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SimMom™ - Laerdal

1. Cervix that dilates from 4 cm to full Realistic vulva and anus for digital exams Realistic at term abdominal skin Pre incised C section skin Fluids e g blood stained amniotic fluid and urine Urine catheterization instillation Pelvic floor Birth canal Breathing Features Simulated spontaneous breathing Variable respiratory rates 0 60 bpm Bilateral and unilateral chest rise and fall Normal and abnormal lung sounds 4 anterior auscultation sites Bilateral midaxillary sites Tension pneumothorax Oxygen saturation waveform Cardiac Features Extensive ECG library Normal and Abnormal Heart sounds synchronized with ECG ECG rhythm monitoring 2 lead ECG display Defibrillation and cardioversion Responds to external pacing with settable pacing threshold 20 200 mA Circulation Features BP measured manually by auscultation of Korotkoff sounds Bilateral carotid pulse brachial and radial pulses right side only synchronized with ECG Pulse strength variable with BP Pulse palpation is detected amp logged Chest Compressions CPR compressions generate palpable pulses blood pressure wave form and ECG artifacts Detection and logging of a series of compressions Other Features Normal and abnormal bowel sounds and fetal heart sounds not at the same time Interchangeable pupils norma
2. From the Instructor Application Click the Stop button lt Mf gt The Stop button is located under the Time display Click the lt Debrief gt button in the lt Start Scenario gt dialog box The Debrief files from the session are then transferred and made available in the lt Laerdal Debrief Viewer gt Note It is important to save the debrief files for later review 2 From Windows Start menu Click the Windows lt Start gt button Select lt All Programs gt Select the lt Laerdal Debrief Viewer gt program folder Select lt Laerdal DebriefViewer gt The system displays the Debriefing window for the session Customizing Scenarios SimMom scenarios can be created and edited using a set of editors Scenario Editor Trend Editor Event Handler Editor The Patient Monitor layout can be customized via the Scenario Editor Select lt Edit Monitor layout gt from the lt Edit gt menu Common learner events can be customized via the Scenario and Event Handlers Editors Select the lt Edit gt menu located at the top of the Instructor Application screen 2 From the drop down menu select lt Start Scenario Editor gt 3 The New Scenario SimMom window opens Select lt Edit gt from the menus shown at the top of the window 4 From the drop down menu select lt Edit Event Menus gt SimMom editors can be accessed through the Instructor Application s
3. Display fetal montoring graph Initial State t On Off Idle Big Numeric Layout Cancel Open Setup Save Setup Set to Default Values OK Apply To change the waveform or numeric layout click on one of the panels to the far left of the screen To change which waveforms and numeric layouts are displayed Click on one of the waveforms or numeric layouts on the large panel in the middle of the screen Scroll over to the Available parameters menu and select the desired parameter 3 Change the waveform or numeric layout by either clicking the lt Select Parameter gt button or double clicking on the desired parameter Click lt Apply gt to apply the changes to the Instructor Monitor Control on the user interface 5 Click lt OK gt to exit the Monitor Setup screen To return to the default values on a waveform or numeric layout click the lt Set to Default Values gt button To download a custom layout click the lt Open Setup gt button To save a layout click the lt Save Setup gt button Running a Scenario Launch the Instructor Application Click lt Start Scenario gt This will open a list of scenarios Select and open Click lt Play gt button to start E The lt Pause Play gt button is located below the lt Start Scenario gt Note lt Pause gt button changes to lt Play gt button when the scenario is paused Software button When a simulation is run
4. Delivery Techniques When simulating deliveries one person must serve as the puppeteer The puppeteer stands to one side of the mother s abdomen and pushes the baby through the birthing canal 5 There are two basic techniques for delivering the baby Note Gloves should be worn during the procedure Jewelry items such as rings should be removed to protect the soft tissue parts of the model One Handed Delivery Place baby in fetal position aligning its limbs for insertion through birth canal Grasp the baby by the back of the trunk Engage the baby s head in the required position in the pelvic inlet Push firmly a e he head should automatically flex on the neck and descend the birth canal dilating the cervix As the head passes through the birth canal it should rotate naturally Rotation can be enhanced by rotating the baby s trunk 24 y If the limbs were properly aligned beforehand they should follow their own path and emerge realistically through the birth canal This technique allows the puppeteer to perform other functions such as midwife birthing partner etc 2 Two Handed Delivery With one hand grasp the baby by the back of the trunk This hand performs most of the pushing Place the palm of the second hand along the chest of the baby Use the tips of two fingers to manipulate the baby s chin or mouth and to rotate the baby s head when requir
5. Performin 0 10 Connect blood feed tube red Luer to blood pump outlet red bulkhead connector ras Note The same pump and connectors can be used to deliver simulated amniotic fluid rather than blood if this is required gt N c 14 Replace abdominal skin S U o Q Y N rs S A 0 S Q Y 2 Performing Simulations Uterus and Post Partum Hemorrhage Installation 8 Fit indwelling catheterization bladder and fold back behind bag The Uterus and PPH module includes a retained placenta module and boggy uterus module To install the uterus Fold back or remove abdominal skin see Maintenance section page 3 7 Abdominal Skin Replacement Remove pelvic ring clamp and cervix Caution Folding the skin downward without support underneath it may cause the skin to tear 2 Push pelvic ring clamp over cervix and flange of PPH uterus Placental Fragment Placenta 3 Locate flange on pelvic clamping face Align holes on flange with pins on clamping face Align notch for urinary connectors with similar notch on pubis Note Gloves are recommended for this procedure Lubricate birth canal and inside of PPH uterus 2 Lubricate placental fragment and insert it into the uterus ensuring the pointed part of the fragment points towards the manikin s head Push pelvic ring clamp into position over locating pins 4 5 Ensure flange holes and pins
6. Trend and Handler Control Trends permit physiological changes over a period of time Trends window displays running trends Use the lt Start Stop gt button to open the Trend and Handler Control dialogue box and make changes select Trends or Handlers and start or stop both Trends and Handlers Trend amp Handler Control 9 Trends La Apnea 4min tnd L Epinephrine high dose tnd L Epinephrine low dose tnd L Fluid Bolus 20 per kg tnd La MonSpO2Trend tnd ae Oxygen tnd Li PerfusionStop tnd 9 Handlers 59 abc_handlers medic_handlers misc_handlers Trend Name Status Stop Trend Stop All Pause All Handler Name Stop Handler Event handlers enable events to trigger simulator responses Handlers window displays currently running handlers Use the lt Hide Trends gt button to hide or show the trend preview window Trend Preview Window hidden by default Window displays the simulation control graph which illustrates the trend in patient parameters of past current and predicted future trends throughout the simulation Introduction Setup 00 VY Q Y S gt Y Specifications Maintenance Performin Spare Parts Trend Preview Window is hidden by default To activate click lt Show Trends gt under the Handlers dialog box To enable at start up go under lt Edit gt on the program menu bar and click lt configuration gt On the Configu
7. Venous Blood Starter Kit Pk 2 5 Lt Birthing Lubricant Please contact your local Laerdal Customer Service Representative for more information on spare parts and accessories Introduction U rs R ae 09 lt R mi Y Notes 48 2011 Laerdal Medical All rights reserved 20 05176 Rev A Printed in USA Limbs amp Things Skills training products for healthcare professionals E Laerdal helping save lives
8. 7 J Manikin vocal sound volume 5 E Monitor alarm volume 4 QRS beep volume 4 V Disable Windows System Sounds J Fetal monitor volume 4 Fetal monitor E Fetal monitor scroll speed fi cmjmin J Tongue edema pressure 6 1 cmjmin 5 Seizure intensity 50 Uterus pressure 4 Uterus bleeding flow 50 SJ Pneumothorax pressure 5 Units J Capnometer unit mmHg SJ ICP unit mmHg SJ Temperature C C Sort event lists alphabetically E Vocal sound when no BP or apnea Disabled Display parameter trend window at startup Enabled E WRR source ECG amp Override default Start Scenario folder Disabled SJ Start Scenario search folder Ke mas U gt U O C Software Tongue Edema From the Configuration menu Select the lt General gt tab on Configuration screen 2 Click the lt Tongue edema pressure gt option under the SimMom feature set values subheading 3 Enter the desired pressure rate into the dialog box General Yolume GS Master sound volume mode Automactic Master sound volume only applies to Manual mode 7 E Manikin vocal sound volume 5 E Monitor alarm volume 4 QRS beep volume 4 Disable Windows System Sounds Fetal monitor volume 4 Fetal monitor E Fetal monitor scroll speed 1 cmjmin SimMom feature set values J Tongue edema pressure 6 E Seizure intensity 50 J Uterus pressure 4 Uterus bleeding flow 50 Pneumothorax
9. FHR offset Acceleration Early decelerations Late decelerations Variable decelerations Sinusoid Baseline variability Only for reference not saved in preset LTV gain g LTV frequency U 0 11 STV gain g 3 Uterine activity Only for reference not saved in preset In labor Baseline q Canbeartinn intansi Note VVhen parameters are changed in a section marked Only for reference not saved in preset the changes will appear in the preview window but will not be saved in the preset 5 Save preset by clicking the lt OK gt button The saved preset should now appear in the Select preset tab underneath the menu corresponding to its pattern type To edit a saved preset click on it in the Select preset tab and press the lt Edit gt button To erase a saved preset click on it in the Select preset tab and press the lt Remove gt button Creating A Composite Fetal Heart Rate Pattern A composite fetal heart rate pattern consists of multiple sub patterns each of which has its own parameters By varying the duration of the sub pattern users can infuse greater degrees of randomness and variability into the simulation The user can create a composite fetal heart rate pattern or select one from the list of presets Preset composite fetal heart rate patterns include episodic accelerations prolonged decelerations variable decelerations and occasional accelerations To create a composite fetal hea
10. pan Note Ifthe manikin is being used as a task trainer to r demonstrate the position and movements of the baby you o should remove the skin completely rather than folding it 5 Y forward This offers a better view of the perineum 3 Maintenance Perineum Birth Canal Skin Replacement 3 Remove cervix by disengaging the holes on the flange from locating pins on pelvic clamping face To replace the perineum birth canal skin Remove abdominal skin by removing retaining screws located on upper pubic clamping plate behind lower part of abdominal skin using 4mm Allen key wrench 4 Remove urinary connector white and urinary valve grey and push the birth canal down into the pelvis 5 Remove retaining screws on lower pubic clamping plate behind 2 Remove pelvic clamp by unscrewing the three black thumbscrews upper part of perineal skin using 4mm Allen key 6 Remove lower pubic clamping plate from birth canal skin 7 Turn manikin over to allow access to posterior screws 38 Maintenance 8 Remove retaining screws on posterior birth canal fixing plate 9 Remove fixing plate 1 Keeping the manikin in the same position push main body of replacement birth canal up into the pelvis 39 2 Push the anus into the corresponding hole in the pelvic floor 2 cw U 5 O pa w ai 5 mas 7 Y 3 Lay the posterior perineal part of the birth canal into the recess in the back
