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User Guide, SimMom
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1. INTRODUCTION SimMom Birthing Simulator Main Components CAUTIONS AND WARNINGS General Simulator Handling FEATURES SimMom Overview General Airway Breathing Circulation Vascular Access Other Features Birthing Positions Birthing Baby Bed Strap Gown Laerdal Simulation Software SETUP Connecting Belly Skin Audio Cable Defibrillator Adapter Plates Connecting Blood Pressure Cuff Preparing for IV Simulations Cleaning IV Arms Intramuscular Injection Site Use and Care Introduction to Manual Deliveries Preparing Baby for Delivery Delivery Techniques Deliveries Cervix Amniotic Bag Postpartum Hemorrhage Inverted Uterus Catheter Installation Filling Blood and Urine Reservoirs Cleaning Blood and Urine Reservoirs NO NN Oo O C amp O N N N D OD d A O O O 11 11 11 11 11 12 12 12 12 la T4 15 16 16 18 20 21 22 2 AUTOMATIC DELIVERIES Introduction to Automatic Deliveries Setting up Automatic Delivery Module Preparing Baby for Delivery Delivery Positions Placing Suprapubic Foam Cleaning Automatic Delivery Module Introduction Replacing the Pupils Replacing the Eyelashes Wig Care and Upkeep Replacing the Neck Collar Cricothyroid Replacing the Arm Replacing the Pneumothorax Bladder Replacing the Thoracentesis Module Replacing the Abdominal Skin Replacing the Perineum Birth Canal Skin
2. Connect the male luer connector of the IV bag not included to the female luer connector on the simulator s forearm p A When performing IV simulation use only distilled or de ionized water to prevent clogging of the system Cautions and Warnings Features m Q v O 2 O O K 5 c S 2 Automatic Deliveries Maintenance Spare Parts Cleaning IV Arms Clean the IV arms after each session or day of use by flushing them with 60 isopropanol or 70 ethanol Intramuscular Injection IM Srte Use and Care There are four sites for intramuscular injections They are located on the left and right deltoid and thigh The IM pads are foam filled and can be injected with fluids Using a 22 gauge needle increases the longevity of the skins Immediately after use the IM pads must be removed from the simulator and allowed to air dry The IM pads can be squeezed like a sponge to remove fluids The IM deltoid pads have a foam interior that must be removed for drying The foam is removed through a slit in the back of the pad Talcum powder may be used to ease the reinsertion of the foam into the skin Introduction to Manual Deliveries Modular Components SimMom is equipped with the following modular components for manual delivery e Cervix Module Amniotic Bag Pelvic Components S WwW e ec Post Partum Support Foam Retained Hemorrage Placenta Uterus Inverted Uterus Boggy
3. 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 1 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 Forceps Delivery To perform a delivery with forceps instrumentation Note It is easier to perform a breech delivery if the cervix is not installed 1 Reduce lubrication on the baby s head 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 they pull on the forceps only when the instructor trainer 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 instructor and trainee so 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 1 Reduce lubrication on the baby s head to prevent the suction
4. Laerdal Simulation Home Laerdal Simulation Home is an application from where LLEAP and other Laerdal programs related to patient simulation can be found and started Also the help files can be opened from here Laerdal Simulation Home is located in the Laerdal Medical folder under the Windows start menu Windows 7 Software used in a simulation session can be divided in the following main applications LLEAP Laerdal Learning Application Voice Conference Application Patient Monitor SimView Server or Session Viewer In addition SimDesigner and other applications are used for designing or preparing a simulation LLEAP LLEAP is the instructor s application from where the simulation session Is run controlled and monitored LLEAP can be operated in Automatic or Manual mode Automatic mode is used for pre programmed scenarios while Manual mode allows the instructor full manual control over the simulation session Running simulations in Manual Mode generally requires some medical expertise to create clinically sound simulations Voice Conference Application VCA software allows the instructor to communicate through the simulator during the session VCA can also be used to communicate with other instructors on a network and create separate channels where only members can communicate Patient Monitor The Patient Monitor application emulates a typical hospital patient monitor It is the learners console and can be
5. Web Downloads Visit www laerdal com downloads to download the latest User Guide and SimMom Software Connecting Belly Skin Audio Cable 1 w N 5 Unhook the belly skin from the three attachment sites on either side of the pelvis Fold the skin over towards the feet Remove the C Section Belly skin shipped inside the pelvis and store with your other SimMom accessories 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 ae amp Reattach belly skin Defibrillator Adapter Plates Preparing for defibrillation using paddles 1 Unscrew and remove defibrillation studs 2 Screw adapter plates into post sockets located on apex and sternum of simulator 11 Connecting Blood Pressure Cuff 1 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 patient simulator cable and the clear pneumatic tubing exiting the lower right side of the simulator are connected to Link Box Preparing for IV Simulations Both simulator 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
6. Compressors and Pneumatic Accessories 210 01650 210 01750 381220 381010 220 01550 Accessories 377 17650 200 03050 200 03050B 200 00150 377 14350 2 0 00250 200 00550 212 17950 212 18050 377 17850 377 14650 3 7 17550 377 05150 Consumables 2590 21050 200 00250 377 14550 377 18850 377 19950 Compressor 110V 240V EU UK Plug Compressor 110V 240V US Plug Regulator Unit 9 ft 3 m Air Hose 25 ft 8 m Air Hose 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 Hospital Gown Bed Strap Hardware Set SimMom Automatic Birthing Module Airway Lubricant 45 ml Cricoid Tape Flesh Venous Blood Starter Kit Pk 2 5 L Birthing Lubricant 250 ml Birthing Lubricant 1L SSUILIPAA put SUCIJNEJ SoJnitos J dn3as S9119AI9 ENUEJAJ S9I13A19 INPBLUOINY QIULCUDSIUIEL Syed aJeds 4l Limbs amp Things BRINGING SKILLS TRAINING TO LIFE faa gt v ol 20 0 7886 2014 Laerdal Medical AS All rights reserved Manufacturer Laerdal Medical Corporation PO Box 38 226 FM 116 Gatesville Texas 76528 USA T 1 254 865 7221 www laerdal com A Laerdal helping save lives
