitators screen To make the lab report available to the provider on the patient monitor screen click Send to VM Lab Preview Lab 01 11 36 Above normal range Cholesterol LDL Cholesterol Normal Range Value Comment HDL Cholesterol mg dL 35 00 85 00 85 00 Cholesterold HDL Ratio 0 00 4 40 5 10 Care required Lipid Panel Both Variable Normal Range Value Comment Cholesterol mg dL 0 00 199 00 190 00 LDL Cholesterol mg dL 0 00 129 00 135 00 Care required Triglycerides mg dL 30 00 200 00 100 00 The preview window also allows the printing of results for distribution and archiving Newborn HAL User Guide 51 Send the completed lab report to the virtual monitor screen to assist the care provider Begin by selecting the report from the lab reports list Lab Reports Hate Template Description sent mestamer tat Report Healthy 2 OB Blood test Healthy Levels mass Healthy Neonate Blood test Healthy Levels oan James Metabolic Panel Session 1 Iinid Pan i es a i ce 7 l Selected Item Lab 02 CBC DIFF High levels mihin Lab 03 Neonate Blood test High levels Delete Lab 04 CBC DIFF Simulation 1 r Preview Lab 05 OB Blood test Session 2 n Lab 06 PPT Session 2 Send to monitor Susan Lipid Panel Session 4 Click the Send to Monitor button to transfer the lab report to the virtual monitor Selected Item Delete Preview
34. nee etn ee eee Pan ere ne etary ee are ere ee nee ee 129 Newborn HAL User Guide 3 End User License Agreement This is a legal agreement between you the end user and Gaumard Scientific Company Inc Gaumard This software is protected by copyright laws and remains the sole property of Gaumard By installing the GaumardUl the Software media you agree to be bound by the terms of this agreement If you do not agree to the terms of this agreement promptly return the uninstalled media and accompanying items to Gaumard at the address indicated below 1 Grant of License Gaumard hereby grants to you an individual or institution the right to install and activate the Software on one computer for use with one Interactive patient simulator system The software may also be installed on any number of other computers at the same institution so that students may access the learning resources One copy of the software may be made for backup purposes You may not network this Software or allow multiple users unless you purchased a multi user workstation license Sharing this Software with other individuals or allowing other individuals to view the contents of this Software is in violation of this license 2 Copyright The Software is owned by Gaumard and protected by United States copyright laws and international treaty provisions Therefore you must treat this Software like any other copyrighted material You may not make this Software
35. of each auto response option is explained below e Off The software does not respond to the electric therapy e Prompt The software detects the electrical therapy and prompts the facilitator before applying the changes configured in the Settings section Newborn HAL User Guide 87 e Auto The software automatically detects the electrical therapy and compares it to a threshold selected by the provider If the threshold is met the vitals will automatically change to the parameters specified on the Settings section Each type of electrical therapy has a unique set of default parameters For example the default response to a virtual defibrillation Shock applies the following vital sign parameter changes NSR 75 bpm BP 120 80 Click on the palette button to program a specific palette item as the auto response Defibrillation Shock Prompt oe Auto w S Setting at Joules 200 Z 3 Shocks convert to NSR 75 bpm BP 170 80 The Load Palette Item window is displayed Select the desired palette and click Load Item Description normal vitals 88 User Guide Newborn HAL The desired palette is now displayed in the Setting section Defibrillation Shock O off Prompt Auto SS Setting at 200 Joules 200 O Shocks The auto response is now configured to automatically apply the Healthy Resting
36. open the floating sensor control panel ECG Leads Resp Monitor Thermometer STAT star Single click the circular icon to enable or disable the sensors displayed on the virtual monitor screen Click the circle dark to disable the sensor and light blue to re enable it In the example above all the sensors are on except the thermometer The file sharing menu allows the facilitator to send images audio and text files to the virtual monitor screen Use the file sharing feature to fulfill laboratory reports and x ray requests by the provider during simulation Newborn HAL User Guide 91 To begin first add the mock image jpg omp or text files txt into the Gaumar_UIl folder located on the home screen of the control computer On the GaumardUI menu bar click Monitors gt File sharing to open the File Sharing Setup menu File Setup Custom numbers Laryngospas Configuration Throat Sound The File Sharing Setup menu is used to manage files shared with the virtual monitor software The list of files stored on the Gaumard_UI folder available for sharing is displayed on the left panel To share a file first select the file from the left panel and click the Add button File Sharing Setup The files on this list will be accessible from the patient me Name will be the name displayed Available Files Shared Files File Enter a context name on the po
37. or copies thereof available in any manner or form or use copy or transfer the Software in whole or in part except as provided herein 3 Other Restrictions You may not rent or lease this Software to any other party You may not alter merge modify adapt reverse engineer decompile or disassemble the software or disclose the contents of this Software to any other party 4 Electronic Transmission of Software If you received the Software by electronic transmission or by Internet delivery by installation of the Software you acknowledge that you have read and understand this license agreement and agree to be bound by its terms and conditions 5 Term of Agreement The term of this Agreement and the license granted to you pursuant hereto shall commence upon installation of this Software This Agreement and the license granted herein may otherwise be terminated by Gaumard in the event that you are in breach of any provision of this Agreement In the event of termination you agree to immediately return this Software accompanying items and any copies thereof to Gaumard 6 LIMITED WARRANTY A THE CD ROM MEDIA THE MEDIA WHICH CONTAINS THIS SOFTWARE IS WARRANTED FOR A PERIOD OF 30 DAYS FROM THE DATE OF PURCHASE TO BE FREE FROM DEFECTS IN MATERIAL AND WORKMANSHIP ELECTRONIC TRANSMISSION IS WARRANTED TO BE FREE FROM DEFECTS AT THE MOMENT OF TRANSMISSION YOUR SOLE AND EXCLUSIVE REMEDY AND GAUMARD S SOLE LIABILITY IS TO REPLACE THE DEF
38. plug it back in Restart the software and wait for initialization On the menu bar go to Setup gt Options gt Environment and select FIXED Then enter the simulator s serial number in the text box Finally restart the software Newborn HAL User Guide 123 Simulator doesn t run for the time specified on the manual Simulator doesn t respond to any com mand even that blin king communication indicator is consis tently green Commands are taking longer than usual to take effect or simulator is not reporting every action blinking com munication indicator is consistently yellow GaumardUl has set the power mode to STAND BY automatically RF module not found message is displayed when Gaumardul is started Chest compressions are not properly detected or not detected at all Battery not charged properly Turn off the software and unplug charger adapter from the wall and the simulator for 1 minute Reconnect the charger to the wall and the simulator Unplug the charger when the charger s LED turns green indicating that the simulator is completely charged Do not turn on the GaumardUI software until the charging process is complete The computer is properly communicating with a different simulator On the menu bar go to Setup gt Options gt Environment and select FIXED Then enter the simulator s serial number in the text box Finally restart the software Distance between
39. these sensors is clicked a message will appear at the bottom left of the screen notifying the user of the status of the reset OK or TRY AGAIN Should the sensor not respond please refer to the troubleshooting guide or contact Customer Support Newborn HAL User Guide 83 Calibration Factory Default Settings Reset ET Tube Sensor At the end of calibrating a function the Calibration Wizard resets the simulator for the changes to take effect and displays the message Done If the wizard displays the message Can t reset it means that the new calibration values will take effect next time you start the software If the changes need to take immediate effect close the GaumardUI software wait about 1 minute for the simulator to turn off and then start the GaumardUI software again The GaumardUI has several options that can be preset by the instructor Each of these sections is explained below Help Remote Access via Network Auto Responses Scan RF Channels To connect to a specific simulator select the FIXED option and enter the simulator s serial number in the text box Establishing a FIXED connection is required before entering the activation codes for the simulators add ons features and detecting hardware upgrades 84 User Guide Newborn HAL If you cannot locate the simulator s serial number first set the mode to GENERIC and establish a connec
40. 00 Details Cyanosis 20 MuscleTone reduced 00 00 05 Model to Newborn 00 00 Details RR 23 EtCO2 46 Cyanosis 10 00 00 06 Applied to Newborn 00 00 Details Cyanosis 0 00 00 07 Model to Newborn 00 00 Details RR 30 lt The Log page consists of four different areas from bottom to top the text log provider action buttons team logging buttons and session info This is the large panel at the bottom of the Log Page containing all the time stamped text entries Every event in a session is recorded as an entry in the Text Log The different types of entries are Actions Applied Changes Detected Events Evaluations Model and Notes Actions refer to those performed by one of the providers in the session The facilitator can quickly log actions from the Provider Actions section and make the entry more specific using the Team Logging feature The following is an example of an Action entry 00 07 24 Action Assess responsiveness An Applied log entry occurs automatically every time there is a change to the physiological condition of the simulator In other words every time changes are made from the Details page Palette page or from a Scenario a log entry like the following is created 00 04 01 Applied 00 30 Details Rhythm Sinus Cardiac event 0 HR 140 68 User Guide Newborn HAL Every time one of the various sensors in the simulator detects a provider action it
41. Additional warnings are found throughout the documentation If the simulator will not be used for an extended period re charge the battery at least once every 3 months to prevent the permanent loss of the battery s total charge capacity due to self discharge Do not attempt to intubate without lubricating the airway adjunct with a silicone oil lubricant provided Failure to do so will make intubation very difficult and is likely to result in damage NEVER disconnect the communications module while the GaumardUI software is running The software will halt and the module may be damaged When simulating drug administration via endotracheal tube providers must use an empty syringe Passing liquids into the trachea or esophagus may cause internal damage Newborn HAL should be cleaned with a cloth dampened with diluted liquid dishwashing soap If medical adhesives remain on the skin clean with alcohol wipes DO NOT USE GOO GONE as the citric acid in the formula will cause pitting of the various materials comprising your simulator Store Newborn HAL in a cool dry place Extended storage above 85 degrees Fahrenheit 29 Celsius will cause the simulator to soften and slowly warp It is acceptable to operate Newborn HAL at an ambient temperature of 95 degrees Fahrenheit 35 Celsius Newborn HAL is splash proof but not water proof Do not submerge or allow a large volume of fluid to enter the interior of the simulator
42. After ventilations and EPI have been given the baby s vitals go towards a good outcome Begin PPV Compressions and Epinephrine Wait Indefinitely for actions 116 User Guide Newborn HAL Newborn HAL Gaumard Simulators for Health Care Educatio MAS Meconium Aspiration Syndrome Apply suction intubate and supply 100 O2 Wait Indefinitely for actions Newborn HAL User Guide 117 A Gaumard Simulators for Health Care Educatior Newborn HAL RDS Newborn with mild Respiratory Distress Syndrome gets a pneumothorax after oxygen is given 118 User Guide Newborn HAL Administer Oxygen Wait indefinitely for action Apply needle aspiration Wait Indefinitely for action Ay N rn HAL Gaumard ewbo Simulators for Health Care Education TTN Transient Tachypnea of the Newborn Apply suction and deliver O2 Wait Indefinitely for action Newborn HAL User Guide 119 Tips on Creating Scenarios As described previously palette items represent complete or partial groups of settings that have been stored as a single item We learned how applying partial states will hold constant all settings that are left unspecified Not only does it take time to customize the palette but a very large palette also becomes
43. By selecting Reset the oxygen flow and the epinephrine dose onboard will be eliminated Newborn HAL User Guide 67 The CPR monitor has two bar graphs and a real time display that give the user some feedback on the CPR given to Newborn HAL Both bar graphs have a label on the left that change color representing low yellow correct green and high red levels of treatment At the same time the real time graphs also show each compression and ventilation Log The Log page allows the facilitator to keep track of every event during a session It automatically creates an entry whenever a detected event occurs as well as every time there is a change in the patient s condition In addition the facilitator can log observed provider actions with a simple click Details Palette Lab Model Scenario Log Gaumard Session Title Facilitator Providers Add Emergency Reported Airway Breathing Circulation device Wheezing Rales pea Team Medication Drug Route ied v v v Administer Log CPR 00 00 00 Applied to Newborn Details Reset the Model 00 00 01 Model to Newborn 00 00 Details HR 140 BP 65 49 RR 14 Inspire 17 OSat 73 EtCO2 40 Temp 36 8 Cyanosis 75 00 00 02 Applied to Newborn 00 00 Details Cyanosis 55 00 00 03 Applied to Newborn 00 00 Details Cyanosis 30 00 00 04 Applied to Newborn 00
44. Concentration that produces 50 of the maximum effect Apply tems Threshold mg l Standard Dose Naloxwone SD Nicardipine OD 4 After configuring the drug properties click the Update Graph button to generate the effect plasma concentration results Continue to the next section to program interactors for this drug Drug Effect Tester Test object weight 75 00 kg Newborn HAL User Guide 61 The Interaction Editor window is used to program and test interactions between medications in the drug library When two or more medications preprogrammed to interact are administered the physiologic model will adjust vital signs as a response of the interaction effect Interaction Editor Naloxone Narcan Current Drug Data Max Alpha 1 9 Half Life 01 15 00 Peak Time 00 02 00 E SD 2mg OD 10mg EC50 0 000img dL lsobologram plasma concentration 5 TO Interactors z Sodium Nitroprusside Nitropress on Drug List Interactor Data Half Life 00 30 00 Peak Time 00 45 00 SD 40mg OD 120mg Furosemide Lasix mg dL 10 EC50 2 6400mg dL Aspirin Bayer mg dL Test Panel Test object weight 75 kg Time Effect Graph A Naloxone Narcan interaction pp y oa m Aspirin Bayer only Dose 2 mg Attime 2 5 1055 OF Furosemide Lasix on Apply Furosemide Lasix Dose 40 mg Attime 9 Results Attime 02 12 51 Max Interaction Effect 22 07 A
45. ECTIVE MEDIA OR TO REPEAT THE ELECTRONIC TRANSMISSION PROVIDED THAT YOU NOTIFY GAUMARD IN WRITING OF SUCH DEFECT OR DEFECTIVE TRANSMISSION AND RETURN THE DEFECTIVE MEDIA IF ANY DURING THE 30 DAY WARRANTY PERIOD B EXCEPT AND TO THE EXTENT EXPRESSLY PROVIDED IN PARAGRAPH A THE SOFTWARE AND ACCOMPANYING WRITTEN MATERIALS ARE PROVIDED ON AN AS IS BASIS WITHOUT ANY WARRANTIES OF ANY KIND INCLUDING BUT NOT LIMITED TO ANY IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR ANY PARTICULAR PURPOSE NO ORAL OR WRITTEN INFORMATION OR ADVICE GIVEN BY GAUMARD ITS DEALERS DISTRIBUTORS AGENTS OR EMPLOYEES SHALL CREATE A WARRANTY OR IN ANY WAY INCREASE THE SCOPE OF THIS WARRANTY AND YOU MAY NOT RELY ON ANY SUCH INFORMATION OR ADVICE GAUMARD DOES NOT WARRANT GUARANTEE OR MAKE ANY REPRESENTATIONS REGARDING THE USE OR THE RESULTS OF USE OF THE SOFTWARE OR WRITTEN MATERIALS IN TERMS OF CORRECTNESS ACCURACY RELIABILITY CURRENTNESS OR OTHERWISE AND THE ENTIRE RISK AS TO THE RESULTS AND PERFORMANCE OF THE SOFTWARE IS ASSUMED BY YOU IF THE SOFTWARE OR WRITTEN MATERIALS ARE DEFECTIVE YOU AND NOT GAUMARD OR ITS DEALERS DISTRIBUTORS AGENTS OR EMPLOYEES ASSUME THE ENTIRE COST OF ALL NECESSARY SERVICING REPAIR OR CORRECTION OTHER THAN EXPRESSLY DESCRIBED ABOVE 4 User Guide Newborn HAL C NEITHER GAUMARD NOR ANYONE ELSE WHO HAS BEEN INVOLVED IN THE CREATION PRODUCTION OR DELIVERY OF THIS PRODUCT SHALL BE LIABLE FOR ANY DIRECT INDIREC
