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1. a VLAJNAJNA Pa ZX Imll ea a atas VV VV VV dCI d al com Equipment Selection Based on the information provided in the Case Scenario select as many pieces of equipment as you NSEC WO Completi INS procedure Select required equipment and advance to next screen Select the equipment you will need during the procedure and click the Right arrow to advance to the procedure Selecting too many pieces of equipment may cause you to be negatively assessed for the procedure Click on equipment in the equipment tray to add it to the tool bar on the left Equipment that appears in the tool bar will be avallable to you during the procedure Hold the mouse still on Items in the equipment tray to see a brief description of that piece of equipment www laerdal com Infant Virtual I V Directions for Use System Overview Click on a piece of equipment multiple times to select more than one The number of selected items will appear both in the toolbar at the left and in the equipment tray To remove a piece of equipment from your toolbar click the x in the equipment tray that corre sponds to that piece of equipment Note The Sharps container and trash can WILL NOT appear in your toolbar but will be available on the Simulation screen Remove unwanted equipment by clicking on the x at the upper right of the item in the supply tray Once you have selected the required equipment advance to the simulation screen ww
2. have installed other software on the computer and the simulator erther slows down there Is an error with the haptic device communication or the program crashes What do do No software should be installed on the computer supplied with the Infant Virtual LV IM Self Directed Learning System except for those products supplied by the manufacturer of the software Other soft ware such as anti virus programs may run on the machine in the background severely limiting the performance of the simulator The best solution is to never install such software in the first place turn it off or delete it once it has been installed An alternative solution if you are required to run anti virus software is to increase the memory on your machine Contact Laerdal Technical Service for further guidance The needle stays in the arm although it has been withdrawn from the device What Is going on If you pull the needle out too quickly a magnet within the haptic device will un latch This is a limi tation of the hardware and is un avoidable Thus you should always remove the catheter from the haptic device in a slow manner Jerking the catheter out of the patient is dangerous Jerking the cath eter out of the device may cause un expected behavior or device failure If the needle gets left inside the arm on the Simulation Screen you can also throw away that needle and select a new needle and the device will reset www laerdal com In
3. Account Management Mame C Specialty Lew Cognitre demouser In Hospital 0 demouserz In Hospital 0 Create O Edil Click on the column labels to sort the accounts by name class specialty level average skill score or average cognitive score If you will be using multiple Infant Virtual V machines and would like to configure them in a connect ed Local Area Network you will need to Install Laerdal Competence Management System Version 1 8 This will allow students to long into any Infant Virtual LV machine and transfer their user histories between machines If you experience significantly long log on times we recommend installing a Laerdal Competency Management System Note Do not use the Infant Virtual I V account management and Learner Competency Review functionality after installing a Laerdal Competence Management System Click on create to add a new learner Username ELE Password Career Mi Class LEA www laerdal com 2 Select a learner and click edit to edit the learners password career and class Username Password Career Hei r Class www laerdal com Configuration Configuration Pre Hospital simulation Options Catheter type Rolling veins enabled Enable display of tourniquet time Assessment Options Assess selection of unavailable site Use quantitative feedback Scoring Correct bevel orientation Equipment frugal limit Assess use of sharps container
4. Needle Insertion and Skin Stretch The device should be placed on the desktop resting flat on the surface The handle Is gripped using the hand and the thumb can be used to stretch the skin during the procedure The needle and cath eter are inserted into the receptacle Initially the learner will feel a slight tug as the device engages the pede Note Once the needle engages the haptic device the simulated needle on the screen will illuminate and you will hear a sound this means you may proceed with needle insertion The force feedback provided to the learner depends on the patient being cannulated the case sce nario the actual stick and any complications In some cases the learner will feel a stick through both skin and vein in other cases the vein or even the skin puncture may be more or less prominent The forces associated with infant catheterization are subtle at times and the force feedback device simu lates these subtle cues and sensations www laerdal com Debriefing The top of the Debriefing screen shows your total score the procedure and constricting band times whether you have successfully completed the procedure the case level and other information ES O A Fall Score 72 Procedure Time 00 06 01 Trainee em2 C Band Time 00 02 18 4 Unsuccessful Completion of Procedure Cannulation Events Correct Cannulation Vein Punctured Critical Errors Procedure completed in appropriate time Standard P
5. simulator providing the various options for the instructor and learner of the learning system Simple overview of the debriefing and testing functions of the Infant Virtual IV product e A Frequently Asked Questions FAQ help guide for answering some of the commonly asked questions regarding the system www laerdal com Infant Virtual I V Directions for Use Benefits learning objectives and features www laerdal com Infant Virtual I V Directions for Use Benefits learning objectives and features www laerdal com Infant Virtual I V Directions for Use Benefits learning objectives and features BENEFITS LEARNING OBJECTIVES AND FEATURES The Infant Virtual IV Self Directed Learning System provides a comprehensive training environment for the placement of intravenous catheters in infants Infants can be difficult to catheterize because of their small size and fragile veins This simulator trains a broad range of cognitive and psychomotor skills in IV insertion based on a wide range of pediatric patient case scenarios The Infant Virtual IV M Self Directed Learning System provides an educational tool to customers that will take learners through the complexity of the pediatric needle insertion skill space By providing intermediate and advanced skill level learners with the opportunity to practice procedures in the pres ence of realistic complications the product provides
6. 4 Place the restraining strap on the haptic device www laerdal com Infant Virtual I V Directions for Use Packing up the System 5 Carefully place the haptic device and tools in the original packaging www laerdal com Infant Virtual I V Directions for Use Packing up the System www laerdal com Infant Virtual I V Directions for Use Frequently Asked Questions FAQ www laerdal com Infant Virtual I V Directions for Use www laerdal com Infant Virtual I V Directions for Use Frequently Asked Questions FREQUENTLY ASKED QUESTIONS FAQ Is there some kind of an Introduction that shows me how to use this product The System Tutorial Video accessible from the Main Menu Screen will show you how to use the prod uct as well as the text in this user manual To access the Main Menu login as Username demouserl or demouser Password password After selecting a body part and site can go back to select a different region Yes and it is not necessary to go back There is an icon for site selection directly above the circular simulation window on the simulation screen Can the instructor select specific supplies and configure the training standards Yes in the Instructor Module supplies and assessment items are configurable and can be set to appropriate local protocols Our local standards of practice do not call for or restrict the use of cert
7. 5 gt 2 This screen provides the learner a choice of which career path to follow In Hospital or Pre Hospital Move the mouse over the different career choices to identify the career chosen for you by your instructor Click on the chosen module to begin learning www laerdal com Infant Virtual I V Directions for Use System Overview Main Menu This screen provides the learner with a menu of options Competency Training A progressive tiered hierarchy of case studies and required skills that ranges from beginner Level to expert Level 4 e Practice Case Scenarios Individual cases can be tried from all of the levels for practicing skills with or without recording assessment Anatomical Viewer This module presents a three dimensional 3D model of the infant that can be used to identify structures and learn anatomy e Procedure Video This video introduces the beginning student to the techniques and skills required for intravenous access e System Tutorial This video shows the learner how to use the Infant Virtual V M simulator system Competency Review This module shows the learner s record of performance For the beginning learner It Is Important to view both the Procedure Video and System Tutorial video prior to using the software Main Menu E D a 7 Competency Traini 4 X Y he 3 Competency Review gt Procedure Video gt Anatomical Viewer www laerdal com Infant Virtual
8. Practice cases will be recorded in your competency review if the administrator has configured the Infant Virtual V system to record practice case scenario s Select your patient by clicking on the patient age Preemie Full Term 6 months 15 months skin tone Dark Fair and weight Skinny Normal Chubby Select the medical condition by clicking on the Medical Trauma or surgical buttons Once you have selected the case scenario you want to attempt advance to the next screen by clicking the right arrow Practice Case Scenario Z Title Hernia Repair Level www laerdal com Competency Review The Competency Review screen presents your competency accomplishments in a concise and Intul tive format Te r T Competency Re O Learner test Show Cases Critical Errors All Last 10 Last 25 Last 50 Last 100 Competency K Show Hide Practice Case Title Show Transient Tachypnea of the Ne Transient Tachypnea of the Ne Transient Tachypnea of the Ne Transient Tachypnea of the Ne Transient Tachypnea of the Ne Transient Tachypnea of the Ne gt Hide Average Skill Scores Type Case Scenario Case Scenario Case Scenario Case Scenario Case Scenario Case Scenario Selecting the number of cases to review Select the number of cases to display by clicking on one of the buttons under the Show Cases heading on the left of the screen Viewing average user scores and progress There
