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1. Details Palette Lab Scenario Model Speech Log Gaumard Legend Clear Settings LoadPaletteitem Save as Palette Item Qo Got Airway Upper Airway Sound v Tongue Edema Breathing Resp Pattern v OSat m Left Lung Right Lung Respiratory Rate change Chest Rise Chest Rise e dida min Inspiratory Time EtCO2 Sounds Sounds o change mmHg J change Circulation Rhythm iv Sinus Arrhythmia Blood Pressure Absent Pulses BESA dear beste Ts Heart Sound Systolic Diastolic mmHg Radial Left Radial Right O change v O change Other cyanosis lew Seizures Eyes State v Level Pupils Enable Rxn o Temperature C CYERnSDIS RET Apply 30 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 F Systemic Urinary Catheterization HAL can be catheterized via exchangeable male and female genitalia To fill the urinary reservoir with liquid use the white urinary port located in his bottom rear shown below Copyright 2010 by Gaumard Scientific All rights reserved 31 Instruction Manual Pediatric HAL S3004 S3005 mL Bowel Sounds Details Palette Lab Scenario Model Speech Log Gaumard Legend Clear Settings Load Palette Item Save as Palette Item Qon Gor Arway Upper Airw
2. Decompression No performed Yes successfully 2 min timeout Wait 20 seconds for CPR Wait 30 seconds for Epi via ET Tube and continue CPR 194 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 Gaumard Simulators for Health Care Education Hypothermia zh Pediatric HAL Five Year Trauma Scenario A five year old boy wandered away from his parent s farm house in freezing temperatures He was found by a passing motorist curled in a snow drift He was dressed only in pajamas and his exposure time was at least four hours The motorist wrapped him up and drove him to the hospital Both External and internal warming 2 min time out Copyright 2010 by Gaumard Scientific All rights reserved 195 Instruction Manual Pediatric HAL S3004 S3005 Pediatric HAL Five Year Trauma Scenario Gaumard Alcohol Ingestion Simulators for Health Care Education Bradycardia and Hypoglycemia m A five year old boy wakes up early and is thirsty His parents had a party the night before and left glasses half full of mixed alcoholic drinks around the living room When the parents get up two hours later they find him asleep on the floor and smelling of alcohol They cannot wake him up so they call 911 Deliv
3. iwl Absent Pulses Heart ia muet Heart Sound Systolic Diastolic 5 mmHg Radial Left Radial Right change a O change is V Seizures x Eyes State Other Gene i Bi Level pecu Pupils Bowel Sounds Ti TT ec gju O EM Enable Rxn Time Ge R Enable Rin _ Apply G m NOW 10sec 30sec 1min 2min 5min 1000min nei Evaluation Care Provided Unsatisfactory Satisfactory Power remaining 00 00 00 l Session 00 48 04 Note lt Add to log Bes Copyright 2010 by Gaumard Scientific All rights reserved 43 Instruction Manual Pediatric HAL S3004 S3005 Automatic Mode Details Palette Lab Drugs Scenario Speech Log Gaumard yum Airway Appearance Tongue Edema Patient s Info Upper Airway Sound Seizures Rane eA Cyanosis Level Eyes Pupils CES aM L Enable Rxn Time sec Gender M R Enable Rxn z Height 80 0 cm Breathing Respiratory Pattern Lung Condition Weight 10 0 kg Respiration Pattern O2 Saturation End Tidal CO2 Infant is a Fes ra puo TL Dose jose MEM 202 u serenge healty 2 year old Mirren va osoz rei ova Total coe evel ja De volume ub m Left Lung Right Lung Chest Rise Chest Rise Sounds Sounds Note Auto means this vital is auto controled by model Click H button to hold this vital to Current
4. Incorrect action Correct action 216 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 M Gaumard Simulators for Healt Cars Education Drowning Boy A one year old boy falls into the pool and is found floating a couple of minutes later paramedics arrive the child is not breathing has severe cyanosis and he is in asystole Pediatric HAL One Year Trauma Scenario When the Wait indefinitely for ABCs CPR Meds Wait 20 seconds for Epinephrine Copyright 2010 by Gaumard Scientific All rights reserved 21 Instruction Manual Pediatric HAL S3004 S3005 Pediatric HAL One Year Cardiac Scenario Gaumard Second Degree Heart Block dd CE LM Mobitz Type I Wenkebach A one year old child was visiting his grandmother and was found playing in her purse She noticed her long acting propranolol bottle was opened and he may have ingested at least four pills about one hour ago She contacted poison control who told her to bring him to the hospital Glucagon 05 15mg kg bolus followed by an infusion No Yes Wait indefinitely for Atropine IV fluids pressors and high dose Epinephrine Wait indefinitely for pressor infusion to treat hypotension 218 Copyright 2010 by Gaumard Scientif
5. Prerecorded Speech My head hurts My name is Voice Recorder Streaming Voice Controls Rec Pediatric Hal Add ons Pediatric Features CPR Options Pacing Shock Tolerances cher General O SINGLE There is only one Pediatric in your facility n LTIFLE There is mare than ane A Pediatric in your facility Multiple Pediatric Setup Enter the Serial Number from the Pediatric manikin that THIS camputer will control SN2 on RF Module P Q000000 Cant Find Serial Number Autamatic Channel Change Select desired channel 1 Check noise in channel OK Cancel Copyright 2010 by Gaumard Scientific All rights reserved 107 Instruction Manual Pediatric HAL S3004 S3005 Streaming Voice Controls This button opens a new dialog box that is available to the user at all times Selections on that dialog box include Mute Listen and Talk Select Mute to stop the communication Listen to hear what providers are saying or Talk to speak to the providers as the manikin s voice Mute Listen and Talk controls are always available on the top right corner of the user interface gr Streaming Voice Output Gain Gaumard Mute Listen Talk Push toTalk Voice Recorder Voice Activation Headset Required Off s Siwe wem C LJ It is recommended that the instructor uses a headset to improve sound quality The headset also allows the user
6. 204 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 Pediatric HAL Five Year Systemic Scenario Gaumard Sinus tor Hed Cant Becton Status Epilepticus Mom calls 911 because as her son was falling asleep she noticed seizure activity of his arms and legs He had had short seizures with high fever when he was one and two This Time he had no fever and was well the entire day There has been no history of trauma He has been seizing for at least fifteen minutes Valium delivered over 5 minute followed by saline IV Yes Wait indefinitely For BVM Wait indefinitely for Lorazepam and Phenytoin Copyright 2010 by Gaumard Scientific All rights reserved 205 Instruction Manual Pediatric HAL S3004 S3005 Pediatric HAL Five Year Systemic Scenario Gaumard ls Simulators for Health Care Education Fire Victim A five year old boy is rescued by his father from a house fire He was found in his bedroom asleep The room was engulfed with flames and smoke His pajamas are charred and his face is burned and covered with soot His pajamas are removed to reveal his arm and torso are burned He inhaled a large amount of smoke during the fire Wait indefinitely for intubation IV access and bolus of normal saline at 20 cc kg Wait indefinitely for second bolus of
7. Wait indefinitely for switching IV fluid to Normal Saline Wait indefinitely for dopamine or dopbutamine drip 222 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 3 Tips on Creating Scenarios Thinking in Terms of Palette Items As described previously Palette items represent complete or partial groups of settings that have been stored as a single item We learned how applying partial states will hold constant all settings that are left unspecified Not only does it take time to customize the palette but a very large palette also becomes difficult to navigate So it is desirable to minimize the number of Palette Items in each Profile To accomplish this an experienced facilitator tries to create items that are as generally applicable as possible and can thus be applied to a wide range of scenarios The key is to only include in your Palette Items the settings that are directly related to the physiological event represented by that Palette Item Smart Scenarios After reading the Details Palette and Scenarios sections of this guide it should be clear how to build a scenario You may have already tried building your own or modifying some of the factory presets The following four guidelines will refine your ability to build the best possible scenarios 1 How will the scenario begin The first thing to consider is the initial condition o
8. Auto Log Settings a Modeling Patient This option allows you to create a new patient or load an already existing one Modeling Modeling Patients new patient Reset Model load patient netos Auto Log Settings recent patients Modeling Modeling Patients new patient Reset Model load patient inte Dwaen Peinte Auto Log Settings recent patients To create a new patient go to Modeling Modeling Patient new patient The following dialog box is displayed 150 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 New Patient New Patient Term weeks i MICIF Height EE Em Weight kg Other Cancel Enter the name of the patient age gender height weight and or additional notes Then click on Save To load an already existing patient go to Modeling Modeling Patient Load Patient Load Model Patient Select Patient Information Infant is a 1 year old male His height is 80 0 Bill cm His weight is 10 0 kq Brian Infant is a healthy 1 year old Load Cancel Delete Copyright 2010 by Gaumard Scientific All rights reserved 151 Instruction Manual Pediatric HAL S3004 S3005 Load Model Patient Select Patient Information Pediatric Pediatric is a 5 year old male His height is 108 0 cm His weight is 18 3 kg Pediatric is a healthy 5 year old Load Cancel Select the desired patient and cl
9. Automatic Mode In this mode vital signs respond automatically to caregiver participation instructor specifications and pharmacologic intervention The model used in this operating mode was developed based on physiologic principles Features unique to this mode include a comprehensive list of drugs for easy administration a drug profile editor for adding new drugs or editing existing ones among other things Pediatric H amp L Five Year Profiles Select Operating Mode Manual Automatic Profiles Profile Description Default Modeling Default Modeling Scenarios Meds Profile Quick Start Pediatric 1 Modeling Quick Stark Pediatric 5 Modeling Mew Profile Copyright 2010 by Gaumard Scientific All rights reserved 35 Instruction Manual Pediatric HAL S3004 S3005 The profiles available for the Automatic operating mode are Default Modeling When creating a new profile it is often useful to include the Default profile contents and begin customization from that foundation Meds Profile This profile contains over a dozen pre programmed drugs to be used on simulations Profiles are used to organize and protect software settings As you begin to customize Pediatric HAL QG it will become clear how profiles can best serve your needs For example e t may be appropriate to assign one profile to each user of your HAL system e Others may choose to create a profile dedicated to a specific academic course w
10. Q Right Lung FR dabsent Pulses Circa d m Other Temperature 37 0 C Heart Rate 85 bpm Q Left Lung ig Temp Vessel Stiffness dua i a Blood volume 1642 ml Heart Sound Preumothorax Eyes State R Has noma y O2 Sat 94 Yo Amb Pressure 1 00 ATIM Blood Pressure R T Pupils State Inspire O2 21 100 70 mmHg LEE Q EnabledRxn Inspire CO2 0 Absent Pulses EtCO2 40 mmHg FE Q EnabledRxn FP 4 39 Radia amp i rk Rxn Time 0 5 sec Shunt Flow 8 4 Cyanosis Dead Space 19 ml At all times the Status panel will be visible along the left edge of the Pediatric HAL software window The vital signs and other details of the simulated patient are shown here Most important are the battery and communication indicators at the top which are described in more details in the following sections The label of the active page is highlighted blue and specific controls undergoing changes will be highlighted in yellow 40 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 Clicking on the arrow button expands the status viewer so that both tabs are visible at the same time Status Airway The Airway section displays the current through sound and airway condition Breathing The Breathing section shows detailed information related to respiration Those parameters In parentheses are only a virtual vital signs that cannot be evaluated on the manikin The
11. ee Cae ae Check Far pulses E Intubation eval Intubation ewal ventilate ventilate n O2 flow m Interpret rhythm Trauma Care Seis Selllick s FRAO FBAO ee LS A M SSS Establish IV Spinal OLEM BURP OLEMjBURP Extubate Extubate ae I 000 Manage bleeding lud Log CPR Applied to Pediatric Details Reset the Model Model to Pediatric 00 00 Details HR 95 BP 96 57 RR 22 Inspire 37 OSat 91 EOZ 37 Temp 37 Model to Pediatric 00 00 Details BP 97 62 Applied to Pediatric Details Reset the Model Model to Pediatric 00 00 Details HR 85 BP 36 57 RR 22 OSat 91 1 Model to Pediatric 00 00 Details BP 37 52 The Log page consists of four different areas from bottom to top the text log provider action buttons team logging buttons and session info a Text Log This is the large panel at the bottom of the Log Page containing all the time stamped text entries Every event in a session is recorded as an entry in the Text Log The different types of entries are Actions Applied Changes Detected Events Evaluations Model and Notes 110 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 Actions Actions refer to those performed by one of the providers in the session The facilitator can quickly log actions from the Provi
12. Apply Approximate Time now 10 sec 20ee0 1mn 2mn hsmin 0100 8 Details Palette Lab Drugs Scenario Speech Log Gaumard Legend Qo eo Circulation Patient Status sy Heart Sound Osa Patient s Info ECG Name Infant Rhythm M T im Gender M Heart Rate Blood Pressure Age l y beats min mmHg Height 80 0 cm Auto Auto i i change n BP O ichange I Vascular Properties M E Weight 10 0 kg Absent Pulses Infant is a Radial Left Radial Right healthy 1 year old d Other Temperature Zz ec UL OUR LL O OLR Hemorrhage Wound Size es gj 9 ies Note Auto means this vital is auto controled by model Click H button to hold this vital to Current Apply Approximate Time hanow 10seo 2000e tmin hamin smin joo mn 44 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 Details Palette Lab Drugs Scenario Speech Log Gaumard Legend Clear Settings Load Palette Item Save as Palette Item Qo Got Q Model n Pause Reset A Cardiac Pat ent s Info r Right Heart Chambers Left Heart Chambers Name Infant Regurgitation Tricuspid Pulmonary Regurgitation Mitral Aortic er e
13. Education Supraventricular Tachycardia Pediatric HAL Five Year Cardiac Scenario 5 A previously healthy boy is brought to the ED According to his dad he has been acting tired and passed out today He said he feels dizzy and his heart jumps O2 De Can Valsalva livered Holding state for initial treatment options No changes to vitals nitial treatment options Speech Heart Jumping nula No 2 minute timeout Action taken None 2 minute timeout 2 adenosine doses Cardioversion BVM Intubation ardioversion Yes Copyright 2010 by Gaumard Scientific All rights reserved 203 Instruction Manual Pediatric HAL S3004 S3005 Pediatric HAL Five Year Systemic Scenario Gaumard Gram Negative Sepsis iri DO Perforated Viscous and Peritonitis A five year old boy with cerebral palsy is carried in to the ED by his foster father He is one of five foster children all with special needs He wears braces to walk and has speech and language delays He has been vomiting for three days and has been refusing to eat He has also been crying a lot He has no medications His foster father says he has to leave because his wife needs the car to go to work IV Fluids only Fluids and Antibiotics Perform Action Wait 45 seconds for IV fluids
14. Upon receiving the manikin connect the charger to the battery port Please charge for 2 3 hours or until the charger displays a green light S3004 Pediatric HAL One Year old Lv Use the battery indicator in the status panel to check the battery life Status cull Mil For more information about the battery indicator refer to Section III B 1 C Battery charge time is approximately 2 4 hours The charger indicator light will show red if the manikin is being charged Copyright 2010 by Gaumard Scientific All rights reserved 15 Instruction Manual Pediatric HAL S3004 S3005 A Warning Avoid using the simulator while the charger is connected If the manikin is being used and the charger is connected the charger slows down the discharge In other words it extends the battery life by making it longer to discharge However it will not charge the battery To charge the battery you must 1 If connected unplug the charger from the manikin 2 Turn off the simulator by turning off the GaumarduUI 3 Connect the charger to the battery port 4 Leave the battery charging for 2 3 hours Power Supply For the S3004 One Year Old only starting with serial number O1010084 Pediatric HAL is being shipped with a power supply and the modification enabling it which can sustain operations after the battery is fully charged Earlier serial numbers may have the option of sending HAL in for a power supply upgra
15. look listen feel 112 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 Breathing Breathing Circulation Assess breathing 4 Assess breathing Options Oz device E Oz device look lis Fen Feel O2 Flow LO Oz flow anterior auscultation posterior auscultation wheezing Rales ilansincaanalns abdominal auscultation Pallor Pallor axillary auscultation and the following entry is added 00 01 28 Action Ventilate look listen feel i The second special button gt allows pre programming common responses to specific actions For example the facilitator can pre program normal respiratory sounds and re enable the lungs when the provider performs a needle decompression Airway Airway Breatt Determine patency Determine patency Assess bre Open airway E asd s i Oddev O2 device Airway management Oz Flow Airway management Se SSS Intubation check Wheezi i R Intubation check E pae ventilate Fallor ventilate E I Extubate Response Extubate gt auo Z Medication OOO O O m m When the extubate button is clicked the following entry is created 00 01 28 Action Extubate cough Medications Manual Mode Only The Medication
16. ae I HN ae The facilitator then enters the dose and clicks on the Administered button and a log entry is created lets say the dose entered was 1 00 05 43 Action Medication Administered Epinephrine 1ml kg IVB IVP c Team Logging The Team Logging feature allows the facilitator to designate which member of the team 114 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 performed a particular action The Team Logging section Is right above the Provider Actions section on the Log page First the facilitator should add all providers in the team one by one by clicking on the Add button and filling the Add Provider dialog box Add Provider Name Charles Parker Color See OK Cancel As shown in the Log Page image at the beginning of this page a colored button is inserted on the Team Logging region for the provider just added There can be up to six different providers each with a corresponding button Every time one of the provider buttons Is clicked that person becomes the active provider To indicate the active provider the vertical bars on each side of the Log page will match the color chosen for that person On the Log Page image for example the provider Charles Parker is the active provider so the vertical bars are teal colored While there Is an active provider every time a Provider Action or Evaluation
17. All rights reserved 93 The Add New Medication window appears Add New Medication New Medication PT Description Unit uaimala Unit Other ug L ugkg O mg O mgg Og O gkg Route C Iv Push Topical Half Life 9 Precise Approximate Medication Response Ph 3 Under Dose LID Properties bul Iv Infusion JIM S5SubQ C Inhalation Peak Time min sec hr mir Sec very quick Smi Approximate wery quick lt Sm 1 9 Precise Threshold Apply Items Standard Dose sp High Dose Over Dose Properties Clear All Instruction Manual Pediatric HAL S3004 S3005 Drugs List Adenosine 4denocard Alprostadil Cayerject PGE1 Calcium Chloride CalFactant InsasurF D10w Dextrose 10 Water D1z _ SW Dextrose 12 5 Water D15wW Dextrose 15 Water Dobutamine Dobutrex Dopamine Intrapin Ephedrine Epinephrine Primatene Adrenalin Heparin Milrinone Primacor Naloxone Narcan Norepinephrine Levaphed Phenobarbital Sample IM Demonstration Sample Inhalation Demonstration Sample Iv Infusion Demonstration Sample Iv Push Demonstration Sample Per Oral Demonstration Sample SubO Demonstration Sample Topical Demonstration Sodium Bicarbonate Sodium MiEraprusside Mibropress MiErapr Edit Drug Delete Drug 3 Type the name of the drug under New Medication following this pattern Generic Name 94 Brand Na