46. HAL Complete the form by first entering the written response in the Problems Identified field and selecting the applicable multiple choice responses throughout 1 Problems Identified Eclamptic Seizure 2 Provider Tasks and Performance Calls for additional help Nursing or Physician Calls for anesthesia Providers turn or assist in turning patient to side during seizure Inserts tongue blade into mouth Places supplemental oxygen on patient Places pulse oximeter on patient Eclamptic Seizure Iv Eclamptic Seizure To save the finished evaluation as digital document select Microsoft XPS Document writer and click Print Select Printer fm Microsoft XPS Document Writer r T Prnt to fie Page Range Selection Curent Page Pages Bime Cana Ay Newborn HAL User Guide 73 Enter the name of the evaluation Select a location and click Save r Save the file as gO Documents Evaluations v 4 e p Organize v New folder ae w A Ft Favorites Documents library iets folie Evaluations Libraries 5 Documents No items match your search i d Music E Pictures E Videos JE Computer Filename Eclamptic Seizure Session 3 xps ee Hide Folders Coie If the tablet is connected to a printer first select and open the evaluation document saved in the previous step
47. Port 8080 USING THE NEO LINK 1 Connect an Ethernet cable to the laptop ee PC After the NEO LINK connection is established the fetal vital information will be automatically sent to the newborn tablet when a labor scenario is complete The Data Received window prompts the facilitator to accept the incoming neonatal vital aL information from the NOELLE model Click eee ee ae Yes to load the information onto the fill as the setup file is downloaded Newborn tablet and continue the scenario 2 Go to the Help menu and click on Check for Updates The GaumardUl automatically starts searching for available updates Upon completion the software Help automatically launches the setup wizard 4 Click Next and follow the wizard instructions to complete the software download On the menu bar click the Help option to perform the following options GUI Help option opens a digital copy of the simulators User Guide Click About GUI for information on the GaumardUI software version and the simulator s firmware revision ABOUT Gaumard Simulators for Health Care Edurck Gaumardll Version 1 19 9 0 Firmware 1 19 Copyright 2010 Gaumard Scientific Ca www daumard cam OK Redistributable GaumardUI installer files are available for download at http www gaumard com software updates Follow the steps below to check for software updates using the built in update feature
48. Provider Actions section on the Log page First the facilitator should add all providers in the team one by one by clicking on the Add button and filling the Add Provider window Add Provider Mane Charles Parker As shown in the Log Page image a colored button is inserted on the Team Logging region for the provider just added There can be up to 6 different providers each with a corresponding button Every time one of the provider buttons is clicked that person becomes the active provider To indicate the active provider the vertical bars on each side of the Log page will match the color chosen for that person On the Log Page image for example the provider Charles Parker is the active provider so the vertical bars are teal colored While there is an active provider every time a Provider Action or Evaluation log entry is created it will have the name of the provider added to it as follows 00 07 41 Charles Parker Action Check for pulses brachial To deactivate deselect the active provider and return to general logging click the Team button and the vertical bars will return to neutral color All provider buttons can be edited or deleted by right clicking them and selecting an option from the menu The session info area contains the Session Title and Facilitator fields at the top of the page These fields are included when a report is saved or printed Details Palette Lab Scenario Model Lo
49. RDUI CONFIGURATION AUTOMATIC MODE On the menu bar click FN gt Setup If the menu is not shown click Setup gt Options gt Other and checkmark Use fetus Neonate Link Monitors CPR Scenario Click find available to find an available communication port Alternately assign a port manually then click connect The status will not read connected until the F N configuration is completed on the Newborn HAL tablet Fetal Neo Link Information e Adapter Wireless Network Connection Controller IP 10 0 0 1 Port 8080 Connected to 10 0 0 2 stop NEWBORN HAL PREEMIE GAUMARDUI AUTOMATIC MODE Access the F N setup menu on Newborn HAL Preemie HAL tablet If the menu is not shown click Setup gt Options gt Other and checkmark Use fetus Neonate Link Newborn HAL User Interface SN B8505004 MEDS PROFILE e Status o0 C O Adv gt Appearance Enter the IP address of the NOELLE tablet and matching port number and click connect Fetal Neo Link Information Noelle Enter the IP and port selected on the controlling computer Controller IP 10 0 0 1 Port Once the connection is established the system is ready to transfer the information between computers Fetal Neo Link Information Noelle Enter the IP and port selected on the controlling computer Controller IP 10 0 0 1
50. SING THE POWER SUPPLY SYSTEM S N B1010788 OR HIGHER The power supply adapter allows the simulator to operate through long simulations sessions by drawing power from the wall outlet and not battery reserve Use the power supply for simulation sessions lasting 2 hours or more If simulation sessions are shorter than 2 hours use the simulators battery reserve The power supply adapter will NOT re charge the battery Avoid using the power supply adapter when the simulator s battery is completely depleted To use the power supply adapter 1 Fully charge the simulator s battery using the Charger adapter 2 Disconnect the Charger and connect the Power Supply adapter 3 Activate the GaumardUI software The GaumarduUI battery icon will display a lightning icon when the power supply is connected Please contact Gaumard for information on the power supply upgrade for earlier Newborn HAL models Newborn HAL User Guide 13 Virtual Monitor The optional virtual patient vital sign monitor system works with GaumardUI to receive and display the simulators vital sign information The system includes an all in one touchscreen computer and the Gaumard Virtual Monitor software Please refer to the documentation included with the all in one computer for important safety installation and start up information After all the system connections are secured power on the touchscreen computer as
51. T CONSEQUENTIAL OR INCIDENTAL DAMAGES INCLUDING DAMAGES FOR LOSS OF BUSINESS PROFITS BUSINESS INTERRUPTION LOSS OF BUSINESS INFORMATION AND THE LIKE ARISING OUT OF THE USE OR INABILITY TO USE SUCH PRODUCT OR RELATED TO THIS AGREEMENT EVEN IF GAUMARD HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES GAUMARD SHALL NOT BE LIABLE TO YOU FOR ANY INDIRECT SPECIAL INCIDENTAL OR CONSEQUENTIAL DAMAGES OR LOST PROFITS ARISING OUT OF OR RELATED TO THIS AGREEMENT OR YOUR USE OF THE SOFTWARE AND OR THE RELATED DOCUMENTATION EVEN IF GAUMARD HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES IN NO EVENT SHALL GAUMARD S LIABILITY HERE UNDER IF ANY EXCEED THE PURCHASE PRICE PAID BY YOU FOR THE SOFTWARE ALL RIGHTS NOT EXPRESSLY GRANTED IN THIS LICENSE AGREEMENT ARE RESERVED BY GAUMARD BY INSTALLATION OF THIS SOFTWARE YOU ACKNOWLEDGE THAT YOU HAVE READ AND UNDERSTAND THE FORE GOING AND THAT YOU AGREE TO BE BOUND BY ITS TERMS AND CONDITIONS YOU ALSO AGREE THAT THIS AGREEMENT IS THE COMPLETE AND EXCLUSIVE STATEMENT OF AGREEMENT BETWEEN THE PARTIES AND SUPERSEDES ALL PROPOSED OR PRIOR AGREEMENTS ORAL OR WRITTEN AND ANY OTHER COMMUNICATIONS BETWEEN THE PARTIES RELATING TO THE LICENSE DESCRIBED HEREIN Newborn HAL User Guide 5 Care and Cautions 6 User Guide Newborn HAL Overall Warnings Remember that damage caused by misuse is not covered by your warranty It is critical to understand and comply with the following guidelines
52. You will be automatically be taken to the Details page and the settings that comprise the selected Palette Item will be displayed Change them as desired and click the Save as Palette ltem button Many of the functions related to Palette Items are also available by clicking the second mouse button usually the right button while the pointer is positioned over an Item Note when using the tablet computer this is best done by holding the stylus button while tapping the screen For more information on customizing the Palette see the Tips on Palette Item and Scenario Creation section of the appendix at the end of this guide 30 User Guide Newborn HAL Scenarios The most advanced method of controlling Newborn HAL is to build a scenario a sequence of Palette Items and delay periods played back in succession Scenarios let the facilitator automate changes to the simulator s condition so their attention can remain on the providers actions The scenario feature also standardizes the patient s presentation of symptoms For fair assessment of providers and any research application such standardization is key GaumardUI includes several preprogrammed scenarios to simulate variety of complications All preprogrammed scenarios are included in the Quick Start Profile To switch between profiles without exiting the software click FILE gt Profile For this example select and load the Quick Start Profile To use a preprogrammed scenario g
53. a new profile it is often useful to include the Default profile contents and begin customization from that foundation Meds Profile This profile contains eighteen pre programmed drugs to be used on simulations Quick Start Newborn Modeling This profile contains eight linear scenarios and One branching scenario allowing instant simulation of a wide range of conditions For more information on the items included on the Quick Start profile navigate to page 45 To change profiles from inside the GaumardUI environment select Profiles from the File pull down menu Profiles are used to organize and protect software settings During customization Newborn HAL it will become clear how profiles can best serve your needs For example e It may be appropriate to assign one profile to each user of your HAL system e Others may choose to create a profile dedicated to a specific academic course which might be taught by multiple instructors e For the most detailed exercises it is sometimes useful to devote an entire profile to one particular subject area or even one particular scenario e To create a user made profile click on the New Profile button on the right panel Manage Rename Enter a name for the new profile followed by a description To include scenarios and palettes from other profiles click the applicable check box For security enable PIN protection which will require a user to enter a four
54. ahythm Asystol AR 0 Ins 5 Model to Anthony 00 00 Detaijs RR 1a a ake oy model to anthony C00 005 betalis RR OF ETC 0 applied to anthony Coo 00 palacee vfib coar i petals Rhythm ventricular fibril Applied te Anthony coo 10 Pale V Tach ae ea Rhythm Ventricular tach 0 petals is HR 120 io inspi re 37 Is WR 12 0 at ies 120 Details HR 120 3 Details KR 120 Fe Detail s HR 120 RR 16 EtCO2 38 3 betalis 20 Of HeartSnd normal LSLU normal This option allows printing a text file containing all the information in the log for the latest session Clicking on Print Report brings up the Print dialog box The shortcut key for this option is Ctrl P Newborn HAL User Guide 79 This tool allows the import of palettes scenarios or modeling patients that may have been created in another tablet PC When Import is clicked the Open dialog box displays Look in Quick Start Newborn 3 Oem E baby deteriorates plt 4 d Asphyxia Sen E APGAR 2 plt E Beth s Baby 1 plt My Recent d Beth s Donna s Baby es APGAR 3 plt E Beth s Baby 2 plt Documents _ Cynthia s baby E APGAR 4 plt E C Section Delivery plt a Elaine s Baby E APGAR 5 plt E Cardiopulmo decline plt a Francines s Baby e APGAR 6 plt E Comp Response plt B Gloria s Baby E APGAR 7 plt E Continued response plt dd Helen s Irene s Baby E APGAR 8 plt E Cynthia s Baby 1 plt e APGAR 9 plt E C
55. al Monitor 4 patches Fontanel Brachial Umbilical Brachial Starting with SN B0906425 Hyper flexion disables chest rise 300 feet Audio Video recording and debriefing Newborn HAL User Guide 99 Newborn HAL s airway can be intubated orally using LMA or endotracheal tubes and nasally using a nasogastric tube Recommended Device Size Procedure Intubation Blade Miller 0 size LMA Size 1 Nasal Intubation 8 Fr catheter Oral Intubation ETT 3 0 no cuff 6 Fr suction catheter Once intubated sensors detect the depth of the intubation tube Should the tube be inserted too deep the left lung is automatically disabled realistically demonstrating right mainstem intubation Correcting the tube position re enables the left lung 100 User Guide Newborn HAL Warning Always lubricate tubing airway and nasal opening prior to performing any nasal or oral intubation Failure to do so will make intubation very difficult and is likely to result in damage Do not insert liquids or spray silicone oil into the mouth and airway HAL has multiple upper airway sounds synchronized with his breathing Breathing Control rate and depth of respiration and choose independent quadrant lung sounds synchronized with the available breathing patterns Listen to the lung sounds using a stethoscope Use the vital sign parameter controls to change between the available sound types Volume cont
56. and then select Modeled Scenarios A sound is absent or Volume not set to user s Every sound has a volume control Play is not heard at criterion with the volume control to get it to the desired volume level desired level Newborn HAL User Guide 125 Diagnostics On the menu bard click Help gt Diagnostics to open the module diagnostics window The diagnostics window is used to test the status of each of the modules equipped in the simulator during troubleshooting Click Check All Modules to perform a full status test Active modules report light blue and inactive modules report black If there is a specific module that fails to respond please contact customer support Modules for features not installed on the simulator will report inactive Audio Mechanical Other Legend Throat voice V 5 M 5 R 0 Ecc Active Trachea Intubation Inactive Heart V 5 M 5 R 0 Check Modules Lung Front Upper Right Vol NA Carotid Check Single Lung Front Upper Left V 1 M 5 R 0 Radial Right Modules Radial Left Cyanosis KK Right v 5 M 5 R 0 Lung Right Virtual Temperature kK Left V 5 M 5 R 0 Lung Left Bowel Upper Right Vol NA Breathing Right Arm Motion Left Arr Motion Pressure BP Right EP Left Ventilation Compression Compressor To perform an individual module check first select the module and click Check Single Module Not
57. are too shallow Waveform peaks do not reach the green zone Ventilations are too strong Waveform peaks exceed the green zone Newborn HAL User Guide 95 Ventilation was performed correctly Waveform peak is inside the green zone A V GaumardUl is capable of interfacing with a number of third party A V recording systems that enable the capture of Audio and Video interlaced with the events recorded in the software log To enable the A V menu go Setup gt Options gt Other and checkmark Use A V system File Setup Monitors Status ofl Quic Airway Tongue Edema A VODs OSS Iy Click Setup to open the configuration window Configure the communication adapter and port number to send log information to a third party recording system In order to set up the connection on the A V System side please consult your A V System s documentation AIV Link Information A V Link Information Adapter Intel R PRO 1000 PL Network Connectior Controller IP 192 168 1 10 Port 8080 Connected to Fetal Neo Link Automatic Mode The Fetal Neo Link feature automatically transfers fetal vitals to the Newborn HAL Preemie HAL tablet once a labor scenario is complete To configure this feature follow the steps below to establish a connection between the NOELLE Model and the Newborn HAL Preemie HAL model 96 User Guide Newborn HAL NOELLE GAUMA