7. The SimMom simulator 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 EJ Note ADM Bag is not suitable for air transport EJ Note The Birthing Baby should not be stored inside SimMom 44 bo S SJ G gR 74 ke Pp gR U FEATURES SimMom Overview Right Arm ECG Lead Left Arm ECG Lead Sternum Defib Plate a Intramuscular Intramuscular Injection Site a Injection Site IV Fluid IV Fluid Connection Connection BP Cuff Connection O Left Leg ECG Lead Right Leg ECG Lead Apex Defib Plate Blood Pressure Arm IV Access ge IV Access Intramuscular Injection Site a Intramuscular Injection Site BP Tubing S External Air Connection 60 Pin Serial Cable Manikin to Link Box Cable FEATURES General Pelvic Components Interchangeable uterus modules Cervix that dilates from 4 cm to full Amniotic bag for intrapartum fluids PPH uterus with tonic and atonic states and with retained placenta and placental fragment Uterine inversion Optional Automatic Delivery Module ADM Bony pelvis with landmarks Realistic vulva and anus for digital exams Realistic at term abdominal skin Pre incised C section skin Fluids e g blood stained amniotic fluid a
8. 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 Intermittent Catheter Tube Indwelling Balloon Catheter 1 Disconnect the white Luer connector from the urine reservoir outlet Ensure reservoir is empty or the tube Is clamped h kesa es 2 Pull the tube free of locating groove on pelvic ring clamp 3 Remove the pelvic ring clamp 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 simply 2 push it back on 5 Grip the grey urinary value through the birth canal skin and 21 push a replacement urinary connector onto valve spigot Ensure that the connector tube is pointing to the simulator s right side 6 Push the connector tube into the groove toward the pelvic ring 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 lug on the Inside of the abdominal s
9. 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 6 Replace filler cap 7 Reconnect all reservoir connectors 8 Ensure slide clamps are in open position CO N a WN A 22 Remove blood and urine reservoirs Drain and rinse out bags with water Flush pump with tap water Leave to air dry Replace reservoirs AUTOMATIC DELIVERIES Introduction to Automatic Deliveries Automatic Delivery Module ADM This section describes how to use SimMom with the optional Automatic Delivery Module ADM With ADM SimMom delivers the baby automatically and can simulate the following delivery scenarios Normal OA Normal OP Breech Shoulder Dystocia In order to use the ADM the cervix and pubic clamp must be removed 23 Setting up Automatic Delivery Module 1 Connect ADM air tubes to the connectors in the simulator 2 Slide the Bottom Bracket onto the bolts that connect torso and pelvis Automatic Deliveries AUTOMATIC DELIVERIES Preparing Baby for Delivery Lubrication Apply at least 2 3 squirts of Connecting Umbilical Cord lubrication to the following areas m l m rior to use If cord cutting is required attac
10. setup and controlled by the instructor as well as by the learner through on screen touch menus Session Viewer and SimView Server Session Viewer and SimView Server are applications that record video and patient monitor screen captures during simulation in addition to providing an interface to debrief your session After a session Is ended log files generated in LLEAP are transferred and merged with the video files in Session Viewer or SimView Server for the debrief Session Viewer typically runs locally on the same computer as used for LLEAP SimView Server runs on a dedicated server in the local network During the first start up of LLEAP you are prompted to select a debriefing system available on your computer or on a local network This can be changed later SETUP Other applications There are also other programs that are used in conjunction with the simulation sessions for example License Manager for handling program licenses and Simulator Firmware amp Network Fixer for updating the firmware of the simulators or troubleshooting network problems SimDesigner SimDesigner is an application for configuring your own preprogrammed scenarios It can also be used to analyze and print out a graphical representation of a scenario SimDesigner must be installed to allow conversion of legacy instructor application files to LLEAP compatible file formats For a full overview of all applications and their help files start LLEAP Home
11. Replacing the Cervix Replacing the Pelvic Floor Replacing the Urine Reservoir Replacing the Blood Reservoir Replacing the Pelvis Replacing Baby Limbs SPARE PARTS AND ACCESSORIES 23 23 23 u pis 28 28 29 29 29 29 30 30 54 32 33 34 34 36 36 eli 37 38 37 40 simMom Birthing Simulator SimMom is a birthing simulator representing a full term pregnant adult woman 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 Main Components SimMom comes with 4 interchangeable modules for Manual Delivery In addition there is an optional module for Automatic Delivery The Instructor PC controls the simulation and interventions can be logged by the instructor and used for later debriefing The headset allows the instructor to simulate interactive voice communication between the patient and the learner The Instructor PC is connected to the SimMom patient simulator via a Link Box While the Link Box must be connected to the SimMom patient simulator using wi
12. Thread the SD string as shown Make sure that the thread Is z MAMI MNA MAPI ONA pushed all the way into the release mechanism and the knot is b Sj pulled right up under tt 1 Attach the SD string to the baby s right leg and close the loop r KAT L J n Right leg SZ K mM OLA CU RSS Dn IN 2 Thread the SD string 3 Connect and fold umbilical cord and placenta in front of the baby Ensure that umbilical cord is covered by the placenta to prevent catching during delivery Place cradle and baby in OA position 5 Slide on the lid 2 Automatic Deliveries AUTOMATIC DELIVERIES Placing Suprapubic Foam Cleaning Automatic Delivery Module Place the Suprapubic Foam as shown below After each training session remove all the applied lubrication using a warm damp cloth 28 MAINTENANCE Introduction Replacing the Eyelashes The following procedures will help lengthen the operational life of 1 Remove pupils See Replacing the Pupil he SimMom simulator ei a Note If you fail to remove the pupils you may accidently drip glue on them This causes them to become cloudy Cautions and Warnings Replacing the Pupil 2 Using a toothpick gently place the eyelash across the edge of the Replacing the Eyelashes simulator s eyelid starting at the corner nearest the nose Wig Care and Upkeep Note Only place the toothpick between the lashes along the white Sl rim of the e