11. Place blood pressure cuff on blood pressure arm 2 Attach clear tubing on cuff to the matching clear pneumatic tubing exiting the torso underneath the blood pressure arm 3 Ensure that both the 37 pin connector cable and the clear pneumatic tubing exiting the lower right side of the manikin are connected to the VitalSim control Unit Note The speaker for the Manikin s blood pressure is located in the right antecubital fossa Preparing for IV Simulations Both manikin arms provide radial IV access through female luer fittings and support training for IV drug administration Connect IV outlet tubes exiting backside of the arm to IV fluid collection bags For realism place collection bags discretely out of sight from scenario participants Connect the male luer connector of the IV bag not included to the female luer connector on the manikin s forearm 13 When performing IV simulation use only distilled or de ionized water to prevent clogging of the system Cleaning IV Arms Introduction Clean the IV arms after each session or day of use by flushing them with 60 isopropanol or 70 ethanol Birthing Positions By manipulating the manikin s limbs and rotating its shoulder and hip joints it can simulate the following birthing positions Setup Supine 4 Left lateral 2 Semi recumbent 5 Legs in stirrups 3 All fours 6 McRoberts Preparing Baby for Delivery SimMom is delivered with a birthing baby tha
12. Radiology Media or Labs by clicking on any of the relevant menus in the Patient Monitor Application Ensure that the main menu is displayed 2 Click on the appropriate Radiology Media or Labs button 3 Click lt Order New gt in the dialog box 4 The system will then notify the Instructor of the order via the Instructor Application The user may also click on any of the relevant menus to check if the Instructor has made any media files available for viewing Laerdal Debrief Viewer The Debrief Viewer is a debriefing tool that allows you to open and review a saved simulation session The debriefing file consists of the following information logged during a simulation Session Log Data and events are recorded and time stamped throughout the simulation session Instructor comments are included Patient Monitor Patient Monitor display can be recorded as a video file Web camera Video signals from a web camera connected either to the Instructors computer or the Patient Monitor computer 20 Microphone inputs Voice and sound recording from the web camera s built in microphone is recorded Review comments Comments can be edited or added to the lt Session Log gt during review in the lt Debrief Viewer gt Accessing the Debrief Viewer Note The sources are all recorded to the same time line and are always played back simultaneously The Laerdal Debrief Viewer can be accessed in two ways
13. Warning Avoid pinch hazards Do not use the manikin without the external skins Storage and Transportation The SimMom manikin and accessories are heavy when packed in boxes or combined in optional carrying cases Always ensure that SimMom is firmly secured during transportation and storage to prevent personal injury or damage to the product Introduction SimMom Overview SimMom has been developed in partnership by Limbs amp Things and Laerdal combining the best that both companies have to offer in healthcare simulation products By integrating the strengths of the PROMPT Birthing Simulator and the ALS Simulator SimMom provides the user with both anatomical accuracy and authentic simulation experiences that together facilitate valuable learning experiences for a wide range of midwifery and obstetric skills SimMom responds to clinical intervention instructor control and pre programmed scenarios and allows for the observation of both maternal and fetal vital signs Instructors can articulate mother and baby in multiple positions in order to simulate various types of deliveries Students can practice diagnosis and treatment of the mother and fetus SimMom can be used to teach skills such as airway management CPR heart and lung sound auscultation and blood pressure auscultation SimMom can also simulate the following delivery scenarios Normal delivery Maternal collapse Breech presentation Post Partum Hemorrh
14. _ _ Wire Exit Configuring System The Instructor PC controls the simulator It includes software programs for creating and editing scenarios as well as an application for debriefing simulation sessions with video capture from a web camera and the patient monitor The Patient Monitor can be configured to replicate most patient monitors It also doubles as a display for other functions such as 2 lead ECG X ray images and lab results to view the patient s case history The Web Camera records video and sound of the simulation for use during the debriefing session Setup Summary Start the Instructor PC Connect the mouse and power supply to the computer and power ON Make sure that the SimMom simulator icon is displayed on the Instructor PC desktop 2 Install the USB hub Connect Power to the USB hub Connect USB hub to Instructor PC 3 Connect the Patient Monitor Cables Put aside the software CD that comes with the monitor DO NOT INSTALL software CD Route the cables through the Patient Monitor stand and connect Setup Setup of SimMom Components Audio cable Video cable USB camera them to the corresponding outlets located at the bottom of the screen Video cable USB cable Audio cable blue mini jack with single wire Power cable Secure the cables using the strain reliefs Connect power cable to a wall outlet and power ON the Patient Monitor 4 Connect the Pa
15. are still correctly aligned 6 Position and tighten black thumbscrews until firm gt Connect red Luer connector on blood feed tube to red blood outlet on the pelvic bulkhead Note Connection only requires a 7 turn to lock Do not over tighten 3 Align the fragment s round prominence with suction hole on posterior wall of uterus on the manikin s right 28 Performing Simulations 4 Lubricate the placenta and introduce it into the uterus It helps to Boggy Uterus Bag Installation fold it in half in order to fit through the cervix Place the boggy uterus bag in position on PPH uterus The c concave surface of bag aligns with the convex surface of uterus a 5 O pa w fa 5 ras 7 Y 5 Orient the placenta so that the round prominence sits snugly into the corresponding cavity in the uterus on the manikin s left j eT l l 2 Attach the air supply tube from the boggy uterus green Luer Ensure the fragment remains aligned with the placenta connector to green air outlet on the pelvic bulkhead 3 4 turn 6 Fitthe connector on vacuum pump hose to the quick fit connector Caution Do not activate boggy uterus until abdominal skin o on one side of the back of the uterus S aad nad is fastened in position The bag will over inflate if it is activated with the skin off Y 3 Place support foam in position under uterus This prevents the uterus from flopping back when palpating
16. collecting on electronic components which could pose a shock hazard Allow the manikin to acclimate before defibrillating Using a defibrillator in temperatures over 35 C 95 F may cause manikin to overheat Do not provide more than 2 x 360 defibrillator discharges per minute After 30 minutes cease all shocking for at least 5 minutes before starting a new sequence The manikin must not come into contact with electrically conductive surfaces or objects during defibrillation Avoid use in all flammable environments For example high levels of pure oxygen should be avoided during defibrillation Ensure good ventilation if concentrated oxygen is used near the manikin To prevent torso skin electrode pitting do not apply conductive gel or conductive defibrillation pads intended for patient use Pressing down too hard on the defibrillation connectors during defibrillation may also cause arcing and pitting Do not defibrillate the manikin if the torso skin is not in place Mechanical or Electrical Hazards Do not use the SimMom manikin if Limbs are not attached to the torso Skins are torn or not properly fastened Internal or external cables tubes or connectors are damaged There is fluid leakage in or on the manikin There are unusual sounds indicating air leakage or mechanical damage There are signs of electrical malfunction such as an unresponsive manikin or unusual smell or smoke A
17. free defibrillation attach adhesive pads to adapter plates For manual defibrillation place defibrillator paddles firmly against adapter plates Note Place paddles firmly against zap plates to read rhythm on a monitor Caution The manikin must not be in contact with electrically conductive surfaces or objects during defibrillation Warnings Read and follow all safety and operation instructions provided with your defibrillator and associated equipment The trainer can be shocked with actual voltage and current during defibrillation Observe all precautions and safety measures during defibrillation and pacing phases of training Failure to follow safety measures could result in injury or death to operators students and or onlookers Only perform defibrillation on the defibrillator connectors Do not press too hard over the defibrillator adapters as this may cause arcing and pitting Do not defibrillate manikin without the torso skin in place Do not provide more than 2 x 360 J defibrillator discharges per minute After 30 minutes cease all shocking for at least 5 minutes before starting a new sequence Connecting Blood Pressure Cuff SimMom is delivered with a customized blood pressure cuff It attaches to the blood pressure arm right arm which when connected to VitalSim can be used to auscultate and palpate blood pressure Performing Simulations To connect the blood pressure cuff
18. in order to record video of the patient monitor for debrief files Patient Monitor Interface Top menu Press lt Swave gt in the top menu to view and change monitor display settings Press to open Alarm Volume 2 Parameters Readout Area The user may also edit scaling alarm limits etc using this interface Clicking the parameter of interest will present a menu with available options Some fields will only be available while appropriate sensors are connected to the Manikin 3 Bottom menus a Bottom Menu There are two bottom menus Press the left or right arrow key to toggle back and forth between Bottom Menu and Bottom Menu 2 Press the left double arrow key to display Bottom Menu Selecting the lt Silence Alarm gt button turns active alarm sounds OFF S Selecting the lt Pause Alarms gt button turns all A sound alarms off for 3 minutes Pause Alarms g Cardiac Output generates a new reading of Cardiac Output The C O details will be shown in the C O Cardiac part of the Patient Monitor PC Output a Select the lt Graph Trends gt button to open and review Graph Trends Selecting the 2 lead ECG button generates a 2 lead ECG strip Select lt Print gt to request this ECG 12 lead strip be printed The request will display on the ECG Instructor Application Bottom Menu 2 gt Press the right double arrow key to display Bottom Menu 2 hg pe Select the lt QRS Volume
19. into molded track around neck area of sik 9 Screw the wing nut on the bolt and tighten until desired manikin articulation is achieved a4 Maintenance 10 Replace hard chest plate 7 Slide the stopper off of the pivot arm I Reattach chest skin back onto shoulder area ensuring ECG posts align 2 5 2 Replace deltoid injection pad on upper arm 5 pa w To remove Right BP arm Remove deltoid injection pad from upper arm 2 Detach chest skin from tabs at shoulders and back 3 Remove skin to reveal internal upper chest area 3 4 Lift chest plate to reveal inside sockets for arm connections 5 Follow the cables exiting the shoulder to the black connector and os Eevee disconnect 9 Insert new arm 10 Thread cables through the stopper 0 La S gt O Y 2s Ls o Aw Secure the stopper to pivot arm with the retaining screw using a Phillips head screwdriver a9 R cod p S R 2 6 Use a Phillips head screw driver to unscrew and remove the retaining screw N c O D G U Gq 2 Reconnect black connector 9 Q 3 Replace chest plate 14 Reattach chest skin onto shoulder area ensuring ECG posts align N 4 S S A 0 a S OQ Y 35 Maintenance Pneumothorax Bladder Replacement 4 Pinch and remove bladder through opening between second and third intercostal spaces These are located on the top side of the To remove the pneumothorax bladder fro