9. V Directions for Use System Overview System Tutorial video This screen presents the System Overview video which is divided into chapters for direct viewing of specific content Click on the corresponding chapter to start the video There Is also a slider on the video player allowing the learner to choose a specific place in the video to review There are Play also pause when playing and Stop buttons The navigation bar at the lower right of the screen allows the learner to return to the previous screen or log off The button activates a help screen that explains all of the elements of the screen Parera a Y NI La ma L A E s 1 Introduction to Infant Virtual N 2 System Overview y 3 Learning Types o ier aaa Os dai O ra ficas AS 7 Conclusion www laerdal com Infant Virtual I V Directions for Use System Overview Procedure Training video This screen presents a procedural video demonstrating proper IV catheterization in the Infant This video is divided into chapters allowing the learner to select the section they wish to view by clicking on the appropriate section There is also a video slider allowing the learner to choose a spe cific place in the video for review It is highly recommend that the beginning student watch the video in Its entirety before attempting the simulation Procedure Video 6 Entire Vide
10. then press SPACE BAR Vertical calibration Move needle catheter all the way up and hold then press SPACE BAR Move needle catheter all the way down and hold then press SPACE BAR This screen indicates that the device has been successfully calibrated and Is ready for use The device has been successfully calibrated The screen below indicates that the device has not been successfully calibrated and the calibration routine should be performed again If problems persist click on the show calibration error button to determine at which step calibration failed and the corresponding error code If calling Laerdal Technical Support please provide the error code The device has not been properly calibrated Restart Calibration E Show Calibration Error Infant Virtual I V Directions for Use Administration and Account Network Configuration Connect multiple Infant Virtual V IM systems to a local or global area network by installing a Laerdal Competence Management System version 1 8 and following the accompanying instructions This will link multiple systems and allow students and instructors to access and review achieved competencies Me rs mensa Change Instructor Password Note The password originally provided on the information sheet inside your desktop computer or by Laerdal Technical Service at 800 431 1055 EXT 5596 will always allow work even if you change the Instructor passwo
11. Stretch The handle is gripped using the hand and the thumb can be used to stretch the skin during the pro cedure The needle and catheter are inserted into the receptacle Initially the learner will feel a slight tug as the device engages the needle Once the needle is engaged in the haptic device the simulated needle on the screen will light up and you will be ready to perform the needle insertion The force feedback provided to the learner depends on the patient being cannulated the case sce nario the actual stick and any complications In some cases the learner will feel a stick through both skin and vein in other cases the vein or even the skin puncture may be more or less prominent The forces associated with infant catheterization are subtle at times and the force feedback device simu lates these subtle cues and sensations www laerdal com Infant Virtual I V Directions for Use System Overview Equipment Use Specific Catheter Lock and Lock with Extension Tubing Click on the catheter lock or lock with extension tubing icons move cursor to the site and then click to apply Needle Selection and Insertion Point Selection Click on the IV catheter icon in toolbar A selection of 8 different length and gauge needles will appear Select the appropriate gauge needle and move cursor over site A target will appear Click to locate needle insertion point The bevel position will be displayed in a
12. are different ways to review the user s general progress Clicking on the Level Averages tab will display a graph of the cognitive test and skills case scenario averages at each level of difficulty Medical Condition Level ScorePassed Clicking on the Average Skill Scores tab will display a list of critical and non critical assessment errors the ratio of the times you performed that category correctly and a list of specific skill errors and how frequently they were performed in correctly Clicking on the Progress graph tab will display a graph of the score on all of the selected cases and cognitive tests in a scatter plot Viewing specific case scenario and cognitive test debriefings Click on the specific case scenario or cognitive test at the bottom of the screen to view the associat ed debriefing Once the specific case scenario Is accessed the learner Is able to display the assessment in html format for printing by clicking on the print icon at the bottom of the case scenario pop up Sorting The case scenarios and cognitive tests can be sorted by clicking the column headings Hypospadius Score 68 Procedure Time 00 05 00 Learner demouser C Band Time 00 02 40 Level G Unsuccessful Completion of Procedure Cannulation Events v Correct Cannulation Vein Punctured Needle Gauge Too Large for Vein ie I ae Critical Errors Procedure Took Too Long to Complete 4 standard Precautions Not Perform
13. circular inset inside the simula tion window Gloves and Goggles To apply gloves and or gogeles click on the Gloves and or Goggles icon To remove click on the cor responding icon on the lower left side of the screen Tape and Dressings To apply tape gauze or dressings click on the corresponding icon move to site and click on desired location IV Infusion To setup an IV Infusion click on the tubing pump and IV fluid icon Tourniquet or Rubber Band To place the Tourniquet or Rubber Band click on the corresponding tool bar icon move the mouse over to the site and click on desired location Site Preparation To use a cleansing solution lodine or sterile saline click on the corresponding icon on the toolbar and move the mouse to the desired site Once over the desired site click hold and move the mouse to cleanse site Release mouse button when cleansing is complete O www laerdal com Infant Virtual I V Directions for Use System Overview Transilluminator To use a transilluminator click on the transilluminator icon in the toolbar move the cursor to the site and click to apply at the desired location Flush and Bolus To use a flush or a bolus click on the corresponding icon in the toolbar move to the site and click to apply www laerdal com Debriefing Following the procedure the learner will be assessed as to how well he or she performed the proce dure To view the debriefing scre
14. for each model each with individualized debriefing cri teria Site availability and assessment is driven by the particular details of each case scenario That is over 19 times 15 285 different insertion site models not to mention the variability that comes from the different case scenarios 5 The Competency Review allows you to a View individual case scenarios and cognitive test assessments View a learning curve for your entire competency training c Focus in on the last 10 25 or 50 cases to understand your current problems and overall progress d Identify specific skill weaknesses 6 Pre existing conditions including in place equipment finding alternatives to the desirable inser tion sites IV infiltrates and other complications add a sense of urgency to the procedure and provide the user with an accurate portrayal of real life situations www laerdal com Infant Virtual I V Directions for Use Benefits learning objectives and features 7 The Infant Virtual 1V Haptic Device provides realistic feel in terms of skin stretch palpation size and Insertion forces that are specific to the child It also allows the user to perform a two finger skin stretch technique that Is appropriate to the procedure 8 The system supports arterial palpation at both temporal scalp sites and the arm allowing the pulse to be felt by the user defining artery location The pulse depends on the heart rate of the pat
15. on or simply go to the System Tutorial Screen and return to the main menu Exiting the application and disconnecting and reconnecting the power cord to the device will usually fix this problem The initialization screen is shown below Haptic device Power cord to power brick s to outlet a Device Set up Haptic Device is not connected Please ask your instructor to check the haptic device before proceeding Some functionality will be disabled www laerdal com The following pages show the series of menu screens that will lead the instructor through the calibra en proce These menu screens show the steps of the calibration sub routine Follow instructions as prompted on tne screens Completely remove needle and catheter from haptic device Do not touch haptic device then press lt SPACE BAR gt 900 Haptic Device Cali Br stretch skin and hold then press lt SPA E BAR gt 000 a T SA A nn SS 6 Return lo the main marca i Remove catheter from needle Lay needle flat on table with alignment ndge facing up and haid than press lt SPACE BAR gt Slide catheter onto needle until flush with needle body then press lt SPACE BAR gt Lateral calibration Haptic Device Calibratic Slide needle catheter halfway into hapbe device Move needie catheter all the way left and hold then press SPACE BAR gt Move needle catheter all lhe way right and hold