13. Uterus 12 Placenta Fragment O Reservoir Cover e di Thumbscrew Pelvic Ring Cervix Popper Bar Pubic Bone Pelvic Floor Pelvic Floor Plate Skin Plate MANUAL DELIVERIES Prepari ng Baby for LDelive ry Apply at least 2 3 squirts of lubrication to the following areas using hands to distribute evenly SimMom is delivered with a birthing baby that can be placed in 4 multiple positions in order to simulate normal difficult instrumental and placenta deliveries Inside the vagina and around the edge of the perineum Cautions and Warnings 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 Features Setup Then push the other end of second connector into the umbilical cord on baby s abdomen 3 To the baby s head shoulders body and limbs Ensure the baby is well covered If cord cutting not required simply push the umbilical cord connector directly into the umbilical cord on baby s abdomen 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 74 me O 2 T O G 5 S 2 Caution Use only SimMom amp PROMPT Birthing Lubricant Laerdal Catalogue Number 377 18850 Limbs amp Things Catal
14. abnormal bowel sounds and fetal heart sounds not at the same time Interchangeable pupils normal dilated and constricted Patient Voice Pre recorded sounds Custom sounds Instructor simulates patients voice Birthing Positions By manipulating the simulator s limbs and rotating its shoulder and hip joints it can simulate the following birthing positions 2 Left lateral 4 Less in stirrups 6 McRoberts 1 Supine 3 Semi recumbent 5 All fours Note A true semi recumbent position is not possible with ADM module or with pelvis locks installed Use a lower degree angle instead D fe O LL Birthing Baby Main Components 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 instructor 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 retain
15. al 300ml Introduce placenta if required A Warning Do not fill the bag over 500ml Note The same pump and connectors can be used to deliver ANNE simulated amniotic fluid rather than blood if this is required ff zj AS j E i E j gt T eN 12 Apply lubrication to the baby s head shoulders body and limbs as described under Preparing Baby for Delivery 14 Fit sealing clip to top end of bag Roll up end of bag and tuck it inside abdomen 15 Replace abdominal skin 16 When delivering the baby the instructor will grasp the baby with both hands and push and squeeze the baby through the bag ly Cautions and Warnings Features Setup 74 SU ES O E Zo O cs 5 S 2 Automatic Deliveries Maintenance Spare Parts MANUAL DELIVERIES Postpartum Hemorrhage Uterus and Postpartum Hemorrhage PPH Installation The Uterus and PPH module includes a retained placenta module and boggy uterus module Uterus Installation 1 Fold back or remove abdominal skin see Maintenance Replacing the Abdominal Skin Remove pelvic ring clamp and cervix Caution Folding the skin downward without support underneath it may cause the skin to tear 2 Install the indwelling catheterization bag as described on page 31 steps 5 8 3 Push pelvic ring clamp over cervix and flange of PPH uterus 4 Locate flange on pelvic clamping face Align holes on flange with pins on clamping face Al
16. amp leaving cervix in position 4 Place new cervix module in position at pelvic inlet with flange lying on top of birth canal flange A Caution Removing the cervix can cause leaks 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 3 Place plastic wrap cling film over cervix if required not included to simulate amniotic membranes Caution For best results plastic wrap cling film thickness should be 20 30 microns Thickness above 30 microns may damage the simulator 4 Thread main part of bag through pelvic ring clamp 6 Replace pelvic ring clamp Ensure it is properly aligned with locating pins and urinary connector 7 Position and tighten black thumbscrews until firm Note Do not over tighten thumbscrews 5 Position bag flange on top of cervix flange on pelvic clamping face 6 Ensure holes align with pins and urinary connector notches are aligned 7 Position pelvic ring clamp over flange 8 Recheck position of pins and notches and that blood feed tube is not caught under ring 16 9 Fit and tighten the three black thumbscrews kk 10 Connect blood feed tube red Luer to blood pump outlet red bulkhead connector MANUAL DELIVERIES 13 Introduce baby through top of the bag ensuring the head is fully engaged into the cervix Pour 100ml of lubrication into the bag and add 200ml of water for a tot
17. area of simulator MAINTENANCE Replacing the Arm To remove Right BP Arm 1 Remove deltoid injection pad from upper arm To remove Left Arm 1 Remove deltoid injection pad from upper arm Detach chest skin from tabs at shoulders and back Cautions and Warnings 2 3 Remove skin to reveal internal upper chest area 4 Lift chest plate to reveal inside sockets for arm connections 5 Follow the cables exiting the shoulder to the black connector and disconnect N O pi 5 4 G O LL PA o 5 4 O YN WY V O Ko O 3 Remove skin to reveal internal upper chest area E C 4 Lift hard chest plate to reveal inside sockets for arm connections s o 6 Use a Phillips head screw driver to unscrew and remove the A retaining screw S gt D EF oa O Po di 4 a O as 5 lt 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 0 U R 0 us ce C 2 8 From inside of chest area thread a washer a spring and another washer on bolt 9 Screw the wing nut on the bolt and tighten until desired articulation is achieved 10 Replace hard chest plate 11 Reattach chest skin back onto shoulder area ensuring ECG posts align 12 Replace deltoid injection pad on upper arm Spare Parts 31 MAINTENANCE 7 Slide the stopper off of the p
18. ator Warning Do not use automated external chest compression machines on the simulator AN Caution Latex This product contains Natural Rubber latex which may cause allergic reactions when in contact with humans Environment In cold conditions wart until the simulator has reached room temperature before starting up the simulator To avoid overheating and reduce wear When using in temperatures above 40 C 104 F always allow the simulator to cool down between training sessions When using in a bed simulator should not be covered with heavy bedding that prevents heat transfer from the simulator Do not use the SimMom simulator 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 simulator here are unusual sounds indicating air leakage or mechanical damage There are signs of electrical malfunction such as an unresponsive simulator or unusual smell or smoke Warning Avoid pinch hazards Do not use the simulator without the external skins General Care To maintain simulator skins wash hands before use and place the simulator 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 simulator skin Do not use felt tipped markers ink p