20. lt Edit gt menu or directly through the Windows lt Start gt menu Click the Windows lt Start gt button 2 Select lt Programs gt 3 Select lt SimMom Instructor Applications gt The following list appears Scenario Editor Software SimMom Help file 7 Click lt Activate gt in the License Manager window SimMom Instructor Application 8 Enter License Key SimMom Program Update 5 Trend Editor Note If you do not know your license key contact a Laerdal F customer service representative for support 4 Select an editor P PP D eet 9 Click lt Automatic activation through Internet gt p Scenario Editor l0 he Li M The Scenario Editor allows you to define relationships between eed cenee Paneer nce learner events and patient response by drawing lines in a simple Restart software and create user name and password graphical editor Software is now ready for use Trends S Trends are sets of physiological parameters pre programmed to amp increase decrease over time Handlers Handlers enable events to trigger simulator responses Laerdal Advanced Video System AVS The Laerdal AVS optional can be installed to allow high quality video capture from up to 4 video cameras during a simulation session and be viewed in the Laerdal Debrief Viewer Note The Laerdal AVS is not included in the SimMom package but can be purchased from your local Laerdal Sales Company or representative o0
21. of the pelvis 14 Fit the posterior birth canal fixing plate and secure with the two retaining screws 0 15 Turn the manikin upright a gt HY 6 Locate the lower pubic clamp under the flap on the birth canal skin 7 Push the pubic clamp into position on the pubis 18 Insert and tighten the two retaining screws 19 Pull birth canal up out of pelvis 2s ED 20 Locate holes in birth canal flange on corresponding pins on pelvic os a clamping face oe Aw 2 Replace urinary valve urinary connector and pelvic ring clamp Cervix Replacement To replace the cervix Remove the three black thumbscrews on the pelvic ring clamp 2 Remove the pelvic ring clamp a9 R Cc cod ras Cc R 2 Note When removing pelvic ring clamp lift so that it remains parallel with the pelvis until it is clear of the screws Specifications Spare Parts Maintenance 3 Remove the cervix Set replacement cervix in position at pelvic inlet with flange lying on top of birth canal flange Ensure that notch for urinary connectors aligns with similar notches on pubic bone and birth canal flange Ensure that holes in birth canal and cervix flanges are positioned correctly on the locating pins on the pelvic clamping face Replace pelvic ring clamp and secure in place by tightening thumbscrews Pelvic Floor Replacement To replace the pelvic floor Remove perineum birth canal pelvic ring and c
22. outside of the uterus 14 Replace skin and lubricate the birth canal and inside of the uterus Note Ensure that both the inside and outside of uterus are g lubricated The degree of lubrication will dictate the ease with which the uterus can be pulled out and pushed back in 7 Push pubic ring clamp over uterus and align with locating pins on Catheter Installation clamping face SimMom includes two types of urinary connectors The first type Is for scenarios involving intermittent catheterization This is referred to as the intermittent catheter tube The second is a bag type connector for scenarios involving an indwelling balloon catheter This is referred to as the indwelling catheterization bladder Except for the extra attachment flap on the bag both connectors are removed and attached in the same way 30 Performing Simulations Intermittent Catheter Tube Indwelling Balloon Catheter lug on the inside of the abdominal skin For PPH scenarios fold flap back and tuck behind indwelling catheterization bladder a U 5 9 Replace pelvic ring clamp D 4 To remove and replace the urinary valve Remove pelvic ring clamp 2 Remove urinary connector 3 Pull grey urinary valve from urethral tube on birth canal r 3 4 Push outlet spigot wider of replacement valve into urethral tube D Disconnect the white Luer connector from the urine reservoir Grip tube through birth canal skin to provide support a out
23. patient monitor he software allows the instructor to use the preset states as well as utilize the customized parameters VitalSim Control Unit The VitalSim control unit serves as the interface between the PC and the manikin VitalSim connects to the PC through the USB powers and controls the manikin and provides feedback from the manikin back to the PC ai N a G mi C gI A On Off button and indicator Press once to turn the unit on Press again to turn the unit off The indicator is steady green if the base unit has contact with the manikin If there is no contact with the manikin the indicator will blink green If the battery needs replacement the indicator will blink alternating between green and orange B DC Power supply input Used for stationary training and to limit battery consumption Manikin connector Connects the base unit to the manikin Microphone input External microphone attachment USB port For connection to PC Remote connector Not applicable to SimMom ommy Blood pressure connector Connects to the blood pressure tube exiting lower right side of manikin H Battery pack Holds 6 replaceable C cell batteries Patient Monitor The optional Patient Monitor has a configurable touch display It simulates a real patient monitor as found in hospitals and ambulances The Patient Monitor Displays patient s clinical status including a maximum of 5 waves and 4 par
24. recording sounds for simulations sessions be Import Vocal Sounds To import vocal sounds and make them available for the simulation sessions In the Instructor Application click lt File gt 2 Click lt Import Vocal Sounds gt in the drop down menu The Instructor may import any of the existing sound files or browse to select a personal sound file 3 To play the imported sound during the simulation click on lt Vocal Sound gt in Instructor Application window C O 4 U gt T O pa 4 Software Importing and Adding Media Files During a session the SimMom software makes media files available to users Media files include Radiology digital images Media videos and Lab reports Import Media Files To import media files and make them available for the simulation Sessions In the Instructor Application click lt File gt 2 Click lt Import Media Files gt in the drop down menu The Instructor may import any of the existing media files or browse to select a personal media file Add Media Files To add media files In the Instructor application click lt File gt 2 Click lt Add Media Files gt in the drop down menu 3 Browse to select a file The Instructor can import and add as many media files as required Instant Display Media files show immediately when transferred AN eal Media Radiology Labs Ordering Radiology Media or Labs The user can order
25. through the abdomen 7 a Oo p S z Y Performin 7 Pump until dial reads 0 8 0 9 bar 25mmHg approximately 8 10 strokes of pump 0 O c S Uterine Inversion Installation g is Fold back or remove abdominal skin see Maintenance section gt page 37 Abdominal Skin Replacement AN Caution Folding the skin downward without support underneath it may cause the skin to tear gt c 2 Remove pelvic ring clamp and cervix see Maintenance section 2 page 39 Cervix Replacement amp U 3 Lubricate the inside of the uterus Y 8 Disconnect 9 Repeat for second connector to secure placenta into back of uterus 0 10 Replace abdominal skin A 0 ja S Q Y 23 Performing Simulations 4 Position the uterus on the pelvic clamping face The umbilical cord 8 Ensure that all holes and notches are aligned and that the blood should pass through the birth canal feed tube passes through the pelvic ring cleanly and without kinks 9 Fit and tighten the three thumbscrews 5 Ensure holes on uterus flange locate with pins on clamping face and that notch for urinary connector locates with corresponding notch on pubis 10 Connect the blood feed tube red Luer connector to the blood pump outlet red on the pelvic bulkhead x Position support foam behind uterus 2 Replace skin 13 A few minutes prior to the scenario pull back abdominal skin and lubricate the
26. u Fetal Heart Activity Waveform 2 Uterine Activity Waveform Adjust Fetal Heart and Uterine Activity Parameters During Simulation To adjust fetal heart parameters and uterine activity parameters click the EFM display to open the Fetal simulation setup window Under the Select preset tab the user can perform the following functions Increase or decrease the fetal heart rate baseline by sliding the toggle left or right Select preset parameters for baseline variability fetal heart pattern and uterine activity amp Fetal simulation setup m Select preset Custom Baseline variability Fetal heart rate Baseline J 140 Marked Moderate Minimal Absent Normal Accelerations Variable Decelerations Late Decelerations Prolonged Decelerations Early Decelerations Uterine activity Shoulders Not in labor 02 10 To load a preset parameter into the simulation Click on a preset parameter in one of the menus Baseline variability Fetal heart pattern or Uterine activity Note The preview screen displays the effects of the parameter changes on the simulation before they are actually loaded into the simulation 2 Click the lt Apply gt button to load the parameter into the simulation Under the Custom tab the user can customize the simulation by manually adjusting certain parameters using the sliding toggle amp Fetal simulation set
27. Configuring System PC Patient Monitor and Webcam Connecting Belly Skin Audio Cable To connect the SimMom belly skin audio cable Unhook the belly skin from the three attachment sites on either side of the pelvis and fold the skin over towards the feet 2 Remove the C Section Belly skin from the pelvis and store with your other SimMom accessories 3 Connect the black audio cable on the under side of the belly skin to the audio port located on the right side of the pelvis 4 Reattach belly skin Attaching Manikin Legs Manikin legs allow full articulation and bend at the knee They can simulate maneuvers performed during various deliveries To attach the manikin leg Grip the thigh and gently push the hip clamp jaws onto the hip ball on the pelvis Note If the jaws must be opened further to fit on the hip ball turn the adjustment screw using the 8mm Allen key wrench z 2 Tighten the adjustment screw using the 8mm Allen key wrench until the desired tension on the hip is reached Do not over tighten the adjustment screw because this may damage the jaws z Gown Features Note Legs can be removed by loosening the adjustment screw and pulling them free of the hip ball The SimMom gown has two flaps that provide access to the abdomen during birthing simulations The gown also has holes through which the manikin s wires can pass Abdominal Access Flap Abdominal Access Flap
28. L Blood Reservoir 800 mL Wig Size Use a large wig Airway Adjustment Sizes 7 5 endotracheal tube 4 LMA Large Adult or Trainer Combitube KING LT 4 Urine Catheter Sizes 2 French Blood Pressure Pressure range 0 300 mmHg Accuracy 4 mmHg Calibration Pressure sensor must be calibrated to sphygmomanometer Carotid brachial and radial Only two pulses can be palpatated at once Radial pulse turns off at systolic BP Brachial pulse turns off at 20 mmHg to prevent noise generation in auscultation area Available pulses Palpated BP Adjust pulses to BP using the chart below Systolic BP Carotid Pulse Radial Brachial Pulse gt 88 Normal Normal lt 88 Normal Weak 380 Normal Absent lt 70 Weak Absent lt 60 Absent Absent Introduction U 74 Q f C U cD fae Y Notes A6 Spare Parts and Accessories Catalogue Numbers Substitute XX with your local language version number Contact your local Laerdal Customer Service Representative for more information SimMom Manikin 377 Q5050 377 8350 377 7750 38 102 381107 200 03 150 381105 381402 377 5350 377 18150 377 8250 375 5100 3804 10 377 8450 200 03750 377 18550 380405 200 01 850 383110 205 03750 377 1 3550 377 3650 377 5550 377 5650 377 5750 377 3250 377 4750 377 4850 377 4950 377 5050 377 5150 377 5850 377 5450 377 3350 377 1 3450 SimMom Maniki