58. at the time they are ready to conduct the simulation They usually don t especially when revisiting a scenario months after creating it When you add Wait and Wait Indefinitely steps to a scenario you have an opportunity to edit the item description Use this description field to hold notes to the facilitator Typically scenario designers write notes in that space to indicate what the provider s or facilitator should be doing at that point Further when saving the scenario you may edit the scenario description This is the best place to put patient history and any other longer notes and instructions 3 Assume that providers will do the right thing 120 User Guide Newborn HAL Usually you should create a scenario with the assumption that the providers will perform correctly As long as they do the scenario can be allowed to continue Naturally you must be prepared for what might happen to Newborn HAL when providers deviate from expectations The consequences of such deviations can sometimes be included in the scenario punctuated by Wait Indefinitely items In other cases the simulation will require more direct control by the facilitator via either the Palette or Details page 4 Choose auto response settings based on the scenario content and the objectives As you ve seen auto responses can be used to free the facilitator s attention They also enhance realism by presenting instant reactions to the care providers On
59. ation including dose and route The software comes preloaded with a set of commonly used drugs Each of these drugs has a default dose unit and a default route for administration which can be overwritten by just typing over For example for Epinephrine the default dose unit is ml kg and the default route is IVP intravenous push In order to enter for example that a provider administered 1 ml kg of epinephrine via IVP the facilitator just has to enter the text e and the software automatically searches the drug list and displays the best match if any Details Palette Lab Model Scenario Log Gaumard Session Title Facilitator Providers aad Emergency Reported Breathing Circulation Team Medication Drug i Log CPR After a drug has been selected just clicking on the dose text field automatically fills the units and route fields with the default values for that particular drug Medication Drug Doze Units Route The facilitator then enters the dose and clicks on the Administered button and a log entry is created let s say the dose entered was 1 00 05 43 Action Medication Administered Epinephrine 1ml kg IVB IVP 70 User Guide Newborn HAL The Team Logging feature allows the facilitator to designate which member of the team performed a particular action The Team Logging section is right above the
60. ce the last compression performed Ventilation Data e Rate Ventilation rate in real time e PIP approx Peak Inspiratory Pressure e Ti Time Inspiration e I E Inspiratory Expiratory Ratio e PEEP approx Positive end expiratory pressure e LV Last Ventilation Time elapsed since the last ventilation performed The CPR trainer reference boxes generate a visual prompt of the compression to ventilation ratio programmed in the CPR Options menu Click the Trainer button to start The V ventilations and C compressions box borders blink to indicate the correct reference CPR rate By default the CPR trainer is configured to blink the reference borders at a 30 2 compression to ventilation ratio To change the ratio navigate to the menu bar and click the CPR dropdown and CPR Options Options Environment General Hal Add Ons Hal Pulses SPR Options Pacing Shock if Tolerances Log Other ventilations and Compressions 100 Compressions per minute Compression Ventilation Ratio 30 2 Only Ventilations 12 Ventilations per minute Compressions are too shallow Waveforms mostly do not reach the green zone Compression indicator is yellow Compressions are too deep Waveforms mostly exceed the green zone Compression indicator is red Compressions are performed correctly Waveform peaks are mostly inside the green zone Ventilations
61. ct independent left and right lung sounds e Chest rise and lung sounds are synchronized with selectable breathing patterns e Accommodates assisted ventilation including BVM and mechanical support e Unilateral chest rise Conductive skin regions allow for ECG monitoring with real equipment Multiple heart rhythms rates and complications Heart sounds include a normal heart as well as atrial and ventricular septal defects Chest compressions are measured and logged Blood pressure can be taken bilaterally using a cuff palpation or auscultation Blood pressure sounds audible between systolic and diastolic pressures Umbilical pulse and bilateral brachial pulses operate continuously Pulse strengths vary with blood pressure and pulses are synchronized with ECG Physical size is 50th percentile at 40 weeks gestational age Interchangeable genitalia Internal rechargeable NiMH battery Venous access Bilateral IV training arms Patent umbilicus Intraosseous access at tibia Wireless tablet PC with stylus control Communication modules are FCC and CE Compliant Communications module can be used simultaneously with the tablet computer s integrated wireless IEEE 802 11b networking device 100 240 VAC Charger Power supply Battery Charger Blood pressure cuff Instructions Carrying case One year limited warranty extended warranty to three years Installation and training available services Newborn HAL User Guide
62. ction For example if the Assess responsiveness button is clicked when the session clock reads 00 07 24 the following entry is automatically generated 00 07 24 Action Assess Responsiveness Special Buttons Some provider action buttons are accompanied by a special option button The first special button lets the facilitator log actions in more detail For example if the button Assess breathing is clicked the following entry is created 00 01 28 Action Assess breathing On the other hand if the button next to Ventilate is clicked a list of additional options appears The facilitator can be more specific and choose for example look listen feel Breathing Circulation Options look listen Feel anterior auscultation posterior auscultation abdominal auscultation axillary auscultation and the following entry is added Newborn HAL User Guide 69 00 01 28 Action Ventilate look listen feel The second special button gt allows pre programming common responses to specific actions For example the facilitator can pre program normal respiratory sounds and re enable the lungs when the provider performs a needle decompression Airway Breath m m When the extubate button is clicked the following entry is created 00 01 28 Action Extubate cry The Medications section allows for easy and fast logging of drugs administr
63. d in the interaction status panel Drug Onboard Administer Epinephrine Primatene Adrenalin 0 05ug kg 0 48 sd 00 01 04 Amiodarone Cordarone 0 2ug kg 0 02 sd 00 00 57 Interaction Status More Potent Drug Effect Change Less Potent Drug Effect Change Max Alpha Current Alpha z z Remove from list Change Dose and or Rate Warp Factor 1 B After the drug s administration is complete select the drug and click Remove from list Drugs cannot be removed from the list during the administration process with the exception of IV infusions However the drug effects for each medication can be turned off To remove all the drugs from the list and reset the patient model click File and New Session Click Stop Infusion to pause the drug s administration During this state the IV infusion dose and or rate can be adjusted or removed altogether if necessary Drug Dose Units _ Route Rate ae Epinephrine Primatene Adrenalin 0 mg IV Push 0 ug kg 02 40 23 Amiodarone Cordarone mg IV Push 3634 019 ug kg 02 13 43 Newborn HAL User Guide 55 Right click on the drug entry to show the drug effect menu 0 0133 ug kg 00 04 48 Unselect Current Effect Effect Off Standard Dose High Dose Over Dose es Select from the following options Unselect Unselect a highlighted drug Current Effects View the effect on the patient s vital signs All effects View all the available programmed drug e
64. d on accurate physiologic principles and therefore choosing a combination of vitals that are inconsistent with medical principles will not deliver desirable results After all creating the vital sign palettes go to the Scenario tab and click Add to Scenario 34 User Guide Newborn HAL The Add Palette item menu is shown Select the vital sign palette previously programmed to be first state in the scenario Enter Omin Osec for the transition time so the initial vital signs are applied immediately Click Add to add the palette to the scenario Details Palette Scenario Lab Speech Log Load Scenario Save Scenario Scenario A Add Palette Item palette File Lab Transition Initial state QQ mt min sec o of H Healthy Resting 59 59 Max Improvement Item Description SEC titel condition al vial sig are specified Deteriorating Wait Wait Indefinitely nat ce The first palette is now added Click Add Palette to Scenario again to add the following vital sign palettes and wait palette items Name Transition Description gt teats ooo tetera vais enpecied SY A Md Newborn HAL User Guide 35 A Wait item holds the vital signs until the transition time expires Alternatively add a Wait Indefinitely palette to hold the vital signs until the facilitator manually advances to the next item using the
65. dd New Medication window appears A list of all the drugs included with the Meds Profile is shown on the right Add New Medication New Medication Medication Response EC50 mg dl Concentration that produces 50 of the maximum effect Description Available Palettes X A Items Threshold ug kg Abciximab SD 2 Standard Dose Abciximab UD FF Adenosine OD Atenolol Tenormin Atropine Sulfate Calcium Chloride Captopril Capoten Drug Effect Tester Clopidogrel Plavix eee ee Valium Digoxin Lanoxin Di Adenosine SD l Digoxin ImmuneFab E M Infusion F IM E Diltiazem Cardizem Topical E Per Oral E Inhalation Dobutamine Dobutr Dopamine Intropin TT in Enalapril Enalaprilat Precise o OF OF Enalapril Vasotec Epinephrine Primat Eptifibatide Integrilin Peak Time eS See Esmolol Brevibloc Precise o OF OF Flumazenil Romazic Furosemide Lasix 10 10 1 Glucagon Glucagen Drug Interactions Plasma Concentration mg dL Heparin LMW Enox x Approximate very quick lt 5m Approximate very quick lt 5m 1 Type the name of the new drug under New Medication following this pattern Generic Name Brand Name New Medication Naloxone Narcan 2 In the Description field type the condition this medication treats and reference information about th
66. difficult to navigate So it is desirable to minimize the number of palette Items in each profile To accomplish this an experienced facilitator tries to create items that are as generally applicable as possible and can thus be applied to a wide range of scenarios The key is to only include in your palette Items the settings that are directly related to the physiological event represented by that palette Item After reading the Details Palette and Scenarios sections of this guide it should be clear how to build a scenario You may have already tried building your own or modifying some of the factory presets The following four guidelines will refine your ability to build the best possible scenarios 1 How will the scenario begin The first thing to consider is the initial condition of the patient Create a Palette Item to describe this condition Make sure that this first step in the scenario is a complete state that is indicate some selection for each and every available setting on the Details page Remember that only the settings you specify will cause a change in Newborn HAL and all other settings will remain constant So by starting with a complete state Newborn HAL s condition will always be the same when the scenario starts regardless of what he was doing previously Likewise the transition duration of the first step in the scenario should be zero indicating that changes are applied immediately There is one point that ca
67. digit key before loading the protected profile Finally click create to save the new profile To import and export profiles navigate to page 79 Create New Profile Profile Name Winter Session Profile Description security ee Include contents of Default Include contents w of Quick Start iv OR g Copy current profile Newborn HAL User Guide 17 Environment The GaumardUI environment is used by the facilitator as the simulation command center In addition to controlling the simulator s functionality and vital signs the facilitator can evaluate student training This powerful combination of tools provides the facilitator with an indispensable tool for simulation training and testing The Status panel is visible along the left edge of the GaumardUI window at all times After the connection with the simulator is established the status panel displays the current information about the battery level signal strength volume controls levels and vital signs in real time Click the right arrow to expand the status viewer Status ool Appearance Skin Color Muscle Tone crying Throat Sound Breathi Ha Resp Pattern Rate 40 bpm In 20 Right Lung snd Left Lung snd O2 Sat 98 EtCO2 35 Circulation Cardiac pa K Heart Rate 140 bpm Sinus Arrhythmia Heart Sound mmHg Blood Pressure 60 35 mmHg BP sounds L args Absent Pulses Brachial L
68. e Apply panel located at the bottom of the Details tab area to submit GaumardUI only sends updated vital information to the simulator and the virtual monitors settings not specified will remain unchanged Outlined below are common control behaviors in the Manual operating mode Click or tap slider control to adjust numerical values using the stylus Alternatively use the onscreen keyboard to manually type in a numerical value Breathing Resp Pattern Respiratory Rate 56 breaths mi change aspiratory Time ulation Rhythm eart Rate beats min C on rhan 22 User Guide Newborn HAL Click on the down arrow to access sound types and rhythms Upper Airway Sound Resp Pattern nor none piratory Rate stridor inspiratory breaths min stridor expiratory O change stridor biphasic Click on the feature control button to enable blue or disable black features such as crying Some feature controls may not be available depending on the simulator configuration No changes will be made to the simulator until the new settings are submitted using the apply panel J pov Tr Preductal OSat Preductal OSat ia on a change ee change For more information about the simulator s features navigate to the Working with Newborn HAL section of this guide After the settings are selected in the details area changes are submitted
69. e Wound size Adjust the virtual bleeding rate using the wound size slider control The Adv vertical tab includes advanced cardiac circulatory respiratory and environment controls All the controls in this page are unique to the modeling mode The advanced tab gives you more control over the model by allowing you to edit additional parameters that have an effect on the cardiovascular and respiratory systems Use this page if you want to add complexity to a scenario or if you need to superimpose special conditions 28 User Guide Newborn HAL Cardiac irritability can be used to modify cardiac rhythms indirectly You can improve move towards normal sinus rhythm or deteriorate move towards ventricular fibrillation and asystole any of the rhythms greatideter ior ate The progression of rhythms generally follows the pattern displayed in the figure below where X represents normal sinus rhythm multifocal atrial tachycardia atrial flutter atrial fibrillation junctional rhythm left or right bundle branch block or atrio ventricular block X rhythm i X with PACs X with unifocal PYC s X with multifocal PVC s Unifacal V tach Multifocal V tach ee Ventricular Fibrillation Asystole Newborn HAL User Guide 29 Palette The second level of control is the Palette tab page Each item on the Palette represents a complete or partial physiological state The Palette page displays all of the Palette Items in the ac
70. e dosage Description Used to reverse the effects of opioid narcotic overdose Note Dose may be repead in 2 3 min intervals until reaching 10mg 3 Select the units and the administration route Unit pugimafa Unit Other W ug E ug kg W mg E mg kg E g E g kg Route IV Push IV Infusion F IM F Suba E Topical Per Oral E Inhalation Newborn HAL User Guide 59 4 5 6 Enter the drug s Half Life and Peak time If these numbers are unknown use the approximate option Half Life j min Precise 155 Approximate very quick lt 5m Peak Time Precise Approximate very quick lt 5m Enter half maximal effective concentration Medication Response ECSO 0 0001 mg dl Concentration that produces 50 of the maximum effect Available Palettes Apply Items Threshold TT H IEEE I TCI Le Naloxone OD From the list select the dose effect palette created earlier and click the applicable dosage button to assign Repeat this step to assign the over dose effect palette to the Over Dose option Medication Response ECSO 0 0001 mq dl Concentration that produces 50 of the maximum effect Available Palettes Apply Items Threshold Morphine Sulfate OD eae meme Naloxone UD Nirardinine On i 60 User Guide Newborn HAL 7 Select the threshold unit and adjust the value for each dosage effect Medication Response ECSO 0 0001 mg dl