18. Gaumard This software is protected by copyright laws and remains the sole property of Gaumard By installing the GaumardUI the Software media you agree to be bound by the terms of this agreement If you do not agree to the terms of this agreement promptly return the uninstalled media and accompanying items to Gaumard at the address indicated below 1 Grant of License Gaumard hereby grants to you an individual or institution the right to install and activate the Software on one computer for use with one Interactive patient simulator system The software may also be installed on any number of other computers at the same institution so that students may access the learning resources One copy of the software may be made for backup purposes You may not network this Software or allow multiple users unless you purchased a multi user workstation license Sharing this Software with other individuals or allowing other individuals to view the contents of this Software is in violation of this license 2 Copyright The Software is owned by Gaumard and protected by United States copyright laws and international treaty provisions Therefore you must treat this Software like any other copyrighted material You may not make this Software or copies thereof available in any manner or form or use copy or transfer the Software in whole or in part except as provided herein 3 Other Restrictions You may not rent or lease this Software to any other party
19. I e your computer tablet TCP Comm Setup If the communication has not been established please enter the IP address and port number selected on the controlling computer Gaumard Uli Premie Enter the IP and port selected on the controlling computer Controller IP 192 168 1 220 L Port 8001 Connect TCP Comm Setup If the communication has not been established please enter the IP address and part number selected an the controlling computer Gaumard li Premie Enter the IP and port selected on the controlling computer Controller IP 192 168 1220 EB Port leni 246 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 TCP Comm Setup If the communication has not been established please enter the IP address and part number selected on the controlling computer Gaumard Uli Premie Enter the IP and port selected on the controlling computer Controller IP On the GaumardUl click on Monitors then Configuration This option displays the monitor setup dialog box and also shows that the connection has been established od Premie H amp L Virtual Monitor Setup Select the number of monitors that will be used with this manikin Also You can name each monitor with an appropiate description use for Swan Ganz Adapter Local Area Connectior z refresh Controller IP 192 168 1 220 Port 8001 Connected to Stop
20. You may not alter merge modify adapt reverse engineer decompile or disassemble the software or disclose the contents of this Software to any other party 4 Electronic Transmission of Software If you received the Software by electronic transmission or by Internet delivery by installation of the Software you acknowledge that you have read and understand this license agreement and agree to be bound by its terms and conditions 5 Term of Agreement The term of this Agreement and the license granted to you pursuant hereto shall commence upon installation of this Software This Agreement and the license granted herein may otherwise be terminated by Gaumard in the event that you are in breach of any provision of this Agreement In the event of termination you agree to immediately return this Software accompanying items and any copies thereof to Gaumard 6 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 6 LIMITED WARRANTY A THE CD ROM MEDIA THE MEDIA WHICH CONTAINS THIS SOFTWARE IS WARRANTED FOR A PERIOD OF 30 DAYS FROM THE DATE OF PURCHASE TO BE FREE FROM DEFECTS IN MATERIAL AND WORKMANSHIP ELECTRONIC TRANSMISSION IS WARRANTED TO BE FREE FROM DEFECTS AT THE MOMENT OF TRANSMISSION YOUR SOLE AND EXCLUSIVE REMEDY AND GAUMARD S SOLE LIABILITY IS TO REPLACE THE DEFECTIVE MEDIA OR TO REPEAT THE ELECTRONIC TRANSMISSION PROVIDED THAT YOU NOTIFY GAUMARD IN WRITING OF SUCH D
21. at one time enable the Multi control button The palettes selected will be shown on the right panel Add Palette Item Transition min sec 0 0 59 59 Max Item Description Blood Test Wait Wait Indefinitely Copyright 2010 by Gaumard Scientific All rights reserved 6 Instruction Manual Pediatric HAL S3004 S3005 The Lab tab will allow the facilitator to include previously lab reports previously created in the User Interface Selected Item Edit Transition Remove Edit Transiton O etes e Duplicate tdtPaete After a palette is added you may select it to move it up and down from the list using the arrows You may also edit the transition time insert a new palette remove or duplicate the palette or check the properties using the buttons on the Select Item panel shown in the figure The buttons found on the top panel can be used to clear any palettes listed on the scenario page load or save a scenario program settings for electrical therapy and switch from linear to branching scenarios 68 Scenario Auto Responses Note Unlike the Non Scenario Auto Responses dialog box described in Section Ill C 2 c setting shock therapy to Auto does not convert the vital signs to a pre selected palette rather it advances the scenario to the next palette item Please note that it will only advance to the next palette if the shock is applied while a
22. ni S3005 EXW Two Year Extended Warranty Extended warranty for years Two AND Three S3005 INST In Service Training Day of In service training and installation S3004 001 A C Virtual Monitor A C Powered 17 Touch Screen monitor and desktop D C Powered 12 Touch Screen Mobile Monitor with S3004 002 D C Virtual Monitor A stylus 248 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 S3004 010 Battery C Rechargeable battery Saoson sateya R 100240VACbater charger wih label samoaoisfrowrcod PR Dark color upper left arm assembly with tethered BP 53004 053L D Upper LEFT Arm M with adaptor Light color upper right arm assembly with tethered BP S3004 053R L Upper RIGHT Arm M with adaptor S3004 081 Silicone Oil Oil based silicone lubricant Audio amp Video Recording S3004 200 A System Saxones revo R reao Hequency Module wih USB connector Wireless Streaming Audio S3004 300 U U Upgrade S3004 EXW Two Year Extended Warranty Extended warranty for years Two AND Three S3004 INST In Service Training Day of In service training and installation C Consumables R Replacements A Accessories U Upgrades M Replace in Miami Factory ONLY Copyright 2010 by Gaumard Scientific All rights reserved 249 Instruction Manual Pediatric HAL S3004 S3005 E Warranty EXCLUSIVE ONE YEAR LIMITED WARRANTY Gaumard warrants that if the accompanying Gaumard product proves to b
23. these simple steps onnect an Ethernet cable to the tablet PC BA Warning Do not change the network configurations of the tablet to connect it to your local wireless network Such changes will interfere with the proper operation between the tablet and your Copyright 2010 by Gaumard Scientific All rights reserved 1 5 Instruction Manual Pediatric HAL S3004 S3005 virtual monitor 1 Go to the Help menu and click on Check for Updates The Gaumard UI automatically Starts searching for available updates 2 If there is an available update the following dialog box is displayed GaumardUI Update Please wait while we check for new updates Current Version 1 19 8 0 Latest Version 1 19 10 0 There is a new update available for the GaumardUI if you wish to proceed please click the Install button to download the update and start the installation automatically Download Progress Click Install to begin the update The download progress bar begins to auto fill as the setup file is downloaded 1 6 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 Gaumardul Update Please wait while we check for new updates Current Version 1 19 8 0 Latest Version 1 19 10 0 There is a new update available for the GaumardUlI if you wish to proceed please click the Install button to download the update and start the installation automatically isl Ga
24. 0 00 normal values are for term neonates 0 00 0 00 31 00 31 00 normal values are for term neonates normal values are for term neonates Monos Basos 0 00 6 00 0 00 2 00 normal values are for term neonates normal values are for term neonates Eos 0 00 2 00 normal values are for term neonates 2 CRP C Reactive Protein Variable CRP mg dL Normal Range 0 00 1 00 Copyright 2010 by Gaumard Scientific All rights reserved 61 Instruction Manual Pediatric HAL S3004 S3005 First select a Lab Template from the drop down menu Edit Lab Report Lab Format Weonate Blood test Neonate Blood test Format Description OB Blood test Provide a Report Name Report Time and Description In addition select a condition color tag for the lab report on the right panel Color tags aid the sorting of lab reports on the report list window Lab Format Neonate Blood test For newborn and premie Format Description Report Name Alice s Baby Description Above Normal Range Hgb Hct Monos Eos Color s Q Healthy Care Report Time 11 56 Input the results of the tests on the Value column Values above the normal range specified will be displayed in bold Include any comments associated with the test performed 1 CBC with differential Variable WBC K uL Hgb g dL Hct 96 4
25. 167 Instruction Manual Pediatric HAL S3004 S3005 LIB Gaumard Scientific CPR Evaluator Trainer Ventlation Data Campression Data oon Rate imin Vent tme sec Camp ame sec Last Vent 00 00 31 Last Comp 00 00 31 dE Open this window when your students or providers are ready to start performing compressions Off and or ventilations Click the Trainer to On as appropriate When a ventilation or compression is detected the label ventilation or compression will blink one of three colors green yellow or red Green represents a correctly performed procedure yellow means that it was too sHALlow or ineffectual and red refers to an overly forceful compression or ventilation The examples below show the range of performance with the trainer frame prompts on 168 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 EE Gaumard Scientific CPR Evaluator VENTILATION Trainer Yerntilation Data Compression Data 3 Rate 60 min Low Vent tme 0 1 sec Comp time 0 7 sec Last Vent 00 01 50 Last Comp 00 00 00 Too Many ventilations 144 Mat Enough Compressions 1 E wr Ok 59 H S EE a a HE Gaumard Scientific CPR Evaluator VENTILATION Trainer Ventilation Data Compression Data 19 Rate 42 min Low vent ime O 1 sec Comp tme 1 1 sec Last Vent 00 02 39 Last Comp 00 00 00 Too Many ventilations 144 Mot Enough Com
26. 48 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 a Airway Breathing The first Details side tab see One Year Old Five Year Old contains controls related to airway appearance and breathing Note that e Some changes are gradual and even if one applies a new value now there is a small delay The delay results from using a closed loop model that adjusts to the target values over time rather than displaying a unique value that is unrelated to other parameters e Mild cyanosis is activated when the oxygen saturation is less than 92 and or the temperature is less than 35 C Values under these thresholds will cause the cyanosis to get progressively worse e Oxygen saturation can be changed by adjusting one of the following four parameters o Total O level oxygen reserve in the body o Shunt flow the percentage of deoxygenated blood in pulmonary capillaries o Respiratory pattern o X Airway construction Oz Saturation v change Total G2 level Shunt Flow Respiratory Pattern Airway Obstruction Click on the question mark button to view a brief description of the four options Doing so brings up the following dialog box Copyright 2010 by Gaumard Scientific All rights reserved 49 Instruction Manual Pediatric HAL S3004 S3005 Model is going to auto adjust Following parameters according to your Sat input Option 1 Total G2 leve
27. 911 Wait indefinitely for racemic epinephrine via inhaled nebulizer and face mask over 10 minutes Wait 15 minutes for hospital transport Real Time Wait 2 min Wait indefinitely for Racemic epinephrine O2 Corticosteroid Copyright 2010 by Gaumard Scientific All rights reserved 213 Instruction Manual Pediatric HAL S3004 S3005 Gaumard Pediatric HAL One Year Respiratory Scenario Simulators for Health Care Education Pneu monia amp u A You are called to a home where a one year old child is gasping forbreath His mother says he has had wheezing before and is being treated for baby asthma He saw his doctor last week and has been receiving nebulized Albuterol three times a day for one week Over the past few days his fever has increased to 39 1 Deg C his nose has become more filled with yellow mucous and he has had little to drink He is not taking any antibiotics Wait indefinitely for O2 via nasal cannula Wait indefinitely for BVM and prepare for endotracheal intubation 214 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 Pediatric HAL One Year Respiratory Scenario Gaumard i I Simulators for Health Care Education Pneumonia With Septic Shock E You are called to a home where a one year
28. E E E 110 BU MU MT T 110 b uueues gei s T H 117 CE Teo og lih esesnenvmUnE E UI MUMUIUEU EDEN 114 9mo eogijo 115 OE ee a M 116 PR a 117 I S E E E ee eee 117 S LO E E ee E E 117 SME EE E 6 A A A A A A A A A 118 c Reset session ClOCK cccsccscsssssesssnssssssssssssssesceeasscscesssssscsneusasscscsuessaseseneaeaseseeusasassceueasaseceneusaseseneueasaseceseneess 119 s i 2 DO T YY 119 E lean 0 0 eee ee ee ee immu 127 iM 0100 T 122 EE I m 124 E E 126 2 Ue E E iinet oinontn 127 MEE ee 127 i Chest Compressions Artificial Ventilations sse 128 BIOO Pie Ss Une GUI s cncaumonEHIMEDnUHEPURURUNIIFUEEDIEUPUBUUHERURIERDBIENU RU UNE DAD 131 UM MS aS e E E E 133 ED CODO IS expo RERUM A EAE AA A DURUM MN MENU UND NOD NE eU A 134 L lei 109 623 9 PNE R 135 Ile LOTT O R 136 Copyright 2010 by Gaumard Scientific All rights reserved 3 Instruction Manual Pediatric HAL S3004 S3005 JN Pediatmit AALO OO ONS atcegacnccceeneeeuern
29. Gaumard Scientific 14 00 SW 136 Street Miami FL 33196 5691 USA Office hours Monday Friday 8 30am 4 30pm EST GMT 5 4 Summer Time 252 Copyright 2010 by Gaumard Scientific All rights reserved
30. Go to 3 nterventions OK Cad The facilitator can edit the time limit and the Go to node by clicking the timer T2 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 Path Controls iz co Once a path is opened for any node you can edit copy or delete the path using the buttons below Edit E This button allows you to add remove or change the order of actions in a specific path _ A Clicking on this button also enables you to select where the scenario should go after the path is finished playing Copy This button allows the user to copy the entire path You can paste it to a different node or paste it in the same node to duplicate it Delete Se m Sy This button allows the user to delete any undesired path a c Scenario Controls Scenarios are controlled from the buttons at the bottom of the Scenario page The same way a music player plays songs the Scenario plays palette items Intuitively the facilitator can play Stop pause skip or repeat items as appropriate The Scenario Position Indicator points to the current item and shows the current status of the scenario The following paragraphs describe in detail the behavior of each button and indicator The Scenario Position Indicator An unfilled triangle means that the scenario is stopped When the Play button is clicked the item pointed by the indicator is
31. MB Adenosine LID NB Adenosine OD NB Adenosine 5D E Standard Dose MB Adenosine SD Scene NE High Dose MB Adenosine SO MB Alprostadil OD eee t A NB Alprostadil SD Over Dose MB Adenosine OD 4 Properties 8 Specify the units for the threshold and type the threshold quantity for each dose effect Threshold I 4r a 2 D AME E Copyright 2010 by Gaumard Scientific All rights reserved O7 9 After completing the drug profile click Add 98 Add Mew Medication New Medication Description Used to show how to set up a new drug in the software Unit ug ml Unit Other lug L ugkg O mg v mgkg Og O akg Route IvPush IvInfusion CO im C SubQ Topical Per Oral Inhalation Peak Time ET Log min Ser e Approximate Threshold Apply Items mg ME Adenosine UD Half Life 9 Precise Approximate Medication Response Asystale Adenosine Under Dose Under Dose Calcium Chloride OD Calcium Chloride SD manm Standard Dose MB Adenosine SD Calcium Chloride LID LK High Dose ME Adenosine SD CalFactant SD Calf actank UD Over Dose NB Adenosine OD Properties Edit Palette Clear All Replace Cancel Note e button labeled Manage Drug List Instruction Manual Pediatric HAL S3004 S3005 Drugs List Adenosine 4denocard Alprostadil Cayverject PGE1 Calcium Chloride CalFactant Insasurf DOW Dextrose 10
32. N A needa 178 PAG II eps dr E E T asatasesenasaencasesesnactenconeead 181 A Overal cls allals e ee ae a eae te ee ae ne eee ee 182 oem al sceid ers WA esc Ae eee nn nee ee ee 185 NN 1D 187 P More ADOBE DS CCMA DSi n REID MEE IIIMINERUPUEUHERUNEREHEIMERU UU MEM 188 1 Quick Start Pediatric 5 S3005 Factory Preset Scenarios sese 189 2 Quick Start Pediatric 1 53004 Factory Preset Scenarios sese 210 3 Tips on Creating ea i6l2 gic ld cmm cm 223 E PIIe SIFUCIUEB eT E E E E 226 4 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 epre Ie e DOUG oes auus E EE EE P E EE E A P MUR MUI MIN ee 228 1 General Troubleshooting Guide sese rennen rare te tenete setas ae se rase te sese sa rosas soi 228 ZEB o T 232 3 Microphone Boost for Streaming Audio sse nennen 235 A COMME CHinG tO Tie auntie GC WOMM OS setae m 238 D Consumables Replacements and Optional Parts sees 248 zd 250 Sopa T s 252 Copyright 2010 by Gaumard Scientific All rights reserved 5 Instruction Manual Pediatric HAL S3004 S3005 End User License Agreement This is a legal agreement between you the end user and Gaumard Scientific Company Inc
33. Network Connection Properties dialog box under Preferred networks Find the Internet Protocol TCP IP inside the selection box labeled This connection uses the following items Highlight it and click the Properties button L Wireless Network Connection Properties x General Wireless Networks Advanced Connect using E Intel PRO Awireless LAN 2100 34 This connection uses the following items AEGIS Protocol IEEE 802 1 v2 2 1 U YT WLAN Transport Internet Protocol TCP IP k Install Uninstall Properties Description Transmission Control Pratacal Intermet Protocol The default wide area network protocol that provides communication across diverse interconnected networks vw Show icon in notification area when connected M Notify me when this connection has limited or no connectivity 8 The Internet Protocol TCP IP Properties dialog box is displayed Set the IP address for this computer Make sure you select Use the following IP address then in the IP address option input the following Computer 1 1 0 0 1 Computer 2 1 0 02 Computer 3 1 0 0 3 And so on Make sure all the IP numbers have the same number for the first three digits and make sure the last one is different Example of IP addresses that will NOT communicate with each other Computer 1 1 0 10 1 Computer 2 1 0 02 242 Copyright 2010
34. Pediatric HAL S3004 S3005 c Reset session clock Setup Monitors CPR Profile New Session Reset Session Clack Save Report Print Report Import Export ExiE Clicking on Reset Session Clock resets the clock back to zero It does not have any effect on the transition time remaining on a scenario it does not reset the vital signs or clear out loaded scenarios The session clock may also be reset by clicking on the Session button next to the Session time Clocks Transition remaining 00 00 00 d Save Report Setup Monitors CPR Profile Mew Session Reset Session Clack Save Report Print Report Import Export ExiE Copyright 2010 by Gaumard Scientific All rights reserved 119 Instruction Manual Pediatric HAL S3004 S3005 This option allows all the information recorded in the log page to be saved as a text file Clicking on it brings up the Save As dialog box Save In di 3aumard User Interface v zi EP ii m Automatic 4 installationFiles My Recent di Labs Documents di manikins di my recordings dJi network di profiles profiles di Fesources di ryms biy Documents My Computer File name Mu Network Save as type Select the desired name and path and click Save 120 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 The shortcut key for saving a report is Ctrl S For a sample
35. Properties E Weight 18 3 kg Absent Pulses Pediatric is a Radial Left Radial Right PedalLeft Pedal Right healthy S year old Bowel Sounds Other Temperature eC uL O Our BOO Hemorrhage Wound Size a Note Auto means this vital is auto controled by model Click H button to hold this vital to Current Apply Approximate Time 46 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 Details Palette Lab Drugs Scenario Speech Log Gaumard Legend Clear Settings Load Palette Item Save as Palette Item Qo of Q ModelOn Pause Reset A Cardiac Patient s Info 7 TN m B Right Heart Chambers Left Heart Chambers ame Pediatric Regurgitation Tricuspid Pulmonary Regurgitation Mitral Aortic ender i Resistance v v Resistance v v Age 5 y o Contractility pa RV o Contractility 4 E LV niri 108 0 cm Eg normal 100 REN normal 100 i Weight 18 3 kg Pediatric is a Circulatory Blood volume ml Cardiac Irritability d healthy 5 year v Vascular Properties old vessel Diameter v Vessel Stiffness v Resp ratory Shunt flow 96 Dead Space rm Prt Environment ambient Pressure ATM Inspired Air Mix 02 CO2 New Load Note Auto means this vital is auto cont