29. V cc Z i far Software Reinstallation To reinstall SimMom software Perform Simul Note Ensure that touchscreen USB is not connected Uninstall current SimMom software 2 Insert SimMom Advanced Software CD into disk drive 3 Follow onscreen instructions 4 Press lt continue anyway gt when you receive a dialog box informing you the software has not passed Windows logo testing This dialog box will appear three times during installation Maintenance SimMom Setup Software Installation The software you are installing has not passed Windows Logo testing to verify its compatibility with this version of Windows Tell me why this testing is important Continuing your installation of this software may impair or destabilize the correct operation of your system either immediately or in the future Microsoft strongly recommends that you stop this installation now an contact the software vendor for software that has passed Windows Logo testing Specifications Continue Anyway STOP Installation 5 Reboot the system 6 Double click the lt SimMom Instruction Application gt desktop ICON Spare Parts SimMom Instructor Application 2 Performing Simulations Introduction to Simulations SimMom is capable of performing a variety of simulations based on the positioning of the manikin and the modules attached to it This section includes the following Airway Management Sett
30. age PPH including atonic Assisted deliveries boggy uterus and retained Forceps placenta placental fragment Vacuum Sepsis Shoulder dystocia Uterine Inversion Cord prolapse Ruptured uterus Eclampsia amp pre eclampsia Modules C p kd EJ USB Webcam SimNewB Items Included Manikin Modules Baby Compressor Laptop USBWebcam USB Hub Vital Sim Control Unit Patient Monitor in applicable versions only Accessories BP Cuff Thoracentesis Pads Eye Kit Skin Collars Hardware Kit Directions For Use DFU IV Fluid Collection Bags DVD Video Guidelines Lubricant Wig Crycothyroid Blood Concentrate SIO ais tale Cuttable Umbilical Cords E aea Kit Normal and C Section Skins Cervix Blood and Urine Reservoirs Manikin USB Hub SS VitalSim Control Unit Patient Monitor SimMan Introduction Right Arm ECG Left Arm ECG Lead T Sternum Defib Plate Intramuscular Injection Site IV Fluid Connection p ao mN BP Cuff Connection t gt amp Right Leg ECG Lead Blood Pressure Arm IV Access 1 lt a Intramuscular Injection Site Lead sc Injection Site lt a IV Fluid Connection Apex Defib Plate ha Left Leg ECG Lead i V Access Intramuscular Injection Site BP Tubing VO D Externa
31. ameters Users can request radiology and lab reports from the instructor via the Patient Monitor software Video capture from the Patient Monitor display and the web camera can be stored for use in the Debrief Viewer Electronic fetal monitoring on the Patient Monitor Interface displays the fetal heart rate and uterine activity parameters Software The Graphical User Interface GUI controls scenario and manikin function via the Instructor PC enabling the instructor to easily operate and adjust mother and fetus vital signs The GUI is highly configurable and capable of running on the fly customized or preprogrammed scenarios The electronic fetal monitoring EFM display on the GUI shows the Fetal Heart Rate and Uterine Activity waveforms alongside the mother s vital signs The software records at least ninety minutes of fetal monitoring which can be viewed by scrolling back on the patient monitor The instructor can use the preset states as well as utilize the customized parameters Web Downloads Visit http www laerdal com to download the latest Directions for Use and SimMom Software Z SimCenter Ko Y U 5 as i Setup Setting Up Your Manikin Before SimMom is ready to run simulations the manikin birthing baby and computer system must be setup correctly This section covers the following Connecting Belly Skin Audio Cable Attaching Manikin Legs Gown Features
32. and in the birth canal to prevent the forceps from slipping off the scalp 2 Flex the head so the forceps can be positioned correctly 3 Coordinate the trainees so that they only pull on the forceps when the puppeteer is simulating the mother s expulsive effort Otherwise the forceps may slip off the head 4 During the rotational part of forceps delivery coordinate the actions of the puppeteer and trainee so that the rotation of the baby s body follows the rotation of the forceps Otherwise the forceps may slip off the scalp Suction Delivery To perform a suction delivery using Kiwi Ventouse instrumentation Reduce lubrication on the baby s head to prevent the suction cups from slipping off the scalp 2 A facilitator may be needed to coordinate the trainees as they pull and the puppeteers as they push Note Step 2 Is less critical for suction delivery than for forceps delivery All Fours Delivery All four delivery can be performed using one or two handed delivery technique though the latter is recommended To perform a delivery on all fours Note All fours delivery requires more force and involves a different technique than other delivery types It should be practiced several times before being used in a scenario 25 Push diagonally upwards into the pelvic floor following the J shape of the birth canal 2 Guide baby horizontally through birth canal opening f using two handed technique apply
33. ay pose a shock hazard or damage the manikin AN Warning Do not use automated external chest compression machines on the manikin AN Caution Latex his product contains Natural Rubber latex which may cause allergic reactions when in contact with humans Defibrillation Hazards A conventional defibrillator may be used on SimMom During defibrillation the defibrillator and manikin may present a shock hazard When using a defibrillator on the manikin take the following safety precautions Read and follow all safety and operating instructions provided with your defibrillator and associated equipment and within your defibrillator s original user manual Follow defibrillation protocol by avoiding contact between the external paddles and any of the electrode sites while defibrillating Failure to follow safety measures could result in injury or death When performing defibrillation use the defibrillator connectors or the zap plate mounted on the manikin s chest Do not use the ECG connectors which are designed exclusively for ECG monitoring Defibrillation on the ECG connectors will damage the internal electronics of the manikin and may cause personal injury Do not defibrillate the manikin when it is turned OFF or if it is not functioning normally Do not perform defibrillation when manikin is resting on a wet surface The manikin torso must always be kept dry Sudden changes in temperature may result in condensation
34. continuous upward pressure with the second hand in order to keep the head flexed and to prevent baby s body from sagging Note For more stability the puppeteer should consider resting his or her elbows on the bed or on a pillow positioned on the ped Shoulder Dystocia Delivery A shoulder dystocia delivery is usually performed using two handed technique Control of the baby s arms is important because the posterior arm must be placed in the proper position To perform a shoulder dystocia delivery Wedge anterior shoulder against the pubis while descending the baby down the birth canal 2 Coordinate the rotational maneuvers of the puppeteer and the student so their movements match each other Note Depending on the level of supra pubic pressure applied by the trainee the puppeteer may experience discomfort The puppeteer may find it more comfortable to hold the baby in a more anterior position so that the hand is between the baby and the anterior abdomen wall Note It is easier to perform a shoulder dystocia delivery if the cervix is not installed Pelvic Components Reservoir Cover Thumbscrew Pelvic Ring Cervix Pubic Bone Pelvic Floor Pelvic Floor Plate Perinium and Birth Canal Skin Plate Introduction amp 74 oO amp a Performin Performing Simulations Modular Components SimMom is equipped with the following modular components Cervix M
35. ctor PC is shipped from Laerdal Medical with a pre activated license installed Any changes or updates of the computer hardware e g new hard drive or mother board may render the license invalid Please contact your local Laerdal support for assistance with re activating the license User Interface The graphical user interface for SimMom is controlled by the Instructor PC It is highly configurable and easy to operate It controls the maternal and fetal vital signs and can utilize custom or prepackaged scenarios Instructor PC Application Screen Overview The Instructor PC application screen provides functional areas for viewing and controlling patient clinical features 7 Trend and Handler Control 8 Trend Preview Window hidden by default 9 Event Windows Program Menu Bar Respiratory Control 3 Difficult Airway Control 4 Defibrillation and 10 Electronic Fetal Montoring Pacing Controls 5 Debrief Log 1 Instructor Monitor Control 6 Scenario Control 2 Simulator Controls Microphone off Same as right h Fetal Heart bad r EM D P EA Shocks to conversion Pacing threshold mA E i m so Sinus Rhythm HR 80 BP 120 80 6 Pneumothorax 7 Boggy Uterus 8 Urine Bladder 9 Uterus Bleeding Tongue Edema 2 Seizure Control 3 Central Pulses 4 Left Lung Resistance 5 Right Lung Resistance Description of Functions refer to image on pg 2 Program Men
36. der the inside of the torso skin to decrease friction Do not spill powder into manikin chest cavity Do not attempt to perform the following techniques on this manikin due to the inability to properly sanitize the airway Mouth to mouth mouth to mask ventilation Insertion of simulated vomit or fluids for suctioning Environment In cold conditions wait until the manikin has reached room temperature before starting up the manikin To avoid overheating and reduce wear When using in temperatures above 40 C 104 F always allow the manikin to cool down between training sessions When using in a bed manikin should not be covered with heavy bedding that prevents heat transfer from the manikin General Manikin Handling Take the following precautions to avoid personal injury or damage to the product Introduce fluids into the manikin only as directed in this document Failure to do so may result in damage to the manikin and its components Lubricate the oral and nasal airways with the lubricant provided prior to inserting any instrument tube or airway device Also lubricate instruments and tubes prior to use Lubricate cervix birth canal and baby before each delivery Do not introduce humidified air into the system during ventilation Do not use the manikin if the internal tubing and cabling is disconnected Never use the SimMom manikin outdoors in wet conditions as this m
37. dth 19 in x 6 in Weight 4 5 Ibs Manikin Power External power VitalSim battery Input voltage VDC 5A 6 C cell batteries Only use approved SimMom external power supply and batteries Air Pressure External air connection Max 16 psi Temperature Limits Operating temperatures 4 C to 40 C 39 F to 104 F Storage temperatures 2157C 16 50 GC 5 Fto 1227P Environment Manikin only Relative humidity 20 90 non condensing DO NOT use outdoors in wet conditions Not tested with salt spray Materials Used in Manikin Clothes Cotton Nylon Skins and airways PVC External hard plastics PVC PC ABS Inner plastics Silicone PVC ABS POM Nylon Polyurethane Latex pneumothorax bladders Metal components Aluminum Brass Steel Caution Latex This product contains Natural Rubber latex which may cause allergic reactions when in contact with humans Minimum Computer Requirements e Core 2 Duo or better e GB RAM 2 GB recommended e GB hard disk space e 1024x768 1280x800 1280x1024 or better e 6brt color resolution or better e 100 DPI required e Optical drive required for installation Minimum Software Requirements e Windows XP or Windows e DotNet 3 5 Cleaning Fluids To clean the manikin use only a mild solution of liquid soap and water IV Fluids Only use distilled or deionized water to simulate IV and IO fluids Reservoir Capacities Urine Reservoir 400 m
38. ectrical connector and two clear tubes and L AY disconnect them Disconnect the clear tubes by twisting the fittings j a Carefully guide wiring out of pelvis oo Disconnect the electrical connector by depressing the black button on the side of the connector 9 Replace access panel 10 Reconnect torso to pelvis by reversing steps Loop tubing in a counterclockwise motion before reconnecting 4 Turn the manikin back over 5 Remove abdominal skin 6 Using a 7 16 wrench and a Phillips head screw driver remove the bolts on both sides of manikin 42 Maintenance Replacing Baby Limbs To replace baby limbs use a screwdriver to unscrew the limb where it connects to the torso VitalSim Battery Replacement The VitalSim unit holds 6 replaceable C cell batteries To replace the batteries Pull out the battery pack located on the bottom of the unit 2 Remove the panel on top of the battery pack Remove and replace batteries E k 43 Introduction Setup Software Performin Simulations co R am ced p S R 2 Specifications Spare Parts Notes 44 Specifications Overall Dimensions SimMom Length Width manikin only 69 in x 19 in 175 3 cm x 48 3 cm Width at Shoulders manikin only 19 in 48 3 cm Width at Hips manikin only 19 in 48 3 cm Weight manikin only 61 5 Ibs 28 kg Baby Length Wi