16. screen to show you how long you have been performing the procedure When the clock turns red you have exceeded the allowable amount of time for this case scenario A second clock may appear as this is configurable that times Tourniquet placement This clock turns red if you have exceeded the allowable amount of Tourniquet time Guiding messages appear at the bottom left of the screen that will help you use the system Once you have completed the procedure advance to the next screen Model Orientation Scroll the mouse wheel forwards and backwards to zoom In and out of the model Click the middle mouse wheel hold and move the mouse to rotate the model An orientation icon Is present on the simulation screen should you need help during the procedure Clicking on the Orientation button plays a movie describing how to orient the model using the mouse Equipment Use and Procedure Tasks General Click the help button on the navigation icon to learn how to use specific pieces of equipment or how USES Only one piece of equipment can be used at a time After a piece of equipment is chosen It needs to be placed on the site or thrown into a disposal container To use or apply a selected item to the site click on the site To throw an item away click on tt move It to the trash bin sharps container or biohazard bag and click Certain Items that have been attached to the site can be removed by clicking on them inside the sim ulation window Th
17. the configuration setting user practice cases may not be stored Learner Competenc Name Class Specialty demousert Demo Users In Hospital demouser Demo Users In Hospital kman Demo Users Pre Hospital Em1 Demo Users Pre Hospital Demo Users Pre Hospital Demo Users Pre Hospital Demo Users Pre Hospital vel Skill Cognitive 20 0 0 0 54 0 98 90 16 0 0 0 0 0 9999699 i E Learner Emi l Average Skill Scores Show Cases K All Last 10 Last 25 Last 50 Last 100 Competency Jem lal 21 he 5 h O Hide Parent Informed at Appropriate Time 2 2 Practice Case Title Type Medical Condition Level ScorePassed Level One Novice Cognitive Test O 90 Yes Fundoplication Case Scenario Surgical 94 Yes Supraventricular Tachycardia 5 Case Scenario Medical 100 Yes Transient Tachypnea ofthe Ne Case Scenario Medical 100 Yes Show amp Hide Viewing average user scores and progress There are different ways to review the users general progress e Clicking on the Level Averages tab will display a graph of the cognitive test and skills case scenario averages at each level of difficulty e Clicking on the Average Skill Scores tab will display a list of critical and non critical assessment errors the ratio of times you performed that category correctly a list of specific skills and how often those skills were performed in correctly e Clicking on the Progress Graph tab will display a gr
18. 4 Standard Precautions and Patient Assessment 5 IV Site Selection O 6 Performing the Procedure O da Concusion 4 www laerdal com Infant Virtual I V Directions for Use Quick Start User Guide System Tutorial The System Tutorial screen presents a training video on how to use the Infant Virtual V M System Tutorial tire Video R 1 Introduction to Infant Virtual N D 2 System Overview oe A 4 www laerdal com Infant Virtual I V Directions for Use Quick Start User Guide Competency Review The Competency Review screen presents your competency accomplishments in a concise and Intul tive format Competency Review a Selecting the number of cases to review Select the number of cases to display by clicking on one of the buttons under the Show Cases heading on the left of the screen b Viewing average user scores and progress There are different ways to review the user s general progress If the administrator has configured the Infant Virtual V system to save practice cases then additional filters will be presented to view competency training and practice cases independently or together Clicking on the Level Averages tab will display a graph of the cognitive test and skills case scenario averages at each level of difficulty Clicking on the Average Skill Scores tab will display a list of critical and non critical assessment errors th
19. Assess use of biohazard container Assess use of goggles Assess use of axtension tubing Assess use of constriction device Assess consticton device selection Retracting Scenario Specific Yes Yes Yes Up No limit Yes Yes Scenario Specific Scenario Specific Yes Yes Number of allowed stick attempts per site E Number of allowed stick attempts per case No limit Assess time to complete the procedure Yes Assess use of armboard Yes Assess use of holder hands Scenario Specific Select from the Pre Hospital or In Hosprtal tabs to select configuration options for that career Click the Reset to default settings button to restore the orlginal settings for all configuration options www laerdal com Infant Virtual V Directions for Use Administration and Account Calibration of the Haptic Device When the haptic device requires calibration a message will appear on the screen which looks like this Device requires calibration Ask your instructor to calibrate device before proceeding It Is Important to calibrate the device at regular intervals or as prompted by the system or the system will drift potentially causing erroneous measurements www laerdal com In cases where the haptic device Is not connected or does not initialize properly the following screen will appear Make sure that the device is properly connected Once properly connected log off and then back
20. B cord of the haptic device into the computer but do not connect to haptic device 4 Remove the haptic device and needle holder from the packaging 5 Completely remove the restraining strap carefully from the haptic device www laerdal com Infant Virtual I V Directions for Use Setting up the System Plug the 7 USB cord and 8 Power Cord into the back of the haptic device 9 Plug the power cord from the wall socket into the power brick The haptic device which has been pre calibrated by the manufacturer Is now ready to use with the simulator mis 10 The completed set up Infant Virtual 1V M Self Directed Learning System Note the location of the haptic device directly in front of the monitor www laerdal com Infant Virtual I V Directions for Use Setting up the System 11 Before using the software you will first need to obtain license keys for the modules you have purchased CU St Une Boo Saes 11 2 Contact your Laerdal representative for customer service agent to obtain the license module key www laerdal com Infant Virtual I V Directions for Use Setting up the System www laerdal com Infant Virtual I V Directions for Use Quick start user guide www laerdal com Infant Virtual I V Directions for Use www laerdal com Infant Virtual I V Directions for Use Quick Start User Guide QUICK START GUIDE Turn on the compute
21. Self directed 1 V learning in Infants SIM 002 W00 rev D Laerdal immersion helping save lives Infant Virtual I V Directions for Use www laerdal com Infant Virtual I V Directions for Use Table of Contents CONTENTS Introduction 5 Benefits Learning Objectives and Features 9 Learning Objectives Il Instructor Benefits 12 Student Benefits 12 Feature List 13 Setting Up the System 17 Quick Start Guide 27 Logging In 29 Help 29 Navigation 31 Career Selection 32 Main Menu 33 Training Types 34 Anatomical Viewer 35 Procedure Video 36 System Tutorial 37 Competency Review 38 Performing the Procedure 39 Case Scenario 41 www laerdal com Infant Virtual I V Directions for Use Table of Contents Site Selection 41 Equipment Selection 42 Simulation Procedure 43 Debriefing 48 Administration and Account Creation 49 Instructor Main Menu 52 Learner Competency Review 53 Account Management 56 Configuration 59 Calibration of the Haptic Device 60 Network Configuration 69 Change Instructor Password 69 System Overview 71 System Icons 73 Basic Menu Screens 76 Procedure Simulation and Debriefing Screens 88 Packing up the System 103 Frequently Asked Questions FAQ 109 Support 115 www laerdal com Infant Virtual I V Directions for Use Introduction www laerdal com Infant Virtual I V Directions for Use www laerdal com Infant Virtual I V Directions
22. ain items that are avail able on the equipment screen or are required for successful completion of the procedure such as the use of goggles or application of iodine to the arm Many options are configurable by the instructor using the Configuration section of the Instructor mod ule By turning specific assessment items on or off it is possible to tailor the system to train to your local protocols Why can t continue to palpate the vein as I m inserting the needle Proper I V insertion technique specifies simultaneous skin stretch and insertion Thus unless you have a helper simultaneous skin stretch palpation and insertion would require more then two hands However if you do palpate you will palpate approximately 72 proximal to the insertion site Is there audio feedback like the patient saying something or making a noise when stick him No it was felt by the clinical design team that this could become annoying to the user over multiple uses although in future versions of the product audio such as this may become a configurable option Audio is provided during the training videos and when the needle engages the haptic device www laerdal com Infant Virtual I V Directions for Use Frequently Asked Questions 7 Will the cleansing agents wet and taint the skin Yes like in actual patients there will be a time period in which topical agents will remain in a liquid state on the skin and then evaporate dependi
23. ame Password About Infant Virtual 1 V The about button will bring up the version number of Infant Virtual IV as well as the Laerdal license agreement LICENSE AGREEMENT FOR SOFTWARE THIS LICENSE IS A LEGALLY BINDING AGREEMENT PLEASE READ IT CAREFULLY This Immersion Medical End User License Agreement License is made by and between Immersion Medical Inc a wholly owned subsidiary of Immersion Corporation with offices at 55 West Watkins Mill Rd Gaithersburg Maryland 20878 USA Immersion and the legal entity you represent Licensee or You Immersion and its Licensors are the creators and sole owners of all Intellectual Property Rights as hereinafter defined in and to the Virtual V TM System the Virtual V System or the System The Virtual IV System which allows clinicians to practice Adult Pediatric amp Geriatric IV procedures and phlebotomy Immersion and its Licensors are also the creators and sole owners of all Intellectual Property Rights as hereinafter defined in and to certain proprietary software applications that are used in conjunction with the System the Licensed Software as defined below Immersion is willing to license the Licensed Software but only on the condition that the Licensee accept Infant Virtual I V Directions for Use System Overview Career Selection Career Selection 7 ada Pre Hospital E gt