19. cups from slipping off the scalp 2 A facilitator may be needed to coordinate the trainees as they pull and the instructors as they push Note Step 2 is less critical for suction delivery than for forceps delivery 15 All Fours Delivery All four delivery can be performed using one or two handed delivery technique though the latter is recommended s To perform a delivery on all fours Note All fours delivery reguires more force and involves a different technique than other delivery types It should be practiced several times before being used in a scenario 1 Push diagonally upwards into the pelvic floor following the J shape of the birth canal 2 Guide baby horizontally through birth canal opening If using two handed technique apply continuous upward pressure with the second hand in order to keep the head flexed and to prevent baby s body from sagging 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 Note For more stability the instructor should consider resting his or her elbows on the bed or on a pillow positioned on the bed To perform a shoulder dystocia delivery 1 Wedge anterior shoulder against the pubis while descending the baby down the birth canal 2 Coordinate the rotational maneuvers of the instructor and the student so their mo
20. e side of the back of the uterus 7 Pump until dial reads 0 8 0 9 bar 25 mmHg approximately 8 10 strokes of pump 8 Disconnect 9 Repeat for second connector to secure placenta into back of uterus 10 Replace abdominal skin 19 Boggy Uterus Bag Installation 1 Place the boggy uterus bag in position on PPH uterus The concave surface of bag aligns with the convex surface of uterus 2 Place support foam under the uterus and feed the air supply tube green luer connector through the right cutout of the foam The support foam prevents the uterus from flopping back when palpating through the abdomen 3 Remove the reservoir cover and attach the air supply tube from the boggy uterus green Luer connector to green air outlet on the pelvic bulkhead 3 4 turn Caution Do not activate boggy uterus until abdominal skin is fastened in position The bag will over inflate if it is activated with the skin off 4 Replace the reservoir cover and ensure the tubing is routed through the slot of the reservoir cover Replace abdominal skin Cautions and Warnings Features Setup 74 se D E T O cs 5 3 2 Automatic Deliveries Maintenance Spare Parts MANUAL DELIVERIES Inverted Uterus Uterine Inversion Installation 1 Fold back or remove abdominal skin see Maintenance Replacing the Abdominal Skin Caution Folding the skin downward without support underneath it may cause the skin
21. ed Fetal heart rate normal bradycardia and tachycardia via software Electronic Fetal Monitoring olle gt CTG EFM graphic display fetal heart rate waveform and uterine activity waveform EFM is displayed on the patient monitor with mothers vital signs Fetal monitoring Is recorded and it is possible to scroll back to view on the patient monitor The software allows the instructor to use the preset states as well as utilize the customized parameters FEATURES Bed Strap SimMom packaging includes a bed strap that can be used to secure the simulator to the table during simulations To use the bed strap 1 Remove bed strap screws and washers from packaging 2 Turn simulator so the backside is facing up 3 Place strap over simulators back Align holes on strap with corresponding screw holes located in the small of the back 4 Place washers on screws Using an Allen wrench and screws secure the bed strap in place 5 Turn simulator so the front is facing up 6 Connect strap ends underneath the bed Gown The SimMom gown has two flaps that provide access to the abdomen during birthing simulations The gown also has holes through which the simulators wires can pass Abdominal Access Flap Abdominal Access Flap a Wire Exit 10 Laerdal Simulator Software To run a simulation LLEAP Laerdal Learning Application must be started from Laerdal Simulation Home on the Instructor PC
22. ement Using a Phillips head screwdriver remove the three screws located underneath posterior birth canal 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 simulator MAINTENANCE Replacing the Urine Reservoir Senne oe 6 Lay new reservoir in position in reservoir bay with red filler cap The urine reservoir is located in the reservoir bay above the blood on the simulator s left facing upwards reservoir The color coded connectors for fluid and compressed air 7 Cc JE onnect yellow Luer on urine reservoir inlet tube to yellow Cautions and Warnings ST NOG at ON eeu ONO eee urine pressurization outlet on bulkhead 3 4 turn do not overtighten 8 Connect white Luer on urine reservoir outlet tube to white Luer on urine connector tube N O pi 9 Ensure slide clamp is open 3 G 10 Replace reservoir cover and reconnect retaining loop and uw Velcro strap Replacing the Blood Reservoir o The blood reservoir is located in the reservoir bay beneath the urine reservoir Blue denotes blood and amniotic fluid carried from blood reservoir to pump 1 Remove reservoir cover and urine reservoir NI YN Red denotes fluid from pump to the module being used PPH 2 Clamp blood outlet with clamp uterine inversion or amniotic bag Green denotes compressed air to and from boggy u
23. ens acetone iodine or other staining medications near the simulator Take care not to place the simulator on newsprint or colored paper Staining may be permanent Clean simulator skins with mild soap and water lf a training session involves the use of fluids in the IV arm or blood and urine bags drain the fluid immediately after the training session Use only Laerdal Airway Lubricant for airway lubrication and apply liberally Use only SimMom amp PROMPT Birthing Lubricant Laerdal Catalogue No 377 18850 Limbs amp Things Catalogue No 10193 to lubricate baby cervix birth canal and modules Do not use any other lubricant Do not use PROMPT Birthing Lubricant Laerdal Catalogue No 376 02950 Limbs amp Things No 50181 or SimMom Birthing Lubricant Laerdal Catalogue No 377 14450 Limbs amp Things No 10191 Non approved lubricants can damage the system Warning SimMom amp PROMPT Birthing Lubricant is not for personal use Rinse clean and dry simulator component modules Fold the torso skin back and powder the inside of the torso skin to decrease friction Do not spill powder into simulator chest cavity Do not attempt to perform the following techniques on this simulator due to the inability to properly sanitize the airway Mouth to mouth ventilation Mouth to mask ventilation Insertion of simulated vomit or fluids for suctioning Storage and Transportation