39. ed The second hand can also hold the umbilical cord and arms in position As the head descends further the puppeteer can adjust the second hand grip to push up under the chin and better extend the baby s head This techniques allows the puppeteer to better control the head g Note The trainer should practice and become familiar with the delivery process prior to any training situation Performing Simulations Deliveries SimMom is capable of simulating normal breech instrumental and shoulder dystocia deliveries Normal Delivery For normal delivery simulation see one handed or two handed delivery in the Delivery Techniques section Breech Delivery A breech delivery can be performed using one or two handed delivery technique The second hand manipulates the baby s limbs and umbilical cord To perform a breech delivery Apply extra lubrication in the lowest part of the birth canal so the baby s bottom can slip up over the J shape of this part of the canal 2 Change grip on the baby s trunk so the delivery can be controlled by holding the head 3 Flex the baby s neck so the head passes more easily through the birth canal 4 The baby can now be delivered using Moriceau Smellie Viet maneuver Note It is easier to perform a breech delivery if the cervix Is not installed Forceps Delivery To perform a delivery with forceps instrumentation Reduce lubrication on the baby s head
40. ent Pelvic Floor Replacement Urine Reservoir Replacement Blood Reservoir Replacement Pelvis Replacement Replacing Baby Limbs VitalSim Battery Replacement CO O ON Oo O O O 2 2 5 5 l6 I8 20 20 Z 2 22 22 Z 22 23 23 25 24 25 25 26 30 3 32 Jd 32 33 33 33 be 34 34 36 37 3 7 38 39 40 40 4 42 43 43 Specifications Spare Parts and Accessories 45 47 Regulatory Information This device complies with Part 15 of the FCC Rules Operation is subject to the following two conditions This device may not cause harmful interference 2 This device must accept any interference received including interference that may cause undesired operation Caution Changes or modifications not expressly approved by the party responsible for compliance could void the user s authority to operate the equipment Laerdal Medical AS hereby declares that when carrying the CE mark this product is in compliance with the essential requirements and other relevant provisions of Directive III EL Dispose of in accordance with local requirements and regulations Disclaimer Use of the SimMom patient simulation system to train personnel should be undertaken under supervision of suitably trained technical or medical personnel with an understanding of educational principles as well as recognized medical protocols As with all manikins or other such
41. ervix See Maintenance section page 38 Perineum Birth Canal Skin Replacement steps l 11 Using a Phillips head screwdriver remove the three screws located underneath posterior birth canal fixing plate 40 3 Lift and remove pelvic floor fixing plate 5 Place new pelvic floor in position 6 Replace pelvic floor fixing plate perineum birth canal cervix and pelvic ring A Caution Do not overtighten screws This may damage the manikin Urine Reservoir Replacement The urine reservoir is located in the reservoir bay above the blood reservoir The color coded connectors for fluid and compressed air are located on the pelvic bulkhead at the bottom of the bay Blue denotes blood and amniotic fluid carried from blood reservoir to pump Red denotes fluid from pump to the module being used PPH uterine inversion or amniotic bag Green denotes compressed air to and from boggy uterus bag Maintenance Yellow denotes compressed air to pressurize urine reservoir Blood Reservoir Replacement To replace the urine reservoir The blood reservoir is located in the reservoir bay beneath the urine a reservoir D Unhook reservoir cover retaining loop detach Velcro strap and z remove lid To replace blood reservoir 5 pa 2 Clamp urine reservoir outlet with sliding clamp Remove reservoir cover and urine reservoir 3 Detach urine outlet from urine connector tube by unlocking 2 Clamp blood outlet wi
42. gt button to open and QRS adjust volume 0 10 Volume Software Select the lt Alarm Volume gt button to open and adjust volume 0 10 Alarm Volume F 7 Select the lt Radiology gt button to open X ray images which have been included in the current scenario Radiology Select the lt Media gt button to open display Select ne tah the lt Close gt button to close the Media display Media Bl Select the Labs button to open Select the lt Close gt button to close the Labs display Labs Select the lt Main Setup gt button to open Options in the lt Main Setup gt menu are identical to the similar options displayed on the Menu line Select the lt Main Screen gt button to return to the lt Main Screen gt and cancels all submenus Submenus can also be closed by selecting the X box of the submenu Select the lt Toggle Monitor gt button to cycle through the patient monitor and fetal monitor pa tient monitor only and fetal monitor only options Toggle monitor Fetal Monitoring Interface The Electronic Fetal Monitor EFM on the Patient Monitor displays the Fetal Heart Rate and Uterine Activity waveforms To see activity on the Patient Monitor once the probe attached simply touch the screen The EFM has the option to scroll at cm or 3 cm per minute At cm per minute the EFM shows 60 minutes of fetal monitoring without having to scroll At 3 cm per minutes it shows 20 minutes without havi
43. he connector tube into the groove toward the pelvic ring A Y 7 Connect the white Luer to the urine reservoir outlet tube 8 For cord prolapse scenarios use the indwelling catheterization bladder Push hole on the flap of the bladder over the retaining 3 6 7 Performing Simulations Replace filler cap Reconnect all reservoir connectors Cleaning Blood and Urine Reservoirs cleaned after each simulation Note Blood and urine reservoirs should be drained and Blood and urine reservoirs are both located in the reservoir bay To clean reservoirs Remove reservoir lid Clamp blood and urine reservoir outlets with sliding clamp To disconnect the blood outlet undo blue Luer connector from blue bulkhead connector To disconnect the urine outlet connector undo both white and yellow luer connector 32 Remove blood and urine reservoirs Drain and rinse out bags with water Flush pump with tap water Let air dry Replace reservoirs Performing Hybrid Simulations SimMom can be used for hybrid simulations which involve disconnecting the manikin s pelvis from its torso To perform hybrid simulations consult the Pevlis Replacement section on page 41 in the Maintenance Section Using the Bed Strap SimMom packaging includes a bed strap that can be used to secure the manikin to the table during simulations To use the bed strap 2 5 6 Remove bed strap screws and washer
44. imMom Directions for Use NURSE Laerdal helping save lives Limbs amp Things Skills training products for healthcare professionals www laerdal com www limbsandthings com Cautions and Warnings Introduction SimMom Overview Items Included Features Setup Attaching Manikin Legs Gown Features Configuring System Software User Interface Changing SimMom Settings During Simulation Changing Default Setting Fetal Monitoring Patient Monitor Laerdal Debrief Viewer Customizing Scenarios Laerdal Advanced Video System AVS Software Reinstallation Performing Simulations Airway Management Setting Up ECG Snaps Defibrillation Connectors Connecting Blood Pressure Cuff Preparing IV Simulations Birthing Positions Preparing Baby for Delivery Delivery Techniques Deliveries Pelvic Components Modular Components Catheter Installation Filling Blood and Urine Reservoirs Cleaning Blood and Urine Reservoirs Performing Hybrid Simulations Using the Bed Strap Maintenance Pupil Replacement Eyelash Replacement Wig Care and Upkeep Neck Collar Cricothyroid Replacement Arm Replacement Pneumothorax Bladder Replacement Thoracentesis Module Replacement Abdominal Skin Replacement Perineum Birth Canal Skin Replacement Cervix Replacem
45. ing Abort attempt A a Anesthesia Related Drugs and Agen amp ns _ aa BP 120 80 SpO2 98 Circulation Cee pearl amp parian 5 _ gt esis ICS 120 80 5p02 98 a g Backdoor O Naani Manikin Ever Qa Conscious Sedation 9 etCO2 34 mmHg Call for help amp an Induction Medication 00 55 00 Summary of vital signs ConsciousnessCheck J IV Fluids awRR 12 HR 80 BP 120 80 SpO2 98 E Examine Opioids etCO2 34 mmHg Start Scenario Scenario Trends Handlers E Healthy patient 80 6 Time 55 49 Nona atte 12 Time in Frame 55 50 11 gt gt Ei Debrief Patient Time 0 00 Start Stop Hide Trends 7 8 I Program Menu Bar 7 Trend and Handler Control 2 Respiratory Control 8 Trend Preview Window hidden by default 3 Difficult Airway Control 9 Event Windows 4 Defibrillation and Pacing Controls 10 Electronic Fetal Monitoring 5 Debrief Log I I Instructor Monitor Control 6 Scenario Control 12 Simulator Controls Introduction to SimMom Software The Instructor PC uses the Instructor Application software to manage simulation scenarios The instructor can pause a scenario at any time and run the simulation in manual on the fly mode customizing the patient parameters as needed SimMom software includes the following features User Interface Help Files Scenarios Electronic Fetal Monitoring Patient Monitor Debrief Viewer Scenario Customization Instructor Software License Instru
46. ing Up ECG Snaps Defibrillation Connectors Connecting Blood Pressure Cuff Preparing IV Simulations and Cleaning IV Arm Preparing Baby for Delivery and Attaching Amniotic Bag Birthing Positions Deliveries Modules Catheter Installation Filling Blood and Urine Reservoirs Cleaning Blood and Urine Reservoir Performing Hybrid Simulations Using the Bed Strap Airway Management 5 A liberal amount of airway lubricant or liquid soap should be applied inside the pharnyx nostrils and all intubation areas prior to performing intubation procedures Note It is recommended that a 7 5 endotracheal tube 4 LMA Large Adult or Trainer Combitube and a KING LT 4 be used during simulation Setting Up ECG Snaps Defibrillation Connectors For rhythm monitoring the manikin is installed with 4 ECG Stud connectors X Note Do not begin training until the manikin is connected to the VitalSim Control Unit via the 37 pin connector cable exiting the right side of the manikin s body S 22 Installing Defibrillator Adapter Plates The manikin torso is fitted with two stud connectors for use with a conventional defibrillator defibrillator not included Defibrillation Studs b To prepare the manikin for defibrillation using paddles Unscrew and remove defibrillation studs 2 Screw adapter plates into post sockets located on apex and sternum of manikin 3 For hands
47. l dialated and constricted Patient Voice Pre recorded sounds Custom sounds Introduction nstructor can simulate patient s voice Vascular Access Pre ported IV access bilateral Subcutaneous and intramuscular injection sites Birthing Baby Realistically modeled head with all head landmarks present fontanelles and sutures Head designed and tested so it can be used for forceps deliveries rotational and normal and vacuum delivery kiwi and ventouse Head can be easily manipulated by puppeteer and flexes naturally as it is pushed through the birth canal Mouth for suction and Smellie Vert if required The birthing baby s body is designed to allow it to be easily pushed through the birth canal Bony prominences of the hips to support Lovsett s maneuvers Realistically positioned landmarks scapulae and clavicles Arms and legs allow full articulation for all maneuvers required during deliveries particularly breech and shoulder dystocia Umbilicus and placenta normal and retained Fetal heart rate normal bradycardia and tachycardia via software Electronic Fetal Monitoring EFM Cardiotocography CTG EFM graphic display fetal heart rate waveform and uterine activity waveform EFM is displayed on the patient monitor with mother s vital signs Fetal monitoring is recorded and it is possible to scroll back to view on the