36. RR 30 Normal pupils NSF can talk Other Status epilepticus 5 Patient recovers after Favorable response to medication vFib 3 all vitals are set to a healthy state VFib recovery Patient recovers after Favorable response to shock VTach recovery Patient recovers after Favorable response to shock Selected Item 66 Oe Sat Edit Alcohol Ingestion 2 HF 80 BP 90 over 60 RR 25 OZ Sat 96 Temp 36 6 Deg C Apneic girl 2 sinus bradycardia Osat improves i Aspiration aspiration of Foreign body Properties Aspiration aspiration of Foreign body v Apply e NOW 40sec 30sec Amin 2min 5min 10 00min Apply Palette Items using the buttons at the bottom of the page exactly as changes to Pediatric HAL condition are applied on the Details page Change Pediatric HAL vital signs and symptoms instantly by clicking to select a Palette Item and clicking the NOW button Or create a gradual transition in physiological state with one of the other Apply buttons Palette Items can be sorted with the View buttons found on the right side of the page Editing existing Palette Items is as simple as selecting the item you wish to modify and clicking the Edit button You will be automatically be taken to the Details page and the settings that comprise the selected Palette Item will be displayed Change them as desired and click the Save as Palette Item button Copyright 2010 by Gau
37. Right Bowel Upper Left Bowel Lower Right Bowel Lower Left Pressure BP Right Q BP Left Ventilation Compression Compressor Extra Compressor S3005 Throat voice Throat Streaming Heart Lung Front Upper Right Lung Front Upper Left Lung Back Upper Right Lung Back Upper Left KK Right KK Left Bowel Upper Right Bowel Upper Left Bowel Lower Right Bowel Lower Left Pressure BP Right Q BP Left ventilation Compression Compressor Mechanical Other Tongue ECG Trachea Intubation Carotid Eyelids Radial Right Q Right Pupil Dilation Radial Left Q Left Pupil Dilation Femoral Cyanosis Lung Right Q Lung Left Q Breathing Q Right Side Seizure Left Side Seizure Mechanical Other Tongue ECG Trachea Intubation Carotid Eyelids Radial Right Q Right Pupil Dilation Radial Left Q Left Pupil Dilation Femoral Cyanosis Lung Right Lung Left Q Breathing Q Right Side Seizure Left Side Seizure Right Index Bleeding Copyright 2010 by Gaumard Scientific All rights reserved Legend Q Active Q Inactive Check Modules Check Single T TANA check All Modules Check ali volumes Legend Active Q inactive Check Modules Check Single check All Modules Instructi
38. Stiffness Option 2 Heart Rake and vascular Properties if necessary Option 3 LV contractility and vascular Properties if necessary Option 4 Total Blood volume and Vascular Properties if necessary There is a control on this page that is unique to the modeling mode Patient status Selecting one of the two available options affects heart rate temperature respiratory rate tidal volume metabolism rate and carbon dioxide formation rate indirectly Circulation Patient Status Click on the question mark button to view a summary of the parameters that will be affected by selecting one of those two options a Model is going to auto adjust following parameters according to the Patient State E Option 1 Resting Skate normal settings Option 2 Excited State after exercises Increase Heart Rate temperature Increase Respiratory Rate Tidal Volume Increase Oz and CO diffusing capacity Increase metabolism rate and CO Formation Rate 5 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 c Advanced The last Details sidetab is the advanced tab see One Year Old Five Year Old It includes cardiac circulatory and respiratory advanced controls This page gives you more control over the model by allowing you to edit additional parameters that have an effect on the cardiovascular and respiratory systems Use this page If you want to add comple
39. The connection configuration will be saved allowing the communication to start automatically next time you start the software Copyright 2010 by Gaumard Scientific All rights reserved 241 Instruction Manual Pediatric HAL S3004 S3005 D Consumables Replacements and Optional Parts Contact Gaumard Scientific for a complete list of consumables and replacement parts and their prices S3005 001 A C Virtual Monitor A C Powered 17 Touch Screen monitor and desktop D C Powered 12 Touch Screen Mobile Monitor with S3005 002 D C Virtual Monitor A stylus S3005 011 Battery Charger OR 100 240 V AC battery charger with label S3005 029R L I O Leg Skin Cover Light color skin cover for right leg tibia bone S3005 031 I O Tibia bones C I O leg tibia reservoir bones Dark color upper left arm assembly with tethered BP 53005 053L D Upper LEFT Arm with adaptor Light color upper right arm assembly with tethered BP 59005 053R L Upper RIGHT Arm S3005 081 Silicone Oil C Oil based silicone lubricant with adaptor Audio amp Video Recording S3005 200 System 53005 206 RF Module PRO Radio Frequency Module with USB connector 53005 223L L Lower Left Arm Reveining Lower left IV arm reveining light color 53005 223R L Lower Right Arm Reveining Lower right IV arm reveining light color S3005 300 Wireless Streaming Audio Wireless streaming audio feature Wireless Streaming Audio S3005 300 U Upgrade Adult PEDIATRIC 5YO Demo S3005 DEMO n
40. causes the scenario to pause at that point until the facilitator manually advances to the next item One can manipulate the scenario items with the Selected Item group of buttons on the right side of the page Most of these functions are also available by right clicking on scenario items When using the stylus hold the stylus button and tap the screen to do a right click Palette Items may also be created by editing the settings on the Details tab and choosing Save as Palette Item As long as it was either created in or exported to the current profile it will appear on the Add Palette Item list Not every field has to be populated in order for a Palette Item to save When all the palettes have been selected and ordered click Save Scenario The scenario may be run immediately click on the Play button Watch the vital signs adjust according to the specifications of each palette item Note There are a few important things to remember when creating your own scenario in the automatic mode 86 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 If you select an inconsistent combination of vitals the model does not adjust to the specified values The model is based on accurate physiologic principles and therefore choosing a combination of vitals that is inconstant with these principles will not deliver the appointed results To observe pneumothorax make sure that
41. click Add node near the bottom of the page ech D Save Sear Go to Normal Scenario hd Node Name 1 Time mit gt End 2 Node Name 2 Time imit Bb End Copy Remove Addpath gt Addnode p gt E 0 a Mh To edit the node name and description click the node s Unique Identifier number Node Properties Unique Identifier p Name Start Bradycardia Description Bradycardial Click Save to apply changes 70 Copyright 2010 by Gaumard Scientific All rights reserved Adding Palettes or Scenarios Instruction Manual Pediatric HAL S3004 S3005 HEN cr Clear Save Scenario Load Scenario Go to Normal Scenario ai med E ub uie ri dd a Time limit E Copy Remo Additem Add Scenario w End Click Add Item to add specific palette items or Add Scenario to add full scenarios to this node Node Description 2 Deteriorate pt Wait No changes are made to manikin Speech 1 01 confusion What happened Cardio Drop 1 00 HR 15 BP 10 OSat 5 Minen addscenio S co Renove addoath gt In this example the following nodes will be created 1 Start Bradycaraia 2 Deteriorate 3 Interventions 4 Atropine 5 Epinephrine 6 Dopamine and 8 Pace Each node has been programmed with specitic palettes Adding Paths After all the nodes are created it is necessary to
42. create paths or branches To add a pathto a node click the Add path button Use the Edit Path window to name rename sort and create your key events In this example the facilitator will administer atropine Key events Selected A Move v om ji Go to End ok Cancel Name the key eventthen click Add Copyright 2010 by Gaumard Scientific All rights reserved 1 Instruction Manual Pediatric HAL S3004 S3005 After adding the key event use the Go to drop down menu to designate the corresponding node Key events Atropine Selected A Move v Po Jii Go to 4 Atropine 1 Start Bradycardia 2 Deteriorate 3 Interventions 4 Atropine 5 Epinephrine 6 Dopamine 8 Pace The facilitator added a total of four paths to Node 2 Deteriorate Atropine Epinephrine Dopamine and Pace The paths are activated by the key events previously programmed 2 Deteriorate Node Description m Wait 02 00 No changes are made to manikin C Atropine Speech 1 00 01 confusion What happened Cardio Drop 01 00 HR 15 BP 10 OSat 5 o Epinephrine Additem addscenario Copy Remove addpath 1 gt If no key event is selected by the time the last palette expires 0 01 O Dopamine ka LJ the scenario will move on to the palette indicated by the timer and arrow Set Time Lirnit min Sec ig 59 59 Max
43. detected at all Is the respiratory rate set to 0 min Chest compres sions are only detected when the respiratory rate is set to 0 per minute 0 min Otherwise they are ignored All others 230 Instruction Manual Pediatric HAL S3004 S3005 Solution Get simulator closer to computer or move away from obstructions Try changing the RF channel by going to the menu for Setup gt Options gt Environment gt Select Auto change to channel number from 1 11 Plug charger for all others including Connect the RF module to any USB port Close the software and try discon necting the RF module for at least five seconds then plug it back in and restart the software See solution above in section making reference to blinking com munication indicator is consistently yellow Set respiration rate to zero See Calibration Wizard section inside Users Manual Copyright 2010 by Gaumard Scientific All rights reserved Symptom Possible Cause Artificial ventilations Is the communication indi are not properly cator panel consistently detected or not yellow detected at all All others Simulator s chest Simulator not running does not rise with artificial ventilation e g BVM eg Disable lung s Low chest rise or no Wrong settings or disabled chest rise at all while lungs breathing Loss of brachial Brachial pulses disabled pulse Pre built scenarios don t show up A
44. even more realistic It allows the instructor to hear everything the providers around the simulator are discussing At the same time the instructor and provider can interact as if the instructor were the patient The instructor will also be able to record his or her own speech phrases that can be used at any given time or within a scenario The streaming audio is located on the Speech Tab of the GUI Details Palette Lab Model Scenario Speech Log Gaumard Voice Recorder Rec Streaming Voice Controls Prerecorded Speech More 106 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 A Warning You must have the GUI environment set on multiple manikins with your simulators serial number specified To do so go to Setup Options and click on the environment tab Options OneYearOld Hal Add Ons Onevearold Features CPR Options Pacing Shock Tolerances Obher General SINGLE There is only one OneYeardld in your facility C ds There is more than one fiie vearOld in your facility Multiple OneYearold Setup Enter the Serial Number from the OneYearOld manikin that THIS computer will control SN2 on RF Module O 0000000 Cant Find Serial Number Autamatic Channel Change Select desired channel Check noise in channel OK Cancel Details Palette Scenario Lab Speech Log
45. for simulating common medical emergencies For many applications the Default profile is a convenient starting point that can be customized to fit your particular simulation objectives Notice that there are a number of options when creating a new profile You may choose to include the contents of the Default or Quick Start Scenarios profiles or to copy the contents of an existing profile For security you can enable PIN protection which will require the user to enter a four digit key before loading that profile For more detail on manually manipulating profiles with Windows Explorer advanced users should refer to the File Structure appendix at the end of this guide Copyright 2010 by Gaumard Scientific All rights reserved 37 Instruction Manual Pediatric HAL S3004 S3005 Create New Profile Profile Name PIN pg eal SEPSI security Profile Description Enter FIM Re Enter PIM Include contents of Default Profile Include contents of Quick Start Pediatric HAL OR rm Copy current profile Create Cancel For more detail on manually manipulating profiles with Windows Explorer advanced users should refer to the File Structure appendix at the end of this guide 38 Copyright 2010 by Gaumard Scientific All rights reserved B The Environment 1 Status a The Status Panel 3004 Pediatric HAL One Year Old Manual Mode Instruction Manual Pediatric HAL S3004 S3005 Automatic Mode Sta
46. is NOT selected By selecting this option it ensure the computer does not try to connect to and access point within the facility the computer will only try to connect to registered ad hoc connections Click Close Networks to access C Any available network access point preferred C Access point infrastructure networks only Automatically connect to non preferred networks Close Click Add on the Wireless Network Connection Properties dialog box The Wireless network properties dialog box is displayed Here is where the wireless network will be created On the Network name SSID type the desired network name Network names are case sensitive so ensure it is typed exactly the same on any computer to which connection is attempted Example network names HalNet NoelleNet GaumardNet Ensure the Network Authentication is Open and the Data encryption is Disabled Click OK Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 Wireless network properties Hetwork N ame ETATIS Ren Gri re ms Key EW Indes advance ES IY The KEW IS Provided for me automatically Ive Thisis a CoMmputer to computer arn hoc network wireless SPOILS ame rat used LO Cancel Copyright 2010 by Gaumard Scientific All rights reserved 241 Instruction Manual Pediatric HAL S3004 S3005 7 The new network now appears on the Wireless
47. levels of anticonvulsants ailure Normal CT Scan spinal fluid and electrolytes A one year old child was visiting his grandmother and was found Second playing in her purse She noticed her long acting propranolol bottle Degree Trauma was opened and he may have ingested at least four pills about one Block hour ago She contacted poison control who told her to bring him to the hospital she knows something is wrong and takes him to the ED A young mother brings her baby to the ED She says her baby was Sinus crawling on the floor and put something in his mouth and swallowed it Tachycardia about an hour ago You notice the mother is thin jittery with open sores on her face and arms You consider the ingestion may be a stimulate You are at a birthday party where you see a one year old trying to blow up a balloon Instead of blowing out he sucks the balloon in and begins Toy cri Respiratory gasping for breath He is turning cyanotic and cannot cry You assess spiration j his airway is obstructed and the obstruction must be removed You try Shak A young mother returned from her night shift to find her one year would aken not wake up when she went to check on him Her boyfriend said he Baby Trauma was probably just sleepy because he had cried a lot the night before Syndrome simple measures as back blows and chest thrusts and activate EMS 80 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Ma
48. old child is gasping for breath His mother says he has had wheezing before and is being treated for baby asthma He saw his doctor last week and has been receiving nebulized Albuterol three times a day for one week Over the past few days his fever has increased to 39 Deg C his nose has become more filled with yellow mucous and he has had little to drink He is not taking any antibiotics Wait indefinitely for O2 via nasal cannula Wait indefinitely for intubation Wait indefinitely for Antipyretic Glucose Calcium and electrolytes Isotonic fluid bolus Antibiotic stat Wait indefinitely for bolus of isotonic fluid Wait indefinitely for dopamine or dopbutamine drip Copyright 2010 by Gaumard Scientific All rights reserved 215 Instruction Manual Pediatric HAL S3004 S3005 Pediatric HAL One Year Trauma Scenario Gaumard simulans for Healt Cars Edicion Shaken Baby Syndrome A young mother returned from her night shift to find her one year would not wake up when she went to check on him Her boyfriend said he was probably just sleepy because he had cried a lot the night before She knows something is wrong and takes him to the ED Elevate head 30 degrees Intubation and IV access draw appropriate labs Request emergency CT of the head and a neurosurgical consult IV fluids with normal saline and low dose mannitol to help reduce intracranial pressure
49. sound is absent or Volume not set to user s is not heard at criterion desired volume level Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 Solution See solution above in section making reference to blinking com munication indicator is consistently yellow See Calibration Wizard section inside Users Manual In some simulators the trachea Is disconnected from the lungs when they are not on Enable the lungs from Detail page on the GaumardUI software Make sure lungs are enabled and both respiration rate and inspiration percent are different than O Try changing the respiration rate to a different value and if still nothing happens try turning the manikin off and restarting everything to make sure the internal air compressor gets its initial settings Make sure to enable brachial pulse on Details tab page Select Quick Start Scenarios when starting the software Should user forget to do so there s no need to shut down the software and open it again in order to load the pre built scenarios Go to File Profile menu and then select Modeled Scenarios Every sound has a volume control Play with the volume control to get it to the desired level 231 2 Diagnostics Instruction Manual Pediatric HAL S3004 S3005 The Diagnostics dialog box can be accessed by going to the Help menu and selecting Diagnostics This dialo
50. the state of Pediatric HAL The model speed can be controlled through the Model warp factor which goes from 1 to 5 1 representing real time Details Palette Lab Model Scenario Log Gaumard Physiological Modeling State Madal ratai PAUSE physiological oxygenation modeling Modeled Therapy i Improve Gain Reset OQ IMPROVE adequate oxygen perfusion breathing J 7 DETERIORATE compromised oxygen perfusion apnea ie jmd Oxygen nn Epinephrine mug Administer Healthy Mild Cyanosis Severe Cyanosis dose onboard men mgka m CPR Monitor Effective Min HF Max ventilation Range 30 VENTILATION COMPRESSION Sy c M J E C C F cc CT col e c n im C Physiological Modeling State Pause Model will pause at the current state Improve Model trend to a healthy state Once the model reaches the complete Healthy state the model will go to Pause mode Deteriorate Model will trend to a severe cyanotic state If ventilations given to the neonate are of correct depth and between 40 and 60 per minute the vital signs will improve Otherwise they will continue to deteriorate 102 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 Cyanosis Levels The facilitator can quickly jump to any of the 3 points in the state of the model Healthy Pedi is pink with adequate oxygenati
51. to use the Voice Activation so that at any time the instructor wishes to speak it is sent directly to the manikin without user intervention The voice activation threshold can be adjusted The Mic Threshold is used to adjust how sensitive the microphone is to the user s voice The higher the threshold the less sensitive the microphone is and vice versa For instance if the threshold is set to high users must speak loudly for the microphone to detect the audio Voice Clarity To achieve better clarity e Verify that the physical MIC control on the headset is set to high e Enable Microphone boost from the Windows setting e Use the Output Gain to increase the microphone volume as a last resource To raise the output gain in increments tap and hold the control then slide to the desired level Voice Recorder Voice Recorder The instructor is able to record his her own speech phrases Rec at any time Once the instructor clicks on the Rec button the software automatically starts capturing everything that is said into the microphone 108 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 Press Stop to finish recording Use the Enter Audio Name window to name the speech phrase Enter Audio Name Enter a name and click OK The phrase will now be accessible under the Prerecorded Speech menu Prerecorded Speech On this section the