71. e example below node 2 is configured with four alternate paths Once the provider performs any one of the actions listed as key events the facilitator will checkmark the key event to alter the trajectory of the node sequence 2 Deteriorate O gt wait Speech 1 Cardio Drop Additem Add Scenario T Dopamine If the provider administers Dopamine the facilitator checkmarks the Dopamine key event to progress the scenario to node 6 Node 6 is programmed with the effects of the medication 42 User Guide Newborn HAL Node er Node nome O Deserpion Start Node vital signs palettes simulate bradycardia Go to bradycardia node 2 Vital signs palettes deteriorate the patients condition by 15 Care provider has 4 options Each option key event moves the scenario to the node specified If no action is taken the scenario will move to node 3 at the end of Deteriorate E a time limit Keyevent event Atropine Epinephrine Dopamine Pace Node 4 Node 5 Node 6 Node 7 Wait indefinitely vital signs are on hold Provider is to intervene ae Intervention p Keyevent event Atropine Epinephrine Dopamine Pace Node 4 Node 5 Node 6 Node 7 Node vital signs palettes simulate the response to atropine Time limit Go to node 3 after 1 minute l l Node vital signs palettes simulate the response to Enea epinephrine Time limit Go to node 3 after 1 minute Boninin Node vital signs palettes simu
72. e facilitator to select from multiple paths within a node to alter the trajectory of the scenario To add a key event to a node first click the Add path button to add an alternate path and then click the key event Edit button 2 Deteriorate Node Description 3 00 01 Edit CO wait 02 00 No changes are made to mank n iage Delete Speech 1 00 01 confusion What happened i Cardo Drop 01 00 HR 15 BF 10 OSat 5 gt Copy Additem Add Scenano 2 Copy Remove Add path m 40 User Guide Newborn HAL Use the Edit Path window to name sort and create key events First type a name for the action and then click Add Edit Path Key events Selected Rename Delete Action Linked Action Defibrillation Shock Cardioversion Shock Newborn HAL User Guide 41 After the action is added to the Key Events list assign the node that this action will move the scenario to using the Go to menu Click OK to save changes Edit Path Key events Selected A Move Rename Delete Action ss Linked Action Defibrillation Shock 200 Joules Shocks Cardioversion Shock 100 Joules Shocks Non Sync Shock 100 Joules Shocks External Pacing 40 mA Add Coin n cancel 1 Start Bradycardia 2 Deteriorate Evalt 3 Interventions 4 Atropine 5 Epinephrine Note 6 Dopamine 8 Pace Previous End In th
73. e gt Exit or set the simulator on STAND BY mode After the simulator is powered down the umbilical cord can be safely unplugged For information about ordering replacement umbilical cords go to page 127 Warning Do not remove umbilical cord while Newborn HAL is in operation Doing so will cause damage to the system BOWEL SOUNDS SYSTEMS S N B0906424 OR HIGHER Auscultate the abdomen for normal and hyperactive bowel sounds Blood Pressure Absent Pulses Systolic Diastolic mmHg Brachial Right change Brachial Left 104 User Guide Newborn HAL TEMPERATURE PROBE PLACEMENT DETECTION The temperature reading on the vital signs monitor is displayed when a temperature probe is placed on the lower right quadrant of the abdominal area To enable the temperature sensor detection feature go to Setup gt Options gt Neonate features Tab Checkmark Use temp sensor and click OK to save The log panel detects the placement of the sensor Details Palette Lab Scenario Model Log Session Title Providers add Oom Emergency Reported Breathing Medication Drug Action Assess responsiveness Action Call for assistance activate EMS Action Open airway head tilt 19 ion Op irway suction Monitor Action Sensor Thermometer ON Monitor Action Sensor Thermometer OFF Action ventilate BYM Action Assess breathing look listen feel Ac
74. e scenario does not respond to the electric therapy e Prompt The software detects the electrical therapy and prompts the facilitator if they would like to advance to the next palette e Auto Automatically advance to the next palette only if the electrical therapy meets the threshold specified Newborn HAL User Guide 37 Unlike linear scenarios which progress from one palette to the next the interactive branching scenario controls allow the facilitator to change the scenario s trajectory in response to provider actions To access the Branching window click the Go to Branching Scenario button on the Scenario tab Details Palette Lab Scenario Speech Log The top panel buttons are used to clear load and save a scenario or to switch from branching to linear scenarios Click Load Scenario to access the preprogrammed branched scenarios in the Quick Start Profile Quick Launch Details Palette Scenario Lab Speech Log The basic process of creating a new branching scenario is the following e Add nodes e Add palettes or scenarios to each node e Add paths to nodes that require provider action e Create key events to alter the progress and trajectory of the nodes within the scenario A branching scenario consists of several Nodes Each node is preconfigured to run a normal scenario or a series of palettes simulating a specific condition or effect To add node
75. eal electrical therapy Do not pace or defibrillate Newborn HAL with real electrical equipment The Gaumard User Interface features a virtual electrical therapy function to simulate defibrillation or pacing Newborn HAL User Guide 7 Getting Started 8 User Guide Newborn HAL Overview Tetherless and fully responsive even while being transported e Powered from an internal rechargeable battery or wall outlet e Battery capable of 300 recharges and e Simulator receives commands from a wireless tablet PC and operate at distances up to 300 feet e Option to operate automatically using Automatic mode or manually by the Instructor e Training Guide with both basic and advanced interactive scenarios e Use pre programmed scenarios modify them or create your own quickly and easily e Installation and training worldwide e Simulation Made Easy AIRWAY e Calibrate head flexion to obstruct airflow and chest rise e Oral and nasal intubation e Use an ET tube or LMA e Sensors detect depth of intubation e Unilateral chest rise with right main stem intubation e Multiple upper airway sounds synchronized with breathing APPEARANCE e Color responds to hypoxic events and interventions healthy mild cyanosis severe cyanosis e Forearms movements reveal muscle tone active medium limp BREATHING e Control rate and depth of respiration and observe chest rise e Ventilation is measured and logged e Sele
76. ection O of this manual 46 User Guide Newborn HAL Lab Laboratory tests are helpful tools for evaluating the health of a patient To simulate this process the Lab tab allows the facilitator to create laboratory tests to aid the provider during simulation Any number of custom templates can be created to supplement many types of scenarios In addition the facilitator is in control of the results of each test Once a laboratory test is prepared the facilitator can send the results to the virtual monitor computer for the provider access during the exercise Details Palette Lab_ Scenario Speech Log Gaumard Lab Reports l Template Description Sent Create New Lab Lab Template Template Description New Template CBC DIFF Platelets Differential A Selected Item ee Metabolic Panel Anion Gap Albumin Alkaline Phos Calcium Choride Deaete f Neonate Blood test For newborn and premie e YYY ja The Gaumard Virtual monitors must be connected before using the file sharing feature To verify the connection go to page 94 To begin navigate to the bottom of the tab and click on the New Template button on the right Lab Template Template Description emp Platelets Differential A Selected Item Cholesterol HDL LDL Triglycerides For newborn and premie x a Newborn HAL User Guide 47 The Edit Lab Results Template window is u
77. ed Range restricts the minimum and maximum value a facilitator can input as a test result Once the test entry is configured click OK to add the new test Hel Add Insert Entry ihe Name HDL Cholesterol Unit mg dL Precision 2 k Normal Range Minimum 35 00 Maximum Allowed Range Minimum Maximum e ee Repeat the process to add more tests and categories using the Category and Single Entry menu Please note that individual items can be moved deleted or modified after they are created Click the Save button to create the new lab template Hel Edit Lab Results Template Name i id Panel Description Cholesterol HDL LDL Triglycerides Category Single Entry add Delete Variable HDL Cholesterol mg dL 35 00 85 00 Cholesterold HDL Ratio 0 00 4 40 Lipid Panel Male Variable Normal Range HDL Cholesterol mg dL 29 00 71 00 Cholesterol HDL Ratio Ratio 0 00 4 90 Lipid Panel Both Variable Normal Range Cholesterol mg dL 0 00 199 00 LDL Cholesterol mg dL 0 00 129 00 Triglycerides mg dL 30 00 200 00 Allowed value range is displayed in Value column It won t be visible when entering data Once a new format is created it is listed on the Lab Template section at the bottom of the Lab tab Use the buttons on the left panel to edit or delete lab templates
78. ed playing palette e Resets vital signs to normal values e Clears out log page e Restart the session clock The session clock is located at the bottom of the window Clocks Transition remaining 00 00 00 ioni 00 00 01 The shortcut key for staring a new session is Ctrl N Clicking on Reset Session Clock resets the clock back to zero It does not have any effect on the transition time remaining on a scenario it does not reset the vital signs or clear out loaded scenarios The session clock may also be reset by clicking on the Session button next to the session time This option allows all the information recorded in the log page to be saved as a text file Clicking on it brings up the Save As dialog box Save in d Gaumard User Interface 3 2 em di Automatic aX installationFiles My Recent Labs Documents d manikins M my recordings network aX profiles aX profiles2 resources ryms My Network Save as type Text files txt t Select the desired name and path and click Save The shortcut key for saving a report is Ctrl S For a sample report look at the figure below or oviders Team model to Brent foo 902 Details Etco2 19 model to erent C00 om pe model to Brent 00 00 Ca es sagen model to anth rere Erco 40 Info con 00 Start 4 Apolied te Anthony coo 700 Palette Start State tose se
79. enario will be halted at the end the transition i e in 10 seconds If the Stop button is clicked again within those remaining 10 seconds the scenario stops immediately p The next button advances the progress indicator to the next item on the scenario Click next when a wait indefinitely palette is playing to proceed to the next palette O lt A Similar to the Next button the Previous button returns the indicator to the previous item in the scenario The Reset button stops the scenario immediately and returns the indicator to the first item in the scenario 32 User Guide Newborn HAL Use the scenario quick launch window to start a scenario with a single click The Quick Launch window displays all the scenarios saved in the current profile D Quick Launch Details Palette Scenario Model Lab Log P Scenario ee e Build new scenarios to expand the number of exercises available in a training program The general process of creating a new linear scenario is the following e Create a vital sign palette item for each state in the scenario e Add the vital signs palettes and wait times to the scenario e Play the scenario e Modify and edit palettes e Save the scenario The first step is to create several vital sign palette items using the Details tab Each palette item will represent a physiological state in the patient s condition during the scenario Remember to program
80. ess for a particular purpose Except for the limited obligations specifically set forth in this one year limited warranty Gaumard will not be liable for any direct indirect special incidental or consequential damages whether based on contract tort or any other legal theory regardless of whether Gaumard has been advised of the possibilities of such damages Some jurisdictions do not allow disclaimers of implied warranties or the exclusion or limitation of consequential damages so the above disclaimers and exclusions may not apply and the first purchaser may have other legal rights This limited warranty applies only to the first purchaser of the product and is not transferable Any subsequent purchasers or users of the product acquire the product as is and this limited warranty does not apply This limited warranty applies only to the products manufactured and produced by Gaumard This limited warranty does not apply to any products provided along with the Gaumard product that are manufactured by third parties For example third party products such as computers desktop laptop tablet or handheld and monitors standard or touch screen are not covered by this limited warranty Gaumard does not provide any warranty express or implied with respect to any third party products Defects in third party products are covered exclusively by the warranty if any provided by the third party Any waiver or amendment of this warranty must be in wri
81. ewer Category let Bene t Newborn HAL User Guide 75 Select the Question with answer region category type and enter the category information title To save the changes click OK Category Options 1 Select Category Type Question with answer region Multiple choice Yes No Multiple choice Disagree Neither Agree or Disagree Agree Multiple choice Unacceptable Poor Average Good Perfect 2 Category Information Problem Description Evaluation Name On Site Reviewer Category 1 Problem description Click Add to include another category Select the Multiple choice category type enter the category information title and click OK Category Options 1 Select Category Type Question with answer region Multiple choice Yes No Multiple choice Disagree Neither Agree or Disagree Agree Multiple choice Unacceptable Poor Average Good Perfect 2 Category Information Provider Tasks and performance 76 User Guide Newborn HAL Highlight the Provider tasks and performance category and then click Add from the Multiple Choice Entry menu Multiple Choice Entry 2 1 Problem Description 2 Provider Tasks and performance Enter the multiple choice information in the entry fields Category Multiple Choice Entry 2 add Remove tosert dep pad Delete arse PJ 1 Problem Description
82. ffects for this medication Drug effect toggle Turn the drug effect off on Controls for fluids and gas administration are found at the bottom of the Drugs page Two fluids can be administered saline or blood Volume ml min statv Concentration L min Startoz To apply any of these options including oxygen select the desired choice and specify the volume or concentration and the rate Then click on Start IV or Start O2 You can pause the administration at any time by clicking Stop Volume Concentration 100 56 User Guide Newborn HAL To add new drugs edit or update existing items and program drug interactions click the Manage Drug List button Change Dose and or Rate Warp Factor Concentration Care Provided Select a drug from the Medication List and click edit to view the medication s properties Add New Medication New Medication Medication Response Medication List Epinephrine Primatene Adrenalin EC50 0 0095 o mg dl Concentration that produces 50 of the maximum effect Description Treats cardiac arrest and other cardiac a Available Palettes g Apply Items Threshold ug dysrhythmias and severe hypotension Common drug Standard Dose Epinephrine SD Epinephrine OD Properties Properties Drug Effect Tester pualma o unit TEDE F ug kg Mmg F mg kg Fg I Test object weight 75 00 kg UpdateGraph oute V V Push N Infusi
83. fully recorded Newborn HAL User Guide 81 F The wizard prompts you with a 2 F Perform a second correct chest compression F A green filled oval indicates that the chest compression was successfully recorded F and so on Calibration Chest Compressions The values from the last compressions user calibration are shown below Press START and do 5 correct chest compressions one at a time following the text cue 3 OK Finish At the end of the calibrating session the wizard shows the average peak depth and duration values for the procedure If you feel you performed the procedures correctly click the Save button Otherwise press the Back button to repeat the calibration Calibration Chest Compressions Press SAVE if you are satisfied with these values or i BACK to re do calibration Sum 972 Peak 278 Duration 0 5 D ea Factory lt Back Finish Notice that you can go back abort or cancel at any time during the procedure Blood pressure cuff calibration should be performed only when the Korotkoff sounds do not match the systolic and diastolic values set from the computer 82 User Guide Newborn HAL Calibration Calibration Wizard Welcome to the Manikin s calibration wizard Proceed only after you have reviewed the calibration section in the user manual Please select the function you would like to calibrate b i Chest Compressions e