48. l Air Connection p 37 Pin Serial Cable Manikin to VitalSim Cable Ko Y U U 6 as Setup Software Ng Maintenance Performi Simulations Specifications Spare Parts Introduction Features Movement Seizure indicator Able to position at all fours Realistic rotation of the shoulder and hip joints Legs bend at the knees Arms bend at the elbow Manikin positions Supine 4 Left lateral 2 Semi recumbent 3 All fours 5 Legs in stirrups 6 McRoberts Airway Features Obstructed airway Tongue edema Right lung left lung and bilateral lung blockage Head tilt Chin lift Jaw thrust Suctioning techniques Bag valve mask ventilation Oropharyngeal and nasopharyngeal airway insertion Combitube LMA and other airway device placement Endotracheal intubation ET Nasotracheal intubation Digital intubation Retrograde intubation Nasal and oral fiberoptic intubation Trans tracheal jet ventilation Right mainstem intubation Surgical and needle cricothyrotomy Chest tube insertion Cricoid pressure Needle decompression Pelvic Components Interchangeable uterus modules PPH uterus with tonic and atonic states and with retained placenta and placental fragment Uterine inversion Amniotic bag for intrapartum fluids Bony Pelvis with landmarks
49. let Ensure reservoir is empty or the tube is clamped 5 Push urinary connector onto inlet spigot narrower D Az 6 Replace pelvic ring clamp D Filling Blood and Urine Reservoirs o S Reservoirs can be filled while disconnected from SimMom or while z in position The urine reservoir contains a maximum of 400 mL The amp blood reservoir contains a maximum of 800 mL Both the urine and blood reservoirs are filled in the same way Remove red filler cap 2 If filling outside the model ensure the slide clamp is in the closed 2 Pull the tube free of locating groove on pelvic ring clamp position 3 Remove the pelvic ring clamp 7 a Oo p S Y Performin 4 Pull the urinary connector from spigot on grey urinary valve using a sideways rocking action Avoid pulling directly because the urinary valve can come away from the urethral tube Note If the urinary valve detaches from the urethral tube a simply push it back on 2 D 4 ix gt 3 Stabilize the reservoir by firmly gripping the filling port 4 Open up the bag by pushing a finger in through the filler hole and separating the two walls 5 U 5 Pour in fluids using a plastic jug or funnel not included E A Y 5 Grip the grey urinary value through the birth canal skin and push a replacement urinary connector onto valve spigot Ensure that the 2 connector tube is pointing to the manikin s right side A 6 Push t
50. m bilateral mid clavicular chest plate sites Detach the chest skin from torso by lifting the tabs at the shoulder and back Remove chest skin 5 Trim the tubing on the new bladder to match original tubing length 2 Remove chest plate from torso 6 Insert new pneumothorax bladder into the top side of chest plate through the second and third intercostal space openings The bladder tubing exits through the back side of the chest plate Ensure the narrow edge of the bladder is closest to the sternum 7 Reconnect hose to Y hose connector 8 Return chest plate to proper position on torso 9 Replace chest skin over torso Secure skin at shoulders and back 10 Conceal puncture marks on the exterior of chest skin with wax In the Bladder Replacement Kit 4 i lt lt r A gt as A 3 Disconnect bladder hose from Y connector located on the Remove chest skin from tabs at shoulder and back underside of chest plate To remove the pneumothorax bladder from midaxillary site RIGHT 2 Remove pneumo bladder insert from right side of torso 36 Maintenance 3 Disconnect bladder hose from inline hose connector Ensure Abdominal Skin Replacement hose does not fall through hole and into torso SimMom is delivered with two abdominal skins normal and C section 5 deliveries D U 5 To replace abdominal skin D Note Skin may have a slight oily feel which is normal and a S amp S part
51. m the VitalSim Control Unit to the USB hub Connect the audio cable white mini jack with single wire to the VitalSim Control Unit Connect the power cable to the Control Unit and power source Connect the Manikin to the VitalSim Control Unit Connect the grey 37 Pin Serial Cable and clear tubing exiting the manikin s middle right side to the back of the VitalSim control unit Place the Blood Pressure cuff on the right arm of the manikin Attach the clear tubing exiting the upper right side of the torso to the clear tubing on the Blood Pressure cuff Power on the VitalSim Control Unit Install the Compressor Unpack the compressor with the power cable Connect the power cable to the compressor and wall outlet Unpack the compressor air tube and connect it between the manikin and the compressor Power on the compressor Operate the unit according the accompanying Instructions The simulation system is now ready to use Cc Oo WY U ma U O YW Maintenance Performing Software Simulations Specifications Spare Parts Software View Simulation Edit Calibration Help Respiration Chest rise On z 3 BO Difficut Airway 0 Reset All On Xk a Shocks to conversi Pacing threshold mA g RR pa HR 20 BP 120 80 snr 2 ARS 4 awRR 12 HR 80 BP 120 80 SpO2 98 a ABC gj Miscellaneous g Medication g 00 53 00 ae TREES 9 Aiway Breath
52. n Only Light SimMom Head Skin Eyelashes Strap Set Head skin Teeth Upper Airway Tongue Assembly Neck skin Set 6 Deltoid Injection Pad IM Injection Pads Thigh Right BP Arm Left Arm Assembly Nursing Anne IV Arm Post Set ECG Defib SimMom Chest Skin Chest foam SimMom Chest Rise Bladder Bladder Assembly Mid Clavicular Bladder Assembly MidAxillary Thoracentesis Pads Lung Assembly Gravid Abdomen Normal Gravid Abdomen C section Perineum Birth Canal Pelvic Floor Skin Pegs for Side of Pelvis 6 Pelvis Assembly Pelvic Ring Clamp Thumbscrew Pubic Clamps 2 Reservoir Cover Velcro Strips for Reservoir Cover Catheterization Valve Access Panel Left Thigh Assembly Right Thigh Assembly Birthing Baby 377 3750 377 6050 377 6150 377 6250 377 6350 Modules 377 3950 377 5250 377 1 3850 377 4050 377 4150 377 4250 377 6550 377 16650 377 6750 377 16850 377 6950 Baby Baby Right Arm Baby Left Arm Baby Right Leg Baby Left Leg Cuttable Umbilical Cords 5 Cervix Placenta PPH Module Kit Uterine Inversion Module Amniotic Bag Module Large Uterus PPH Module Large Uterus Support PPH Module Boggy Uterus Bag PPH Module Small Placenta with Retained Fragments Hand Pump 377 7050 377 7150 377 7250 377 7350 377 7450 2 Part Nylon Sealing Clamp Indwelling Catheterization Bag 2 Indwelling Intermittent Catheterization Tube Blood Reservoir Bag 2 Urine Reserv
53. ndow will not effect the default settings of the manikin In the Instructor Application click lt Edit gt in the Program Menu Bar 2 Select lt Start SimMom Dialog gt in the drop down menu 3 Increase or decrease to desired values 4 Click lt Apply gt l Edit Calibration Help SimMom parameters Edit Monitor Setup C Seizure Start Scenario Editor Start Handler Editor Seizure intensity 60 100 Start Trend Editor Boggy uterus v Configuration 9 Uterus pressure Microphone Configuration video Recording Configuration C Uterus bleeding Set vital Signs Uterus bleeding flow 60 100 Korotkoff Controls Start SimMom Dialog Changing Default Setting Default settings for simulations can be changed by accessing the Configuration Menu To access the Configuration Menu from Instructor Application screen Select the lt Edit gt menu in the Instructor Application 2 Select lt Configuration gt from the drop down menu Note Once the new default settings are saved the new parameters will become the start up default for future simulations aia Calibration Help General Patient Monitor Edit Monitor Setup Start Scenario Editor Start Handler Editor Start Trend Editor amp Master sound volume mode Automactic S Master sound volume only applies to Manual mode 7 Manikin vocal sound volume 5 S Monitor alarm v
54. ng hot water To remove left manikin arm as it may damage the wig Remove deltoid injection pad from upper arm 3 Pour two cups of synthetic wig shampoo into the sink Submerse wig into water Note Use only synthetic wig shampoo 4 Once the wig is completely soaked move it around in the water for a minute Let it soak for an additional minute Remove wig from water Note For best results let the wig soak for five minutes before washing 5 Rinse wig with cold water Once all suds have been rinsed away let the wig dry on a bath towel overnight Note Do not ring out or twist the wig This may damage the fibers Do not comb or brush the wig while it is still wet This may break the fibers Neck Collar Cricothyroid Replacement To attach cricothyroid membrane Remove Neck Skin Collar by undoing Velcro strips on the back of neck 3 Remove skin to reveal internal upper chest area 4 Lift hard chest plate to reveal inside sockets for arm connections 2 Cut a two inch strip of Cricothyroid Membrane Tape 3 Adhere tape to edges of cricoid opening Ensure that tape covers and seals the opening 5 Unscrew wing nut and remove spring and washers 6 Remove arm and threaded bolt 7 Insert threaded bolt through new arm and torso The bolt should now be visible in chest cavity 8 From inside of chest area thread a washer a spring and another washer on bolt 4 Place a Neck Skin Collar
55. ng to scroll It records at least 90 minutes of fetal monitoring that can be viewed by scrolling back To scroll back or forward and view additional activity touch and drag the EFM interface POCA A A Fetal Heart Rate Waveform 2 Uterine Activity Waveform To change the volume for fetal tone click or touch anywhere in the EFM display a speaker should appear Click or touch the speaker icon to access the volume control and then adjust to desired level BL Jol To close volume control click or touch away from icon Importing Vocal Sounds During a session the SimMom software can play audio files for users Users can import audio files into the simulation from a list of prerecorded sounds or record their own sounds and then import them Record Vocal Sounds Vocal files can be recorded using a shortcut available in the SimMom software program group To record vocal files and make them available for the simulation sessions Launch sound recorder from SimMom Instructor Application program group Click lt Start gt Select lt All Programs gt Select lt SimMom Instructor Application gt from the pop up menu Click lt Record Vocal Sound gt on the pop up menu 2 Record sound using the Sound Recorder window 3 Save the sound to make it available for import into the simulator SESSIONS sure to use the Record Vocal Sound shortcut available in the SimMom Application program group 5 Note When
56. ning click this button to pause the session Adjust Patient Parameters During Simulation The Patient Monitor shows the patient s current status To manually adjust the patient parameters click the individual graphs or numeric parameters Pop up menus allow the instructor to change the relevant parameters Hold the cursor over a numeric parameter for second the selected parameter s background will turn to grey and the mouse pointer will change appearance Indicating that the scroll wheel can be used to increase or decrease the value Stop Simulation Session When the simulation session is complete click the Stop button lt w gt below the lt Start Scenario gt button Debrief Log The Debrief Log records the patient responses and learner events that occur during simulation Events can also be added manually by the instructor This information is then made available in debrief files at the end of the simulation session To add a comment to the Debrief Log on user performance click the lt Add Comment gt button Save Files and Laerdal Debrief Viewer Save the Debrief Log to archive and or review later Click lt Debrief gt to start the Debrief Viewer For more information see The Laerdal Debrief Viewer section of this manual Changing SimMom Settings During Simulation By accessing the SimMom Dialog Menu you can adjust the Seizure Boggy uterus and Uterus bleeding settings during the simulation Any changes made in this wi