52. wait indefinitely palette is being played Scenario Brent automatic responses settings All Off All Auto External Pacing off C Prompt C Auto setting Capture at mA to paced rhythm Defibrillation Shack off C Prompt Auto setting at 2005 Joules C Shocks advance to next scenario item when at INFINITE WAIT Display warning when non shockable cardiac rhythm is shocked Cardioversion Shock C off C Prompt S Auto i Setting 4 WC ue w at Joules Shocks advance to next scenario item when at INFINITE WAIT OK Cancel E Non Sync Shock v off C Prompt C Auto Setting at 100 Joules C Shocks advance to next scenario item when at INFINITE WAIT Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 b Branching Scenarios The branching scenario is an advanced linear scenario editor It allows the user to branch towards different scenarios palettes depending on specific Key Events activated by the instructor To access the Branching window click on the Go to Branching Scenario button on the Scenario tab Similar to the linear scenario page the buttons on the top panel can be used to clear load and save a scenario or to switch from branching to linear scenarios Details Palette Lab Scenario Speech Log Load Scenario Save Scena
53. water Diz SW Dextrose 12 5 Water D15w Dextrose 15 Water Dobutamine Dobutrex Dopamine Intropin Ephedrine Epinephrine Primatene Adrenalin Generic Brand name Heparin Milrinane Primacor Naloxone Narcan Norepinephrine Levophed Phenobarbital Sodium Bicarbonate Sodium Mitraprusside Mitropress MiErapr Delete Drug You can edit the drug profile of any of the drugs To do so click on the Select the drug you will to edit and click on Edit Drug Make the desired changes and click on the Replace button to save them e You can view alist of all palettes by clicking on the Palette tab From this page you can also view the properties you selected for each item To do so highlight the desired palette and click on properties on the left side column under Selected Item Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 Details Palette Lab Drugs Scenario Log Gaumard Newborn Name Description APGAR 10 2 P 2 G 2 gag cough sneeze A22 R 2 VIEW APGAR 7 A 1 P 2 G i coughs A some tone R 2 Sort by Name APGAR 8 amp 1 P2z G l icoughs 2z R z APGAR 9 A 2 P 2 G lfcoughs A22 R 2 Heat APGAR 4 4 0 P 2 G lirespond ta patin 0 R 1 Care Required APGAR 5 amp P 2zi G lirespond to patini 4 1 some tone R 1 Critical APGAR 6 4 amp 1 P 2 6 ifrespond to pa
54. with copies of 1 the original bill of sale or receipt and 2 this limited warranty document to Gaumard at 14 00 SW 136 Street Miami FL 33196 5691 USA 3 Ifthe necessary repairs to the Gaumard product are covered by this limited warranty then the first purchaser will pay only the incidental expenses associated with the repair including any shipping handling and related costs for sending the product to Gaumard and for sending the product back to the first purchaser However if the repairs are not covered by this limited warranty then the first purchaser will be liable for all repair costs in addition to costs of shipping and handling Extended Warranty In addition to the standard one year of coverage the following support plans are available e Two Year Extension covers second and third years Call for pricing USA only Copyright 2010 by Gaumard Scientific All rights reserved 251 Instruction Manual Pediatric HAL S3004 S3005 F Contact Us If you have read this user s guide and still require assistance it s easy to reach us E mail Technical Support support gaumard com E mail Sales and Customer Service sales gaumard com Phone Toll free in the USA 800 882 6655 Worldwide 01 305 971 3790 Note Before contacting Tech Support you must 1 Have the manikin s Serial Number located in the left leg under the IM site 2 Be next to the simulator if troubleshooting Is needed Fax 305 667 6085 Post
55. 00 05 00 Treats bronchospasm anaphylactic reactions cardiac arrest nasal Under Dose NB Epinephrine UD Oug kg decongestant Upperway obstruction Note Indicated dose is administered every Standard Dose NB Epinephrine SD 1Dug kg 3 5 minutes as needed High Dose MB Epinephrine SD 30ug kg Over Dose MB Epinephrine OD 31ug kg Specify the dose units route and rate if applicable and click on the Administered button When a drug is administered it appears below the drop down menu Under Dose Onboard you will see how much drug is left in the body The picture below displays a list of sample configurations of drugs Remove any drug that has been completely delivered to the patient by highlighting it and clicking Remove Details Il Palette Lab Drugs Scenario Il Log Gaumard Drug Dose Units Route Rate jns EN mM Onboard Sample IM Demonstration 0 mg kg IM 943 3125 uglkg 00 01 10 Sample Inhalation Demonstration 0 mg kg Inhalation 950 417 ug kg 00 01 02 Sample Iv Push Demonstration mgka Iv Push 961 5749 uglkg 00 00 48 Sample Per Oral Demonstration mg kg Per Oral 10 0543 ug kg 00 00 39 Sample SubO Demonstration mg kg Sub 970 5576 uglkg 00 00 27 top Infusion Remove from list Change Dose and or Rate Warp rator 7 Manage Drug List Fluids amp Gas Concentration 96 Rate L mh f Start 02 You can also stop the administration of any drug being applied via IV Infusion Copy
56. 005 e Scan RF Channels Manually select the best possible RF channel for tablet manikin communications by selecting Setup then Scan RF channels The following notice displays while the scan Is in progress Communication inia When the scan is complete a series of bars will display with the highest bar indicating the best signal On mouseover a popup will display Recommended Channel over the channel bar with the best measured signal The other bars will only display a Double Click to Select Channel message Channel Strength d Recommended Channel Double Click to Select Channel Click on the recommended channel in the graph to select it The following message will display while the command Is processed 148 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 Communication infa CTT a z The new channel should subsequently ensure four solid bars display in the communications indicator at the top of the Status bar aiii Copyright 2010 by Gaumard Scientific All rights reserved 149 Instruction Manual Pediatric HAL S3004 S3005 3 Modeling Automatic Mode Only The Modeling drop down menu in the top left corner of the GaumardUI contains four options Modeling Patient Reset Model Import Between Patients and Auto Log Setting Modeling Monitors CPR Ajv Modeling Patients Reset Model Import Between Patients
57. 010 by Gaumard Scientific All rights reserved AT Instruction Manual Pediatric HAL S3004 S3005 Ventricular Tachycardia 1 minute has passed since the patient is in ventricular tachycardia da you wish Ea degrade to ventricular Fibrillation Click MO to re check Ehe Cardiac Rhythm in ane minute Click CANCEL to stop checking every minute Ehe Cardiac Rhythm Cancel Clicking Yes degrades the cardiac rhythm to ventricular fibrillation Clicking No does not degrade the cardiac rhythm but re checks the rhythm after a minute Clicking Cancel stops the software from checking the cardiac rhythm every minute The Details page is also used to create Palette Items A Palette Item is any full or partial set of physiological parameters that have been grouped and saved together under a single name To create a Palette Item choose the desired parameters on the Details page and click the Save as Palette Item button near the top of the page You will be prompted to name and describe the item and to assign it one of four color codings for easier identification Gave as Palette Item Palette Item Name Healthy Child Palette Item Description H all vitals are naminal Color ie Healthy C Critical 2 Care Required LJ other save cance The collection of all Palette Items n this profile are displayed on the Palette page the next section of this guide The Details page tabs are explained below
58. 2 00 51 00 Normal Range 9 00 30 00 13 50 16 50 z S 53 00 PLTS K uL 242 000 00 378 000 00 Neutrophils 59 00 59 00 Bands 0 00 0 00 Metamyelocytes 96 0 00 0 00 Lymphs 56 31 00 31 00 Monos 0 00 6 00 Basos 0 00 2 00 Eos 0 00 2 00 2 CRP C Reactive Protein Variable Normal Range CRP mg dL 0 00 1 00 j Cancel 000 00 c ce LJ H ra e cea m un uu eiit NS Mo e Ld _ ca ce c ce Comment normal values are for term neonates normal values are for term neonates normal values are for term neonates normal values are for term neonates normal values are for term neonates normal values are for term neonates normal values are for term neonates normal values are for term neonates normal values are for term neonates normal values are for term neonates normal values are for term neonates 62 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 The newly created lab report will be listed on the Lab Reports list Lab Reports Description Create New Lab Alice s 5abv _Neonate Blood test Above Normal Range Hab Het Monos Eos View SortbyName Healthy Levels Normal values SetbyCoor Selected Item Lab reports can be sorted by name template description sent or color On the right panel the Preview button will display the final lab report on the
59. 4 S3005 d Auto Log Setting Modeling Monitors CPR Auto Log Setting Modeling Patients Auto Log Reset Model Comman Import Between Patients Log vitals when Auto Log Settings Heart Rate changes more than Systolic BP changes more than T Diastolic BP ch th This menu option is used to specify SEL oleae certi a various vitals that you would like to Resp Rate changes more than be logged automatically after E Insp Percentage changes more than reaching a specific threshold Etro changes more than Sp 02 changes more than Temperature changes mare than Cancel na Ln Ln Ln Ln Ln Ln 156 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 4 Monitors The Vital Signs Monitor simulates a vital signs monitor Sensors attached to the simulated patient The vital signs are synchronized through a wireless network between the File sharing facilitators tablet and the computer running the monitor Custom numbers Vital Signs Monitor allows the user to customize each trace Configuration Independently of each other users can set alarms time scales boundaries and grid options A Warning The menu option for Monitors is not visible unless the user has enabled it from the Options dialog box and enters the activation code on the field provided See Section IlII C 2 b iii for more information Options Options Environm
60. 5 CH EtCO2 20 in HR 120 Detalls ETO 14 model to anthary Details EtCO2 9 Model to Anthony Details EtCO2 4 Applied 00 000 Oetails d OFF Apolied tc Anthony 00 00 Details Rhythm Sinus 0 HeartSned normal L SLU normal Apolied to anthony Oetails Reset rhe Model model to anthony Tob ipea is ErCO2 40 model to Anthony 00 000 Details Inspire 32 Applied 00 000 Details Bleeding OFF Apoliec tc Brent Details Reset the Model Copyright 2010 by Gaumard Scientific All rights reserved 121 Instruction Manual Pediatric HAL S3004 S3005 e Print Report Setup Monitors Profile Mew Session Reset Session Clock Save Report Frink Report This option allows printing of a text file containing all the information in the log for the latest session Clicking on Print Report brings up the Print window The shortcut key for this option is Ctrl P f Import Setup Monitors CPR Profile Mew Session Reset Session Clack Save Report Print Report This tool allows the import of palettes scenarios or modeling patients that may have been created in another tablet PC When Import is clicked the Open dialog box displays 122 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 Alice s Baby APGAR 1 pit baby deteriorates plt if i Asphyxia Sen APGAR 2 plt Beth s Baby 1 plt Mu Recent Beth s Donna s Ba
61. Action Hypoxia Model deteriorating Notes Copyright 2010 by Gaumard Scientific All rights reserved 111 Instruction Manual Pediatric HAL S3004 S3005 Notes can be entered directly from the Evaluation panel or by right clicking on the text log and adding anote The following is an example of a Note entry 00 10 10 Note provider took too long to assess patient b Provider actions The Provider Actions section refers to the collection of buttons in the middle of the page It allows the facilitator to accurately keep track of provider actions The buttons are grouped into 6 groups Basic Trauma Care Airway Breathing Circulation and Medication Anytime the facilitator clicks one of the buttons a time stamped log entry is generated with that particular action For example if the Assess responsiveness button is clicked when the session clock reads 00 07 24 the following entry is automatically generated 00 07 24 Action Assess Responsiveness Special Buttons Some provider action buttons are accompanied by a special option button The first special button lets the facilitator log actions in more detail For example if the button Assess breathing is clicked the following entry is created 00 01 28 Action Assess breathing On the other hand if the button next to Ventilate is clicked a list of additional options appears The facilitator can be more specific and choose for example
62. B Adenosine SD MB Alprostadil SD Over Dose Properties Properties Edit Palette Clear All Replace Cancel Instruction Manual Pediatric HAL S3004 S3005 Drugs List Adenosine 4denocard Alprostadil Caverjeck PGE1 Calcium Chloride CalFackant Insasurt DOW Dextrose 1095 Water Diz SW Dextrose 12 595 Water D15w Dextrose 15 Water Dobutamine Dobutrex Dopamine Inkropin Ephedrine Epinephrine Primatene Adrenalin Generic Brand Name 000 Heparin Milrinone Primacar Naloxone Narcan Norepinephrine Levophed Phenobarbital Sodium Bicarbonate Sodium Mitroprusside Nitropress MiErapr Delete Drug Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 The Palette Editor appears when the Edit Palette button is clicked Palette Editor NB Adenosine OD Description Over Dose Airway Appearance Cyanosis Level om c Upper Airway Sound y crying Muscle Tone Auto o Breathing Respiratory Pattern z Respiration Pattern End Tidal CO2 generaO pre post duct d De Rate auto bem mmHg O2 Saturation change E Eco Auto echange Lung Condition v M i iration Auto Auto aa Duos Auto 96 via Total CO2 level v OSat O Sischange Une Volum
63. EFECT OR DEFECTIVE TRANSMISSION AND RETURN THE DEFECTIVE MEDIA IF ANY DURING THE 30 DAY WARRANTY PERIOD B EXCEPT AND TO THE EXTENT EXPRESSLY PROVIDED IN PARAGRAPH A THE SOFTWARE AND ACCOMPANYING WRITTEN MATERIALS ARE PROVIDED ON AN AS IS BASIS WITHOUT ANY WARRANTIES OF ANY KIND INCLUDING BUT NOT LIMITED TO ANY IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR ANY PARTICULAR PURPOSE NO ORAL OR WRITTEN INFORMATION OR ADVICE GIVEN BY GAUMARD ITS DEALERS DISTRIBUTORS AGENTS OR EMPLOYEES SHALL CREATE A WARRANTY OR IN ANY WAY INCREASE THE SCOPE OF THIS WARRANTY AND YOU MAY NOT RELY ON ANY SUCH INFORMATION OR ADVICE GAUMARD DOES NOT WARRANT GUARANTEE OR MAKE ANY REPRESENTATIONS REGARDING THE USE OR THE RESULTS OF USE OF THE SOFTWARE OR WRITTEN MATERIALS IN TERMS OF CORRECTNESS ACCURACY RELIABILITY CURRENTNESS OR OTHERWISE AND THE ENTIRE RISK AS TO THE RESULTS AND PERFORMANCE OF THE SOFTWARE IS ASSUMED BY YOU IF THE SOFTWARE OR WRITTEN MATERIALS ARE DEFECTIVE YOU AND NOT GAUMARD OR ITS DEALERS DISTRIBUTORS AGENTS OR EMPLOYEES ASSUME THE ENTIRE COST OF ALL NECESSARY SERVICING REPAIR OR CORRECTION OTHER THAN EXPRESSLY DESCRIBED ABOVE C NEITHER GAUMARD NOR ANYONE ELSE WHO HAS BEEN INVOLVED IN THE CREATION PRODUCTION OR DELIVERY OF THIS PRODUCT SHALL BE LIABLE FOR ANY DIRECT INDIRECT CONSEQUENTIAL OR INCIDENTAL DAMAGES INCLUDING DAMAGES FOR LOSS OF Copyright 2010 by Gaumard Scientific All rights reserved T Inst
64. M ol omeno 82 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 2 Click on Load Scenario The Load Scenario dialog box appears Load Scenario Scenarios aol Cardiac Tamponade Rename Fire victim Delete Fareign spir akian a Girl w Tach Scenario Description Septic Shock 4 tive year old known asthmatic began coughing and wheezing the previous Cancel 3 Select the desired scenario and click on load Details Palette Lab Model Scenario Speech Log Gaumard Cew Lad Scenario Save Scenario scenario Aut Responses 99 Branching 4 five year old known asthmatic began coughing dd Asthma and wheezing the previous day His parents had run nut of his daily steroid inhaler two weeks z mara to scenario m m Selected Item Name Transition Description Speech 1 00 01 complaint Can t breath wait Indefinitely ros Wait Far O2 and Albuteral Move Asthma 3 00 30 Slight O2 improvement is wait Indefinitely a Wait For albuterol and atrovent Asthma 2 00 30 Transport to hospital EM Edit rensition iE Transition Speech z 00 01 complaint I wank mommy m Insert odeets Remove Remove Remove Duplicate Duplicate Properties Properties Properties Edit Palette Edit Palette O Edt Palette im oe Poe Sopes rset After loading the desir
65. O Virtual Monitor Set Up dialog box by clicking on Monitors Configuration on the GaumardUI g Monitors CPR Help i Sensors b po File sharing Custom numbers Configuration On this dialog box select the Adapter you will be using usually the wireless adapter 244 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 ES Premie HAL Virtual Monitor Setup select the number of monitors that will be used with this manikin Also you can name each monitor with an appropiate description Keep in mind that Noelle s vital signs and fetal monitor are considered together as 1 monitor Monitor 1 All sensors always ON Thot connected Adapter Loopback no network v E refresh Controller IP 127 0 0 1 Port C find avail Connected to Connect The Vital Signs Monitors should be configured to connect to the Controller IP designated by the selected Adapter Make sure the port numbers are the same for the tablet and the computer running the Vital Signs Monitor Copyright 2010 by Gaumard Scientific All rights reserved 245 Instruction Manual Pediatric HAL S3004 S3005 11 On the Monitors go to the menu labeled v located on the upper left corner Click on it and select Comm Setup Open the TCP Comm Setup window and input the Controller IP address This is the IP of the computer running the GaumardUI software
66. Pediatric HAL S3004 S3005 Instruction Manual Contains documentation for Pediatric HAL S3004 S3005 and GaumardUI the Gaumard User Interface software amp Gau mard Leadership Through Innovation Simulators for Health Care Education Pediatric HAL is an interactive educational system developed to assist a certified instructor Itis not a substitute for a comprehensive understanding of the subject matter and not intended for clinical decision making Manual Version OP 11 2 1 for GaumardUI HAL v1 20 8 0 Copyright 2004 2010 All Rights Reserved www gaumard com Instruction Manual Pediatric HAL S3004 S3005 Contents Ena Y er ECEE Ae RR mmm 6 LRE T E EEE A E E A ee 9 AOE AVAA RR 10 Be TONINO M ES E ET E E E SE 12 C Equipment Set Up 13 1 Connecting the Communication Module eese seien tate sa rarae setate tete te setas sse ro soto t 13 2 Configure Tablet ComMputer m 14 OTCE BA T a A E A A ene ene eee 15 ae ca S SIE A ee ee ee ee ee E O ee Neb MUN A UM UM M ME 17 IBI eg Oe E E 20 Pr PUN AY A 22 D BrE ATN 24 quus e 25 DRO go PES p E EEEE EEE E ee ee 26 EE D E E A I A A tee etch ce cs A T AAAA S E A A S A 29 EELE A e E E 31 ERO iole eo ee 33 IIL Working witri ine Gaumardtl m 34 A d KO i CS 35 B The zia Ce igi NN 39 zu P 39 a h
67. Results Format Name Neonate Blood Test Description For newborn and premie Category Single Entry Add Remove Rename inset A Y 1 CBC with differential Variable The Add Insert Entry menu is used to customize the different parameters on a specific test Begin by providing the name of the test and the unit used The normal range will be displayed on the lab report for the provider to use as guide while reading the results Meanwhile the allowed range restricts the minimum and maximum value a facilitator can input as a test result Use the comment field for any notes regarding this test The comments will appear on the final report HE Add insert Entry Name Hgb Unit Normal Range Minimum 13 50 hlaximum 15 50 Allowed Range Minimum 0 00 Maximum Comment Normal values are for term neonates Once the test entry is configured click OK to add the new test Copyright 2010 by Gaumard Scientific All rights reserved 59 Instruction Manual Pediatric HAL S3004 S3005 Repeat the process to add more tests and categories using the Category and Single Entry menu Please note that individual items can be moved deleted or modified after they are created Edit Lab Results Template O nm aoe sae aan aoe reae EE 2 CRP C Reactive Protein CRB frre Inl rnn 1 nn n rirT 56 irl Allowed value range is displayed in value column It won t be visible when enteri