24. aph of the cognitive test and skill case scenario scores for the shown cases Sorting The learners and case scenarios can be sorted by the column headings Viewing specific case scenario and cognitive test assessments Click on the specific case scenario or cognitive test at the bottom of the screen to view the associ ated assessment Once the specific case scenario Is accessed the instructor Is able to display the assessments in html format for printing by clicking on the print icon at the bottom of the case scenario pop up Hypospadius Score 68 Procedure Time 00 05 00 Learner demouseri C Band Time 00 02 40 Level O Unsuccessful Completion of Procedure Cannulation Events Correct Cannulation Vein Punctured Needle Gauge Too Large for Vein Critical Errors Procedure Took Too Long to Complete 4 Standard Precautions Not Performed Correctly 4 Gloves not used Hands not washed C Band or Rubber Band Usage Incorrect 4 C Band or rubber band left on too long C Band or rubber band not removed before flushing or attaching to IV infusion Catheterization Attempted Vein Cannulated and Correctly Threaded Flash Chamber Observed Correctly Flush Successful Site Preparation Incorrect d Site preparation not attempted No Site Contamination Equipment Disposed Correctly Insertion Made at Allowable Site Non Eritical Errors Appropriate Site Selected Insarrarstlles af Canebrirhna Aana Varene Dii har Bana A
25. ary equipment for IV catheter ization 4 The Simulation screen allows you to perform the procedure by interacting with the software and the haptic device 5 The Debriefing screen presents a complete assessment of your performance and allows you to review proper technique where errors have been made Fall Level O Procedure Time 00 08 00 A 2 week old Black female is brought in to the Emergency Department by EMS unit after sustaining possible bilateral femur fractures Appropriate fluid resuscitation was initiated for shock from injuries and the EMT reports the peripheral V became dislodged during the current IV bolus of NSS Vitals Respiration Breaths Per Minute 50 Blood Pressure Systolic Dystolic 40 p Heart Rate Beats Per Minute 168 Temperature C NA Pulse Oximeter NA Age Full Term Weight kg 3 5 Review case and advance to next screen gt So Case Scenario The patient scenario contains information vital to the learner s successful performance of subsequent venous cannulation Read and understand the case scenario review the vital signs and look at the yel low bulleted highlights below to ensure that you select the correct equipment and cannulation site for the CAS presented The case scenarios become more difficult as you progress in competency training mode from level 1 to level IV In levels 111 and IV yellow highlights are not provided Once you have read and understand the case s
26. cenario advance to the next screen Site Selection Click on an extremity or the head of the infant in the upper left corner of the screen salsa ue soe Site fool cores raton ben Une TRS TEST E IE ep e ERE ele sortean Note You can perform an insertion only at the selected site At any time you can change sites by selecting Site Selection from within the Simulation screen Once you have selected the site you would like to attempt advance to the next screen Site Selection right supinated wistiforeanm right pronated forearm antecubital fossa Select site and advance to next screen LAZMA AAZ a PAIO PANPYA VV W VYV IdEel UdI CQO TI Equipment Selection Select the equipment you will need to perform the IV catheterization procedure on this patient Click on equipment in the supply tray on the right side of the screen to add equipment items to your equipment toolbar on the left side of the screen Clicking on a piece of equipment multiple times will add multiple items to your toolbar Hold the mouse over a particular piece of equipment to identify It Note The Sharps container and trash can WILL NOT appear in your toolbar but will be available on the Simulation screen 6 151 Remove unwanted equipment by clicking on the x at the upper right of the Item in the supply tray Once you have selected the required equipment advance to the simulation screen Equipment Selection Select required eq
27. ch and one half and inch ll Different gauges 26 GA needles appear very small on the screen while 20 GA needles appear much larger Bio Hazard Container T connector Lock w extension tubing Rubber Band to substitute for a C band as used for premature and newborn infants Different pumps for Pre Hospital and In Hospital careers Manual fluid delivery of a bolus Is available for Pre Hospital cases Saline Wipe for removing cleansing agents after disinfection Different equipment availability for the Pre Hospital and In Hospital careers www laerdal com Infant Virtual I V Directions for Use Benefits learning objectives and features 12 Usability a Navigation The user can easily go to different sites gather equipment and even view the case scenario all while performing the procedure b Procedure Screen Improvements Easily understood and labeled icons ll Haptic Device Interact icon that tells you when to Interact with the haptic device during the procedure ll Sound when the needle is successfully engaged in the haptic device Iv Easy model orientation v Precise targeting for optimal needle positioning 13 Procedure Simulation a Medically correct flushing and extension tubing application b Extension tubing and locks are automatically flushed prior to application and come with the flush attached This allows for proper line setup and fluid administration c C band can be removed while the needle is inse
28. ctions for Use Administration and Account ADMINISTRATION AND ACCOUNT CREATION There are certain features only available to the instructor These features are accessed by logging In as Username Administrator Password lt Provided on the information sheet Inside your desktop computer or by Laerdal Technical Service at 800 431 1055 EXT 5596 gt www laerdal com Infant Virtual I V Directions for Use Administration and Account Instructor Main Menu nstructor Main Menu Account Management e Learner Competency Review _ eS Configuration View Instructional Video ol O Once logged in you can 1 View an instructional video on Infant Virtual LV instructor functionality 2 Access a complete review of learner competency Learner Competency Review 3 Manage user accounts Account Management 4 Configure the simulation based on local protocols and preferences Configuration 5 Calibrate the haptic device which occasionally requires calibration Haptic Device Calibration 6 Change the Instructor password Change Instructor Password Note The password orlgl nally provided on the information sheet inside your desktop computer or by Laerdal Technical Support will always allow work even if you change the Instructor password www laerdal com Learner Competency Review Selecting a learner for review Click on a learner at the top of the screen to revi
29. e ratio of times you performed that category correctly and a list of errors and how often a specific skill was performed in correctly n la TAJXAJXAY PAL puro VR UV VAS VAS a ar a CC 31 VV VV VV IGANG RICCI NIB Infant Virtual I V Directions for Use Quick Start User Guide Clicking on the Progress graph tab will display a graph of the score on all of the selected cases and cognitive tests In a scatter plot c Sorting The case scenarios can be sorted by the column headings d Viewing specific case scenario and cognitive test debriefings Click on the specific case scenario or cognitive test at the bottom of the screen to view the associ ated debriefing Once the specific case scenario Is accessed the learner is able to display the assessment in html for mat for printing by clicking on the print icon at the bottom of the case scenario pop up 6 Competency Review Car AD A Performing the Procedure Whether you have selected practice case scenarios or competency training you will need to perform the actual procedure www laerdal com Poorman me Procedure Conie eT e DTO The Case Scenario screen presents the case scenario the patient and the patient vital signs 2 The Site Selection screen allows you to select a particular site for IV catheterization Note You can change the site later in the procedure UJ The Equipment Selection screen allows you to select the necess
30. e scenario and begin the procedure Note Results from practice case scenarios could be stored in the competency review by changing the configuration setting O www laerdal com b Competency Training Selecting competency training will step you through an entire curriculum of cases from Level Novice through Level 4 Expert with increasing requirements for competency The curriculum includes remediation cases that provide hints as well as multiple choice cognitive tests Note Results from competency training case scenarios are stored in the competency review Anatomical Viewer The anatomical viewer allows you to identify structures and review relevant infant anatomy Click on the relevant organ system at the right of the screen to selectively dissect away the anatomical struc tures A display at the bottom of the screen shows the corresponding anatomical name of any struc ture that you move the mouse over Anatomical Viewer Anatomical Filters __ P Show Bone Y Show Arteries and Heart P Show Muscle and Connective Tissue Py Show Nerves P Show Veins P Show Skin www laerdal com Infant Virtual I V Directions for Use Quick Start User Guide Procedure Video The Procedure Video screen presents a didactic training video on proper Infant intravenous catheter ization Procedure Video Entire Video M 1 Introduction to Infant IV 2 Special Considerations in In 3 Equipment
31. ection Equipment Selection and Simulation Screens The guiding messages at the bottom of the simulation screen change depending on your actions and What task you are trying to perform If you are stuck or do not know how to proceed these mes sages should guide you through using the system Note The guiding messages are not designed to help you successfully complete the procedure they are only designed to explain how to use the system O Site Selection O Case Scenario O Equipment Palpation Q Request Holder Wash Hands O Warn Patient of Stick Ca Orientation ES d Click at desired insertion location T www laerdal com Infant Virtual I V Directions for Use Quick Start User Guide NS Patient of Stick Orientation Click at desired insertion location Navigation At the bottom right of the screen Is a navigation icon The navigation icon allows you to advance to the next screen return to the previous screen go to the main menu log off and access the help for that screen Note Not all navigation functions are available on all screens www laerdal com Infant Virtual I V Directions for Use Quick Start User Guide Career Selection Once logged in you will need to select the relevant career Click on the In Hospital or Pre Hospital buttons to define which configuration options case scenarios text and screen images will be present ed Yo