24. eplace access panel 12 Reconnect torso to pelvis by reversing steps Loop tubing in a counterclockwise motion before reconnecting 6 Turn the simulator back over 7 Remove abdominal skin 38 MAINTENANCE Replacing Baby Limbs To replace baby limbs use a screwdriver to unscrew the limb where it connects to the torso Cautions and Warnings Features Setup Manual Deliveries Automatic Deliveries 0 U ra 0 rus ev 2 Spare Parts 39 SPARE PARTS AND ACCESSORIES Spare Parts and Accessories For latest version of Spare Parts and Accessories visit www laerdal com Catalogue Numbers Substitute XX with your local language version number SimMom Simulator 377 18350 377 17750 381102 381107 200 03150 381105 381402 377 15350 377 18150 377 18250 375 51001 380410 377 18450 200 03750 377 18550 380405 200 01850 383110 205 03750 377 19150 377 19250 37 7 15550 377 15650 3 7 15750 377 13250 377 14750 377 14850 377 19350 377 19450 377 18950 377 15050 377 15150 377 15850 377 15450 377 13350 377 13450 Birthing Baby 377 13750 377 16050 377 16150 377 16250 377 16350 Modules 377 13950 377 15250 377 13850 377 14050 377 14150 377 14250 377 16550 377 16650 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 Ar
25. es Breathing 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 FEATURES Circulation Cardiac Features Extensive ECG library Normal and Abnormal Heart sounds synchronized with ECG ECG rhythm monitoring 12 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 8 logged Chest Compressions CPR compressions generate palpable pulses blood pressure wave form and ECG artifacts Detection and logging of a series of compressions Warning Do not use automated chest compression machines on the patient simulator ECG For rhythm monitoring the simulator is installed with 4 ECG Stud connectors Note Do not begin training until the simulator is connected to Link Box Defibrillator The simulator torso is fitted with two stud connectors for use with a conventional defibrillator defibrillator not included The simulator can also be
26. h firmly The 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 14 If the limbs were properly aligned beforehand they should follow their own path and emerge realistically through the birth canal This technique allows the instructor trainer to perform other functions such as midwife birthing partner etc 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 required The second hand can also hold the umbilical cord and arms in position As the head descends further the instructor trainer can adjust the second hand grip to push up under the chin and better extend the baby s head This technique allows the instructor trainer to better control the head Note The trainer should practice and become familiar with the delivery process prior to any training situation 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
27. h one of the cuttable umbilical cords P to th tor and push d tor into fi d of tube a o the connector and push second connector into free end of tube Milo pda evenly The lubricant can be reactivated with a spray of pet SOD 1 Birth canal and inside of vulva and Chamber base Then push the other end of second connector into the umbilical 2 Inside the vagina and around the edge of the perineum cord on baby s abdomen Stake If cord cutting not required simply push the umbilical cord connector directly into the umbilical cord on baby s abdomen The baby s head shoulders body and limbs Ensure the baby is well covered 5 Umbilical cord and Placenta 6 Cradle 24 AUTOMATIC DELIVERIES Delivery Positions A Caution Use only SimMom amp PROMPT Birthing Lubricant Laerdal Catalogue Number 377 18850 Limbs amp Things Catalogue Normal Occiput Anterior OA No 10193 Do not use PROMPT Birthing Lubricant Laerdal Catalogue No 376 02950 Limbs amp Things No 50181 or EJ Note Make sure all parts are thoroughly lubricated SimMom Birthing Lubricant Laerdal Catalogue No 377 14450 Limbs amp Things No 10191 Do not use any other lubricant Non approved lubricants can damage the system 1 Place the baby in the cradle C 9 A Caution A poorly lubricated cord may pull away from the baby during delivery Poorly lubricated parts may cause damage to the simulator as the baby is pushed thro
28. ign notch for urinary connectors with similar notch on pubis El 5 Push pelvic ring clamp into position over locating pins 6 Ensure flange holes and pins are still correctly aligned 7 Position and tighten black thumbscrews until firm 8 Connect red Luer connector on blood feed tube to red blood outlet on the pelvic bulkhead E Note Connection only requires a turn to lock Do not over tighten 18 9 Fit indwelling catheterization bladder and fold back behind bag Replace abdominal skin Retained Placenta Installation Round Beem Placental F ent F Placenta Note Gloves are recommended for this procedure 1 Remove the abdominal skin and ensure the PPH uterus is installed Lubricate the 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 simulators head 3 Align the fragments round prominence with suction hole on posterior wall of uterus on the simulator s right MANUAL DELIVERIES 4 Lubricate the placenta and introduce it into the uterus It helps to fold it in half in order to fit through the cervix br T 5 Orient the placenta so that the round prominence sits snugly into the corresponding cavity in the uterus on the simulator s left Ensure the fragment remains aligned with the placenta 6 Fit the connector on vacuum pump hose to the quick fit connector on on
29. ion protocol by avoiding contact between the external paddles and any of the electrode sites while defibrillating FEATURES Do not defibrillate the simulator when tt is turned OFF or if it is not functioning normally The simulator torso must always be kept dry Sudden changes in temperature may result in condensation collecting on electronic components which could pose a shock hazard Allow the simulator to acclimate before defibrillating To prevent torso skin electrode pitting do not apply conductive gel or conductive defibrillation pads intended for patient use 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 simulator 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 Link Box can be used to auscultate and palpate blood pressure Note The speaker for the Simulators blood pressure is located in the right antecubital fossa Adjust pulses to BP using the chart below Systolic BP Carotid Pulse Radial Brachial Pulse gt 88 Normal Normal lt 88 Normal Weak lt 80 Normal Absent lt 70 Weak Absent lt 60 Absent Absent Vascular Access Pre ported IV access bilateral Subcutaneous and intramuscular injection sites Other Features Normal and