68. a scenario with the assumption that the providers will perform correctly As long as they do the scenario can be allowed to continue 224 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 Naturally you must be prepared for what might happen to HAL when providers deviate from expectations The consequences of such deviations can sometimes be included in the scenario punctuated by Wait Indefinitely items In other cases the simulation will require more direct control by the facilitator via either the Palette or Details page 4 Choose auto response settings based on the scenario content and the objectives As you ve seen auto responses can be used to free the facilitators attention They also enhance realism by presenting instant reactions to the care providers On the other hand sometimes It is not possible or desirable to determine the responses before the simulation begins Different environments and applications call for different settings some teaching practices are best done with the auto response settings in Prompt mode Responses must be triggered by a vigilant facilitator Though it is slower and requires more attention the benefit of Prompt over other modes is that the simulation can be allowed to go in any direction and it will be possible to choose the response on a case by case basis Other learning exercises require a higher degree of automation For such applica
69. a time following the text cue Never Calibrated Qe Factory Deen Settings z Back Finish The facilitator should follow the text cue on the screen to perform just ONE compression or ventilation at a time until prompted for the next one For example if calibrating chest compressions k The wizard prompts you with a 1 Calibration Chest Compressions The values from tne last compressions user calibration are shown below Press START and do 5 correct chest compressions one at a time following the text cue 1 C 2 Abort z Back Finish Factory Settings k Perform one correct chest compression kA green filled oval indicates that the chest compression was successfully recorded t Ihe wizard prompts you with a 2 Copyright 2010 by Gaumard Scientific All rights reserved 129 Instruction Manual Pediatric HAL S3004 S3005 k Perform a second correct chest compression kA green filled oval indicates that the chest compression was successfully recorded k and so on Calibration Chest Compressions The values from the last compressions user calibration are shown below Press START and do 5 correct chest compressions one at a time following the text cue Z 3 0K C2 Abort Factor Finish Settings F Atthe end of the calibrating session the wizard shows the average peak depth and duration values for the procedure If the procedures ha
70. adial Left Left Pupil Dilation Femoral Cyanosis Lung Back Upper Right Check All Modules Lung Back Upper Left Check All valumes KK Right Lung Right KK Left Lung Left Bowel Upper Right Breathing Bowel Upper Left Bowel Lower Right Bowel Lower Left Q Right Side Seizure Left Side Seizure Pressure BP Right Right Index Bleeding BP Left ventilation Compression Compressor You can also check individual modules by clicking on the module you will like to check Notice that the name of the module Is displayed on the right column Legend KE Active Inactive Check Modules Check Single Module Check All Modules Check All alumes Now click on the Check Single Module button Copyright 2010 by Gaumard Scientific All rights reserved 233 Instruction Manual Pediatric HAL S3004 S3005 Other Legend C ECG Q Active 3 Trachea Intubation Inactive Check Modules Eyelids Check Single O Right Pupil Dilation r OQUE 2 Left Pupil Dilation Check All Modules Check All volumes Active modules report light blue and inactive modules report black If there is a specific module that fails to respond please contact customer support make sure that the module that is unresponsive Is not specific to an Add On feature that is not installed on your manikin 234 Copyright 2010 by Gaumard Scientific All
71. aimers and exclusions may not apply and the first purchaser may have other legal rights This limited warranty applies only to the first purchaser of the product and is not transferable Any subsequent purchasers or users of the product acquire the product as is and this limited warranty does not apply This limited warranty applies only to the products manufactured and produced by Gaumard This limited warranty does not apply to any products provided along with the Gaumard product that are manufactured by third parties For example third party products such as computers desktop laptop tablet or handheld and monitors standard or touch screen are not covered by this limited warranty Gaumard does not provide any warranty express or implied with 250 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 respect to any third party products Defects in third party products are covered exclusively by the warranty If any provided by the third party Any waiver or amendment of this warranty must be in writing and signed by an officer of Gaumard In the event of a perceived defect in material or workmanship of the Gaumard product the first purchaser must 1 Contact Gaumard and request authorization to return the Gaumard product Do NOT return the Gaumard product to Gaumard without prior authorization 2 Upon receiving authorization from Gaumard send the Gaumard product along
72. al Number Automatic Channel Change Select desired channel Check noise in channel Cancel Ie Instruction Manual Pediatric HAL S3004 S3005 Options Pediatric Hal Add Ons Pediatric Features CPR Options Pacing Shack Talerances Other environ man Sene SINGLE There is only one Pediatric in your facility MULTIPLE There is more than one Pediatric in your facility Multiple Pediatric Setup Enter the Serial Number fram the Pediatric manikin that THIS computer will control SN2 on RF Module P 0000000 Cant Find Serial Number Autamatic Channel Change Select desired channel 1 Check noise in channel OK Cancel This tab allows you to choose how many HAL s in the facility Notice that if the MULTIPLE button is selected the correct manikin s serial number in the text box must be entered If the serial number cannot be found try connecting to the HAL using SINGLE press on the button that says Can t find Serial Number and follow the instructions At the bottom of this tab the channel that the RF module will use to communicate with the manikin may be selected It is recommended that the Auto Channel Change is active because it makes sure the initialization channel is always clear for other manikins to use on start up To ensure the manikin always uses the cleanest channel possible select the Check noise in channel button Copyright 2010 b
73. alettes scenarios branched or linear and model patients may be exported After selecting the kind of file to export the following dialog box is displayed appropriate to the file type Export Palette Export Palette Palette Palette Description HR 50 BP 80 over 45 RR 15 Oe Sat 90 Temp 36 1 Deg cC Bb Oz Sat 59 oz Sal 96 Oz Sat Alcohol Ingestion Z Alcohol Ingestion 3 Alcohol Ingestion 4 Apneic girl 2 Anneir nirl 3 Export 124 Export Scenario Export Scenario Scenario Scenario Description You are called to a home where a one year old child is gasping forbreath His mother says he has had wheezing before and is being treated for baby asthma He saw his doctor last week and has been receiving nebulized Albuteral three times a day for one Croup Drowning Boy Hypovolemic Shock Pneumonia Pneumonia and Septic Export Cancel Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 Export Branching Scenario Export Model Patient automatic mode only Export Branched Scenario Export Model Patient Branched Model Branched Scenario Description Bill Model Patient Description amp five year old boy was Evan is a 1 year old male racing his BMX bike over a He is 71 cm tall and weighs dirt hill in his back yard He Charlie 10 kg had his helmet on but not Esel his chest protector His mother was watching and Epiglattitis E said he bec
74. ame airborne Henry and the handle bar of the Sea bike landed on his chest Boc when he hit the ground He Infant OP Pnisnninn Panl Alcohol Ingestion Cardiac 4rrest Brian Cardiac Ischemia Chest Injury Diabeticketoacidosis Hypothermia Export Cancel Export Cancel Export Model Drug automatic mode only Export Profile Pediatric HALE Five Year Profiles Select Operating Mode Manual Automatic Export Model Drug Profiles Multi 3 Profile Description Model Dru Quick Start Newborn factory preset scenarios Adenosine Model Drug Description Albuterol Atropine Sulfate Calcium Chloride Calcium Gluconate Dobutamine Dopamine Tnamrinnne Used to treat hypotension Unit ug ug kg mg mg kg Route IV Push IV Infusion Inhalation IM SubQ Half Life 00 02 00 Peak Time 00 00 30 UD Epinephrine UD 100ug SD Epinephrine SD 200ug HD Epinephrine HD 300ug OD Epinephrine OD 500ug Cancel Copyright 2010 by Gaumard Scientific All rights reserved Quick Start Moelle Quick Start Pediatric 1 Quick Start Pediatric 5 Quick Start Premie Quick Start Susie Export 125 Instruction Manual Pediatric HAL S3004 S3005 Make a selection and click Export The Save As dialog box is then displayed Save in 8B Desktop my Documents Y My Computer My Recent my Network Places Documents dwlg510_driver_100 E520 Gaumard User Inter
75. ard Scientific All rights reserved 163 Instruction Manual Pediatric HAL S3004 S3005 Click on the button and select Other Choose the value to display Glucose Hematocrit Time TSH Do the same for as many new values as preferred for display The figure below shows three new values Glucose level hematocrit and TSH levels along the bottom of the display 164 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 Delete any parameter by clicking Remove Custom Numerical Parameters on ParnitartsJ m Load Remove Glucose update Hematocrit Or update TSH 4 jucu mL update Save any list of added custom numbers by clicking on the Save button After clicking this button the Save As dialog box is displayed hu Recent i Healthy 4 Documents Healthy B m Mewborn 3 n Preeclampsia n Shoulder Dystocia Uterine Rupture m variations Desktop My Documents My Computer E My Network Save as lupe Custom Scalars files v Type a file name and click Save You can load any of the pre saved combination of custom numbers by clicking on the Load button Copyright 2010 by Gaumard Scientific All rights reserved 165 Instruction Manual Pediatric HAL S3004 S3005 d Configuration CFR Monitors Alw Help Sensors File sharing Custom numbers Configurat
76. ase select the arm you would like to calibrate Factory Settings The software will prompt for setting the BP cuff to a certain pressure hold that pressure constant and press the OK button Follow the text cue on the screen and repeat the procedure for each pressure level until Done is displayed For example 20 mmHg e t The wizard prompts with 0 mmHg k Set the pressure on the BP cuff to O i e cuff valve open k Click the OK button kA green filled oval indicates that the value was successfully set t Ihe wizard then prompts with 20 mmHg t Set the pressure on the BP cuff to 20 mmHg k Click the OK button kA green filled oval indicates the value was successfully set k and so on Once the prompt reads Done go back and calibrate another function or click the Finish button to close the calibration wizard 132 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 IIl Factory Settings Factory Settings is a very useful tool to consider when recalibrating It restores the sensors to factory settings over riding any calibrations performed by users Make sure that when you are restoring the sensors to the factory settings that no one Is practicing chest compressions ventilations intubation or reading a blood pressure Any of these actions may interfere with the reset Each time that one of these sensors is clicked a message will appear at
77. asine 5D Adenosine UD Item Description Albureral OD Albuteral 5D Albuteral LID Atropine SulFate OD Atropine SulFate SD Atropine SulFate LID Ca Chlaride OD Ca Chlaride 5D Ca Chlaride LID Instruction Manual Pediatric HAL S3004 S3005 Click on the palette button to program a specific palette to be applied after the electrical therapy The Load Palette Item dialog box is displayed Highlight the desired palette and click Load Defibrillation Shock The desired palette is now displayed in the Setting section off Prompt Auto Setting Elo 9 Joules T Shocks Epinephrine SD e Copyright 2010 by Gaumard Scientific All rights reserved You can delete the palette by clicking the X button 145 Instruction Manual Pediatric HAL S3004 S3005 The Non scenario automatic responses settings dialog box has two additional features in the automatic mode Link All Auto Response to Cardiac Irritability and the Drug Model Effect panel Link All Auto Response to Cardiac Irritability Modeling greatlrandarm O off slighttiniprove Ten eee REESE DNUS ERU l l On if cerae tts E slight deteriorate Display warning when non shockable multichaice is enabled a d great deteriorate cardiac rhythm is shocked e Link All Auto Response to Cardiac Irritability if this feature is turned on the auto responses will work auto or prompt if and only if the cardia
78. at randam O of slighttinprove EM creat improve j bemben krtn on if Cardiac Irritability is AEN o Display warning when non snockable Alato multichaice is enabled great deteriorate cardiac rhythm is shocked External Pacing Defibrillation Shack Cardioversion Shack Mon Svnc Shock Drug Model Effect off Off off off en Prompt M Prompt s Prompt C Prompt Set Prompt Auto Auto Ex Auto CTS Auto T Auto at at NE Drug takes effect Joules Ee Joules 20 7 Joules according to the dase 40 5 Shacks 2 Shocks 20 Shocks appliediauto or user mi convert to NSR anert to NER m dearade to setting prompt i5 bom BP i5 bpm B rentricular OK These three states are defined below Off The software does not respond to the electric therapy e Prompt The software detects the electrical therapy and prompts the user if they would want to change the manikin s vitals to some preset healthy vitals Auto The software automatically detects the electrical therapy and compares it to a threshold selected by the provider and once this threshold is accomplished the vitals automatically change to a healthy vital state 144 Copyright 2010 by Gaumard Scientific All rights reserved Defibrillation Shack off Prompt Auto Setting Joules Shocks convert to MSR 85 bom BP 100 70 Load Palette Item fiche IQ Adenasine OD Aden
79. ay Sound 2 Tongue Edema Breathing Resp Pattern DSat o Left Lung Right Lung Respiratory Rate Bec O Chest Rise O Chest Rise a ee Inspiratory Time on EtCO2 Sounds Sounds EER Omm change Circulation Rhy gt Sinus Arrhythmia Blood Pressure Absent Pulses Pea Heart Sound Systolic Diastolic Radial Left Radial Right 9 beats min j 9 mmHg epu 4 LL oes 0 Cyanosis Y Level aa Pupils OWE Dounas L Enable Rxn Time sec Temerre g Suet Ld pore none Ap P ly normal imperative sii NOW 10 sec 30 sec 5 min 10 00 min s The Five Year Old HAL has four speakers to produce bowel sounds each can be adjusted for volume or disabled entirely as desired The One Year Old HAL does not have this feature 32 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 G Other Streaming Audio optional Details Palette Lab Scenario Model Speech Log Voice Recorder Streaming Voice Controls Rec Prerecorded Speech a Streaming Voice Output Gain Mute O Listen O Talk Push toTalk Voice Activation Headset Required Off 1 Mic Threshold This feature allows you to be the voice of the simulator listen with headsets to any discussions occurring near the simulator and record your own voice commands in any language For information abou
80. be played A rapidly blinking triangle means that the scenario is playing the item to which the Y Indicator is pointing Copyright 2010 by Gaumard Scientific All rights reserved 3 Instruction Manual Pediatric HAL S3004 S3005 A slowly blinking triangle means that the scenario is paused at the item to which the al Indicator is pointing The Scenario Buttons Plays the item to which the scenario position indicator is pointing This button has to states play or pause i i Pauses the scenario This state of the play button Is only active when the scenario 14 is playing Itis disabled when a Wait indefinitely item is playing because in such case the scenario is already paused The Stop button has 2 behaviors depending on when it is clicked When clicked once the Stop button halts the scenario at the end of the currently playing item When clicked a second time the scenario is stopped immediately For example if the currently playing item has a transition of 1 00 minute and the Stop button is pressed when it has 0 10 seconds left the scenario will be halted at the end the transition I e in 10 seconds If the Stop button is clicked again within those remaining 10 seconds the scenario stops immediately The Next button advances the indicator to the next item on the scenario regardless if the scenario Is playing paused or stopped It can also be used to move the indicator to select an it
81. bserved provider actions The following example illustrates this idea Info 00 00 Start scenario Applied 01 00 Palette Asphyxia 1 Details HR 140 BP 83 54 RR 40 Inspire 25 OSat 95 95 EtCO2 40 Temp 37 Cyano Applied 00 30 Palette Asphyxia 2 Details HR 112 BP 66 43 OSat 80 Cyanosis 71 96 Charles Parker Action Open airways suction Charles Parker Action Call far assistance additional staffing Charles Parker Evaluation Care Provided Satisfactory Note in the highlighted lines above that the provider Charles Parker cleared the patient s airway called for help and was then evaluated on those actions The evaluation panel is part of the team logging system described previously When a particular provider is selected log entries generated via the Evaluation panel will be prepended with the providers name For more information on Team Logging see the previous section of this guide on Logging Details Palette Lab Scenario Model Log Gaumard Session Title Simulation 101 Facilitator John Eggert Providers add Team Charles Parker Kathy O Brien Christopher Jorge Ming Jiang 116 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 C Menus 1 File Setup Monitors Profile Mew Session Reset Session Clock Save Report Print Report Import Export Exit a Profile Setup Monitors This o
82. by APGAR 3 plt Beth s Baby 2 plk Documents Cynthia s baby APGAR 4 plt C Section Delivery plt di Elaine s Baby APGAR 5 plE Cardiopulmo decline plt di Francines s Baby APGAR 6 plE Comp Response plt MK Gloria s Baby APGAR 7 plE Continued response plt n Helen s Irene s Baby APGAR plt Cynthia s Baby 1 plt APGAR 9 plt Cynthia s Baby 2 plt APGAR 10 plt Cynthia s Baby 3 plt apnea pit Cynthia s Baby 4 plt Alice s Baby 1 plE Asphyxia 1 plE Cynthia s baby pit Alice s Baby z plE Asphyxia z plE Elaine s Baby 1 plt Alice s Baby 3 plE Asphyxia 3 plE Elaine s Baby z plt APGAR 0 plt Asystole pit Elaine s Baby 3 plt My Documents hy Computer File name My Network Files of tupe alette Items plt Browse to the location where the documents are saved and open it They are automatically brought into the GaumarduUI Make sure the correct file type is selected File name BEN bal Cancel Files of type Scenario Files scz v Scenario Files scz Branched Scenarios baz Palette terns plt Model Patient Model mpz Protiles ptz Model Drugs Copyright 2010 by Gaumard Scientific All rights reserved 123 g Export Setup Monitors Aw Help Profile New Session Reset Session Clack Save Report Print Report E Cyanosis Palette Item Scenario Resp Pattern Branched Scenario normal Profile Instruction Manual Pediatric HAL S3004 S3005 P
83. by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 Computer 1 0 0 10 Lue wissen Computer 2 1 0 10 2 Computer 1 10 10 10 1 Computer 2 10 10 10 1 To simplify the procedure have the first three numbers to be 1 0 0 X and make sure X is different on each computer Copyright 2010 by Gaumard Scientific All rights reserved 243 Instruction Manual Pediatric HAL S3004 S3005 9 Now select Subnet mask It should auto fill itself with 255 0 0 0 Ensure everything else Is empty blank and click OK Internet Protocol TCP IP Properties ajx General fou can get F settings assigned automatically if your network supports this capability Othenvise you need to ask your network administrator for the appropriate F settings C Obtain an IP address automatically Use the following IP address JP address 10 0 0 X Subnet mask 255 O Oo O Default gateway C Obtain DHS server address automatically f Use the following ONS server addresses Preferred ONS server Advanced Alternate ONS server Cancel Laptop IP and Desktop IF must be different This process has to be repeated on the each computer you are trying to connect to the GaumardUl Remember to name the network exactly the same but when you setup the IP addresses make sure they are different 10 Following the IP address configuration go to the HAL