57. nt tip of the toothpick into the glue De Replacing Baby Limbs io co VitalSim Battery Replacement Ls o Aw Pupil Replacement SimMom is delivered with normal pupils installed in the eyes A separate kit included with SimMom contains plastic pupil inserts constricted and dilated To change the pupils co U R a9 p R 2 Using the suction cup tool provided in the kit or with the edge of your fingernail carefully remove the pupil from the eye 4 Using the toothpick apply super glue sparingly along the top of the eyelash where it meets the eyelid 2 Replace the pupil with the desired insert using the suction cup tool or by gently pressing in place Wig Careand Upkeep 2 D When brushing the wig use combs and brushes that are specially S designed for wigs If using a regular comb or brush ensure that it has E a rubber tip at the end of each bristle or tooth To ease brushing and 4 removal of tangles use a wig spray as lubricant ms Note Avoid using combs and brushes without rubber tips These can damage and split the wig fibers Avoid using hair care products such as hair spray These may damage the fibers 5 To wash the wig A 0 Note Avoid excessive washing It shortens the lifespan of the S wig n Remove tangles by gently brushing or separating the strands with 22 Maintenance your fingers Arm Replacement 2 Fill a sink with two quarts of cool water Avoid usi
58. odule 3 Post Partum Hemorrhage including Boggy Uterus and Retained Placenta 4 Inverted Uterus Cervix 2 Amniotic Bag Inverted Uterus Post Partum Hemorrhage Uterus Oo aE Bag o Placental Fragment Boggy i Uterus a Retained Placenta Cervix Installation Fold back or remove abdominal skin see Maintenance section page 37 Abdominal Skin Replacement 2 Unscrew the three black thumbscrews around pelvic ring clamp Remove pelvic ring clamp from clamping face Caution Folding the skin downward without support underneath it may cause the skin to tear Note When removing pelvic ring clamp lift so that it remains parallel with the pelvis until rt is clear of the screws 3 Remove current cervix module if necessary and set aside 4 Place new cervix module in position at pelvic inlet with flange lying on top of birth canal flange 26 5 Carefully align holes on cervix module with locating pins on clamping face Ensure that urinary connector is aligned with similar notch on cervix module 6 Replace pelvic ring clamp Ensure it is properly aligned with locating pins and urinary connector 7 Position and tighten black thumbscrews until firm E Note Do not over tighten thumbscrews Amniotic Bag Installation The amniotic bag is required during delivery simulations in which blood and or amniotic fluid will be used g To connect the amniotic bag Note P
59. of the manufacturing process AN Caution Folding the skin downward without support underneath it may cause the skin to tear AN Caution Do not cut skin i 5 T Detach skin from pegs on the side of the pelvis n 4 Remove bladder from pneumo pad and discard 5 Irim new bladder tubing to match original tubing length Connect new bladder hose to inline hose connector 0 6 Fold and insert new pneumo bladder in pneumo box a gt WY 7 Replace chest skin over torso Secure skin at shoulder and back Y tabs 8 Conceal puncture marks on the exterior of chest skin with wax in the Bladder Replacement Kit ene Thoracentesis Module Replacement 2 Pull out audio jack from socket on pelvis 5 o ED To replace thoracentesis module on the manikin 3 Using 4mm Allen key wrench undo upper pubic clamp retaining os i pa Remove chest skin from tabs at shoulders and back pe ie cated ee NEE PATE a pE 2 Remove the thoracentesis module from the midaxillary site of the manikin left 3 Insert a new thoracentesis module 4 Replace the chest skin over the torso Secure the skin at the 0 Oo c shoulders and both sides g S gt 74 4 Remove both skin and clamp 5 D 5 Remove clamp from skin and push into position behind flap in S lower part of replacement skin E A 6 Push clamp into position on pubis j 7 Secure replacement skin by replacing and tighten retaining screws 8 Plug in audio jack 2
60. oir Bag 2 Software and Hardware 377 1950 377 1951 200 4000 200 40033 200 0 1450 200 1 0550 200 1 1350 245 950XX 225 09 XX 225 090XX 245 980XX 200 1 0250 200 10150 245 960XX SimMom Advanced SW CD amp License Key SimMom Advanced License Key 1 VitalSim Control Unit US VitalSim Control Unit EUR Cable Tube Assembly VitalSim to Manikin AC Adapter Control Unit Control Unit Battery Case Patient Monitor Peripheral Kit Standard No Patient Monitor Peripheral Kit Advanced With Patient Monitor USB Hub USB Cable Control Unit Carry Case Webcam Compressors and Pneumatic Accessories 210 01 150 210 01050 220 0990 220 09933 381220 381010 220 011550 SimMan Compressor 5V SimMan Compressor 230V SimNewB Compressor 15 V SimNewB Compressor 230 V Regulator Unit 9 ft 3 m Air Hose 25 ft 8 m Air Hose Accessories 377 7650 200 03050 200 03050B 200 001 50 377 4350 2 0 00250 200 00550 212 1 7950 212 1 8050 210 05250 377 7850 377 4650 377 7550 377 7950 377 8050 Wig Pupil Inserts Kit Blue Pupil Inserts Kit Brown Pneumo Repair Kit Fluid Bags Set IV Bag Transfer Set Blood Pressure Cuff Torso Transportation Soft Case Legs Transportation Soft Case Peripherals Hard Case Hospital Gown Bed Strap Hardware Set Directions for Use DFU Quick Setup Guide Consumables 250 2 1050 200 00250 377 4550 377 4450 Airway Lubricant 45ml Cricoid Tape Flesh
61. olume 4 E QRS beep volume 4 E Disable windows System Sounds Fetal monitor volume 4 Fetal monitor Fetal monitor scroll speed 1 cm min SimMom feature set values E Tongue edema pressure 6 S Seizure intensity 50 uterus pressure 4 Uterus bleeding flow 50 E Pneumothorax pressure 5 Units E Capnometer unit mmHg E ICP unit mmHg E Temperature C O Sort event lists alphabetically S Vocal sound when no BP or apnea Disabled Display parameter trend window at startup Enabled E awkRR source ECG S Override default Start Scenario Folder Disabled Start Scenario search folder Microphone Configuration Video Recording Configuration Set Vital Signs Korotkoff Controls Start SimMom Dialog Open profile Save profile The following default settings are listed under the SimMom feature set values heading on the Configuration menu longue edema pressure 0 6 Uterus bleeding flow 60 100 Pneumothorax pressure 0 6 Seizure intensity 75 100 Uterus pressure 0 6 Fetal Monitor Scroll Speed From the Configuration menu Select the lt General gt tab in on the Configuration screen 2 Select the lt Fetal monitor scroll speed gt option under the Fetal monitor subheading 3 Adjust the speed in the drop down menu General Yolume S Master sound volume mode Automactic Master sound volume only applies to Manual mode
62. or scroll speed is set at 3 cm per minute the monitor displays 20 minutes of activity Instructor Monitor Control View status of mother s vital signs throughout the simulation Use the lt Fetal Monitor gt button to connect or disconnect the EFM sensor to the Patient Monitor Use the lt Toggle Monitor gt button to select which vital signs patient EFM or both are displayed on the Patient Monitor Adjust patient monitor waveforms and parameters by either clicking the individual waveform or scrolling over the numeric parameter readings and using the mouse wheel 2 Simulator Controls View and set lungs heart bowels and fetal heart sounds Set vocal sounds View sound volume by clicking on the speakers displayed next to the area you want to configure Set seizure Set lung resistance function on off Set pneumothorax Set tongue edema Set boggy uterus and bleeding uterus Set pulse strength Pressurize urine bladder Editing Monitor Setup To edit the monitor setup Click lt Edit gt in the Program Menu Bar 2 Select lt Edit Monitor Setup gt from the pull down menu Monitor Setup Layout Name Default Layout 5 Waveform Layout Waveform 1 Primary ECG Lead Available parameters Arterial BP co2 CYP NONE Pleth Sp02 Primary ECG Lead Secondary ECG Lead 4 Waveform Layout Select Parameter al gt Unavailable parameters 3 Waveform Layout
63. pressure 5 Units Capnometer unit mmHg E ICP unit mmHg Temperature C C Sort event lists alphabetically Vocal sound when no BP or apnea Disabled amp Display parameter trend window at startup Enabled SJ awRR source ECG amp Override default Start Scenario folder Disabled S Start Scenario search folder i 4 Seizure From the Configuration menu Select the lt General gt tab on Configuration screen 2 Click the lt Seizure intensity gt option under the SimMom feature set values subheading 3 Enter the desired intensity into the dialog box Help Files Software Help files can be accessed as follows Click the Windows lt Start gt button 2 Select lt Programs gt 3 Select lt SimMom Instructor Applications gt 4 Select the lt SimMom Help File gt Fetal Monitoring The electronic fetal monitor EFM on the user interface displays the Fetal Heart Rate and Uterine Activity waveforms The EFM has the option to scroll at cm or 3 cm per minute At cm per minute the EFM shows 60 minutes of fetal monitoring without having to scroll At 3 cm per minutes it shows 20 minutes without having to scroll It records at least 90 minutes of fetal monitoring that can be viewed by scrolling back To scroll back left click and hold on the EFM display and then move the mouse to the right 14Q o e EEES d pCa ait ebb und soo inte esgY i waa ebb ladae iaabe ienar eee aa
64. ration menu screen click lt Display parameter Trend Preview Window at startup gt and select lt enabled gt from the drop down menu Configuration test General Patient Monitor General Volume 2 Master sound volume mode Automactic SJ Master sound volume only applies to Manual mode 7 Manikin vocal sound volume 5 Monitor alarm volume 4 E QRS beep volume 4 YJ Disable Windows System Sounds Fetal monitor volume 4 Fetal monitor E Fetal monitor scroll speed 1 cm min SimMom feature set values Tongue edema pressure 6 S Seizure intensity 50 S Uterus pressure 4 Uterus bleeding flow 50 Pneumothorax pressure 5 Units E Capnometer unit mmHg E ICP unit mmHg E Temperature C C Sort event lists alphabetically J vocal sound when no BP or apnea Disabled Display parameter trend window at startup E awRR source ECG Override default Start Scenario folder Disabled Start Scenario search folder Open profile 9 Event Windows 3 Contains checklists of events relevant for the simulation An Event is an action or behavior exhibited by the user Electronic Fetal Monitoring View status of fetal heart rate and uterine activity To view additional waveform activity left click and hold the EFM display and drag to the right When the fetal monitor scroll speed is set at cm per minute the monitor displays 60 minutes of activity VWWhen the fetal monit
65. rior to beginning simulation apply liberal amounts of lubrication to the birth canal cervix baby bag and placenta if required This greatly eases delivery of the baby Fold back or remove abdominal skin see Maintenance section page 37 Abdominal Skin Replacement 2 Remove pelvic ring clamp leaving cervix in position Caution Folding the skin downward without support underneath it may cause the skin to tear 3 Place plastic cling film over cervix if required not included to simulate amniotic membranes Caution For best results plastic cling film thickness should be 20 30 microns Thickness above 30 microns may damage the manikin Performing Simulations 4 Thread main part of bag through pelvic ring clamp Lubricate inside of bag baby placenta cervix and birth canal Q ras U 5 O 5 Q 5 pP a 5 Position bag flange on top of cervix flange on pelvic clamping face 2 Introduce baby through top of the bag in required position Add 6 Ensure holes align with pins and urinary connector notches are fluids if required Introduce placenta if required aligned 7 Position pelvic ring clamp over flange o 8 Recheck position of pins and notches and that blood feed tube is not caught under ring Es Y 9 Fit and tighten three black thumbscrews 3 Fit sealing clip to top end of bag Roll up end of bag and tuck it inside abdomen 72 Oo ss S gt z 79
66. rt rate pattern Inthe Fetal Simulation Setup window open the Edit fetal monitor preset window and select the composite Fetal heart rate pattern from the Pattern type pull down menu 15 x Pattern name Shoulders Pattern type r Sub pattern duration __ Preview Up Between 280 and 560 seconds Fetal heart rate Only for reference not saved in preset R Baseline 30 Fetal heart pattern FHR offset Variable decelerations i o X oO Sinusoi id Only for reference not saved in preset LTV gain _ 1 4 i cm min LTV frequency _ 0 1 STV gain g i 1 2 Uterine activity Only for reference not saved in preset In labor O Baseline i Ea Contraction interval i _ Ess Contraction duration i _ eo Height t oo Introduction i V m 1 Software 2 Create sub patterns Input a sub pattern duration by clicking in the dialogue boxes underneath the Sub pattern duration heading and typing in a number Note If the same number is inputted into both dialogue boxes the sub pattern will always last for the same amount of time If different numbers are inputted into the dialogue boxes the pattern will last for a random duration that is never less than the smallest number or more than the greatest number For example if the displa