32. ed Correctly 4 Gloves not used Hands not washed C Band or Rubber Band Usage Incorrect 4 C Band or rubber band left on too long C Band or rubber band not removed before flushing or attaching to IV infusion v Catheterization Attempted Vein Cannulated and Correctly Threaded Flash Chamber Observed Correctly Flush Successful site Preparation Incorrect 4 Site preparation not attempted No Site Contamination Equipment Disposed Correctly Insertion Made at Allowable Site Non Critical Errors Appropriate Site Selected Inearrart leao af Canetichne Band Marcio Bithhor Band A Y Infant Virtual I V Directions for Use System Overview Procedure Simulation and Debriefing Screens The procedure simulation and debriefing screens allow you to perform the intravenous catheteriza tion procedure and assess your performance Whether you have selected practice case scenarios or competency training you will need to perform the actual procedure Performing the procedure consists of 5 screens The Case Scenario screen presents the case scenario the patient and the patient vital signs 2 The Site Selection screen allows you to select a particular site for IV catheterization Note You can change the site later in the procedure 3 The Equipment Selection screen allows you to select the necessary equipment for IV catheter Ization 4 The Simulation screen allows you to perform the procedure by inte
33. en push the advance button after performing the procedure Fall Score 712 Procedure Time 00 06 01 Trainee 2 C Band Time 00 02 18 0 Unsuccessful Completion of Procedure Cannulation Events Correct Cannulation Vein Punctured Critical Errors Procedure completed in appropriate time Standard Precautions not performed correctly 4 Gloves not used Hands not washed C Band or rubber band usage incorrect 4 C Band or rubber band left on too long Catheterization attempted Vein cannulated and correctly threaded Flash chamber observed correctly Flush Successful Site preparation incorrect 4 Site preparation not attempted No site contamination Equipment disposed correctly Appropriate needle insertion site Non Critical Errors Proper use of Constricting Band versus Rubber Band at sites Darant nab nranarhs imbrrmrmod AN The top of the Debriefing screen shows your total score the procedure and C band times whether you have successfully completed the procedure the case level and other information The assessment screen presents Cannulation events Critical Errors and Non Critical Errors Cannulation events present general subcutaneous animations of what occurred during your cannula tion attempts For example if the angle of insertion was too steep the video will display the con sequences of a steep Insertion Click on the movie icon next to the cannulation event to view the animation Positive and nega
34. er first child The mother had good prenatal care and had an uneventful pregnancy including all blood work within normal limits She was negative for Vitals Respiration Breaths Per Minute 72 Blood Pressure Systolic Dystolic 66 40 H Heart Rate Beats Per Minute 156 Y Temperature C 36 6 Oxygen Saturation 93 Weight kg 3 5 Review case and advance to next screen e Po Site Selection screen The site selection screen allows you to select a site for V catheterization Select the site and advance to the next screen by clicking the right arrow lo sesara site celia Onecare crei Or une lesa Orea ens Un pele cre sersan As will bring up a list of 2 to 4 sites available for that body portion Select the specific site by clicking on the button next to the site name Depending on the specific case scenario some sites might not be available for V catheterization Select the specific site for IV catheterization from the buttons at the top center of the screen Note You can only perform the I V catheterization procedure at the currently select ed site If you want to perform the I V catheterization outside the currently selected site then you must select a different site Once you have selected the site you would like to attempt advance to the next screen Site Selection right supinated wrist forearm right pronated forearm antecubital fossa 900 Select site and advance to next screen Ad Pr
35. erfor mance while more expert practitioners will be surprised by the scope and realism of the simulation and its ability to accurately reproduce important training elements of the procedure This Learner Manual is to be used only as a reference for using the system as the simulator provides a System Tutorial video a Procedure video and Help screens that can stand on their own for tutor ing the student in how best to use the simulator This Manual includes e The Learning Objectives for this product to serve as a guide for instructors and students to make the best use of the training benefits offered by the Infant Virtual 1V M Self Directed Learning System e A feature list that summarizes the extensive list of product attributes that comprise the most detailed learning system ever developed for training the skills required for effective intravenous needle insertion in difficult pediatric cases e Directions for setting up the system including the equipment that comes with the product and the maintenance of the haptic device This section includes the Quick Start Set Up guide which is also incorporated as a fold out with the product packaging www laerdal com Infant Virtual V Directions for Use Introduction e The Quick Start Reference guide which provides the learner with rapid directions for use of the Infant Virtual IV simulator e An instructional manual for using the Infant Virtual IV
36. ese include the Tourniquet Catheter Lock extension tubing IV Infusion Trans lluminator Flush Arm Board and IV catheter Palpation and Requesting a Holder are turned on and off by clicking on the corresponding icon Washing hands calming patient informing the parent and warning the patient of stick are displayed as pop up messages O www laerdal com Infant Virtual I V Directions for Use Quick Start User Guide Using the Haptic Device The haptic device simulates the basic elements of intravenous cannulation in the infant It supports tasks such as palpation occlusion double sided skin stretch and needle insertion The next few pages show the basic ways to manipulate the haptic device in the performance of the procedure The following schematic depicts the various parts and functions of the haptic device shown from above The device should always be placed on a flat level surface Needle Insertion Palpation and Occlusion y XE Skin Stretch Special Note Under no circumstances should any needle or catheter other than those supplied with the Infant Virtual 1 V Self Directed Learning System ever be used with the Haptic Device www laerdal com Infant Virtual I V Directions for Use Quick Start User Guide When It Is time to insert the needle into the haptic device this icon will appear www laerdal com Infant Virtual I V Directions for Use Quick Start User Guide
37. ew that learner s progress Different learners can be selected for review at any time Learner Comp r la Name Class Specialty Student150 Group Pre Hospital Student 27 Group5 Pre Hospital StudentiD0 Group Pre Hospital Student88 Group5 Pre Hospital Student418 Groups Pre Hospital Student 9 Group6 Pre Hospital student203 GroupO Pre Hospital vel Skill Cognitive 0 0 0 gse 66 64 24 58 51 57 61 33 0 37 65 0999009090 Leamer StudentiO0 Level Averages fd LC ab a x yr Sy eee Cognitive K All Skill Last 10 Last 100 Competency e Show Level 1 Novice Level 2 Intermediate Level 3 Advanced Level 4 Expert Case Title Type Medical Condition Level ScorePassed Necrotizing Enterocolitis Case Scenario Surgical 50 Yes ay aua POW 068 Dyspnea Case Scenario Medical 62 No Arce 59 Yes 61 Yes 91 No 12 No eo TT Hyperbilirubinemia Case Scenario Medical Pneumothorax Case Scenario Surgical Acute Gastroentertis Case Scenario Medical Laceration Case Scenario Trauma Suspected Child Abuse Case Scenario Madical 000060 Selecting the number and type of cases for review Select the number of cases to display by clicking on one of the buttons under the Show Cases heading on the left of the screen Selectively filter the competency training and practice cases for review The information in the com petency review will change accordingly Remember that depending on
38. f the software Running any program such as anti virus software on the computer supplied with the simulator may cause the Infant Virtual LV Self Directed Learning System to crash or slow the simulation to an unstable condition This is a dedicated computer and should not be used for other purposes except those explicitly stated by the software manufacturer www laerdal com Infant Virtual I V Directions for Use Setting up the System This diagram also available as a fold out set of instructions that is included in the Infant Virtual V M packaging explains the order of unpacking and installation of the simulator Special attention should be paid to unpacking the haptic device and plugging in the cables in the correct order and placement 1 Set up and turn on the computer as indicated by the manufacturer 2 Plug in the power cord of the haptic device into the wall socket but do not connect to haptic device www laerdal com Infant Virtual I V Directions for Use Setting up the System 3 Plug in the USB cord of the haptic device into the computer but do not connect to haptic device WARNING AN Do not discard your packing materials or shipping restraint You will need these to move transport your device 4 Remove the haptic device and needle holder from the packaging www laerdal com Infant Virtual I V Directions for Use Setting up the System 3 Plug in the US
39. fant Virtual V Directions for Use Frequently Asked Questions 20 In the Simulation Screen inserted a needle through someone s finger although the needle appears to completely penetrate the finger the Haptic device pushed the needle almost completely back out It is possible to over power the device In some cases you may hit a bone and the device will not respond correctly with forces required to penetrate it This is a limitation of the system www laerdal com Infant Virtual I V Directions for Use Support www laerdal com Infant Virtual I V Directions for Use Support www laerdal com Infant Virtual I V Directions for Use SUPPORT For Customer Service contact Laerdal at 800 433 5539 ser Tecni Serias eontaem eacrcaleadin 010 a e For additional module licenses and other Issues please contact your local Laerdal representative Please contact Dell for service and support of the computer and all software except the Infant Virtual IV software www laerdal com