84. g Gaumard Session Title Sirnulation 101 Facilitator John Eggert Providers z Charles Parter eam Add m Emergency Reported Airway Breathing Circulation ba Assess responsiveness Determine patency Assess breathing fa h vagal maneuver fe i z Open aira O02 device ale 2 The Evaluation panel always visible at the bottom of the software window allows the facilitator to insert standard evaluations or arbitrary notes into the log The stylus device and hand writing recognition technology makes annotating in real time very fast and convenient Evaluation Care Provided Unsatisfacto ryo Sa atisfactory wif el Newborn HAL User Guide 71 Standard evaluations are given context by their position in the log relative to detected and observed provider actions The following example illustrates this idea Info 00 00 Start scenario Applied 01 00 Palette Asphyxia 1 Details HR 140 BP 83 54 RR 40 Inspire 25 OSat 95 EtCO2 40 Temp 37 Cyano Applied 00 30 Palette Asphyxia 2 Details HR 112 BP 66 43 OSat 80 Cyanosis 71 Charles Parker Action Open airway suction Charles Parker Action Call for assistance additional staffing Charles Parker Evaluation Care Provided Satisfactory Note in the highlighted lines above that the provider Charles Parker cleared the patient s airway called for help and was then evaluated on those ac
85. grastat ml min OOo saty Vasopressin Pitressin pee Verapamil Isoptin Calan umn Starto A brief description is displayed at the top of the window The half life peak time and drug concentration are listed in addition to the standard and over dose dosages Drug Route Dose Adenosine Adenocard X mg v IV Push Onboard Drug Properties Description Half Life 00 00 10 Peak Time 00 00 25 EC50 0 0355mg dl Treats paroxysmal supraventricular tachycardia Note Initial dose is 6mg if no effect is observed in 2 minutes an additional 12mg may be administered This Standard Dose Adenosine SD 6mg 12mg dose may be repeated one more time after 10 minutes if no effect is observed Common drug ly Over Dose Adenosine OD 30mg Enter the dose units route and rate if applicable and click the Administer button Drug Route Adenosine Adenocard IV Push Newborn HAL User Guide 53 By default the Proceed Drug window prompts the facilitator to confirm dosage effects before applying them Adjust the peak effect percentage and or the dosage effect Click Yes to begin administering the drug Proceed Drug 6 0mg of Adenosine Adenocard through IV_Push has just been Administered This dose will be treated as Dose Do you want this drug to take the following peak effect 100 View effect Reverse effect when the drug s level begins to drop To tur
86. hown when there is no communication with the simulator and the program cannot get the battery information The bolt symbol indicates that the power supply is connected When the battery is so low that the indicator turns blinking red the simulator is sent automatically to STAND BY mode to protect some of the simulator s internal components and will not operate until the battery is recharged Please note that the power supply will not re charge the battery and an initial charge is necessary for the power supply to maintain Newborn HAL operating To recharge the battery turn off the GaumardUI software and connect the adapter labeled Charger The volume of each sound can be adjusted from the Status Panel Click on the volume level indicator next to each sound and a volume control will display Select the volume level you want and the sound will be adjusted instantly on the simulator i e there is no need to click Apply Throat Sound Resp Pattern BeA 20 User Guide Newborn HAL The standby button is located on the bottom right corner of the GaumardUl software Use the standby mode to save battery power between exercises Newborn HAL will establish a connection less than one minute after resuming from standby The connection bars will display the connection strength confirming that the wireless RF link between the controller and model has been established Newborn HAL User Guide 21 Details
87. hrough a C Section and is responsive but need some attention after a while all vitals go to a healthy state Francine s Baby Gonde Bab This baby is born with mild asphyxia but no matter how good the interventions are this y disastrous intrapartum complication results in neonatal death This baby is born with a severe asphyxia that has to be treated emmidiately after ventilations and EPI have been given the baby s vitals go towards a good outcome Meconium aspiration syndrome Newborn with mild Respiratory Distress Transient Tachypnea of the Newborn Helen s Irene s Baby Newborn HAL User Guide 45 These scenarios in the Automatic mode are found in the Meds profile There are three linear scenarios and no branching scenarios All shown are for a premature infant patient Scenario Name Linear Scenario Description Adenosine OD Asystole gt severe AVB asthma exited Adenosine SD Asystole gt Sinus Adenosine UD Asystole gt previous rhythm The scenarios in the Automatic mode are found in the Quick Start Newborn Modeling profile There are eight linear scenarios and one branching scenario All shown are for a premature infant patient Scenario Name Linear Scenario Description Variations A Uterine Rupture A Preeclampsia A Healthy Baby B Baby was delivered SVD and is fairly vigorous Healthy Baby A Baby is vigorous and earns good APGARS Flowcharts for these scenarios can be found in S
88. ice that the name of the module is displayed on the right column when it is selected Check Modules 126 User Guide Newborn HAL Consumables Replacements and Optional Parts Contact Gaumard Scientific for a complete list of consumables and replacement parts and their prices C Consumables R Replacements A Accessories U Upgrades M Factory Repair ONLY Item ID Name Type Description 3010 001 A C Virtual Monitor A 17 Touch Screen monitor and desktop 3010 002 D C Virtual Monitor A D C Powered 12 Touch Screen Mobile Monitor with stylus 3010 010 Battery C Rechargeable battery S3010 011 Battery Charger R 100 240 V AC external battery charger 3010 013 Power Cord R 3010 020 Umbilical Cord Kit C S3010 023L L Lower Left Arm C Lower left arm assembly S3010 023R L Lower Right Arm C Lower right arm assembly S3010 027L L Lower Left Leg Light color lower left leg No IV access S3010 027L R Lower Left Leg R Includes knee plastic connectors S3010 029R L 1 O Leg Skin Cover Light color skin cover for right leg tibia bone rm O S3010 031 I O Tibia bones C I O leg tibia reservoir bones 3010 060 Simulator Transport Case R Soft storage and transport case 3010 061 Simulator Transport Case A Hard storage and transport case 3010 080 Simulated Blood Concentrate C S3010 081 Silicone Oil C Oil based Silicone lubricant S3010 085 Modified Neonatal Blood Pressure R BP Cuff for Newborn Hal S3010 Cuff 3010 204 Tablet PC R
89. ilt in drug editor allows facilitators to stay current with new medications or make changes to the properties of existing drugs All of the preprogrammed drugs included in the library are found in the 2008 Handbook of Emergency Cardiovascular Care published by the American Heart Association Follow the steps below to administer a medication directly from the medication tab Begin by selecting a medication from the drug list Details Palette Scenario Lab Drugs Speech Log Gaumard Drug Dose Units Route Naloxone Narcan ug v IV Push Onboard Furosemide Lasix Glucagon Glucagen Heparin LMW Enoxaparin Lovenox Peak Time 00 02 00 EC50 0 0001mg dl Heparin UFH overdose Note Dose may be a Ibutilide Corvert g Standard Dose Naloxone SD 2mg Inamrinone Isoproterenol Isuprel Labetalol Trandate Normodyne Over Dose Naloxone OD 10mg Lidocaine Xylocaine Lisinopril Prinivil Zestril Lorazepam Ativan Magnesium Sulfate Mannitol Osmotrol Metroprolol Tartrate Lopressor Milrinone Primacor Morphine Sulfate Avinza Roxanol Naloxone Narcan Nicardipine Cardene Ls Nitroglycerin Nitrostat Norephinephrine Levophed Procainamide Pronestyl Propranolol Inderal Ramipril Altace Retaplase Retavase ige Dose and or Rate Warp Factor Manage Drug List Sodium Nitroprusside Nitropress Nipride Sotalol Sotacor Betapace Tenecteplase TNKase Tirofiban Ag
90. is automatically logged as a Detected entry These actions include intubation BP cuff placement artificial ventilations and chest compressions The following example shows an entry after a provider performs BVM ventilation 00 03 26 Detected ventilation correct Evaluations are added by the facilitator by clicking on the Satisfactory or Unsatisfactory buttons on the Evaluation panel Team Logging allows the facilitator to evaluate individual providers with a single click For example if provider Charles Parker did a correct procedure the Evaluation entry would be 00 00 28 Charles Parker Evaluation Care Provided SATISFACTORY When the facilitator changes the state of the cyanosis model from the Model page an entry in the text log is automatically generated 00 18 10 Action Hypoxia Model deteriorating Notes can be entered directly from the Evaluation panel or by right clicking on the text log and adding anote The following is an example of a Note entry 00 10 10 Note provider took too long to assess patient Provider actions The Provider Actions section refers to the collection of buttons in the middle of the page It allows the facilitator to accurately keep track of provider actions The buttons are grouped into 5 groups Emergency Reported Airway Breathing Circulation and Medication Anytime the facilitator clicks one of the buttons a time stamped log entry is generated with that particular a
91. isting one Setup Monitors CPR A V FN Help US of new patient ii C 0 Reset Model load patient Import Between Patients Auto Log Settings recent patients To create a new patient go to Modeling Modeling Patient new patient The following dialog box is displayed ag New Patient New Patient Name Term weeks OM Or Height cm Weight kg Other Enter the name of the patient age gender height weight and or additional notes Then click Save Newborn HAL User Guide 89 To load an already existing patient go to Modeling Modeling Patient Load Patient Load Model Patient Select Patient Infor Mebo Newborn is a 33 0 cm His Preeclampsia Shoulder Dystocia terine Rupture Variations Select the desired patient and click on Load Notice that the factory pre set patient Newborn cannot be deleted as opposed to any of the patients that you create yourself which can be deleted Patient information is displayed on the right side and near the top of the Details tab Clicking on Reset Model under the Modeling drop down menu will restore all vitals and physiologic controls to normal state For instance if the ECG rhythm is currently on Ventricular Fibrillation clicking on reset model changes the ECG rhythm back to sinus Use the Import between patients menu to import palettes scenarios and branching scenarios fro
92. late the response to p dopamine Time limit Go to node 3 after 1 minute 7 Vital signs simulate the effect of pacing Scenario ends Aropne A Linked action automatically triggers a key event when virtual electrical therapy is detected To add a linked action first open the Edit Path window Click the Linked Action radio button and select from Defibrillation Shock Cardioversion Shock Non Sync Shock or External Pacing Then set the parameters for response to either joules or number of shocks Delete Linked Action Electrical Therapy Defibrillation Shock Joules Shocks Joules Shocks Joules Shocks mA ma Goto m an 8 Cardioversion Shock 4 Non Sync Shock 4 O External Pacing 40 AF TET LA TE a ale Newborn HAL User Guide 43 Specify the Go To node the linked action will move the scenario to and click the Add to insert the electrical therapy into the Key Events Click OK to save the changes Edit Path Key events Defibrillation gt 3 Shocks Selected Rename Delete Linked Action Electrical Therapy Model Medication Defibrillation Shock 3 Joules Shocks Cardioversion Shock 4 Joues Shocks Y Non Sync Shock 4 Joules External Pacing 40 mA Go to OK Conca In Automatic Mode a Model Medication tab is also available to add medications from the Drugs list to the branching scenario Similar
93. lows standardized presentation of symptoms Scenario Item a Palette Item that is part of a scenario Scenario Items may also represent a fixed delay period Wait or a pause Wait Indefinitely Stylus a special pointing device for the tablet computer The stylus is the fastest and easiest means of controlling the Newborn HAL software See the Equipment Set up section of this guide for more information on working with the stylus 10 User Guide Newborn HAL Equipment Set up Newborn HAL User Guide 11 Control Tablet Computer The touchscreen tablet computer serves as the simulator s control center Startup and control commands are sent from the Gaumard control software GaumardUl to the simulator wirelessly using the RF communication module shown in the next section Please refer to the computer s documentation for important user and safety information before powering on the tablet computer for the first time The stylus operates very much like a mouse You will notice that the pointer moves when the stylus is held near but without touching the screen Tapping the screen with the Stylus tip is like clicking the primary usually left mouse button Holding the stylus button while tapping the screen is like clicking the secondary usually right mouse button For working with the Gaumard control software and many other applications the Stylus input is far Superior to a mouse in both speed and comfort
94. lpha 1 68 Compared to Additive individual drug effect reduced by 39 70 om Time min First select the drug from the drug list that will be programmed to interact with the current medication and click Add Information about the interactor drug is displayed in the Interactor Data window EC50 0 0001mg dL Interactors Remove Remove All edit Drug List Captopril Capoten Interactor Data Half Life 01 54 00 Peak Time 01 00 00 SD 25mg oD 75mg EC50 0 0240mg dL 62 User Guide Newborn HAL Once added the drug is shown in the interactors list Repeat the process to add more drugs to the interactors list if necessary Interactors Sodium Nitroprusside Nitropress Select the interactor and click Edit Interactors Captopril Capoten Sodium Nitroprusside Nitropress On the right adjust the Max Alpha to modify the type of interactivity effect Monitor the graph for a visual model of the plasma concentration e Alpha 1 Additive e Alpha lt 1 Synergistic Induction e Alpha gt 1 Antagonistic Inhibition SB Max Alpha 0 75 Wj a om E T T B 2 m O z m m O 100 15 201 Naloxone Narcan mg dL 10 6 Newborn HAL User Guide 63 The test panel simulates the interactivity between the drugs based on dosage and time of administration Test Panel Test object weight 75 kg Time Effect Graph Apply Naloxone Narcan interaction Naloxone Na
95. ly to the Electrical Therapy entries the Model Medication is added via Edit Path Linked Action Select from a list of medications dose and routes click Add to list in the Key events window then OK to add to the path itself Model Medication events use blue text in the node display Medication Dose Route Rate Adenosine Adenocard SD W Infusion medium Goto cman Node 1 of a Cardiac Arrest branching scenario with Model Medication and Electrical Therapy paths added 44 User Guide Newborn HAL FACTORY PRESET SCENARIOS MANUAL MODE These scenarios in the manual mode are found in the Quick Start Newborn profile There are eleven linear scenarios and no branching scenarios All shown are for a premature infant patient Alice s Baby Healthy baby Baby has an asphyxia attack and the providers need to give ventilations to help bring pe cL back the vitals to a healthy state Baby is born with a mild asphyxia that needs attention Once ventilations is started the Beth s Donna s Baby baby s vitals go to a healthy state Male infant with central cyanosis limp flaccid and requires immediate resuscitation No Cynthia s Baby spontaneous movement of right arm is noted Stat CXR reveals a fractured right clavicle and right pneumothorax NOD This baby is born with moderate asphyxia and will require CPR and oxygen to bring the Bane s Baby vitals to a healthy state This baby was born t
96. m other patient profiles into the current active one 90 User Guide Newborn HAL To begin select the item category to import i Import Between Patients Importing Select Scenarios Branching Scenarios Anthony is m Brent Start State Then select the patient name that contains the items that will be imported into the active patient Importing Palettes Select Anthony Asystole Brent Healthy Res Christian Start State V Tach apne Sie TERN Frank Koila dia Pa VEib For this example select one or more palettes to import from the list and click Import Darrell Hal Healthy Resting normal vitals Start State The palettes are now imported and saved into the HAL patient Hal Healthy Resting normal vitals V Tach stable RR 16 Insp 40 va VFib V Fib This menu option is used to specify various vitals to be logged automatically after reaching a specific threshold Auto Log Setting Auto Log Log Vitals when Heart Rate changes more than Systolic BP changes more than Diastolic BP changes more than Resp Rate changes more than Insp Percentage changes more than EtCO2 changes more than Sp O2 changes more than Temperature changes more than Monitors Use the Monitors drop down menu to enable disable sensors on the virtual monitor screen share files program custom scalars and verify the