30. ivot arm Replaci ng the Pneu mothorax A Bladder To remove the Pneumothorax Bladder from bilateral mid clavicular sites 1 Detach the chest skin from torso by lifting the tabs at the shoulder and back Remove chest skin 8 Remove arm 9 Insert new arm 10 Thread cables through the stopper 11 Secure the stopper to pivot arm with the retaining screw using a Phillips head screwdriver 3 Disconnect bladder hose from Y connector located on the underside of chest plate 12 Reconnect black connector 13 Replace chest plate 14 Reattach chest skin onto shoulder area ensuring ECG posts align 32 MAINTENANCE 4 Pinch and remove bladder through opening between second 3 Disconnect bladder hose from inline hose connector Ensure and third intercostal spaces These are located on the top side hose does not fall through hole and into torso of the chest plate Cautions and Warnings N O pili 5 4 AG O LL 4 Remove bladder from pneumo pad and discard gt e tubing on the new bladder to match original tubing E Molt dli Connect new bladder hose to inline hose connector 6 Insert new pneumothorax bladder into the top side of chest E Folded ciber pneumo box A plate through the second and third intercostal space openings ra The bladder tubing exits through the back side of the chest plate 7 Replace chest skin over torso Secure skin at shoulder and back A Ensure the narrow edge of the bladder is closest to the ste
31. kin 9 For PPH scenarios fold flap back and tuck behind indwelling catheterization bladder 10 Replace pelvic ring clamp To remove and replace the urinary valve 1 Remove pelvic ring clamp 2 Remove urinary connector 3 Pull grey urinary valve from urethral tube on birth canal 4 Push outlet spigot wider of replacement valve into urethral tube Grip tube through birth canal skin to provide support 5 Push urinary connector onto inlet spigot narrower 6 Replace pelvic ring clamp Cautions and Warnings Features Setup 74 ie O 2 oO O G 5 S 2 Automatic Deliveries Maintenance Spare Parts MANUAL DELIVERIES Filling Blood and Urine Reservoirs Reservoirs can be filled while disconnected from SimMom or while in position The urine reservoir contains a maximum of 400ml The blood reservoir contains a maximum of 800ml Both the urine and blood reservoirs are filled in the same way 1 Remove red filler cap 2 If filling outside the model ensure the slide clamp is in the closed position I 3 Stabilize the reservoir by firmly gripping the filling port gt 4 Open up the bag by pushing a finger in through the filler hole and separating the two walls U9 5 Pour in fluids using a plastic jug or funnel not included Cleaning Blood and Urine Reservoirs Note Blood and urine reservoirs should be drained and cleaned after each simulation Blood and urine reservoirs are both
32. m 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 Snaps Gravid Abdomen C section Snaps Perineum Birth Canal Pelvic Floor Skin Pegs for Side of Pelvis 6 Pelvis Assembly Pelvic Ring Clamp Thumbscrew Upper Pubic Clamp Skin Attachment Bar Lower Pubic Clamp Perineum Bar Pubic Bone Reservoir Cover Velcro Strips for Reservoir Cover Catheterization Valve Access Panel Left Thigh Assembly Right Thigh Assembly 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 40 377 16750 377 16850 377 16950 377 17050 377 17150 377 17250 377 17350 377 17450 377 20050 377 20150 Boggy Uterus Bag PPH Module Small Placenta with Retained Fragments Hand Pump 2 Part Nylon Sealing Clamp Indwelling Catheterization Bag 2 Indwelling Intermittent Catheterization Tube Blood Reservoir Bag 2 Urine Reservoir Bag 2 Shoulder Dystocia String Extra Finger Screw Software and Hardware 400 96050 400 302xx 200 30650 212 29650 400 97050 400 01050 USB HD Webcam Link Box Simpad Manikin strap Headset and Mic with USB con Network Switch LLEAP Software
33. nd urine Urine catheterization instillation Pelvic floor Birth canal Movement Seizure indicator Able to position on all fours Realistic rotation of the shoulder and hip joints Legs bend at the knees Arms bend at the elbow Hybrid Simulations SimMom can be used for hybrid simulations which involve disconnecting the simulators pelvis from its torso To perform hybrid simulations see Maintenance Replacing the Pelvis Airway Obstructed airway Tongue edema Right lung left lung and bilateral lung blockage Head tilt Chin lift Jaw thrust Suctioning techniques D fe o LL 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 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 A liberal amount of airway lubricant or liquid soap should be applied inside the pharynx nostrils and all intubation areas prior to performing intubation procedur
34. ogue No 10193 Do not use PROMPT Birthing Lubricant Laerdal Catalogue No 376 02950 Limbs amp Things No 50181 or SimMom Birthing Lubricant Laerdal Catalogue No 377 14450 Limbs amp Things No 10191 Do not use any other lubricant Non approved lubricants can damage the system Automatic Deliveries Caution A poorly lubricated baby or placenta may damage the birth canal or the cervix as it is pushed through Maintenance Caution SimMom and PROMPT Birthing Lubricant is not for personal use o Important It is vitally important that after each training session all lubrication is cleaned from all simulator and baby surfaces with a warm damp cloth Spare Parts 13 MANUAL DELIVERIES Delivery Techniques When simulating deliveries an instructor must manually deliver the baby The instructor stands to one side of the mothers abdomen and pushes the baby through the birthing canal 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 Note The belly skin should be attached by one peg on each side of the pelvis during the procedure There are two basic techniques for delivering the baby One handed Delivery Place the baby in the fetal position aligning its limbs for insertion through the birth canal Grasp the baby by the back of the trunk Engage the baby s head in the required position in the pelvic inlet Pus