40. fic information about What did wrong Yes the Debriefing screens have links to video animations and textual information about errors and the way to achieve proper performance in the procedure www laerdal com Infant Virtual I V Directions for Use Frequently Asked Questions Can the student print out the debriefing Yes Students and instructors can print out specific case scenario and cognitive test debriefings from two locations the debriefing screen and the competency review screen when a specific debriefing is accessed Installation of a Laerdal Competence Management system will allow you to print additional information Can the debriefing report be downloaded into a database Yes Installation of a Laerdal Competence Management System will allow you to download various reports into a database format Can access the student performance database from my office computer over a network Yes Installation of the Laerdal Competence Management System will allow users to access student performance and competence from anywhere on the internet keep getting the message Put the catheter back on the device even though have already performed that function What do do This may be an indication that the device requires calibration If you do this 3 times you will get a message asking you to automatically calibrate the sensor Place the catheter completely on the needle and click Auto Calibrate
41. for Use Introduction INTRODUCTION The Infant Virtual V IM Self Directed Learning System is designed to provide both the novice student and advanced practitioner the opportunity to learn and practice the psychomotor skills of intravenous catheterization on a range of pediatric cases ranging from premature infants to infants 5 months of age The simulator offers both an introduction to IV insertion serving as a part task trainer and as a tiered progressive path to build the competence required for advanced practice The Infant Virtual IV Self Directed Learning System is designed to meet the training needs of those responsible for placing peripheral intravenous catheters in the infant population The simulator encom passes an extensive spectrum of infant patient models case scenarios tallored to specific learning objectives pathophysiologic reactions and complications By combining realistic 3D visual effects and haptic effects that allow you to feel the patient with whom you are working a completely immersive and authentic environment Is created to optimize the learning process At the heart of the learning process is the comprehensive assessment of performance competency review mechanisms and a complete competency training curriculum Novices will find that with every simulation they will learn from their mistakes and complications learn from the automated assessment remember critical steps and be able to improve their p
42. ient 9 Practice Mode Patient Selector This feature allows the learner to define which patient and medical condition they want for the practice case scenario by choosing the age weight skin tone and case type lO Many patient complications based specifically on infant physiology and issues that arise during infant IV catheterization al E Accidental arterial punctures and how to deal with this error Punctured arteries will bleed from the site until pressure is applied Correct recovery from accidental arterial puncture Is assessed in the debriefing module If the needle is larger than the vein the vein will blow This adds significant realism to the simulation since the size of the vein becomes critical to correctly performing the proce dure Also many veins that are visible are not sufficiently large enough to be cannulated If the C band or occluding finger Is left on the site while flushing the vein will blow Equipment items and procedure steps add depth understanding and a sense of immersion to the simulation experience a D a d D Trans illuminator a concentrated light source for improved vein visualization Hand washing is included for proper training Syringe flushes that behave differently depending on whether you are inside or outside a vein Holder hands to help stabilize the patient Availability of arm boards for joint site stabilization Diriezent 2D spec reede 2 different lengths one in
43. ight of the screen Is a picture of the haptic device This icon will tell you when tt Is appro priate and how to Interact with the haptic device to perform the IV catheterization procedure A clock appears at the top left of the screen to show you how long you have been performing the procedure When the clock turns red you have exceeded the allowable amount of time for this case scenario Guiding messages appear at the bottom left of the screen that will help you use the system Once you have completed the procedure advance to the next screen Model Orientation Scroll the mouse wheel forwards and backwards to zoom in and out of the model Click the middle mouse wheel hold and move the mouse to rotate the model Equipment Use and Procedure Tasks General Click the help button on the navigation icon to learn how to use specific pieces of equipment or how to perform specific Procedure Tasks Only one piece of equipment can be used at a time After a piece of equipment is chosen It needs to be placed on the site or thrown into a disposal container To use or apply a selected item to the site click on the site To throw an item away click on It move It to the trash bin sharps container or biohazard bag and click Certain Items that have been attached to the site can be removed by clicking on them inside the sim ulation window These include the Tourniquet Catheter Lock extension tubing IV Infusion Trans luminator Flush Arm B
44. lfunction during procedure www laerdal com Infant Virtual I V Directions for Use Packing up the system www laerdal com Infant Virtual I V Directions for Use Packing up the System 9 PACKING UP THE SYSTEM WARNING Precautions when packing and moving the haptic device The haptic device is a precise and sensitive instrument To ensure proper working order please handle and pack with care Be certain to replace the shipping restraint before moving the device Dropping the haptic device bending the needle or other abuse may render the device inoperable e To ensure proper functionality calibrate the haptic device after moving Although the needle is blunt it can still cause injury if used in an improper manner Be careful when handling www laerdal com Infant Virtual I V Directions for Use Packing up the System This series of diagrams is also available as a fold out set of instructions that were included in the Infant Virtual I V packaging It explains the order of packing the simulator Special attention should be paid to unplugging the cables and packing the haptic device 1 Shut down the computer as indicated by the manufacturer 2 Unplug the power cord of the haptic device from the wall socket www laerdal com Infant Virtual V Directions for Use Packing up the System 3 Carefully unplug the needle from the haptic device
45. mpetency Training for more structured procedural simulations and performance tracking Learn and review proper IV insertion procedures anatomy and physiology with dynamic simulations and tutorials www laerdal com Infant Virtual I V Directions for Use Benefits learning objectives and features e Full integration with the Laerdal Competence Management System Version 1 7 1 or above allows students to remotely review progress and understand problem areas Feature List The Infant Virtual IV incorporates the use of developmentally appropriate skills and considers the specific needs of infants to promote a complete understanding of IV catheterization in the infant 2 Over 1 0 unique case scenarios 85 In each career a There are over 20 case scenario specific and site specific simulation variables that add huge depth and variability to the product spanning the range of infant physiology and pathophysiology b Each case scenario debriefing is driven by the corresponding procedure providing a very accurate instructional environment for each case c Each case scenario focuses on specific learning objectives defined in the curriculum pro vided with the application 3 There are 19 different infant models ranging in skin color weight and age from preterm to 15 months Each model presents different challenges and characteristics in the context of IV cath eterization 4 There are 5 possible cannulation sites
46. n depicting ideal performance Progress through a tiered hierarchy of ever more difficult patient cases ranging from beginning student through advanced practitioner Benefits for the Instructor Track learner history including test results Record student performance and compare results using easy to understand ratings and recognized standards Metrics based debriefing of student performance to facilitate effective feedback and guidance to students Instructor mode for configuration of the simulator options and tracking the performance of students Improved Instructor control to configure many Items that tailor the product to either the Pre Hospital or In Hospital environment as well as allowing the instructor to configure the product to their local requirements Simplify training and skills sustainment in an engaging training environment Present the student with a customized training experience adjusted to their needs and perfor mance level Identify student deficiencies and remediate using a range of case scenarios and basic science tutorials Student Benefits Learn and practice needle procedures through interaction with life like patient anatomy in real world scenarios Test your skill against other learners and experts in the context of ever increasing challenges Track your progress as you progress through the levels Compare performance with national rankings Select Practice Cases mode for quick play or Co
47. ng on the nature of the solution applied to the arm 8 Will blood drip out of the needle hub if the vein isn t occluded Yes under most conditions if the procedure has been performed to elicit this problem bleeding will occur 9 Will a hematoma and or ecchymosis form if stick through or blow a vein Yes under most conditions if the procedure has been performed to elicit these problems a hema toma and or ecchymosis will occur lO Why do need to select a sharps container There is one on the wall in every room where work An option can be configured in the Administrator module to make the sharps container always avail able The goal is to reinforce the concept that sharps contaminated gloves and other items must be disposed of in a prescribed fashion The same is true for the biohazard container Il Is there some way to mark the selected needle entry point lose the spot when prep the skin As with an actual patient there is no way to mark the point of insertion 2 Is there a lateral transparent view so can see my angle and depth of entry No currently there is no real time display of angle and depth of entry Future versions may feature this capability but for training purposes it was felt that since this is not available while performing the procedure on an actual patient it was not a preferred method of training the technique I3 Will the debriefing tell me what did correctly and give me more speci