97. mardUI icon on the tablet s home screen to start the simulator If you are working with the PRO system login by entering admin for the user name and password fields then click submit to continue eIC Event Triggered Cameras KbPor User Login Password suet User Name admin Password admin The simulator selection menu is shown Select Newborn HAL and click Start E Gaumardul Version 1 29 13 0 L Please select one Simulator Newborn HAL The RF link between the computer and the simulator is established in approximately 1 minute or less hs min Sounds ange change upper Communication info 16 User Guide Newborn HAL When the GaumardUl is not active the simulator is in stand by To troubleshoot connection and startup issues go to page 123 Profiles and Operating Modes A profile is a unique configuration of customized palettes scenarios and options Each Profile functions independently in that changes made to one profile have no effect on the others Manual Mode In this operating mode vital signs and other responses are changed according to the specifications given by the instructor Newborn HAL Profiles Select Operating Mode Manual Automatic Profiles Profile Description Default Profile Default Quick Start Newborn Manage Rename pea The p
98. n cause confusion and warrants further explanation It is an extension of the above discussion of partial states The issue is best illustrated through the following example Suppose that you are creating a Palette Item to start your scenario In this case you have decided that the patient will be apneic The question is How should the lung sounds be set Most people s first inclination is to set the lung sounds to none This is incorrect despite apnea Obviously no lung sounds should be heard during apnea but since you have already set respiratory rate to zero none will be Sounds are synchronized to the breathing cycle What you are really setting here when you choose a lung sound is the condition of the lungs given respiratory drive That is if the patient s respiratory rate were changed from zero what sound would be heard Assuming that the lungs themselves are normal in this scenario you would choose normal for the lung sound setting Then as the scenario progresses if the patient starts breathing there will be no need to set the lung sound again It will already be set The same principle applies to the heart sound and other settings 2 Include notes to guide the facilitator during the simulation It is common for scenario designers especially those who act as facilitators to neglect the importance of notes in the scenario They think that they will remember the learning objectives patient history and other details
99. n off the Proceed Drug prompt go to the menu bar and click Setup gt Auto Responses then change Drug Model Effect to Auto alloff Link All Auto Response to Cardiac Irritability Modeling none off slight random On if Cardiac Irritability is 9 2t random multichoice is enabled pono me All Auto External Pacing Defibrillation Shock Cardioversion Shock Off Off eee Off mm Prompt EP Prompt Prompt Auto 2 Auto Ss Auto Ss Setting at at Setting Setting Capture at Joules 100E Joules 40 mA Et Shocks Shocks convert to NSR convert to NSR 75 bpm BP 75 bpm BP to paced hythm r ae 120 80 120 80 coe 54 User Guide Newborn HAL Display warning when non shockable cardiac rhythm is shocked Non Sync Shock Off Prompt Auto SS Setting at 100 2 Joules Shocks la degrade to ventricular fibrillation Drug Model Effect gerr Prompt Auto Drug takes effect according to the dose applied auto or user setting prompt The administered drug panel displays information on dosage rate percentage of dose completed and total time of administration Drug _Dose Units Route Rate me Amiodarone Cordarone 0 IV Push 3639 025ug kg 02 12 14 In addition if a drug interaction is detected information about the effect and the interactor is displaye
100. n ventilation ratio e Set number of ventilations per minute if the Only Ventilations button is selected 86 User Guide Newborn HAL Checkmark Once a Palette is applied load to Details Tab to show the value of each of the palette s vital signs parameters on the Detail s tab control entries GaumardUl is capable of interfacing with a number of third party A V recording systems Checkmark the Use AV System to enable the AV setup option on the menu bar For more information about the A V menu go to page 96 Checkmark Use Fetus Neonate Link to enable the F N setup menu on the menu bar For more information about using the Neonate Link feature go to page 86 Options Environment General Newborn Hal Add Ons Neonate Features Tolerances Once a Palette is applied load to Details Tab Use Fetus Neonate Link E Use AV System _ Start AV Automatically on Scenario Start _ Output Log Events to Windows Log Link Respiration sensor to ECG Leads sensors The Remote Access via Network connection feature allows the simulator to receive control commands from the virtual monitor computer stationed at the bedside In this configuration the RF module is connected to the virtual monitor computer instead of the control tablet The close proximity between the RF module and the simulator may provide better connectivity in environments with solid walls
101. o create a new lab report go to page 47 Add Palette Item o ID 0H OF H 59 59 Max Item Description Lab results are sent to the Gaumard Monitors screen The scenario auto response settings move the scenario to the next palette item when virtual electrical therapy is detected Use the Virtual Shock panel to simulate electrical therapy intervention Warning Do not defibrillate or pace Newborn HAL Preemie with real medical equipment Doing so will result in damage to the simulator s internal components Auto responses advance to the next palette if the virtual shock is applied while a wait indefinitely palette is being played and if the simulator s is in a shockable rhythm Scenario Brent automaticresponses settings Display warning when non shockable cardiac rhythm is shocked External Pacing Defibrillation Shock Cardioversion Shock Non Sync Shock Setting Capture at to paced rhythm m Setting at J Joules C Shocks advance to next scenario item when at INFINITE WAIT Setting at Joules C Shocks advance to next scenario item when at INFINITE WAIT off C off C off off pa C Prompt a Prompt oie Prompt oie Prompt re N C Auto 4 Auto i 3 Auto SS C Auto NS Setting at eS Joules Shocks advance to next scenario item when at INFINITE WAIT pm fein The three response options are defined below e Off Th
102. o to the Scenario tab and click Load Scenario The Load Scenario dialog box appears Select a scenario and click on Load For a list of all the scenarios available go to page 45 Linear scenarios are composed of vital signs palette items and wait palette items played in succession Vital sign Palette items E need to give ventilations to help bring back the vitals to a healthy state mores Name Transition Description s Asphyxia 1 00 00 Crying none NSR HR 140 RR 40 BP 83 54 02 Sat 95 Selecta p Wait Indefinitely m Wait for suction and 02 B Asphyxia 3 00 30 Limp RR 0 02 Sat 70 HR 55 BP 35 20 i Wait Indefinitely n Wait for ventilations and chest compressions b Asphyxia 1 01 00 Crying none NSR HR 140 RR 40 BP 83 54 02 Sat 9 Progress indicator Wait palette items During the scenario each vital signs palette updates the patient s condition As outlined previously palette items are created using the Details tab The transition time trends the increase or decrease of numerical vital signs such as blood pressure over seconds or minutes Wait palettes do not update or change vital signs Instead wait palettes give the provider time to perform an action this may be treatment in response to a complication or performing a standard assessment Newborn HAL User Guide 31 Scenarios are controlled using the buttons at the bottom of the tab The same way a music player plays songs the scenario pla
103. ock Panel shortcut on the main screen me w FM ME usien Tak Gaumard Legend Oo of The shock panel is a floating control used by the facilitator to administer electrical therapy to the patient via software For more information on working with the shock panel during a scenario go to page 22 Shock Pace Panel Wirtual Shock Virtual Pacer Close u c L Newborn HAL User Guide 85 Customize the following simulator specific features e Fine tune the pulse intensity for normal blood pressure e Synchronize the leg blood pressure to the arm blood pressure when the values are not specified e Synchronize post ductal and pre ductal oxygen saturation parameters when values are not specified e Use temperature sensor Mptions Environment General Newborn Hal Add Ons CPR Options Tolerances Other Pulse Cyanosis ET Tube Sensor Set pulse If the system gives strengths Set Waz false ET tube for normal cyanosis readings it needs to EFP level be reset Simply 60 40 remove the ET tube from the baby and click on the button below 1 0 30 J H E Reset ET Tube ae T Sensor Head Position Defaut Defaut Lise HP sensor Virtual Temperature C Use ternp sensor 6 h Cancel Customize the compression to ventilation ratio signaled by CPR Trainer prompt e Set the number of compressions per minute e Set the compressio
104. on 112 User Guide Newborn HAL Newborn HAL Gaumard ae Simulators for Health Care Education Elaine s Baby This baby is born with moderate asphyxia and will require CPR and oxygen to bring the vitals to a healthy state Administer 100 O2 with bagging Wait Indefinitely for actions Newborn HAL User Guide 113 Newborn HAL Gaumard Simulators for Health Care Education Francines s Baby This baby was born through a C Section and is responsive but needs some attention after a while all vitals go to a healthy state Warm baby apply suction and administer O2 Wait Indefinitely for actions 114 User Guide Newborn HAL sonerd Newborn HAL Siroulators for Health Care Education Gloria s Baby This baby is born with mild asphyxia but no matter how good the interventions are this disastrous intrapartum complication results in neonatal death Begin PPV Wait Indefinitely for action Begin PPV and chest compressions Wait Indefinitely for action Administer Epinephrine Wait Indefinitely for action Newborn HAL User Guide 115 a Newborn HAL Sredabors Sor Health Cine Eckocation Helen s Irene s Baby This baby is born with a severe asphyxia that has to be treated immediately
105. on F IM F Topical E Per Oral E Inhalation Half Life hr min c Precise oF 24 oF Approximate very quick lt 5m Peak Time gt hr min sec Precise al oF 305 Approximate very quick lt 5m Newborn HAL User Guide 57 First go to the Details tab and create a palette item with vital sign parameters consistent with the effects of a standard drug dose Then create an additional palette for the effects of an overdose These two palette items will be later used to program the medication s dosage effect For general information on creating a palette items go to page 30 Right Heart Chambers Left Heart Chambers Regurgitation Tricuspid Pulmonary Regurgitation Mitral Aortic Resistance iv i Resistance i Contractility Contractility normal 100 on bead normal 100 ak Sed Circulatory Blood Volume ml Cardiac Irritability slight improve Vascular Properties Vessel Diameter l Vessel Stiffness I Respiratory Shunt flow 8 Dead Space ml PH Environment ambient Pressure ATM Inspired Air Mix 02 After creating the dose effect palettes got to the drug tab and click the Manage Drug List button Warp Factor lt ml Rate ml min StatiV Rate L min Starto 58 User Guide Newborn HAL The A
106. owing effect Standard Dose v View Effect C Reverse effect when the drug s level begins to drop Yes No Effect Manually select the best possible RF channel for tablet simulator communications by selecting Setup then Scan RF channels The following notice displays while the scan is in progress When the scan is complete a series of bars will display with the highest bar indicating the best signal On mouseover a popup will display Recommended Channel over the channel bar with the best measured signal The other bars will only display a Double Click to Select Channel message Channel Strength J Recommended Channel Double Click to Select Channel Click on the recommended channel in the graph to select it The following message will display while the command is processed The new channel should subsequently ensure four solid bars display in the communications indicator at the top of the Status bar Modeling Automatic Mode Only The Modeling drop down menu in the top left corner of the GaumardUI contains four options Modeling Patient Reset Model Import Between Patients and Auto Log Setting Setup Modeling Monitors CPR Modeling Patients Reset Model Import Between Patients Auto Log Settings This option allows you to create a new patient or load an already ex
107. p up menu and click OK to share Enter Context Name X ray Chest 92 User Guide Newborn HAL Files currently shared are listed on the Shared Files list Shared Files File Context Name X ray 1 bmp X ray Chest Once a file is added to the Shared Files list a yellow notification icon is shown on the patient menu at the top left of the virtual monitor screen The icon notifies the provider that a file is available for viewing Click on the patient name button to bring down the selection of available files and select the context name to open p Blood Test The x ray file is now open To troubleshoot file sharing access errors go refer to the Gaumard Monitors Guide Use the custom numbers menu to add custom numerical parameters to the virtual monitor main screen such as a glucose levels or a platelet count On the GaumardUI menu bar click Monitors gt Custom Numbers to open the Custom Numerical Parameters on Monitor menu Click the Add button to create a new parameter Custom Numerical Parameters on Monitor s Load Type the name and units of the new parameter and then click OK Custom Numerical Parameters on Monitor s Name Hematocrit The scalar parameter is now created Enter a value for the parameter and click Update Remove Hematocrit 52 update Glucose 83 mg dl update On the
108. plays a green light The charger indicator light will show red during the charge period and green once the process is complete The simulator s battery charges only when the control software is disabled Avoid using the simulator while the battery charger is connected If the simulator is in use while the charger is connected the battery will not charge To charge the battery you must 1 If connected unplug the charger adapter from the simulator and the wall outlet 2 Turn off the simulator by closing the GaumardUI control software 3 Re connect the charger adapter to the wall outlet and the simulator s battery port 4 Leave the simulator charging for 2 3 hours with the GaumardUI control software disabled Newborn HAL has a maximum battery runtime of approximately 3 hrs Total runtime is dependent on factors such as breathing sounds seizures and muscle tone The battery status is displayed on the software status panel after the connection with the simulator is established For more information about the battery indicator refer to page 20 WARNING Do not store the simulator with a discharged battery It is good practice to re charge the battery at the end of every simulation session If the simulator will not be used for an extended period re charge the battery at least once every 3 months to prevent the permanent loss of the battery s total charge capacity due to self discharge U
109. r extended or hyper flexed Calibration Calibration Wizard Welcome to the Manikin s calibration wizard Proceed only after you have reviewed the calibration section in the user manual Please select the function you would like to calibrate Chest Compressions Artificial Ventilation Blood Pressure Cuff Head Position Hold the head in the position shown hyper extended or hyper flexed with the desired level and click the OK button A green filled oval indicates the value was successfully set Calibration Head Position Calibration Hold Newborn Hal in the position shown and click nT OK i il Hyper Flexed Calibration Head Position Calibration Hold Newborn Hal in the position shown and click OK Calibration Head Position Calibration Hold Newborn Hal in the position shown and click Once the prompt reads Done the facilitator can go back and calibrate another function or click the Finish button to close the calibration wizard and go back to normal operation Factory Settings is a very useful tool to consider when recalibrating It restores the sensors to factory settings over riding any calibrations performed by users Make sure that when you are restoring the sensors to the factory settings that no one is practicing chest compressions ventilations intubation or reading a blood pressure Any of these actions may interfere with the reset Each time that one of