67. s from packaging Turn manikin so that backside is facing up Place strap over manikin s back Align holes on strap with corresponding screw holes located in the small of the back Place washers on screws Using an Allen wrench and screws secure the bed strap in place Turn manikin so that the front is facing up Connect strap ends underneath the bed Maintenance Maintenance Eyelash Replacement The following procedures will help lengthen the operational life of the To replace manikin eyelashes 5 SimMom manikin p Remove pupils See Pupil Replacement page 33 5 U Pupil Replacement Note If you fail to remove the pupils you may accidently drip gt Eyelash Replacement glue on them This causes them to become cloudy Wig Care and Upkeep 2 Using a toothpick gently place the eyelash across the edge of the manikin s eyelid starting at the corner nearest the nose Neck Collar Cricothyroid Replacement Note Only place the toothpick between the lashes along the Arm Replacement white rim of the eyelash Do not depress the lashes a 3 Pneumothorax Bladder Replacement i Thoracentesis Module Replacement Abdominal Skin Replacement Perineum Birth Canal Skin Replacement Cervix Replacement s gt Pelvic Floor Replacement E Y Urine Reservoir Replacement Blood Reservoir Replacement ee 3 Drip a small amount of super glue onto a sheet of paper Dip the Pelvis Replaceme
68. sured in hertz Uterine activity parameters include baseline contraction interval contraction duration and height Once the desired parameters have been set click lt Apply gt to load them into the simulation Creating and Saving Preset Parameters for Fetal Heart and Uterine Activity To create preset parameters for fetal heart and uterine activity Inthe Fetal Simulation Setup window open the Edit fetal monitor preset window by clicking either the lt New gt button under the Select preset tab or the lt Save as preset gt button under the Custom tab 2 Choose a name for the preset and enter it into the Pattern name dialogue box 3 Select one of the four pattern types from the Pattern type pull down menu Note The pattern types correspond to the menus under the Select preset tab Edit fetal monitor preset Pattem name PT Pattern type We fetal heart rate pattern Simple baseline variability pattern Simple uterine activity pattem Composite fetal heart rate pattern 4 Set preset parameters by sliding toggles and or entering numbers into dialogue boxes Note For greater detail on creating a composite fetal heart rate pattern proceed to the Creating A Composite Fetal Heart Rate Pattern section Edit fetal monitor preset DER Pattern name EarlyDecel1 Pattern type le feta Fetal heart rate Only for reference not saved in preset Baseline J Fetal heart pattern
69. t can be placed in multiple positions in order to simulate normal difficult instrumental and placenta deliveries Software Connecting Umbilical Cord If cord cutting is required attach one of the cuttable umbilical cords to the connector and push second connector into free end of tube 7 Oo p S z Y Performin v Oo c G c oO rus S F gt Then push the other end of second connector into the umbilical hole on baby s abdomen N Z Ke R O U D Q Y WY rs j a S fala o Ca co Q Y If cord cutting not required simply push the umbilical cord connector directly into the umbilical hole on baby s abdomen Performing Simulations Lubrication The baby umbilical cord placenta birth canal cervix inside of vulva and amniotic bag should be thoroughly lubricated prior to use A poorly lubricated cord may pull away from the baby during delivery Caution Use only SimMom Birthing Lubricant Do not use PROMPT birthing lubricant Non approved lubricants can damage the system Baby is now ready for delivery either via bag if fluids are required or directly through the cervix Caution A poorly lubricated baby or placenta may damage the birth canal or the cervix as It is pushed through Caution Vhen performing a delivery without the umbilical A cord ensure the connecting plug is not left in the umbilical hole as it can damage the birth canal when the baby is pushed through
70. th clamp white Luer connector aW 5 ras 7 Y 0 a S gt eZ O 3 Undo blue Luer connector from the blue bulkhead fitting ua 4 Remove blood reservoir 5 Lay new reservoir in position in reservoir bay with red filler cap to the manikin s right facing upwards 00 c 6 Connect blue Luer connector to blue blood pump inlet ES C bulkhead fitting OS D E o s 7 Ensure slide clamp is open Aw 8 Replace urine reservoir 9 Replace reservoir lid 5 Remove urine reservoir 6 Lay new reservoir in position in reservoir bay with red filler cap on the manikin s left facing upwards co R am ced p S R 2 7 Connect yellow Luer on urine reservoir inlet tube to yellow urine pressurization outlet on bulkhead 3 4 turn do not overtighten 7 8 Connect white Luer on urine reservoir outlet tube to white Luer C O on urine connector tube om G 2 9 Ensure slide clamp is open E A 10 Replace reservoir cover and reconnect retaining loop and Velcro Tp strap N 4 Sa S A 0 an S Q Y 4 Maintenance Pelvis Replacement To detach and replace the pelvis Turn the manikin over so that the backside is facing up 2 Using a Phillips head screw driver unscrew the access panel and remove 7 Separate pelvis from torso Note To prevent the bolts washers and nuts from getting lost reattach them to the torso section 3 Locate the black el
71. tient Monitor video cable and 3 way audio cable black mini jack with double wire to the Instructor PC IMPORTANT Do NOT connect the USB cable to the PC or USB Hub yet 5 Set Up the Instructor PC for Extended Desktop Display to Support the Patient Monitor Right click on the instructor PC desktop In the drop down menu select lt Screen Resolution gt In the lt Multiple Displays gt option select lt Extend these displays gt Click lt Apply gt and then lt Keep these Settings gt The Instructor PC display should have a resolution of 600 x 900 The Patient Monitor display 2 should have a resolution of 1280 x 1024 Click lt OK gt Connect the Patient Monitor to the USB Hub Calibrate the Touchscreen Patient Monitor Double click on the Elo logo in the system tray in the right corner of the screen Click the lt Align gt button on the dialog box that appears If target indicators first appear on the Instructor PC screen press lt Esc gt or wait until they appear on the Patient Monitor When the target indicator appears on the Patient Monitor Optional External Air Source z w 2 gt touch each target as it changes position and follow the arrow with your finger When the ELO Touchscreen dialog box appears touch the green check box button Click lt OK gt 8 Connect the USB Camera to the USB hub 9 Connect the VitalSim Control Unit Connect the USB cable fro
72. training devices there may be approximations variations and inaccuracies in anatomical features and the physiological modeling This being the case Laerdal does not guarantee that all features are completely accurate Global Warranty See the Laerdal Global Warranty Booklet or see www laerdal com Country of origin SimMom is made in USA Laerdal Medical PO Box 38 226 FM 116 Gatesville Texas 76528 USA General Care To maintain manikin skins wash hands before use and place the manikin on a clean surface Laerdal recommends the following Use gloves during simulation scenarios Avoid using colored plastic gloves as they may cause discoloration of the manikin skin Do not use felt tipped markers ink pens acetone iodine or other staining medications near the manikin Take care not to place the manikin on newsprint or colored paper Staining may be permanent Clean manikin skins with mild soap and water Ifa training session involves the use of fluids in the IV arm or blood and urine bags drain the arm immediately following the training session Use only Laerdal Airway Lubricant for airway lubrication and apply liberally Use only SimMom Birthing Lubricant to lubricate baby cervix birth canal and modules Do not use PROMPT birthing lubricant Non approved lubricants can damage the system Rinse clean and dry manikin component modules Fold the torso skin back and pow
73. u Bar Software File includes controls for starting a scenario turning on and off monitor sound importing vocal sounds and media files adding media files and exiting the software View can select patient or instructor monitor setup Simulation includes controls for starting pausing fast forwarding simulations and going to debriefing Edit includes controls for editing monitor setup starting editors scenario handler and trend configuration microphone and video recording setting vital signs adjusting Korotkoff controls and starting SimMom dialog Calibration calibrates the BP instrument Help includes help files Respiratory Control Adjust the simulator s respiratory rate Turn chest rise off and on Difficult Airway Controls Set ventilation and intubation Preset controls for Normal Cannot intubate can ventilate Cannot intubate cannot ventilate 4 Defibrillation and Pacing Control View and control shocks to conversion and pacing threshold Select and exchange running and waiting rhythms Click the lt Extrasystole gt button to insert an extra systole into the running rhythm Debrief Log Session Log Shows all activities performed during the simulation Scenario Control To start pause or halt scenarios This section also contains the Debrief button which will stop the session and open the debrief log in the Debrief viewer
74. up Select preset Custom A Fetal heart rate Baseline A Fetal heart pattern FHR offset j 0 Acceleration Early decelerations Late decelerations Variable decelerations Sinusoid v Baseline variability v Uterine activity ety ae tat Baseline fetal heart rate parameter controls the rate of the fetal heart Fetal heart pattern parameters include the following FHR fetal heart rate offset sets FHR relative to baseline Acceleration slider sets amplitude of periodic accelerations Software arly decelerations slider sets amplitude of decelerations occurring simultaneously with each contraction Late decelerations slider sets amplitude of decelerations occurring after each contraction Variable decelerations slider sets amplitude of decelerations proceeding and following each contraction Sinusoid box sets fetal heart rate waveform resembling sinusoidal wave Note The fetal heart pattern parameters are mutually exclusive When one is set to a certain value the others automatically remain at 0 Baseline variability parameters include LTV long term variability gain LTV frequency and STV short term variability gain STV gain measures the beat to beat change in the fetal heart rate LTV gain measures changes in the fetal heart rate over a longer period of time LTV frequency is the frequency of long term variability mea
75. y reads Between 60 and 60 seconds the sub pattern will always last one minute However if the display reads Between 60 and 80 seconds the sub pattern will last a random duration between and 3 minutes Varying the numbers is a way to introduce a greater degree of randomness into the simulation Set Fetal heart rate pattern parameters for the sub pattern by sliding toggles and or typing numbers into appropriate dialogue boxes Click the lt New gt button to start on a new sub pattern Repeat step 2 for each required sub pattern Note To move sub patterns around in the simulation click on it under the Sub pattern menu and press the lt Up gt or lt Down gt button To delete a sub pattern from the simulation press lt Remove gt lo make a copy of a sub pattern press lt Save as gt 3 Click lt OK gt to save the composite fetal heart rate pattern The saved composite preset should appear in the Select present tab under the fetal heart pattern menu Patient Monitor The optional Patient Monitor has a Touchscreen display and is used to simulate a real patient telemetry monitor 2 4 2 2 32 e Aana veume Meteo mote tte so Patient Vital Signs 2 Fetal Heart Monitoring 3 Patient Monitor Interface Video capture from the patient monitor display and the web camera can be stored for use in the Debrief Viewer The Patient Monitor must remain connected throughout the simulation

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SimMom™ - Laerdal