48. ning System except for those products supplied by the manufacturer of the software Running any program such as anti virus software on the computer supplied with the simulator may cause the Infant Virtual V Self Directed Learning System to crash or slow the simulation to an unstable condition This is a dedicated computer and should not be used for other purposes except those explicitly stated by the software manufacturer System Icons There are a number of navigation icons that are usually found on the corners of the screen The icon will change color when activated by a mouse click In other cases icons will become transparent if they are not usable See the System Tutorial video within the application for more detailed information Examples of these icons and their definitions are shown on the pages below www laerdal com Infant Virtual I V Directions for Use System Overview Navigation Icons Right arrow Proceed to the next screen Back arrow Return to Previous screen Help for Current Screen Inactive Icon Icons that appear grey are not avallable Exit the application to the virtual products boot screen Return to the Main Menu eS ii tie STN RISE GT IE HE SHG Information about Infant Virtual IV Interface Icons o vi MESA ETS DIO e No cancel Make Active Inactive www laerdal com Infant Virtual I V Directions for Use System Overview Sim
49. o N O 1 Introduction to Infant IV C on 2 Special Considerations in Infants O 3 Equipment 4 Standard Precautions and Patient Assessment O 5 IV Site Selection C 6 Performing the Procedure 7 KHU Z There are play pause when playing and stop buttons in the video player www laerdal com Anatomical Viewer The Anatomical Viewer allows the learner to view and identify anatomical structures in the infant The infant can be positioned by clicking the mouse scroll wheel and holding then moving the mouse Click the orientation icon to view a descriptive video on how to orient the infant To zoom in and out of the infant model scroll the middle mouse wheel Structures can be revealed through the selection and de selection of different tissues using the Anatomical Filters at the right of the screen Selecting a structure causes It to appear while deselect ing a structure causes It to fade Anatomical Viewer Anatomical Filters P Show Bone Y Show Arteries and Heart Yi Show Muscle and Connective Tissue Y Show Nerves Yi Show Veins P Show Skin For identification move the mouse cursor over the anatomic structure and its name will appear in the text box at the lower left of the screen www laerdal com Infant Virtual I V Directions for Use System Overview Practice Case Scenario screen The Practice Case Scenario screen allows you to select a specific case scenario to practice
50. oard and IV catheter Palpation and Requesting a Holder are turned on and off by clicking on the corresponding icons Washing hands calming patient informing the parent and warning the patient of stick are displayed as pop up messages Clicking on the Orientation button plays a movie describing how to orient the site using the mouse www laerdal com Infant Virtual I V Directions for Use System Overview Using the Haptic Device The haptic device simulates the basic elements of intravenous cannulation in the infant It supports tasks such as palpation occlusion two finger skin stretch and needle insertion The next few pages show the basic ways to manipulate the haptic device in the performance of the procedure The following schematic depicts the various parts and functions of the haptic device shown from above The device should always be placed on a flat level surface Needle Insertion Palpation and Occlusion O Skin Stretch Special Note Under no circumstances should an needle or catheter other than those supplied with the Infant Virtual 1 V Self Directed Learning System ever be used with the Haptic Device www laerdal com Infant Virtual I V Directions for Use System Overview When it Is time to insert the needle into the haptic device this icon will appear www laerdal com Infant Virtual I V Directions for Use System Overview Needle Insertion and Skin
51. proper functionality calibrate the haptic device as required e Although the needle and catheter are blunt they can still cause injury if used in an improper manner Be careful and always replace them in the needle holder after use e The catheter is tethered to protect against catheter misplacement The tether can be removed to optimize use of the device e Before starting the procedure make sure that the needle is completely removed from the device and that the catheter is completely attached to the needle Here is a schematic of the needle catheter configuration Catheter Needle Needle Cord e After completing procedure remove the catheter from the device CAREFULLY and SLOWLY www laerdal com Infant Virtual V Directions for Use Setting up the System WARNING Precautions when using the haptic device The Infant Virtual IV Self Directed Learning System has been designed to work on the computer supplied with the product The computer is an integral part of the system It will not work on other computer platforms because of its requirements for very specific high speed graphics capabilities Do not attempt to install and run this software on any other computer other than that which has been provided by the manufacturer No software should be installed on the computer supplied with the Infant Virtual LV IM Self Directed Learning System except for those products supplied by the manufacturer o
52. r To start the application click on the Infant Virtual IV section of the boot SE Logging In Once started log onto the application with one of two default users Username demouser Password password Username demouser2 Password password Login as Administrator to access Instructor features and create accounts Username Administrator Password lt Provided on the information sheet inside your desktop computer or by Laerdal Technical Service at 800 431 1055 EXT 5596 This password will always work even if you change the Administrator password gt Read Uric InsusUctions to learn hei crearte Mew User accounts Help Three types of help are provided throughout the product to familiarize you with the system and assist you In the learning process These include Tool Tips or Hold Over text Tool tips or Hold Over text are provided on almost all of the interactive and even some of the non interactive items on the screens Hold the mouse cursor still on a particular button or icon on the screen and you will see a brief pop up description or explanation www laerdal com Context Specific Help In the navigation icon at the bottom right of every screen Is a question mark Click the question mark to view help for that particular screen Guiding Messages There are guiding messages at the bottom left of many screens that describe the required action Guiding messages are provided on the Case Scenario Site Sel
53. racting with the software and the haptic device 5 The Debriefing screen presents a complete assessment of your performance and allows you to review proper technique were errors have been made Examples of these screens are depicted on the following pages www laerdal com Case Scenario screen The patient scenario contains information vital to the learner s successful performance of the subse quent venous cannulation Read the case scenario thoroughly and advance to the next screen by clicking on the right arrow From the case scenario screen you can return to the main menu However If you advance from the case scenario screen you will be required to complete the procedure At levels and Il you will be presented with highlights of the case scenario The highlights describe the more important facts of the case and appear in yellow During competency training you may be presented with a remediation case scenario If you fall a spe cific case scenario two times The hints on the remediation case scenario present specific procedure steps that need to be performed for successful completion of the case and appear in red Case Scenario Transient Tachypnea of the Newborn TTN Level O Procedure Time 00 10 00 A term male has been transferred to the Neonatal Intensive Care Unit with tachypnea at 3 hours of age He was delivered by Cesarean Section at 40 weeks gestation only because the mother had a previous C section with h
54. rd www laerdal com Infant Virtual V Directions for Use www laerdal com Infant Virtual I V Directions for Use System Overview www laerdal com Infant Virtual I V Directions for Use www laerdal com Infant Virtual I V Directions for Use System Overview USING THE SYSTEM The Infant Virtual 1V M Self Directed Learning System software consists of two distinct parts 1 The basic menus screens which present the case scenario provide debriefing of performance and support many other functions and 2 The simulation training sequence that enables interaction between the learner inserting the needle and the three dimensional 3D model of the infant The following section describes the Icons and Buttons Basic menu screens and the Training Sequence also covered briefly in the Quick Start Guide A WARNING Precautions when using the simulation software e The Infant Virtual IV Self Directed Learning System has been designed to work on the computer supplied with the product The computer is an integral part of the system It will not work on other computer platforms because of its requirements for very specific high speed graphics capabilities Do not attempt to install and run this software on any other computer other than that which has been provided by the manufacturer e No software should be installed on the computer supplied with the Infant Virtual IV Self Directed Lear