35. olding the skin downward without support underneath it Canal S ki nN may cause the skin to tear N Caution Do not cut skin 1 Remove abdominal skin see Maintenance Replacing the Abdominal Skin E EM pee a oe je 2 Remove pelvic clamp by unscrewing the three black thumbscrews 2 Underneath the skin disconnect the audio jack from the pelvis 3 Remove cervix by disengaging the holes on the flange from locating pins on pelvic clamping face 3 Carefully unbutton the skin starting at one of the lower corners on the pubis 4 Remove the skin 5 Fit the replacement skin onto the pelvis and plug in the audio jack 4 Remove urinary connector translucent or black and urinary 6 Secure the replacement skin on both sides and the pubis UE S Deere a SO sa MAINTENANCE 5 Remove retaining screws on lower pubic clamping plate behind 11 Keeping the simulator in the same position push main body of upper part of perineal skin using 4mm Allen key replacement birth canal up into the pelvis Cautions and Warnings Features 6 Remove lower pubic clamping plate from birth canal skin 12 Push the anus into the corresponding hole in the pelvic floor 7 Turn simulator over to allow access to posterior screws 8 Remove retaining screws on posterior birth canal fixing plate Setup 13 Lay the posterior perineal part of the birth canal into the recess 9 Remove fixing plate in the back of the pelvis Man
36. prepared for defibrillation using paddles see Setup Defibrillation Studs Note Place paddles firmly against zap plates to read rhythm on a monitor For hands free defibrillation attach adhesive pads to adapter plates For manual defibrillation place defibrillator paddles firmly against adapter plates Caution The simulator must not be in contact with electrically conductive surfaces or objects during defibrillation A 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 simulator 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 15 minutes before starting a new sequence Using a defibrillator in temperatures over 35 C 95 F may cause simulator to overheat Do not perform defibrillation when simulator is resting on a wet surface Follow defibrillat
37. re the communication between LLEAP computer and Link Box also support wireless alternatives Laerdal Patient Monitor can be configured to replicate most patient monitors The Patient Monitor also doubles as a display for other functions such as EFM 12 lead ECG X ray images and lab results to view the patients case history In the system software is included like LLEAP for controlling scenarios SimDesigner for creating and editing scenarios or Session Viewer for debriefing simulation sessions with video capture from a web camera and an application for the Patient Monitor SimMom is compatible with Laerdal approved air sources CAUTIONS AND WARNINGS General Simulator Handling Take the following precautions to avoid personal injury or damage to the product Introduce fluids into the simulator only as directed in this document Failure to do so may result in damage to the simulator 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 simulator if the internal tubing and cabling is disconnected Never use the SimMom simulator outdoors in wet conditions as this may pose a shock hazard or damage the simul
38. rnum tabs 7 Reconnect hose to Y hose connector 8 Conceal puncture marks on the exterior of chest skin with wax a in the Bladder Replacement Kit 8 Return chest plate to proper position on torso 9 Replace chest skin over torso Secure skin at shoulders and back N 10 Conceal puncture marks on the exterior of chest skin with wax Replac ng the T horace ntesis in the Bladder Replacement Kit S Module E G lo nA the Pneumothorax Bladder trom 1 Remove chest skin from tabs at shoulders and back z midaxillary site right S 2 Remove the thoracentesis module from the midaxillary site of 2 1 Remove chest skin from tabs at shoulder and back the simulator left 2 Remove pneumo bladder insert from right side of torso l 3 Insert a new thoracentesis module a O 4 Replace the chest skin over the torso Secure the skin at the J shoulders and both sides see U O 4 a O 4 5 lt a9 U R 0 us ce C 2 Spare Parts 33 MAINTENANCE Rep ACI ng th e Abd om Nal S DA nN Note If the simulator is being used as a task trainer to demonstrate the position and movements of the baby you should remove the skin completely rather than folding it forward This SimMom is delivered with two Abdominal Skins normal and offers a better view of the perineum C section deliveries Note Skin may have a slight oily feel which is normal and a part of i i Sle eee Replacing the Perineum Birth Caution F
39. se a wig spray as lubricant 5 To wash the wig 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 Note Avoid excessive washing It shortens the lifespan of the wig 1 Remove tangles by gently brushing or separating the strands with your fingers 2 Filla sink with cool water Avoid using hot water as it may damage the wig 3 Pour two cups of synthetic wig shampoo into the sink Submerse wig into water Note Use only synthetic wig shampoo 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 5 Rinse wig with cold water Once all suds have been rinsed away let the wig dry on a bath towel overnight Note For best results let the wig soak for five minutes before washing 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 30 Replacing the Neck Collar Cricothyroid To attach cricothyroid membrane 1 Remove Neck Skin Collar by undoing Velcro strips on the back of neck Nad 2 Cuta two inch strip of Cricothyroid Membrane Tape 3 Adhere tape to edges of cricoid opening Ensure that tape covers and seals the opening S A 4 Place a Neck Skin Collar into molded track around neck
40. terus bag a Yellow denotes compressed air to pressurize urine reservoir rf o To replace the urine reservoir 1 Unhook reservoir cover retaining loop detach Velcro strap and A remove lid 5 2 Clamp urine reservoir outlet with sliding clamp 2 3 Detach urine outlet from urine connector tube by unlocking white Luer connector 3 Undo blue Luer connector from the blue bulkhead fitting n 4 Remove blood reservoir o 5 Lay new reservoir in position in reservoir bay with red filler cap E to the simulators right facing upwards m Y 6 Connect blue Luer connector to blue blood pump inlet bulkhead fitting fe 5 7 Ensure slide clamp is open lt 8 Replace urine reservoir 9 Replace reservoir lid 0 U ra 0 rus ev 2 Spare Parts F MAINTENANCE Replaci ng the Pelvis 8 Using a 7 16 wrench and a Phillips head screw driver remove the bolts on both sides of simulator 1 Turn the simulator over so that the backside is facing up 2 Using a Phillips head screw driver unscrew the access panel and remove 9 Separate pelvis from torso Note To prevent the bolts washers and nuts from getting lost v reattach them to the torso section 3 Locate the black electrical connector and two clear tubes and disconnect them 4 Disconnect the clear tubes by twisting the fittings weg 5 Disconnect the electrical connector by depressing the black button on the side of the connector 11 R