84. c Irritability option on the details page matches the selection on this dialog box If the cardiac irritability on the details page does not match the selection on this dialog box the following error message Is displayed when the electrical therapy is detected T Defibrillation shock detected Shock x 1 20 Joules But current cardiac irritability does MOT allow rhythm bo change e Drug Model Effect this feature is used to panel has two options 1 Auto applies drug effect as soon as the drug recognition module detects a drug Note that the effect applied will be determined by the calculated dosage 2 Prompt This option displays the Proceed Drug every time a drug is detected by the drug recognition module to ask the user if the drug effect should be applied now This option allows the user to select which drug effect to apply and whether or not the drug effect should reverse when the drugs level begins to drop 146 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 Proceed Drug 5 0ug of D15 Dextrose 15 Water through IV Push has just been Administered This dose will be treated as UnderDose Do you want this drug to take the following effect Jnder Dose View Effect Reverse effect when the drug s level begins to drop YES Mao Effect Copyright 2010 by Gaumard Scientific All rights reserved 147 Instruction Manual Pediatric HAL S3004 S3
85. caeuucenensnenonecacucaueengaceenuen 137 j uc 138 v Pediatric Features labeled as OneYearOldFeatures on the S3004 sss 139 JR ejjo 9 140 Mme qesiol X M T 140 IMS 141 CREMO TACCO d M Ihn o Kousa S 142 Cl AUTO telels c M 144 Neck liac a A EEE 148 3 Modeling Automatic Mode Only sse 150 he Mogelnig PATE MN uuuu A em 150 Fs FR SSS I OCS MM E S 154 C Import TSS TI UCU Rc MTS 154 Om Clon Meeps tt o i a ea ae ee ee 156 7a Og O io E E ee 197 NS OS AAAA AA EA OA 158 oa ELSE E E E S 160 C Cu ust m NUM DCTS sasies enera penne Ora deco nec ran aa ea reai Tana rani rere aeaaaee iana 162 GS ONT cio CREER E eia aia En then a EEE OA A Ee aA SE 166 e 167 cM U lbcuo e 167 om 8 oe 172 173 THEI m 174 TORRI Eaa A A A E er 174 Om oo UGC 0 E E E EE E E EE TE E EEE buda 174 CC ls qedils i TNM ee 175 ODB EEE E SC A EA A A AA EN E A A AANE N A A
86. cation so they didn t see a doctor Calcium Chloride IV 20mg kg x que 198 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 Pediatric HAL Five Year Cardiac Scenario Gaumard Simulators for Health Care Education Soccer Boy With SVT A previously healthy boy is brought to the ED because his mother says he has been acting tired and passed out while playing soccer today He said his chest hurts and his heart jumps Administer O2 adenosine rapid bolus IV and perform vagal maneuvers No adenosine4 Adenosine given Copyright 2010 by Gaumard Scientific All rights reserved 199 Instruction Manual Pediatric HAL S3004 S3005 r E F Gaumard Pediatric HAL Five Year Cardiac Scenario Simulators for Health Care Education Cardiac Arrest While watching a baseball game a five year old boy was hit by a high velocity foul ball in the chest He immediately falls to the ground and cries I m hurt As you approach he becomes unresponsive You access the ABC s and find him to be pulse less and not breathing You call for an EMT and report a cardiac arrest EES No Shock effective Wait indefinitely for additional shock A Wait indefinitely for Epi via ET Tube 200 Copyright 2010 by Gaumard Scientific All rights reserve
87. cing Shack CPR Options Pacing Shack Tolerances Other Tolerances Other Ewronmet Genera Ewronmet Genera SINGLE There is only one One Year ld in SIMGLE There is only ane Pediatric in vour your facility facility MULTIPLE There is more than one MULTIPLE There is more than one OneYearOld in your facility Pediatric in your facility Multiple OnevearGld Setup Multiple Pediatric Setup Enter the Serial Number fram the Enter the Serial Number fram the QnevearOld manikin that THIS computer Pediatric manikin that THIS computer will control SN2 on RF Module will control SN on RF Module O 0000000 P 0000000 Cant Find Serial Number Cant Find Serial Number Autamatic Channel Change Autamatic Channel Change Select desired channel 1 Select desired channel 1 Check noise in channel Check noise in channel Cancel OK Cancel Each of these sections is further explained below 134 Copyright 2010 by Gaumard Scientific All rights reserved i Environment Options OnevearOld Hal Add Ons OneYearold Features CPR Options Pacing Shack Tolerances Other prO Gere SINGLE There is only one One Year ld in your facility MULTIPLE There is more than one OneYearOld in your facility Multiple OnevearOld Setup Enter the Serial Number fram the One vearOold manikin that THIS computer will control SN2 on RF Module 0000000 Cant Find Seri
88. ctrolytes Variable Normal Range Value Comment Na mmol L 135 00 145 00 The preview window also allows the printing of results for distribution and archiving To make changes click Close and then edit Copyright 2010 by Gaumard Scientific All rights reserved 63 c Send to Monitor Begin by selecting the report from the lab reports list Lab Reports Template Healthy 2 OB Blood test Healthy Neonate Blood test James Metabolic Panel Lab 02 CBC DIFF Lab 03 Neonate Blood test Lab 04 CBC DIFF Lab 05 OB Blood test Lab 06 PPT Susan Lipid Panel Description Sent Healthy Levels Healthy Levels Session 1 High levels High levels Simulation 1 Session 2 Session 2 Session 4 Instruction Manual Pediatric HAL S3004 S3005 Create New Lab Report View Sortby Color Selected Item On the Virtual Monitors window an exclamation icon notifies the provider a file is ready for access Click the HAL drop down menu to select the available lab report Pediatric The lab report will open using the system s default application 64 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 E Lab 08 rtf WordPad Fie Edt View Insert Format Heb 15 12 22 Once the report is sent the letter Y will be present on the Sent column Template Description Hematology High Glucose Cardiac High range Hematology Norma
89. cturers safety guidelines B Defibrillation is only allowed on the large sternum and apex sites marked green below NEVER deliver a shock to ECG lead targets on the shoulders and waist Doing so will not create a fire hazard nor is there risk of shock to the provider but major internal damage will result This situation is considered improper use and is NOT covered by the HAL warranty The system will require repair at our facility B Electrode gel on the skin between any two electrode paddle targets can become a pathway for electrical current just as in real life If this occurs HAL s skin can be burned Only deliver electrical therapy when the simulator is intact and fully assembled NEVER attempt to service or modify any of the electrical connections especially those between conductive skin sites and the internal electronics Discontinue use if any wires are found exposed with damaged insulation B Real medical products especially electrodes sometimes use powerful adhesives that can be difficult to remove HAL should be cleaned with a cloth dampened with diluted liquid dishwashing soap or with alcohol wipes DO NOT USE GOO GONE as the citric acid in the formula will cause pitting of the various materials comprising your manikin Copyright 2010 by Gaumard Scientific All rights reserved 185 Instruction Manual Pediatric HAL S3004 S3005 186 Copyright 2010 by Gaumard Scientific All rights reserved Instructio
90. d Yes Instruction Manual Pediatric HAL S3004 S3005 Gaumard Simulators for Health Care Education Pediatric HAL Five Year Cardiac Scenario Cardiac Ischemia Carbon Monoxide Poisoning During the ride home from a family camping trip a five year old boy falls asleep in the back of his parents truck camper The night was cold so the heater in the cab was turned on When they returned home he seemed confused couldn t walk and complained of a headache and vomited His parents bring him to the ED and are worried about meningitis 0096 O2 delivered via non rebreather mask Wait 15 minutes Copyright 2010 by Gaumard Scientific All rights reserved 201 Instruction Manual Pediatric HAL S3004 S3005 Pediatric HAL Five Year Cardiac Scenario Gaumard Cardiac Tamponade 4 Simulators for Health Care Education Obstructive Shock Pulseless Arrest A five year old boy has a gunshot wound to his chest The family has called 911 but has not begun CPR You are the first responder with your emergency team The boy is unresponsive with an entry wound near his heart The family said he was crying a few minutes ago 202 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 Gaumard Simulators for Health Care
91. de Power adapter with exchangeable plugs for various international power systems 16 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 4 Start the System Pediatric HAL is ready to go After reading the Care and Cautions section of this guide you can begin working with the simulator To start the simulator click on the GaumardUI icon on the desktop of your tablet computer My Computer Gaumardul Recvcle Bin A dialog box is then displayed which prompts you to select the active manikin If you have the 53004 Pediatric HAL One Year Old Select Pediatric HAL One Year and click Start r Gaumardut version 1 13 5 j Gaumard Simulators for Health Care Education Please select one Simulator OHAL OldRF OHAL ONewborn HAL amp ONoele 574 575 Pediatric HAL Five Year Pediatric HAL One Year IPremie HAL ISusie R Copyright 2010 by Gaumard Scientific All rights reserved 17 Instruction Manual Pediatric HAL S3004 S3005 If you have the S3005 Pediatric HAL Five Year Old select Pediatric HAL Five Year and click Start Now select the profile of your preference and click load For more information about profiles go to Section III A Working with the GaumardUl Profiles Pediatric HALE One Year Profiles Select Operating Mode Manual Automatic Profiles Profile Description Default Profil
92. del Scenario Speech Log Gaumard Clear ma L oad Scenario Save Scenario Scenario Auto Responses cain Sii ena Se eT cenar ia 4 five year old known asthmatic began coughing dd Asthma and wheezing the previous day His parents had adde run out of his daily steroid inhaler two weeks more to scenario T Selected Item Name Transition Description Speech 1 00 01 complaint Can t breath wait Indefinitely T Wait For O2 and Albuterol Move Asthma 3 00 30 Slight Cz improvement wait Indefinitely is Wait For albuterol and atrovent Asthma 2 00 30 Transport to hospital Edit Transition Transition Speech 2 00 01 complaint I wank mommy Insert Duplicate Properties Edit Palette Remove m s4 a gt 66 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 To add palettes to the Scenario click on the Add to scenario button Add Use the add palette item window to add Palettes and Labs Add Palette Item Multiple Palettes selected Allergic Reaction ID BP 40 59 59 Max Item Description 40 increase in blood pressure Choose the desired palette and specify a transition time If the list of palettes is long you may search a desired palette using the search bar next to the search icon To select multiple palettes
93. der Actions section and make the entry more specific using the Team Logging feature The following is an example of an Action entry 00 07 24 Action Assess responsiveness Applied Changes An Applied log entry occurs automatically every time there is a change to the physiological condition of the manikin In other words every time changes are made from the Details page Palette page or from a Scenario a log entry like the following is created 00 04 01 Applied 00 30 Details Rhythm Sinus Cardiac event 0 HR 140 Detected Events Every time one of the various sensors in the manikin detects a provider action it is automatically logged as a Detected entry These actions include intubation BP cuff placement artificial ventilations and chest compressions The following example shows an entry after a provider performs BVM ventilation 00 03 26 Detected ventilation correct Evaluations Evaluations are added by the facilitator by clicking on the Satisfactory or Unsatisfactory buttons on the Evaluation panel Team Logging allows the facilitator to evaluate individual providers with a single click For example if provider Charles Parker did a correct procedure the Evaluation entry would be 00 00 28 Charles Parker Evaluation Care Provided SATISFACTORY Model When the facilitator changes the state of the cyanosis model from the Model page an entry in the text log is automatically generated 00 18 10
94. dicator on battery charger goes through the sequence described in its label usually red or orange after plugging it and then green when charge is completed If LED does not go through label s indications then Check plug connection making sure it is all the way In Make sure you are using the appropriate charger labeled with its simulator name If you have more than one manikin in your facility make sure that your computer is properly set up to control the manikin that you wish to control Go to Options on the Setup pull down menu and check the Environment preferences Copyright 2010 by Gaumard Scientific All rights reserved 229 Symptom Possible Cause Commands are Distance between taking longer than computer and manikin is usual to take effect or reaching its limit simulator is not or reporting every there are too many ob action blinking structions between walls communication etc indicator is consis There s too much RF inter tently yellow l ference either from another Gaumard tetherless simu lator in the vicinity or an RF radiator GaumardUl has set The battery on the manikin the power mode to STAND BY automatically Is depleted RF module not RF module not connected found message Is displayed when Caumardiiie stanced RF module not identified by the computer Chest compressions Is the communication indi are not properly cator panel consistently detected or not yellow
95. e amp uto ml via Respiratory Pattern Left Lung Right Lung Chest Rise Chest Rise Sound Sound v v Note Auto means this vital is auto controled bv model Click H button to hold this Modify The Properties windows using Adenosine as the example will look as follows Single view Expanded HE Model Properties Ee Model Properties NB Adenosine OD NB Adenosine OD Appearance Appearance Circulation Cardiac Skin Color Auto Skin Color Auto Muscle Tone Muscle Tone CAB c o Adv A irwa 9 Airway 9 Breathing Breathing ca eu Cardiac Heart Rate 30 bpm Q Sinus arrhythmia Circulatory Rate Auto bpm Rate Auto bpm In Auto In Auto Tidal Volume Auto ml Tidal volume Auto ml Auto Blood Pressure Resp ratory O2 Sat Auto O2 Sat Auto Q EtCO2 Auto nmHg EtCO2 Auto nmHg Notice that the same three tabs from the details page are present A B C O Adv When you click on any one of those only the options that were selected under each section are displayed Copyright 2010 by Gaumard Scientific All rights reserved 101 Instruction Manual Pediatric HAL S3004 S3005 7 Model Cyanosis modeling is one of the most exciting features of Pediatric HAL The physiological model controls all vital signs and skin color and depending on effectiveness of provider intervention it will improve or deteriorate
96. e 5 Default Quick Start Pediatric 1 Quick Start Pediatric 5 Manage Rename Mew Profile Cancel Pediatric HAL Five Year Profiles Select Operating Mode Manual Automatic Profiles Profile Description Default Modeling Default Modeling Scenarios Meds Profile Quick Start Pediatric 1 Modeling Manage Quick Stark Pediatric 5 Modeling Rename Delete Mew Profile Cancel 18 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 You are now ready to use the Gaumard User Interface For more information about the software refer to Section III of this manual It is important to note that Pediatric HAL uses what is called soft power which means that the manikin is activated from the software It is very important to understand the behavior of the soft power feature described below Power STAND BY When the battery is connected Pediatric HAL is always in SLEEP mode Pediatric HAL will automatically wake up in the ON mode less than 1 minute after starting the software The com munication indicator on the Status panel should blink green confirming that the wireless RF link between the controller and model has been established To extend battery lifetime click the power button in the lower right corner of the program window to put the system in STAND BY mode Battery will last approximately 3 hours depending on factors like breathin
97. e Status Panel MENOR 39 Om CClaglag Claleciielam pole E a ne 41 C BaN A O m 42 d S0und R10 UTR NN 42 ZNSE 43 WAT Aslfzi uellaro MM 49 D Crceuldion ANd OIG M 51 EA VAN CCO e eee eee E S 53 C 55 a E 1 S cee PE PAI PA AI TAAI I PA AN A AN EA AA T A AA A AN A TATA o a Creating a Lab Template eerereeeenereeere mee rerereer tne UU MEUM MIDI IM MMEMUME 58 DGE A T a LDR o p O NR A N A A A A A ener ery se eT oe 61 Co ATTO TAO O ee a ee E ee ee ee E 64 5 SCOMAMIOS EE 66 CANIS IR Nile aan a en a en a en a ee nee nee ne a eee A et E E E E EE 66 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 D Branehld kel o g ic 6 uusnsuduenenUmEnUREnUIEnVIEPUHUNDMU REN MU E A E E E 69 CS OO OLS 13 d Factory i i i ies Gs Bc UO c RR RERUM fis L Manual Cel eee 75 e AORTE N O a 81 e Using Factory Preset ScenallOS MNT 82 Gi ccrc lige meee a Olina 2 ici Coe UU UU ee 85 6 Drugs Automatic Mode only ertet netten nete 88 ACANT NON DUO eae ee ee ee ee ee ee er 92 IAN 9 102 29 0 ee 104 zu mii i eoQeepeobge NNNM Nm 104 b Streaming Audio if factory MU gcse e 106 SE a E E E E E
98. e defective in material or workmanship within one year from the date on which the product is shipped from Gaumard to the customer Gaumard will at Gaumard s option repair or replace the Gaumard product This limited warranty covers all defects in material and workmanship in the Gaumard product except 1 Damage resulting from accident misuse abuse neglect or unintended use of the Gaumard product 2 Damage resulting from failure to properly maintain the Gaumard product in accordance with Gaumard product instructions including failure to property clean the Gaumard product and 3 Damage resulting from a repair or attempted repair of the Gaumard product by anyone other than Gaumard or a Gaumard representative This one year limited warranty is the sole and exclusive warranty provided by Gaumard for the accompanying Gaumard product and Gaumard hereby explicitly disclaims the implied warranties of merchantability satisfactory quality and fitness for a particular purpose Except for the limited obligations specifically set forth in this one year limited warranty Gaumard will not be liable for any direct indirect special incidental or consequential damages whether based on contract tort or any other legal theory regardless of whether Gaumard has been advised of the possibilities of such damages Some jurisdictions do not allow disclaimers of implied warranties or the exclusion or limitation of consequential damages so the above discl
99. e two controls are defined below Hold H allows you to keep a value constant Recall that in the manual mode if you want to keep a value constant you simply have to leave that control blank In this mode leaving a control blank allows the automatic model to auto adjust it Therefore by clicking this button you can lock the vital at the specific value Auto allows the model to auto adjust a value Note that blank controls default to auto 5A Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 3 Palette The second level of control is the Palette tab page Each item on the Palette represents a complete or partial physiological state The Palette page displays all of the Palette Items in the active profile Each profile has its own separately customizable Palette Create Palette Items with the Details page as described previously SS TD m RI Details Palette Lab Model Scenario Speech Log Gaumard Name Description Apneic girl 3 HF 100 RR 14 cyanosis level improves View BMS 4 Patient recovers Sort by Mame CO Poisoning Recover MSR HR 100 BP 105 72 3 Healthy Diabetes Recovery MSF HR 100 RR 30 BP 90 60 E epiglottis treated HR 100 O2 Sat 95 BP 90 70 Care Required HeakhvPed alvitals are sst to aheatthystate 0 O oma e Obstructive Shock 4 MSR HR 91 O2 Sat 9795 BP 93 71 Organoph Poisoning 4 BP 95 over 69 HR 90
100. ed scenario click on play and watch the vital signs adjust according to the Specifications of each palette Copyright 2010 by Gaumard Scientific All rights reserved 83 84 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 Instruction Manual Pediatric HAL S3004 S3005 f Creating Your Own Scenarios Building a scenario Is very simple Click the Add to Scenario button on the right side of the page Details Palette Lab Model Scenario Speech Log Gaumard Go to Branching Scenario Load Scenario Add to scenario Mame Transition Description gt um lt MEME You will be presented with a list of all the Palette Items in the active Profile and a field for setting the transition time When running a scenario this transition time functions just as the time on the Apply buttons on the Details and Palette pages Copyright 2010 by Gaumard Scientific All rights reserved 85 Instruction Manual Pediatric HAL S3004 S3005 Add Palette Item Palette Lab Transition Apneic girl i H pneustic 59 Oo M ax i Aspiration Item Description Aspiratianz Respiratory distress Asthma 2 Asthma 3 systole Amwayobstr 2 Walt Wait Indefinitely Cancel From the Add Item dialog box you may also choose the Wait item which causes a delay of a specified duration or a Wait Indefinitely item which