110. rcan only Dose 2 mg Attime 9 OF Captopril Capoten only Apply Captopril Capoten Dose 2 mg Attime OF OF Results Attime 00 09 00 Max Interaction Effect 96 17 Alpha 1 00 15 Time min To simulate the interaction first enter the patient s weight and then the dose for each drug Test Panel Test object weight 75 kg Apply Naloxone Narcan Dose 2 mg At time Apply Captopril Capoten Dose i mg At time Test Panel Test object weight 75 kg Time Effect Graph A N int ti pply Naloxone Narcan a oe wee an Dose 2 mg _ Attime OF 105 aptopril Capoten only Apply Captopril Capoten Dose 25 mg Attime 9 Results At time 01 27 03 Max Interaction Effect 93 38 Alpha 1 01 Compared to Additive individual drug effect reduced by 0 08 Time min The results indicate that the maximum interaction effect 93 38 occurs at 01 27 03 The alpha at that point is 1 01 and the drug effect for each drug is reduced by 0 08 If the drug interaction effect is not realistic fine tune the Max Alpha control and retest Results t time 01 27 03 Max Interaction Effect 93 38 Alpha 1 01 Compared to Additive individual drug effect reduced by 0 03 64 User Guide Newborn HAL A time effect graph is also generated from the test results Tap and hold to draw a zoom area Time Effect Graph interaction Naloxone Narcan anky z Capoten onh E
111. rofiles available under Manual Mode are the following Default Profile includes one palette with healthy vital signs When creating a new profile it is often useful to include the Default profile contents and begin customization from that foundation Quick Start Newborn contains eleven scenarios It is recommended that first time users select the Quick Start profile which was created in conjunction with experienced healthcare instructors and working medical professionals It contains prebuilt scenarios for simulation and it serves a convenient starting point Once the operating mode and profile is selected click Load to continue Automatic Mode In this mode vital signs respond automatically to caregiver participation instructor specifications and pharmacologic intervention The model used in_ this operating mode was developed based on physiologic principles Features unique to this mode include a comprehensive list of drugs for easy administration a drug profile editor for adding new drugs or editing existing ones among functions To activate this operating mode as an upgrade option go to page 85 Newborn HAL Profiles Select Operating Mode Manual Automatic Profiles Profile Description Default Modeling Default Modeling Scenarios Meds Profile Quick Start Newborn Modeling Manage The profiles available for the Automatic operating mode are Default Modeling When creating
112. rols for the lung sounds are located on the status panel Enable or disable the right or left lung independently Ventilate using a BVM or a mechanical ventilator To display chest rise during ventilation and receive feedback on the CPR window set the lungs to the Enabled state and the respiratory rate to 0 For more information on the CPR trainer go to page 94 Cardiac Auscultate realistic heart sounds synchronized to the heart rate and heart rhythms ECG MONITORING AND ELECTRICAL THERAPY The conductive skin sites allow the use of real EKG electrodes Track the cardiac rhythm with real equipment just like with a human patient Warning Do not pace or defibrillate the simulator Doing so will result in damage to the simulator Use the virtual shock panel to simulate the administration of electrical therapy via software To enable the virtual shock panel feature go to page 85 Circulation Palpable pulses are dependent on blood pressure Use the software controls to disable distal pulses and simulate severe hypotension PROGRAMMABLE BLOOD PRESSURE Use the modified sphygmomanometer included with the system to get blood pressure readings controlled by GaumardUI In addition auscultate the Korotkoff sounds using a stethoscope Connect the Luer Lok fitting on the end of the extra branch to the Luer Lok port on the simulator s left shoulder Bilateral IV training arms allow intravenous infu
113. s click the Add node button Quick Launch Details Palette Scenario Labor Lab as Labor 1 Log Clear Load Save Auto Res ponses Go to Normal Scenario 38 User Guide Newborn HAL Click the node s identifier number to edit the node properties Enter a name for the node and description then click Save Node Properties Unique Identifier i Description In this example the following nodes are created 1 Start Bradycardia 2 Deteriorate 3 Interventions 4 Atropine 5 Epinephrine 6 Dopamine and 7 Pace Each node is programmed with palettes that simulate the effect described Newborn HAL User Guide 39 A path refers to the trajectory from one node to another after the last palette in a node expires Click on the Time Limit icon to modify the Go To point for the default path Path Go to point Configure the countdown timer and the go to point for the default path Click OK to save Set Time Limit After After the last palette expires the scenario will move on to the node as indicated by the arrow Node 1 is now configured to continue to Node 2 as indicated by the path s time limit re Node Description O gt bradycardia 00 00 RR 10 HR 45 2nd deg AVB Speech 1 00 01 complaint Feel dizzy Add item Add Scenario Key events allow th
114. s it adjust related physiological parameters GaumardUI includes several patients in the Quick Start Modeling profile Each patient simulates a different complication Newborn is loaded as the default patient when the Quick Start Modeling Profile is selected and it is an ideal candidate for most simulations Information about the patient is shown on the right panel For information on creating new patient profiles go to page 89 In the automatic mode the Details tab includes additional vital sign parameters and control options Details Palette Lab Drugs Scenario Log Gaumard Legend Clear Settings Load Palette Item Save as Palette Item on or Reset with fetal Data Model On Pause Reset Airwa arance Cyanosis Level Patients Info g Name Newborn Upper Airway Sound x D Crying Muscle Tone Auto Gender M1 Terr 40 weeks Breathing Respiratory Pattern v Lung Condition v Height 35 0 cm Se Weight 2 5 k Respiration Pattern End Tidal CO2 general pre post ductal 2 TEN bpm Resp Rate Auto mmHg 02 Saturation H Auto O change EJ coz Auto oO change to iration Av OSat Auto EXrspiration ia Total CO2 level v change Ero Volume Auto ia Total 02 level v2 Left Lung Right Lung Chest Rise Chest Rise
115. scenario controls Use wait palette items to give the care provider time to perform an assessment or action fa Add Palette Item Transition sec OF 59 59 Max Item Description Care provider intervention H Name Description gt initial state Initial condition all vital signs are specified pianos Wait Care provider intervention and assessment A Send Lab Lab Results 1 Lab results are sent to the Gaumard Monitors screen 7s Selected Item Move Wait Indefinitely bon Hold in current state until action is taken Improvement Vital signs improve 50 in 45 seconds Healthy Resting normal vitals are loaded immediately After the scenario is completed click Save Scenario to store the scenario in the current profile for later use Save Scenario Scenario Name Allergy to medication Scenario Description Demo scenario O Swe Cancel 36 User Guide Newborn HAL Instructors can also incorporate the following features into a scenario for added realism e Auto responses Automatically move onto the next palette item when electric therapy is detected e File sharing and lab reports Send lab reports to the virtual monitor computer The scenario can also automate the distribution of shared files and labs Click on the Add to scenario button the select the File and Lab tabs to view the files available For more information making files available for file sharing go to page 91 and t
116. sed to create templates that will be later used to create lab reports Hel Edit Lab Results Template Description Category Single Entry ee ee ee Allowed value range is displayed in Value column It won t be visible when entering data Enter a name for the lab template followed by a description Categories are used to group a series of tests in a lab report From the category box click Add to name and create a category He Edit Lab Results Template Name Lipid Panel Description Cholesterol HDL LDL Triglycerides gia eee Remove Rename Insert A v add Delete Edit Insert A A HS Category Name Lipid Panel Female Comment Then click OK to save the new category Use the Single Entry menu to add a test under the category previously created EI Edit Lab Results Template Name Liquid Panel Description Cholesterol HDL LDL Triglycerides Category Single Entry Add Remove Rename Insert A vyv Delete Lipid Panel Female Variable 48 User Guide Newborn HAL Use the Add Edit Entry menu to customize the different parameters on a specific test Begin by providing the name of the test unit and decimal precision The Normal Range will be displayed on the lab report for the provider to use as guide while reading the results Meanwhile the Allow
117. sions as well as drawing fluids Newborn HAL User Guide 101 Follow the steps below to fill the IV vasculature for drawing fluids 1 Fill the modified syringe with water or diluted Gaumard simulated blood 2 Connect the syringe into the fill port and the drain connector to the drain port as shown 3 Slowly push the fluid into the IV circuit until it begins to flow out of the drain connector 4 Remove the fill syringe and drain connector The self sealing ports will keep the fluid inside the veins Repeat the procedure to fill the IV vasculature on the lower leg During infusion exercises always leave the drain tube attached and direct the outflow into a container Warning Fill the IV vasculature with diluted Gaumard simulated blood only Any other simulated blood brand containing Sugar or additives may cause blockage and or interruption of the vasculature system 102 User Guide Newborn HAL Do inject into or fill IV systems without the drain connector in place Doing so could result in damage to the self healing ports Use flashlight to detect dorsal pedal injection site on the left foot veins simulators with serial number BO906424 or higher ONLY IM sites are located on both deltoids and quadriceps for placement and technique exercises Warning Do not inject fluids into the intramuscular sites The intraosseous access allows for infusing fluids blood and or
118. t CPR Monitor Effective Max Min Ventilation Range 30 VENTILATION COMPRESSION Pause Model will pause at the current state Improve Model trend to a healthy state Once the model reaches the complete Healthy state the model will go to Pause mode Deteriorate Model will trend to a severe cyanotic state If ventilations given to the neonate are of correct depth and between 40 and 60 per minute the vital signs will improve Otherwise they will continue to deteriorate The facilitator can quickly jump to any of the three points in the state of the model Healthy Pedi is pink with adequate oxygenation Mild Cyanosis Pedi is bluish and vital signs are starting to deteriorate Severe Cyanosis Pedi is blue apneic and vital signs are rapidly worsening Improve Gain Moving this slider will help increase or decrease the cyanotic response to ventilations Oxygen By selecting an oxygen rate the baby will improve faster with proper ventilation Flow On must be selected to activate the oxygen response Epinephrine Select the desired epinephrine dose and then select Administer Immediately the heart rate of the Newborn HAL should rise and the dose on board should start diminishing over time The dose should be enough to increase the heart rate a small percentage in order to help the oxygen delivery in the system therefore helping improve the neonate with proper ventilation Reset
119. the other hand sometimes it is not possible or desirable to determine the responses before the simulation begins Different environments and applications call for different settings Some teaching practices are best done with the auto response settings in Prompt mode Responses must be triggered by a vigilant facilitator Though it is slower and requires more attention the benefit of Prompt over other modes is that the simulation can be allowed to go in any direction and it will be possible to choose the response on a case by case basis Other learning exercises require a higher degree of automation For such applications most facilitators choose Auto mode for the auto response settings The key issue is standardized timing of symptom presentation A consistent repeatable simulation is essential for fair assessment of that care provider in relation to others and for the broader interpretation of results in the context of training validation studies When in doubt it is best to choose Prompt mode in which the facilitator will be given direct control of the responses as events are detected Advanced users may find it helpful to understand the GaumardUI directory structure With direct file manipulation one can easily move palette items and scenarios between profiles as well as move entire profiles from one computer to another Ei Desktop My Documents 4 My Computer S Local Disk 0 4 E gt Program Files E Gaumard Scientific
120. ting and signed by an officer of Gaumard In the event of a perceived defect in material or workmanship of the Gaumard product the first purchaser must Contact Gaumard and request authorization to return the Gaumard product Do NOT return the Gaumard product to Gaumard without prior authorization Upon receiving authorization from Gaumard send the Gaumard product along with copies of 1 the original bill of sale or receipt and 2 this limited warranty document to Gaumard at 14700 SW 136 Street Miami FL 33196 5691 USA If the necessary repairs to the Gaumard product are covered by this limited warranty then the first purchaser will pay only the incidental expenses associated with the repair including any shipping handling and related costs for sending the product to Gaumard and for sending the product back to the first purchaser However if the repairs are not covered by this limited warranty then the first purchaser will be liable for all repair costs in addition to costs of shipping and handling In addition to the standard one year of coverage the following support plans are available Two Year Extension covers second and third years Call for pricing USA only 128 User Guide Newborn HAL Gaumard Simulators for Health Care Education Contact Us E mail Technical Support support gaumard com E mail Sales and Customer Service sales gaumard com Phone Toll free in the USA 800 882 6655 Worldwide 01
121. tion 02 device nasal cannula The virtual monitor touchscreen display simulates the functionality of a patient vital signs monitor Users can customize the type of waveforms and scalars displayed set alarms and display lab reports x rays and other files for the provider to access during simulation 17 03 57 For information on how to setup Gaumard Monitors with GUI please refer to the help File included with the Gaumard Monitors software The Pro system is an all in one session recording and simulator control solution for facilitators in a lab or mobile environment The built in GaumardUI software allows the facilitator to control Newborn HAL while recording care provider interaction and event logs The upgrade replaces the standard tablet with a convertible touchscreen laptop loaded with the Pro environment and GaumardUl 2 WIFI enabled cameras 1 motorized 180 view USB camera and carrying case COON gt Te Tom mu m o For more information on using the Pro system refer to the documentation included with the upgrade option Newborn HAL User Guide 105 Appendix 106 User Guide Newborn HAL More about Scenarios Factory Preset Scenarios 3 Beth s Dona s Baby 9 s 1 TTN Newborn HAL User Guide 107 C C C C C ES OO Preeclampsia A En o eom Quick Start Newborn Modeling Automatic Branching M 108 User Guide Newborn HAL
122. tion is Providers will be evaluated by the system based on this criteria The chest compressions and ventilations are calibrated the same way After making a selection this window Is displayed The software will now ask you to perform a number of correct chest compressions or artificial ventilations depending on what you are calibrating Calibration Chest Compressions Please select the type of calibration you would like to do Normal Calibration You will be asked to b fa c perform based on your criteria Providers Sees vwilbe evaluated based on that criteria Never calibrated Calibration Chest Compressions The values from the last compressions user calibration are shown below Press START and do 5 correct chest compressions fone at a time following the text cue Never Calibrated Doi Finish The facilitator should follow the text cue on the screen to perform just ONE compression or ventilation at a time until prompted for the next one For example if calibrating chest compressions The wizard prompts you with a 1 Calibration Chest Compressions The values from the last compressions user calibration are shown below Press START and do 5 correct chest compressions one at a time following the text cue 1 Finish Factory F Perform one correct chest compression F A green filled oval indicates that the chest compression was success