41. to tear Remove pelvic ring clamp and cervix see Maintenance Replacing the Abdominal Skin Lubricate the inside of the uterus Position the uterus on the pelvic clamping face The umbilical cord should pass through the birth canal Ensure holes on uterus flange locate with pins on clamping face and that notch for urinary connector locates with corresponding notch on pubis Fit indwelling catheterization bladder 7 Push pubic ring clamp over uterus and align with locating pins on clamping face nm 20 8 10 11 12 13 Ta 15 Ensure that all holes and notches are aligned and that the blood feed tube passes through the pelvic ring cleanly and without kinks Fit and tighten the three thumbscrews Connect the blood feed tube red Luer connector to the blood pump outlet red on the pelvic bulkhead Position support foam behind uterus Replace skin A few minutes prior to the scenario pull back abdominal skin and lubricate the outside of the uterus Replace skin and lubricate the birth canal and inside of the uterus Note Ensure that both the inside and outside of uterus are lubricated The degree of lubrication will dictate the ease with which the uterus can be pulled out and pushed back in To ensure a stedy trickle of blood when starting up scenario prime vagina with 200 250ml of blood MANUAL DELIVERIES Catheter Installation SimMom includes two types of urinary connectors
42. ual Deliveries 14 Fit the posterior birth canal fixing plate and secure with the two retaining screws 15 Turn the simulator upright 16 Locate the lower pubic clamp under the flap on the birth canal skin 17 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 Automatic Deliveries 20 Locate holes in birth canal flange on corresponding pins on pelvic clamping face 21 Replace urinary valve urinary connector and pelvic ring clamp 0 U ra 0 rus ev 2 Spare Parts 35 MAINTENANCE Replacing the Cervix 1 Remove the three black thumbscrews on the pelvic ring clamp 2 Remove the pelvic ring clamp Note When removing pelvic ring clamp lift so that it remains parallel with the pelvis until it is clear of the screws I t a 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 Pru Le h ahi 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 36 Replac ng the Pelvic Floor 1 Remove perineum birth canal pelvic ring and cervix See Maintenance Perineum Birth Canal Skin Replac
43. ugh A Caution SimMom and PROMPT Birthing Lubricant is not for 2 Connect umbilical cord to the baby personal use m 3 Fold umbilical cord and placenta in front of the baby Ensure that umbilical cord is covered by the placenta to prevent catching during delivery Place cradle and baby in OA position Make sure the bottom knob on the cradle is placed in the track Slide the cradle as far as possible against the bellow 44 eb ne 0 2 zo Q pb R O Ps lt 4 Slide on the lid 25 AUTOMATIC DELIVERIES Normal Occiput Posterior OP Breech Note Make sure all parts are thoroughly lubricated Note Make sure all parts are thoroughly lubricated 1 Place the baby in the cradle 1 Connect umbilical cord to the baby and fold the baby into breech position C Q 2 Connect umbilical cord to the baby 2 Place the baby s buttocks in the birth canal 3 Fold umbilical cord and placenta in front of the baby Ensure that umbilical cord is covered by the placenta to prevent catching during delivery Place cradle and baby in OP position Make sure the bottom knob on the cradle is placed in the track Slide the cradle as far as possible against the bellow 3 Place the placenta under the baby s chin Ensure that umbilical cord Is covered by the placenta to prevent catching during delivery 4 Slide on the lid 4 Slide on the lid 26 AUTOMATIC DELIVERIES der Dystocia S D 4
44. vements match each other Note Depending on the level of supra pubic pressure applied by the trainee the instructor may experience discomfort The instructor 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 z MANUAL DELIVERIES Cervix Cervix Installation 1 Fold back or remove abdominal skin see Maintenance Replacing the Abdominal Skin Caution Folding the skin downward without support underneath it may cause the skin to tear 2 Unscrew the three black thumbscrews around pelvic ring clamp Remove pelvic ring clamp from clamping face Note When removing pelvic ring clamp lift so that it remains parallel with the pelvis until it is clear of the screws Amniotic Bag Amniotic Bag Installation The amniotic bag is required during delivery simulations in which blood and or amniotic fluid will be used Note Prior to beginning simulation apply liberal amounts of EJ lubrication to the birth canal cervix baby bag and placenta if required This greatly eases delivery of the baby To connect the amniotic bag 1 Fold back or remove abdominal skin see Maintenance section Replacing the Abdominal Skin 3 Remove current cervix module if necessary and set aside a JJ me 2 Remove pelvic ring cl
45. yelash Do not depress the lashes Replacing the Neck Collar Cricothyroid Features Replacing the Arm Replacing the Pneumothorax Bladder Replacing the Thoracentesis Module Replacing the Abdominal Skin Replacing the Perineum Birth Canal Skin Replacing the Cervix Replacing the Pelvic Floor Setup Replacing the Urine Reservoir Replacing the Blood Reservoir 3 Drip a small amount of super glue onto a sheet of paper Dip the SOS E E tip of the toothpick into the glue RN Replacing Baby Limbs Replacing the Pupils SimMom is delivered with normal pupils installed in the eyes A separate kit included with SimMom contains plastic pupil inserts constricted and dilated Manual Deliveries 1 Using the suction cup tool provided in the kit or with the edge of your fingernail carefully remove the pupil from the eye 2 Replace the pupil with the desired insert using the suction cup tool or by gently pressing in place 4 Using the toothpick apply super glue sparingly along the top of the eyelash where rt meets the eyelid Automatic Deliveries 0 U rar 0 rus ev 2 Spare Parts 29 MAINTENANCE Wig Care and Upkeep When brushing the wig use combs and brushes that are specially designed for wigs If using a regular comb or brush ensure that rt has a rubber tip at the end of each bristle or tooth lo ease brushing and removal of tangles u
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