101. em before playing it Similar to the Next button the Previous button returns the indicator to the previous item in the scenario The Reset button stops the scenario immediately and returns the indicator to the first item in the scenario Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 d Factory Preset Scenarios i Manual Mode These scenarios in the manual mode are found in the Quick Start Pediatric 5 profile Six of these scenarios are linear and fourteen are branching All shown are for a five year old patient Scenario Scenario l E Scenario Description Name Type Linear A five year old known asthmatic began coughing and wheezing the previous day His parents had run out of his daily steroid inhaler two weeks ago He received two nebulized Albuterol the day before and Asthma Respiratory slept through the night He had one treatment this morning but by mid morning he was in respiratory distress with audible wheezing and visible retractions He cannot speak in full sentences A five year old boy has a gunshot wound to his chest The family has Cardiac Cardiac called 911 but has not begun CPR You are the first responder with Tamponade your emergency team The boy is unresponsive with an entry wound near his heart The family said he was crying a few minutes ago A five year old boy is rescued by his father from a house fire He was found in his bedroom asleep T
102. ent General Environment General CPR Options Pacing Shock CPR Options Pacing Shack Tolerances Tolerances OnevearOld Features Pediatric Hal 4 EE Pediatric Features OneYearOld HAL s Add Ons add even more PEDIATRIC HAL s Add Ons add even more fidelity fidelity ta your simulation to your simulation Line vearQld HAL virtual Monitor EELIATRIC HAL Virtual Monitor se OneYearOld Virtual Vital Signs Monitor se Pediatric Virtual Vital Signs Monitor Emgiatric Kits Ede Right Index Bleeding Kit Cancel Cancel Once the Vital Signs Monitor option is enabled the menu will appear Copyright 2010 by Gaumard Scientific All rights reserved 157 Instruction Manual Pediatric HAL S3004 S3005 a Sensors This tool allows you disable any of the waveforms present in the Virtual Signs monitor Monitors CPR Aw Help ECG Leads Spo Probe File sharing Custom numbers NIBP Cutt Thermometer Configuration Resp Monitor Capnography Appearance ABP cannula all On Arwar Upper airway Dp all OFF Breathing Window Select any of the waves that you will like to display and click on ON or OFF ECG Leads Spo Probe NIBP Cuff File sharing Custom numbers Configuration Resp Monitor Capnography ABP cannula Appearance ja Al ON Aimwaw Upper AH WV pp all OFF ge ees 30 ng Window The virtual sig
103. er O2 20cc kg normal saline bolus Bolus of D10W Infusion of IV fluids with glucose Chin lift and deliver O2 Treat glucose deficiency and hypotension Deliver O2 and correct hypotension Intubation Or 2 Min Timeout gt 196 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 Gaumard Simulators for Health Care Education Pediatric HAL Five Year Trauma Scenario Organophosphate Poisoning OP Poisoning A five year old immigrant boy wandered in a field that was recently sprayed with pesticides Organophosphate His parents took off his cloths and washed him off with water but a few minutes later he began vomiting and became limp They drove him to the ED that was thirty minutes away Atropine 0 01 epeat Atropine at higher dose and add mg kg IV 2PAM YES Copyright 2010 by Gaumard Scientific All rights reserved 197 Instruction Manual Pediatric HAL S3004 S3005 e Pediatric HAL Five Year Trauma Scenario Gaumard i Sid tors for Heeb ab Ed caton Renal Failure and Hyperkalemia A five year old boy presents to the ED with some tiny red dots on his arms and legs and his mother says he hasn t peed since yesterday Last week he had some bloody diarrhea and has been vomiting for two days but they were on va
104. er than these settings will be taken into account by the software In this tab you can e Select the number of desired compressions per minute e Specify the compression ventilation ratio e Select number of ventilations per minute if the Only Ventilations button is selected Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 vill Other ame Other oo Once a Palette is applied load to Details Tab Use AV System Start AY Automatically on Scenario Start Output Lag Events to Windows Log Model Activation Code A fff OK OK Cancel This tab gives you additional control over the simulation The first option Once a Palette is applied load to Details Tab is useful for people that want to keep track of the latest parameter that were updated using the Details Tab The second option Use AV System Iis used to enable the A V Link NOTE Please consult with your A V System s manufacturer for compatibility with Gaumard s Simulators prior to setting up the A V Link Interface GaumardUl is capable of interfacing with a number of third party A V recording systems that enable the capture of Audio and Video interlaced with the events recorded in the software log Enabling the AV Link displays the following A V menu Copyright 2010 by Gaumard Scientific All rights reserved 141 Instruction Manual Pediatric HAL S3004 S3005 Clic
105. ew 10 Completely self contained and mobile Pediatric HAL is fully responsive and functional even when carried RF communications up to 150 feet 50 meters Powerful yet intuitive user interface software Airway Oral and nasal intubation Use an ET tube or LMA Sensors detect depth of intubation Unilateral chest rise with right main stem intubation Multiple upper airway sounds synchronized with breathing Appearance Color responds to hypoxic events and interventions healthy mild cyanosis severe cyanosis Eye blinking eyes open close and blink at given rates Pupil Dilation responsive to low ambient light and high intensity light Breathing Control rate and depth of respiration and observe chest rise Ventilation is measured and logged Gastric distension with excess BVM ventilation Select independent left and right lung sounds Chest rise and lung sounds are synchronized with selectable breathing patterns Accommodates assisted ventilation including BVM and mechanical support Unilateral chest rise Circulation Conductive skin regions allow for ECG monitoring with real equipment Conductive skin regions for electrical therapy defibrillation cardioversion pacing Multiple heart rhythms rates and complications Heart sounds include a normal heart as well as atrial and ventricular septal defects Chest compressions are measured and logged Blood pressure can be taken on the left arm using a cuff palpation or au
106. expressions that can be initiated with a single click on the Speech page The collection of soeech and other sounds was chosen to cover a wide range of simulated emergencies S3004 Pediatric HAL One Year Old Details Palette Lab Drugs Scenario Speech Log Gaumard Reply Yes No Urgency Ouch That hurts Complaint iE Were is dad mommy Evasion Want to go Don t touch Feel fine peas Effect cough COUGH gag GAG More 104 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 S3005 Pediatric HAL Five Year Old Gaumard Occurrence 2 EEEEEEEEIEE History manm mm em ames HH EE Copyright 2010 by Gaumard Scientific All rights reserved 105 Instruction Manual Pediatric HAL S3004 S3005 One benefit of prerecorded sounds are that they are consistent so that providers interpretation of Pediatric HALG s speech is not colored by the variable quality of an actor s performance Further the facilitator need not spend time and resources casting and directing said actor For ease of use Pediatric HAL s expressions are divided into natural categories and laid out on a single page all visible at once b Streaming Audio if factory installed otreaming audio makes your simulation
107. f the patient Create a Palette Item to describe this condition Make sure that this first step in the scenario is a complete state That is indicate some selection for each and every available setting on the Details page Remember that only the settings you specify will cause a change in HALG and all other settings will remain constant So by starting with a complete state HAL s condition will always be the same when the scenario starts regardless of what he was doing previously Likewise the transition duration of the first step in the scenario should be zero indicating that changes are applied immediately There is one point that can cause confusion and warrants further explanation It is an extension of the above discussion of partial states The issue is best illustrated through the following example Copyright 2010 by Gaumard Scientific All rights reserved 223 Instruction Manual Pediatric HAL S3004 S3005 Suppose that you are creating a Palette Item to start your scenario In this case you have decided that the patient will be apneic The question is How should the lung sounds be set Most people s first inclination is to set the lung sounds to none This is incorrect despite apnea Obviously no lung sounds should be heard during apnea but since you have already set respiratory rate to zero none will be Sounds are synchronized to the breathing cycle What you are really setting here when you choose a lung s
108. face IO Gaumard_UI CONE Palettes IO Tech Support ED Shortcut to Debug i Shortcut to Gaumard User Interface 3 Shortcut to Help Images ig Shortcut to manuals on devin My Documents My Computer aS File name IK ealthy Resting plt v My Network Save as type Palette Items plt v Specify a path and click Save Note that only one item may be exported at a time h Exit Setup Monitors Profile Mew Session Reset Session Clack Save Report Print Report Import Export Exit the software at any time by going to File Exit The software can also be closed by using the shortcut key Alt F4 Also exit by clicking on the x button at the top right corner of the user Interface 126 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 2 Set up a Calibration Ary Help Options 1s m e mm m m um um Do dcm fy lira a Remote Access via Meteor Scan RF Channels This tool allows easy calibration of the sensors Inside the manikin First choose which function to calibrate Chest compressions artificial ventilations or blood pressure cuff Calibration Calibration Vizard Welcome to the Manikin s calibration wizard Proceed only after voL have reviewed the calibration section in the user manual Please select the function yo
109. facilitators screen Click on the Preview button to view the lab report Lab Preview Alice s Baby Report Time 11 56 Description Above Normal Range Hgb Hct Monos Eos 1 CBC with differential Variable Normal Range Comment IWBC K uL 9 00 30 00 27 10 normal values are for term neonates iHgb g dL 13 50 16 50 00 normal values are for term neonates Hct 96 42 00 51 00 53 00 normal values are for term neonates PLTS K uL 242 000 00 378 000 00 300 000 00 normal values are for term neonates Neutrophils a 59 00 59 00 59 00 normal values are for term neonates Bands 96 0 00 0 00 0 00 normal values are for term neonates Metamyelocytes 56 0 00 0 00 0 00 normal values are for term neonates Lymphs 96 31 00 31 00 31 00 normal values are for term neonates Monos 96 0 00 6 00 6 30 normal values are for term neonates Basos o 0 00 2 00 1 00 normal values are for term neonates 0 00 2 00 E normal values are for term neonates 2 CRP C Reactive Protein Variable Normal Range 0 00 1 00 3 Blood gas Variable Normal Range 7 30 7 50 7 30 7 40 within 1st hr of life 7 35 7 45 after 7 30 7 50 7 30 7 40 within 1st hr of life 7 35 7 45 after 35 00 45 00 35 00 50 00 l 50 00 80 00 pO2 CBG mmHg 35 00 45 00 HCO3 ABG mmol L 19 00 26 00 lower limit of normal after 48 hrs of life is 22 HCO3 CBG mmHg 19 00 26 00 lower limit of normal after 48 hrs of life is 22 2 00 2 00 2 00 2 00 0 00 1 00 0 00 1 00 4 Ele
110. g box is very useful for troubleshooting because it gives the user feedback on all of the working modules inside the manikin The user can click on the button that says Check All Modules and the software checks which modules are responding 53004 Diagnostics Info SN 00000000 File Audio Throat voice Throat Streaming Heart Lung Front Upper Right Lung Front Upper Left KK Right Q KK Left Bowel Upper Right Bowel Upper Left Bowel Lower Right Bowel Lower Left Pressure BP Right Q BP Left ventilation Compression Compressor Extra Compressor 232 Mechanical Other Tongue ECG Trachea Intubation Carotid Eyelids Q Radial Right Q Right Pupil Dilation Radial Left Left Pupil Dilation Femoral Cyanosis Lung Right Lung Left Breathing Right Side Seizure Left Side Seizure Legend Q Active Inactive Check Modules Check Single Module Check All Modules Check All volumes Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 Audio Mechanical Other Legend Throat voice Tongue ECG Active Throat Streaming Trachea Intubation Inactive Q Heart Check Modules Lung Front Upper Right Carotid Eyelids Check Single Lung Front Upper Left Q Radial Right Q Right Pupil Dilation Module R
111. g rate cyanosis etc Copyright 2010 by Gaumard Scientific All rights reserved 19 20 Il Manikin Features Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 Instruction Manual Pediatric HAL S3004 S3005 A Disclaimer The section below describes all possible features in the Pediatric HAL simulator series Please use the table below to identify which features are standard and which ones are optional in your HAL model before you complete reading Section ll Manikin Features Legend Y Yes N No O Optional T 5YO Manikin Feature 3005 Y 1YO Comments S3004 Y Breathing Airway Sounds R L Chest Rise Breathing Lung Sounds Locations Cardiac Defibrillate cardiovert pace Right and left ECG generated in real time Right arm IV Circulation eft arm virtual BP Disable Pulses Bowel Sounds Systemic Male Female Catheterization Streaming Audio Physiologic Model Other y g Instructor control data change The content of this table is subject to change without prior notice Please contact Gaumard Carotid brachial radial femoral Starting with SN P0904113 Y DEI 150 feet 300 feet Scientific for the most current information Copyright 2010 by Gaumard Scientific All rights reserved 21 Instruction Manual Pediatric HAL S3004 S3005 A Airway Intubation HAL s airway can be intubated both nasally and orall
112. h an extra branch in the tubing The Luer lok fitting on the end of the extra branch must be connected to the Luer lok fitting on Pediatric HALG s left shoulder some facilitators prefer to make this connection before commencing a simulation session 26 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 IV Arm HAL has IV training functionality in his right arm only it can be used for bolus or intravenous Infusions as well as for drawing fluids Locate the fill syringe and fill it with the desired fluid water or simulated blood Insert the fill syringe and drain connector as shown and push the fluid into the IV circuit until it starts to come out the drain connector A Warning Use only Gaumard s provided simulated blood Any other simulated blood brand containing sugar or any additive may cause blockage and or interruption of the vasculature system Copyright 2010 by Gaumard Scientific All rights reserved 27 Instruction Manual Pediatric HAL S3004 S3005 After the circuit is full just remove the fill syringe and drain connector and the self sealing ports will keep the fluid inside the veins For simulation of high volume infusions it is necessary to leave the drain tube attached and run it to a suitable outlet or container t d Warning Do not attempt to fill IV systems without the drain connector in place as It can seriously damage the system Intra
113. he desired choice and specify the volume or concentration and the rate then click on Start IV or Start O2 You can stop the administration at any time by clicking Stop Fluids amp Gas Canines bs m Rae mooo sibi f ee nenne x top IV MM M j Concentration E Yo Rate a umin Stop D Adding New Drugs In the event that a desired drug is not found in the list provided as many drugs as might be desire to complete scenarios can be added To do so follow the simple procedure described below 1 First create a palette that illustrates the effect of that drug You should create four different dose effect pallets per drug an under dose standard dose high dose and an overdose palette 2 After completing the dose effect palettes create a drug profile To do so go to the Drugs page and click on the button labeled Manage Drug List 02 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 Status c m e e Re Gaumard I a m Rate pu Dose Administer Airw ay Crying Throat Sound Breathing Lung Condition Resp Pattern Rate 14 bpm 9 i M E Stop Infusion Remove from list Change Dose and or Rate Warp Factor 7 Q Right Lung Fluids amp Gas Q Left Lung Oxygen Concentration oO Rate tumin Transition remaining 00 00 00 ON i z3 Q fa n G li Copyright 2010 by Gaumard Scientific
114. he room was engulfed with flames Fire Victim Systemic and smoke His pajamas are charred and his face is burned and covered with soot His pajamas are removed to reveal his arm and torso are burned A five year old boy was visiting his grandmother who had a bowl full of peanuts on the table He and his older brother were throwing the peanuts in each others mouths and laughing The five year old Foreign began choking and gasping for air He could still say a few words Respiratory Aspiration between coughing but then he collapsed to the floor His grand mother ran into the room and his older brother explained he had choked on a peanut His grandmother saw he was turning blue She told her grandson to call 911 5 year old female with heart condition is poorly responsive has a Girl w VIT ach Cardiac IE weak pulse and diminished perfusion Copyright 2010 by Gaumard Scientific All rights reserved 15 Instruction Manual Pediatric HAL S3004 S3005 Scenario Scenario l mE Scenario Description Name Type A five year old boy with Sickle Cell Anemia is brought to the ED with what the mother thought were infected mosquito bites She treated them with antibiotic ointment Most of them improved except for one Septic Sereni large area on his abdomen that now measures 3X4 cm with a Shock localized abscess formation He developed fever yesterday of 104 degrees F Today he has developed chills and his temperature is still 104 de
115. he volume of each of Pediatric HAL sounds can be adjusted from the Status Panel Click on the volume level indicator next to each sound and a volume control will pop up Select the volume level desired and the sound will be adjusted instantly on the manikin i e there is no need to click Apply 42 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 2 Details It is best to think of controlling the Pediatric HAL simulator in terms of three levels of complexity first Details then Palette and finally Scenarios The Details page is the first of the tab pages found in the main area of the software window This is the simplest form of control available to the facilitator Note that for each item in the Status panel there is a corresponding field or control on the Details page S3004 Pediatric HAL One Year Old Manual Mode Details Palette Lab Model Scenario Speech Log Gaumard Legend Clear Settings Load Palette Item Save as Palette Item Qo eot Airway Upper Airway Sound v Tongue Edema Breathing Resp Pattern v OSat na Left Lung Right Lung Respeto Rate x change Chest Rise Chest Rise breaths min 1 Sounds __ change Inspiratory Time EtCO2 EU Sounds ouncds n change Circulation Rhythm Sinus Arrhythmia Blood Pressure
116. hich might be taught by multiple instructors e For the most detailed exercises it is sometimes useful to devote an entire profile to one particular subject area or even one particular scenario Profiles are used to organize and protect software settings As you begin to customize Pediatric HAL it will become clear how profiles can best serve your needs For example v tmay be appropriate to assign one profile to each user of your HAL system v Others may choose to create a profile dedicated to a specific academic course which might be taught by multiple instructors v Forthe most detailed exercises it is sometimes useful to devote an entire profile to one particular Subject area or even one particular scenario 36 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 To access the Profiles dialog box at any time select Profiles from the File pull down menu setup Monitors CPR Profile New Session Reset Session Clack Save Report Print Report Import Export Exit When starting out with Pediatric HAL it is recommended that you use the Quick Start Scenarios profile which was created in conjunction with experienced healthcare instructors and working medical professionals Quick Start Scenarios instantly turn you into a simulation expert One can also choose the Default profile which has a generally applicable palette that is useful