55. recautions not performed correctly 4 Gloves not used Hands not washed C Band or rubber band usage incorrect 4 C Band or rubber band left on too long Catheterization attempted Vein cannulated and correctly threaded Flash chamber observed correctly Flush Successful Site preparation incorrect 4 Site preparation not attempted No site contamination Equipment disposed correctly Appropriate needle insertion site Non Critical Errors Proper use of Constricting Band versus Rubber Band at sites Daran nab nranarh imbrremnmmad AN The rest of the Debriefing screen displays the Cannulation Events Critical Errors and Non Critical Erros Cannulation events present general subcutaneous animations of what occurred during your cannula tion attempts Click on the movie icon next to the cannulation event to view the animations Positive and Negative critical and non critical assessment headings and specific assessment errors are displayed below the cannulation events Clicking on the movie icon next to a negative assessment heading will play a short vignette describ ing how to perform the relevant portion of the procedure correctly Once you have reviewed your debriefing advance to the next screen www laerdal com Infant Virtual I V Directions for Use Administration and Account Creation www laerdal com Infant Virtual I V Directions for Use www laerdal com Infant Virtual I V Dire
56. rted in the site as may be the standard for some practitioners 14 Anatomical Viewer a Complete body anatomical viewer of relevant structures with stage loading to reduce wait times 5 Debriefing a Debriefing ensures the learner performs the procedure correctly or is negatively assessed b Assessment of equipment usage complications and procedure tasks l6 Instructor Configurability many configurable items tailor the product to either the Pre Hospital or In Hospital environment as well as allowing the instructor to configure the product to meet their local requirements 7 Improved Case Scenario presentation with patient image and vital signs 18 Cognitive questions that follow training guidelines for novice to expert users 19 Fully integrated with the Laerdal Competence Management System www laerdal com Infant Virtual V Directions for Use www laerdal com Infant Virtual I V Directions for Use Setting up the system www laerdal com Infant Virtual I V Directions for Use www laerdal com Infant Virtual I V Directions for Use Setting up the System SETTING UP THE SYSTEM WARNING Precautions when using the haptic device e The haptic device is a precise and sensitive instrument To ensure proper working order please handle with care e Dropping the haptic device bending the needle or catheter or other abuse may render the device inoperable e To ensure
57. the opportunity to practice techniques and refine the necessary decision making skills needed to successfully complete complex venous access tasks In the infant population Learning Objectives The Infant Virtual IV Self Directed Learning System provides the learner with the ability to e Overcome initial discomfort and fear associated with performing the IV procedure on actual infants e Perform differential diagnosis of patient cases related to placement of a peripheral LV in differ ent regions of the arm hand foot and scalp of a variety of pediatric cases e Select proper equipment including needle gauge from an inventory e Perform appropriate cleansing and site preparation e Learn the proper feel of the procedure from palpation to needle insertion and feeling the pop to threading the catheter to skin stretch e Train the hand position for performing the procedure on a variety of relevant body parts spe cific to the pediatric case being presented e Perform appropriate orientation and angle of V needle insertion e Secure and finish the procedure of V catheterization including site dressing and fluid adminis tration as appropriate to the patient case scenario www laerdal com Infant Virtual V Directions for Use Benefits learning objectives and features Be presented with automated debriefing including identification of critical and non critical errors and video and animatio
58. tive critical and non critical assessment headings are displayed below the cannulation events Critical errors are vital to proper performance of the procedure Depending on the configu www laerdal com ration chosen by the administrator a quantitative score may be displayed This Overall Rating may be high but the learner will still fail the procedure if critical errors were made The total time of the pro cedure as well as the time the constricting band was placed on the site Is timed For some critical and non critical errors a movie icon will appear next to the error Clicking on the movie icon next to a negative assessment heading will play a short vignette describing how to per form the relevant portion of the procedure correctly Once you have reviewed your debriefing you can advance to the next screen return to the main menu or log off from the application If the learner Is in Career Mode and succeeds at the procedure then the next case or a qualification test will be automatically presented when the learner advances to the next screen If the learner fails the procedure he or she may be presented with the same case scenario a different case scenario or a remediation case scenario with hints Infant Virtual I V Directions for Use If the haptic device malfunctioned during the procedure the assessment will be discarded and you will receive the below error message Assessment will be discarded due to Haptic Device ma
59. uipment and advance to next screen www laerdal com Simulation Procedure Overview The equipment you have selected appears in the equipment toolbar at the left of the screen You can use any of these pieces of equipment at any time by clicking on the corresponding Icon a Case Scenario O Equipment O Site Selection Palpation Q Request Holder gt A Wash Hands Calm Patient e S Warn Patient of Stick Ca Orientation ES Click at desired insertion location At the top of the screen are 3 buttons that allow you to review the case scenario Case Scenario select more equipment Equipment or select a different site for catheterization Site Selection You can select these throughout the procedure Certain procedural steps can be performed by clicking on the corresponding icons These icons are located around the left periphery of the circular simulation window At the bottom of the simulation window are three disposal containers trash can sharps container and bio hazard bag Dispose of equipment into the appropriate receptacle once It has been used www laerdal com Infant Virtual I V Directions for Use Quick Start User Guide At the top right of the screen Is a picture of the haptic device This icon will tell you when It Is appro priate and how to Interact with the haptic device to perform the IV catheterization procedure A clock appears at the top left of the
60. ulation and Debriefing Icons Haptic Device Available Haptic Device is Not Available Insert Needle into Haptic Device Indicator Palpate Haptic Device Indicator View case scenario Select equipment Change site for insertion Vy asalmamas Request Holder Inform Parent Palpate Site www laerdal com Infant Virtual V Directions for Use System Overview Warn of Stick Calm Patient Learn how to orient the site Case scenario level indicator Movie available Click to play movie Basic Menu Screens To start the application click on the Infant Virtual V section of the boot screen This will initially bring up a loading screen immediately followed by the Login Screen see below and prompt the learner to enter their user name and password Please note that these need to be created by the System Administrator usually the Instructor see section called Administration below www laerdal com Introductory screen This provides the initial introduction to the application press any key to continue y immersion About Q Help O Exit www laerdal com Logging In This screen prompts the learner to enter user name and password Click the check button to move to log on or the null button to remove the Login pop up screen Press Exit to quit the application About to view the license agreement and version number or Help to view help Usern
61. ur instructor will define the appropriate career Career Selection gt LA STAN a f NS E f x In Hospital 1 Cs _ 2 7 a Pre Hospital K www laerdal com Infant Virtual I V Directions for Use Quick Start User Guide Main Menu Note If this is your first time using the Infant Virtual 1 V it is highly recommended that you view the System Tutorial video To view the system tutorial click on the System Tutorial button The main menu allows you to access the different training types view a system tutorial view a proce dure training video review your achieved competencies and access the anatomical viewer Main Menu c Competency Traini 4 o y N Y O Competency Review j A J Procedure Video gt Anatomical Viewer www laerdal com Infant Virtual I V Directions for Use Quick Start User Guide Training Types a Practice Case Scenarios The Practice Case Scenario screen allows you to select the infant on whom you will be performing the procedure and the specialty you would like to practice Practice Case Scenario Hemia Repair Select the infant age preemie full term 6 month or 15 month the skin color Fair Dark and the weight Skinny Normal Chubby Then select the medical domain you would like to attempt Trauma Medical or Surgical Once the desired combination is selected advance to the next screen to view the cas
62. w laerdal com Simulation Procedure screen Overview The equipment you have selected appears in the equipment toolbar at the left of the screen You can use any of these pieces of equipment at any time by clicking on the corresponding icon O O Case Scenario O Equipment Q Site Selection Palpation Q Request Holder d ee Wash Hands e Calm Patient e ay form Parent P dg Warn Patient of Stick P Orientation S At the top of the screen are 3 buttons that allow you to review the case scenario Case Scenario select more equipment Equipment or select a different site for catheterization Site Selection You can select these throughout the procedure Click at desired insertion location Certain procedural steps can be performed by clicking on the corresponding procedure icons These icons are located around the left periphery of the circular simulation window and include palpation requesting assistance with holding the infant washing your hands calming the patient informing the parent of the procedure warning the patient of the stick and learning how to orient the infant within the simulation window www laerdal com Infant Virtual V Directions for Use System Overview At the bottom of the simulation window are three disposal containers trash can sharps container and bio hazard bag Dispose of equipment into the appropriate receptacle once It has been used At the top r

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