123. tion with the simulator Then click the Can t find Serial Number to retrieve the serial number from the simulator you are currently connected to Jot down the serial and switch over to the FIXED mode once the information is saved Options Neonate Features Newborn Hal Add Ons _ GENERIC Find and establish a connection with Newborn Hal Please switch to FIXED once e FIXED The software will enable controls for features available on your simulator FIXED Newborn Hal Setup Enter the Serial Number from the Newborn Hal simulator that THIS computer will control SN on RF Module B 8505004 Can t find Serial Number Automatic Channel Change Select desired channel 1 5 E Check noise in channel 0K Cancel Use the Select desired channel field to set the channel that the RF module will use to communicate with the simulator Checkmark the Check noise in channel button to switch automatically to a cleaner channel if poor signal or interference is detected Manually assign a unique channel for each simulator to prevent crosstalk when operating multiple Gaumard simulators in close proximity For best results leave one channel open between the channels in use Set the intensity tolerances for the following features e CPR intensity for artificial ventilations and chest compressions e CPR rate tolerances for artificial ventilation and chest compression e Max c
124. tions The evaluation panel is part of the team logging system described previously When a particular provider is selected log entries generated via the Evaluation panel will be prepended with the provider s name For more information on Team Logging see the previous section of this guide on Logging Details Palette Lab Scenario Model Log Gaumard Session Title Simulation 101 Facilitator John Eggert Providers e sm areal nn esl Evaluation Form The evaluation tool assists facilitators in reporting and assessing provider interaction using a questionnaire form A completed evaluation form can then be stored as a digital document or printed for distribution Facilitator Several evaluation templates are built in to GaumardUI s evaluation tool Each template includes a set of multiple choice questions related to the type of assessment being performed To begin select an evaluation template from the Load Template dropdown New templates created in the edit mode will also be listed Evaluation Form Load template Breech Vaginal Delivery Evaluation Nar EAE Forceps Delivery On Site Reviev Postpartum Hemorrhage Shoulder Dystocia Vacuum Delivery Evaluation Form Load template Eclamptic Seizure Evaluation Name Eclamptic Seizure On Site Reviewer James C 1 Problems Identified 72 User Guide Newborn
125. tive profile Each profile has its own separately customizable Palette Create Palette Items with the Details page as described previously Details Palette Lab Drugs Scenario Log Gaumard Newborn Name Description APGAR 10 2 P 2 G 2 gag cough sneeze A 2 R 2 APGAR 7 1 P 2 G 1fcoughs 4 1 some tone R 2 APGAR 8 A 1 P 2 G 1f coughs A 2 R 2 APGAR 9 A 2 P 2 G 1 coughs A 2 R 2 heathy APGAR 4 0 P 2 G 1 respond to patin 0 R 1 Care Required APGAR 5 0 P 2 G 1 respond to patin 4 1 some tone R 1 FEF APGAR 6 1 P 2 G 1frespond to patin 4 1fsome tone R 1 APGAR 0 4 amp 0 P 0 G 0 4 0 R 0 Other APGAR 1 amp 4 0 P 1 G 0 A 0 R 0 APGAR 2 4 amp 0 P 1 G 0 0 R 1 gasping APGAR 3 0 P 1 G 1 respond to patin 0 R 1 Apply Approximate Time Apply Palette Items using the buttons at the bottom of the page exactly as changes to Newborn HAL condition are applied on the Details page Change Newborn HAL vital signs and symptoms instantly by clicking to select a Palette Item and clicking the NOW button Or create a gradual transition in physiological state with one of the other Apply buttons Palette Items can be sorted with the View buttons found on the right side of the page Editing existing Palette Items is a matter of selecting the item you wish to modify and clicking the Edit button
126. to Gaumard User Interface G Shortcut to Help Images 2 Shortcut to manuals on devin My Computer File name Healthy Resting pl My Network Save as type Palette Items plt J Specify a path and click Save You can exit the software at any time by going to File Exit You can also close down the software by using the shortcut key Alt F4 You can also exit by clicking on the x button at the top right corner of the user interface Monitors CPR A V Calibration Options Remote Access Via Network Auto Responses Scan RF Channels This tool allows you to easily calibrate the sensors inside the simulator First choose which function you would like to calibrate chest compressions artificial ventilations or blood pressure cuff Calibration Calibration Wizard Welcome to the Manikin s calibration wizard Proceed only after you have reviewed the calibration section in the user manual Please select the function you would like to calibrate Chest Compressions Artificial Ventilation Blood Pressure Cuff Head Position The procedures for each specific calibration are described in the sections below COMPRESSIONS ARTIFICIAL VENTILATIONS This tool helps you calibrate the chest compressions and the artificial ventilations to your specific criteria That is you will be telling the system what a correct chest compression is and or what a correct artificial ventila
127. tt 1 200 Time min interaction Hakone Narcan only Cz Save Image As Page Setup Print Show Point Values Un Zoom Undo All Zoo0m Pan Set Scale to Default es Max Alpha 1 1 _ E lsobologram plasma concentration 70 Newborn HAL User Guide 65 Lastly review all the properties of the new medication and click Add to save In the example below two drugs programmed with interactions have been administered The physiologic model has detected the interaction and displays additional information for the facilitator to monitor Max Alpha Current Alpha 66 User Guide Newborn HAL Model The physiological model controls all vital signs and skin color and depending on effectiveness of provider intervention it will improve or deteriorate the state of Newborn HAL The model speed can be controlled through the Model warp factor which goes from 1 to 5 1 representing real time Details Palette Lab Model Scenario Log Gaumard Physiological Modeling State Model rate 1 PAUSE physiological oxygenation modeling Modeled Therapy Improve Gain Reset Oxygen IMPROVE adequate oxygen perfusion breathing DETERIORATE compromised oxygen perfusion apnea 0 w Limin Epinephrine 0 04 mg Administer Healthy Mild Cyanosis Severe Cyanosis dose onboard 0 mg kg Therapy can also be indica
128. using any of the apply buttons located near the bottom of the page Apply Clocks Evaluation Click the NOW button to change the simulator s condition instantly Alternatively click a trending time to gradually increase or decrease to the numerical value specified e g heart rate blood pressure in the time allotted The right most button can be customized to any transition time you require by clicking the part of the button labeled Edit Please note that settings not specified will remain unchanged Some settings are applied immediately such as cardiac rhythm and breathing pattern while numerical settings such as heart rate and respiratory rate can be easily made to transition As transitions are applied the time remaining in the transition is displayed in the Clocks panel at the bottom of the GaumardUI window If there is already an ongoing transition at the moment you click an Apply button it will stop and a new transition will begin from the current physiological state Clocks Transition remaining 00 00 09 N Session 00 05 03 Newborn HAL User Guide 23 When cardiac rhythm is maintained at Ventricular Tachycardia for one minute the following prompt dialog box will be displayed Ventricular Tachycardia x 1 minute has passed since the patient is in Ventricular tachycardia A do you wish to degrade to Ventricular fibrillation Click NO to re check the Cardiac Rhythm in one minute
129. virtual monitor screen click on a scalars menu and select Close to make the entry available for the custom parameter Click on the empty scalar menu and select Other from the list of available scalar parameters Select the name of the custom parameter e F Fa F a g g p Time Glucose The figure below shows two new values Glucose level and hematocrit levels Return to the custom parameter menu on the GaumardUI software to update the values when necessary The scalar entry is now a blank field Newborn HAL User Guide 93 On the GaumardUI menu bar click Monitors gt Configuration to open the virtual monitor setup window Use the virtual monitor setup window to verify the connection between the GaumardUl software and the Gaumard Monitors vital signs software re configure the communication ports and view the controller IP address To troubleshoot connectivity issues go to page 123 SS Newborn HAL Virtual Monitor Setup Select the number of monitors that will be used with this manikin Also you can name each monitor with an appropiate description O Al sensors always ON l except tor Swan Ganz Adapter Controller IP 10 0 1 1 Port 8001 Connected to 10 0 1 2 Step CPR GaumardUI features a CPR performance evaluator and trainer On the menu bar click CPR gt Evaluator to access the CPR Evaluator window File Setup Monitors Status oE a E Options Airway
130. w a O Artificial ventilation actori O Next gt Cancel To calibrate place the blood pressure cuff on the arm you wish to calibrate right or left Remember to connect the cuff s luer lock connector to the simulator s shoulder Select which arm you will like to calibrate Calibration Blood Pressure Cuff Please select the arm you would like to calibrate Manikin s RIGHT arm Manikin s LEFT arm 1 biy ea You will then be prompted to set the BP cuff to a certain pressure hold that pressure constant and press the OK button Follow the text cue on the screen and repeat the procedure for each pressure level until Done is displayed For example if calibrating the left arm 20 mmHg F The wizard prompts you with 0 mmHg F Set the pressure on the BP cuff to 0 i e cuff valve open F Click the OK button F A green filled oval indicates that the value was successfully set F The wizard then prompts you with 20 mmHg P Set the pressure on the BP cuff to 20 mmHg F Click the OK button F A green filled oval indicates the value was successfully set F and so on Once the prompt reads Done go back and calibrate another function or click the Finish button to close the calibration wizard Head position calibration allows the facilitator to show the system at what point to obstruct air flow through the airway when the neck is hype
131. will turn green when the simulator is completely charged Do not turn on the GaumardUl software until the charging process is complete blinking communi cation indicator is consistently red The adapter labeled Power Supply does not recharge the battery Disconnect the Power Supply and follow the charging procedure explained above Computer is too far away Get simulator closer to computer from simulator RF module is not Close the GaumardUI software and connected connect the USB RF module to the tablet computer Trying to communicate After clicking the GaumardUI icon select with a different simulator the name of the applicable simulator and click Start On the menu bar go to Setup gt Options gt Environment and select FIXED Then enter the simulator s serial number in the text box Finally restart the software Multiple simulators are on Select different channels for each of the at the same time simulators and then turn them on one ata time meaning Wait until a link has been established between the tablet and the simulator the yellow window goes away Only after that start running the GaumardUI software in the second tablet and so on for the rest of the simulators To do so go to menu Setup Options gt Environment gt Select Auto change to channel number from 1 11 All others Close the GaumardUI software and unplug the RF module for at least 5 seconds then
132. y appearance and breathing controls Outlined below are notable controls available in this section Oxygen saturation can be changed by adjusting one of the following four parameters Click on the question mark button to view a brief description of the four options Options 2 4 take from 30 seconds to 3 minutes to change Lower OSat settings will decrease the model s stability and put patient into crisis O2 Saturation E osat asic otal O2 level e Total O level oxygen reserve in the body e Shunt flow the percentage of deoxygenated blood in pulmonary capillaries Total 02 level Shunt Flow Respiratory Pattern e Respiratory pattern i Obstruction Airway construction e Airway obstruction e Total CO level CO build up in the body e Dead Space part of tidal volume that doesn t participate in gas Total CO level exchange Respiratory Pattern e Respiratory Pattern PH level o Ph level Lung Condition Change the condition and shunt flow dead space airway resistance and respiratory pattern are adjusted by the model Lung Condition isi Normal Emphysema Fibrosis Asthma __ Newborn HAL User Guide 27 Tidal Volume Adjust the tidal volume or amount of air breathed in or out during normal respiration In the model a tidal volume of 500 m L is considered the normal level for an average adult build If the respiratory rate goes to zero the model does not restore it
133. yanosis intensity level Enter the activation code to enable upgrade features Activation codes are unique to the simulator s serial number Before entering a code go to the Environment tab and set the connection mode to FIXED then enter the simulator s serial number e Virtual Monitor Enable the Monitors menu option to configure the virtual monitor connection To verify the connection status between GaumardUI and the Gaumard Monitors go to page 94 e S T A B L E Activate the S T A B L E scenarios e Automatic Mode Activate the Automatic mode and the physiologic model NEWBORN HAL s Add Ons add even more fidelity to your simulation NEWBORN HAL Virtual Monitor E Use Newborn Hal Virtual Vital Signs Monitor 5 T A B L E OK Caa This tab allows the facilitator to e Enable auto saving of the log e Save your current log report e Enable stand by warning e Select units SI or English e Enable electrical therapy virtual shock panel Options C Enable Log Auto Save Auto save every 10 Session Timer C Reset session timer once scenario is started Electrical therapy Panel Show defibrillation cardioversion panel Stand by warning E Warn the first time trying to apply settings when system is on Stand By mode Units International System SI Imperial 0k cancel Checkmark the Defibrillation Cardioversion Panel to show the virtual Sh
134. ynthia s Baby 2 plt e APGAR 10 plt E Cynthia s Baby 3 plt E apnea plt E Cynthia s Baby 4 plt Alice s Baby 1 plt es Asphyxia 1 plt E Cynthia s baby plt Alice s Baby 2 plt E Asphyxia 2 plt E Elaine s Baby 1 plt Alice s Baby 3 plt e Asphyxia 3 plt E Elaine s Baby 2 plt APGAR 0 plt E Asystole plt E Elaine s Baby 3 plt i d Alice s Baby E APGAR 1 plt File name My Network Files of type Palette Items plt Browse to the location where the documents are saved and open it They are automatically brought into the GaumardUI Make sure that to select the correct file type E File name Files of type Scenario Files scz Branched Scenarios bsz Palette Items plt Palettes scenarios branched or linear model patients and drugs and profiles may be all exported Branched Scenario Model Patient Model Drug Profile If the Multi button is selected turned green more than one item may be selected for export at one time 80 User Guide Newborn HAL Make a selection and click Export The Save As dialog box is then displayed Save As Save in E Desktop my Documents p My Computer My Recent my Network Places Documents dwilgS10_driver_100 e520 Gaumard User Interface Gaumard _UI nb Palettes Tech Support fq Shortcut to Debug Desktop faa Shortcut
135. ys palette items Intuitively the facilitator can play stop pause skip or repeat items as necessary Wait Indefinitely ca Wait for suction and 02 BR Asphyxia 3 Limp RR 0 02 Sat 70 HR 55 BP 35 20 Wait Indefinitely Wait for ventilations and chest compressions Asphyxia 1 Crying none NSR HR 140 RR 40 BP 83 54 02 Sat 95 Previous palette Next Pause palette J ee wm e t E An unfilled triangle means that the scenario is stopped When the Play button is clicked the item pointed by the indicator is be played A rapidly blinking triangle means that the scenario is playing the item to which the indicator is pointing A slowly blinking triangle means that the scenario is paused at the item to which the a indicator is pointing Start or play the item to which the scenario position indicator is pointing This button has two states play or pause Pauses the scenario This state of the play button is only active when the scenario is playing It is disabled when a Wait indefinitely item is playing because in such case the scenario is already paused The stop button has 2 behaviors depending on when it is clicked When clicked once the Stop button halts the scenario at the end of the currently playing item When clicked a second time the scenario is stopped immediately For example if the currently playing item has a transition of 1 00 minute and the Stop button is pressed when it has 0 10 seconds left the sc

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