117. ic All rights reserved Instruction Manual Pediatric HAL S3004 S3005 Pediatric HAL One Year Cardiac Scenario Gaumard Sinus Tachycardia and Hypertension Simulators for Health Care Education Methamphetamine Ingestion A young mother brings her baby to the ED She says her baby was crawling on the floor and put something in his mouth and swallowed it about an hour ago You notice the mother is thin jittery with open sores on her face and arms You consider the ingestion may be a stimulate No cooling blanket fluids or Diazepam Cooling blanket fluids or Diazepam Perform actions Treat hypertensive urgency with IV Enalaprilat Vasotec and wait 15 minutes Wait 15 minutes for BP to drop further Copyright 2010 by Gaumard Scientific All rights reserved 219 Instruction Manual Pediatric HAL S3004 S3005 Pediatric HAL One Year Cardiac Scenario Gaumard Simulators for Health Care Education Congenital Heart Failure A one year old boy is transferred to your facility with a history of weakness and seizures despite therapeutic levels of anticonvulsants Normal CT Scan spinal fluid and electrolytes 30 second wait V Magnesium Sulfate 220 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 Pediatric HAL One Yea
118. ick on Load Notice that the factory pre set patient Infant or Pediatric cannot be deleted as opposed to any of the patients that you create yourself which can be deleted Also notice that after loading a patient there are two places where you can see the name 152 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 1 Right side of the page under the Details tab Patient s Info Patient s Info Name Infant Name Pediatric Gender wl Gender M Age 1 Age y Height 80 0 cm Height 108 0 cm Weight 10 0 kg Weight 18 3 kg Infant is a Pediatric is a healthy 1 year healthy 5 year old old Mew Load New Load The three buttons at the bottom of this display can also be used to add a new edit or load patients to the model 2 Top of the page under the Palette tab Details Palette Lab Scenario Drugs Speech Log Gaumard Infant Name Description Details Palette Lab Scenario Drugs Speech Log Gaumard Pediatric Name Description Copyright 2010 by Gaumard Scientific All rights reserved 153 Instruction Manual Pediatric HAL S3004 S3005 b Reset Model Modeling Monitors CPR AJV Modeling Patients Reset Model Import Between Patients Auto Log Settings Clicking on Reset Model under the Modeling drop down menu will restore all vitals and physiologic controls to normal state For instance if the ECG rhythm i
119. icular Tachycardia Adenosine OD Adenosine SD Adenosine UD Copyright 2010 by Gaumard Scientific All rights reserved 189 Instruction Manual Pediatric HAL S3004 S3005 s r oe Pediatric HAL Five Year Respiratory Scenario 7 Simulators for Health Care Education Asthma AL H y v ON A five year old known asthmatic began coughing and wheezing the previous day His parents had run out of his daily steroid inhaler two weeks ago He received two nebulized Albuterol the day before and slept through the night He had one treatment this morning but by mid morning he was in respiratory distress with audible wheezing and visible retractions He cannot speak in full sentences Wait indefinitely for O2 and Albuterol Wait indefinitely for second inhalation treatment with albuterol and atrovent 190 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 Gaumard Pediatric HAL Five Year Respiratory Scenario Simulators for Halth Care Education Foreign Body Aspiration SUA A five year old boy was visiting his grandmother who had a bowl full of peanuts on the table He and his older brother were throwing the peanuts in each others mouths and laughing The five year old began choking and gasping for air He could still say a few words between coughing but then he collapsed to the floor His grandmo
120. ientific All rights reserved 161 Instruction Manual Pediatric HAL S3004 S3005 c Custom Numbers Use the custom numbers tool to add a new parameter such as glucose level or platelet count to HAL s virtual monitor EnsOrs File sharing Custom numbers Configuration On clicking the Custom numbers option the following dialog box is displayed Custom Numerical Parameters on Monitoarts y Remove Click Add to enter a new parameter for display in the virtual monitor This dialog box Is displayed Custom Numerical Parameters on Monitor s y JK Cancel Enter the name and units of the new parameter and click OK The new parameter is displayed Several custom numbers may be entered at a time 162 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 Custom Numerical Parameters on Monitarts y ave Load Add Remove On e Glucose os mg dl update Off On l gt Hematocrit Je On update oT B TSH 4 ucu mL update oo Enter the amount to be displayed in the virtual monitors and click update Have the student or provider close one of the parameters currently displayed by the virtual monitor by clicking on the button of the value to be removed and selecting Close Now the new custom number has a display slot Copyright 2010 by Gaum
121. ific All rights reserved 211 Instruction Manual Pediatric HAL S3004 S3005 Pediatric HAL One Year Respiratory Scenario Gaumard Upper Airway Obstruction T DELE Toy Aspiration RN You are at a birthday party where you see a one year old trying to blow up a balloon Instead of blowing out he sucks the balloon in and begins gasping for breath He is turning cyanotic and cannot cry You assess his airway is obstructed and the obstruction must be removed You try simple measures as back blows and chest thrusts and activate EMS Unsuccessful or 1 min timeout Airway cleared successfully Yes Intubation Airway cleared performed Yes Yes successfully successfully Unsuccessful or 1 min timeout Unsuccessful or 1 min timeout 30 second wait 212 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 Pediatric HAL One Year Respiratory Scenario Gaumard Simulators for Health Care Education Crou p You are called to a home at two a m because a one year old boy can t breathe His parents said he was fine when they put him to bed He has had no illness before and there is no history of asthma He woke up with a barking cough and then began to struggle for each breath They called their advice line that said to put him in some steam from the bathroom shower He did not improve so they called
122. inate any noise caused by rubbing of internal parts during breathing Store HAL in a cool dry place Extended storage above 85 degrees Fahrenheit 29 Celsius will cause the manikin to soften and slowly warp It is acceptable to operate HAL at an ambient temperature of 95 degrees Fahrenheit 35 Celsius HAL is splash proof but not water proof Do not submerge or allow a large volume of fluid to enter the interior of the manikin Do not expose the tablet computer to water or excessive dust unless it is protected by a rugged case available separately Mouth to mouth resuscitation without a barrier device is not recommended as it will contaminate the airway Treat HAL with the same precautions that would be used with a real patient The use of needles larger than 22 gauge will reduce the lifetime of the lower arms skin and veins Copyright 2010 by Gaumard Scientific All rights reserved 183 Instruction Manual Pediatric HAL S3004 S3005 Replace needle decompression targets by exposing the ribs and disconnecting the Luer lok fitting that secures the target Follow the instructions for closing the chest in the Equipment Set up section of this guide Replacing the battery should only be done while HALO is in STAND BY mode or when the software Is not running Refer to the Equipment Set up section of this guide for more details on power modes When the arm veins require replacement contact Gaumard to arrange for a lower a
123. ing e Gaumard Monitor PC next to the Simulator e RF should be disconnected from the GaumardUI PC and connected to the Gaumard Monitor PC e Once the GaumardUl has established communication with the Gaumard Monitors using WiFi or Ethernet connection the user should proceed to connect the Remote Access Via Network Remote Access Via Network should only be used when having difficulty maintaining a connection with the Simulator in an enclosed environment such as a simulation center with many walls between the Simulator and the controlling PC The user will require the following e Gaumard Monitor PC next to the Simulator e RF should be disconnected from the GaumardUI PC and connected to the Gaumard Monitor PC e Once the GaumardUI has established communication with the Gaumard Monitors via network the user should proceed to connect using the Remote Access Via Network Settings must also be adjusted on the Gaumard Monitors to complete the connection correctly See Section V C 3 b for the Virtual Monitor menus and settings Copyright 2010 by Gaumard Scientific All rights reserved 143 Instruction Manual Pediatric HAL S3004 S3005 d Auto Responses Monitors CPR Alv Help Calibration Options Auto Responses Scan RF Channels Auto responses Is used to program electrical therapy to auto prompt or off Mon scenario autanmatic resparises settings All Off Link All Auto Response to Cardiac Irritability gre
124. instructor is able to play any of the custom phrases by either typing on the text box or clicking on the menu option Once a phrase is selected it can be played as the manikin s voice or deleted Details Palette Scenario Lab Speech Log Voice Recorder Streaming Voice Controls Rec Prerecorded Speech I m scared My head hurts My name is More If the instructor wishes to play any of the Simulators prerecorded speech phrases he or she will need to click on the More button located on the bottom right corner of the Speech page Copyright 2010 by Gaumard Scientific All rights reserved 109 Instruction Manual Pediatric HAL S3004 S3005 9 Log The Log page allows the facilitator to keep track of every event during a session It automatically creates an entry whenever a detected event occurs as well as every time there is a change in the patients condition In addition the facilitator can log observed provider actions with a simple click Details Palette Lab Drugs Scenario Speech Log Gaumard Providers add Team Basic Airway Breathing Circulation Assess Determine Airway Vagal maneuver wa in FesSparisiveness I wr patency me E management ur MS Bcesecdkenihing mn lan aetna T m Attach electrodes T Call For Open airway Open airway E Intubation check Intubation check m O2 device mistica i assistance
125. io Description b Linear You are called to a home at two a m because a one year old boy cant breathe His parents said he was fine when they put him to bed He has had no illness before and there is no history of asthma He woke up with a barking cough and then began to struggle for each breath They called their advice line that said to put him in some steam from the bathroom shower He did not improve so they called 911 A one year old boy falls into the pool and is found floating a couple of minutes later When the paramedics arrive the child is not breathing has severe cyanosis and he is in asystole A one year old boy presents to the ED with a three day history of vomiting and watery diarrhea with out blood or mucous He attends daycare and a note was sent home about two other children with rotavirus diarrhea He was given Pedialyte the first day and his vomiting and diarrhea decreased on the second day Today however his diarrhea is constant and he has refused to drink His urine output is unclear because of the diarrhea in the diapers During your assessment he has a thirty second period of tremors You are called to a home where a one year old child is gasping for breath His mother says he has had wheezing before and is being treated for baby asthma He saw his doctor last week and has been receiving nebulized Albuterol three times a day for one week Over the past few days his fever has increased to 39 1 Deg C his no
126. ion The configuration button is used to properly connect the virtual monitor to the tablet Clicking on it displays the following window a Pediatric HALE Five Year Virtual Monitor Setup Select the number of monitors that will be used with this manikin Also vou can name each monitor with an appropiate description except tor Swan Ganz Adapter Loopback no network v lt refresh Controller IP 127 0 0 1 Port 8001 lt find avail Connected ta Connect When properly configured and connected the connection status display will turn green and the monitors will show waveforms and readings 166 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 o CPR HAL can also be used as a teaching aid for CPR There are a couple of features that allow the instructor to get some feedback on how well the providers are doing the CPR Click on the CPR menu for those options Evaluator Options It is Important to know that the chest compressions will only give feedback to the instructor if the heart rate is not set to a healthy state and ventilations will only be reported if the respiration rate IS set to zero a Evaluator Evaluator Options This feature allows the instructor to get real time feedback on the current compressions and ventilations being done by the providers Copyright 2010 by Gaumard Scientific All rights reserved
127. istance Contractility RA 100 Rv 100 LA 100 Lv 100 5 Cardiac Irritability circulatory essel Diameter Vessel Stiffness Blood velume 900 m Hespiratory Amb Pressure 1 00 ATM Inspire 2 21 Inspire coz 0 So PH 40 Shunt Flow 8 95 Dead Space 12 mi 39 Instruction Manual Pediatric HAL S3004 S3005 S3005 Pediatric HAL Five Year Old Manual Mode Automatic Mode Status coll T u T Status cU T E ABC More i0 Am EE Adv E nau cs Temperature 37 5 C Airway 2 Circulation Cardiac Tongue Edema yf skin color Q Tongue Edema Tricuspid Valve Regurgitation Throat Sound SeIZUres Throat Sound Resistance Es Regurgitation Breathing M Breathing Patient State Resistance Resp Pattern Pupils Skate LIS Enabied on Heart Sound Eyes State Pulmonary Valve Mitral Valve Regurgitation Resistance Rate 15 bpm I 33 9 4 Fm Q Enabled Ren Exn Time 0 5 sec Q Right Lung EIL Cardiac Rhythm snd Bowel Sound Aortic Valve di Lung Condition Fegurgitation Q Left Lung Resistance mm L he oun sn EN LL _ Gir Resp Pattern Heart Rate 95 bpm Contractility Oz Sab 98 o Sinus arrhythmia RA 100 RY 100 EbCO2 37 mmHg Ji Right Index Bleeding Rate Z2 bpm Blood Pressure L R L 100 Lv 100 95 Circulation We In 37 E 99 65 mmHg Cardiac Irritability Tidal Volume 116 ml Cardiac Rhythm
128. ive year old girl was recently adopted from another country Her immunization status is in question and her parents had planned to have her immunized soon Two weeks after her arrival in the United States she developed a high fever of 40 Deg C and has difficulty in swallowing Her voice became weak and she had coarse siridor with every breath Her parents tried treating her for croup with some cool mist as they had their other children but she showed no improvement Her parents then brought her to the E D E li ED Intubation with O2 Intubation or cryco Fluid bolus Dopamine drip Antibiotics IV Antibiotics Corticosteroids Copyright 2010 by Gaumard Scientific All rights reserved 193 Instruction Manual Pediatric HAL S3004 S3005 Pediatric HAL Five Year Trauma Scenario Gaumard Simulators for Health Care Education Chest Injury A five year old boy was racing his BMX bike over a dirt hill in his back yard He had his helmet on but not his chest protector His mother was watching and said he became airborne and the handle bar of the bike landed on his chest when he hit the ground He is crying my chest hurts and l cant breathe He was not unconscious and his extremities and abdomen appear normal You suspect fractured ribs a lung contusion or a tension pneumothorax
129. king on A V Setup displays the following dialog box ATP Link Information 4 Link Information Adapter Controller IP 192 168 1 10 Connected to This menu permits sending Start and Stop messages to the recorder as well as displaying the connection status In order to set up the connection on the A V System side please consult your A N System s documentation GaumardUl also permits automatic sending of a Start Record message to the A V Unit NOTE Because it is possible to extend a simulation session beyond the last step in a scenario the Stop Recording message does not have an automatically stop option c Remote Access Via Network Monitors CPR Help Calibration Options Remote Access Via Network Auto Responses Set Med ID Scan RF Channels The Remote Access Via Network should only be used when having difficulty maintaining a connection with the Simulator in an enclosed environment such as a simulation center with many walls between the Simulator and the controlling PC 142 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 He Remote Access Via Network Standard RF Communication Remote Access Via Network Remote Access Via Network Adapter Local Area Connection Y lt refresh Controller IP 192 168 1 126 Port 8002 lt findavail Connected to Connect The user will require the follow
130. l Of reserve in the body Option 2 Shunk Flow rate percentage of deoxygenated blood in pulmonary capillaries Option 3 Respiratory Pattern and shunt Flow if necessary Option 4 Airway Obstruction and shunt Flow if necessary Please note 1 Option 2 4 bake From 30 sec to 3 min to make the change Lower settings of GSat would decrease model s stability and put patient into crisis e Similarly EtCO2 can be changed by adjusting one of four parameters o Total CO level CO build up in the body o Dead Space part of tidal volume that doesnt participate in gas exchange o Respiratory Pattern o Phlevel End Tidal CO2 mmHg E etcoz change via EINST Total CO level Dead Space Respiratory Pattern PH level Click on the question mark button to display a brief summary of these options Doing so displays the following dialog box Model is going to auko adjust Following parameters according to your EbCOe input Option 1 Total CO level CO build up in the body Option 2 Dead Space volume part of tidal volume thak doesn t participate in gas exchange Option 3 Respiratory Pattern Option 4 PH level Please note Option 2 4 take From 30 sec bo 3 min to make the change There are two controls on this page that are unique to the automatic mode 5O Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 1 Lung Condition This control allows
131. l white blood cell coagulation Ta NEN Neonate Blood test For newborn and premie 7 OB Blood test for Noelle m Copyright 2010 by Gaumard Scientific All rights reserved 57 Instruction Manual Pediatric HAL S3004 S3005 a Creating a Lab Template To begin navigate to the bottom of the tab and click on the New Template button on the right Delete Lab Template Template Description New Template IT Neonate Blood best For newborn and premie Selected Item OB Blood test For Moelle di The Edit Lab Results Template window opens to create and edit templates that will be later used to create lab reports GR Edit Lab Results Template Name Description Category Single Entry Add Remove Rename Insert A v Add Delete Allowed value range is displayed in Value column It won t be visible when entering data Enter a name for the lab template followed by a description 58 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 From the category box click Add to name and create a new category Categories will be used to group a series of tests in a lab report EI Edit Lab Results Format Name Neonate Blood Test Description For newborn and premie Category Single Entry a Click OK to save the new category Use the Single Entry menu to add a test under the category oreviously created EI Edit Lab
132. l range Cardiac Normal range Hematology Low white blood cell count Blood Gases Below normal range pH An editable copy of the lab report is also copied onto the Gaumard UI folder on the tablets home screen For information on how to access other files from the Gaumard Monitor screen navigate to Section lIlI C 4 b Copyright 2010 by Gaumard Scientific All rights reserved 65 Instruction Manual Pediatric HAL S3004 S3005 5 Scenarios The most advanced method of controlling the Pediatric HAL system is to build a scenario a sequence of Palette Items and delay periods This is done on the third tab page in the main area of the software window The best way to think of a scenario is like a playlist of palette items Consistent with this analogy scenario controls at the bottom of the page look and behave just like traditional and software based media players Scenarios let the facilitator automate most of the changes to Pediatric HAL s condition so that their attention can remain on the providers actions The scenario system can also provide standardization of the patient s presentation of symptoms For fair assessment of providers and any research application such standardization Is key a Linear Scenarios Linear scenarios consist of palette items added in sequence with specific transition times as shown in the figure below Details Palette Lab Mo
133. lays the following drop down menu Details Palette Lab Drugs Scenario Log 4 Gaumard Drug Dose Units Route Rate Dose eee Administered Sample Inhalation Demons Unselect D mg kq Inhalation 478 5604 ug kg 00 14 45 Sample Iv Infusion Demon Current Effect Sample Iv Push Dermonstre All Effects Under Dose IV Push 484 1787 ugikg 00 14 31 Sample Per Oral Demanstr Effect Off Standard Dose Per Oral 200 5371 ug kg 00 14 22 Sample SubQ Demonstration High Dose SubQ 492 73 ug kg 00 14 10 D D Sample Topical Demonstration abr Topical 495 6139 uglkg O0 14 02 Stop Infusion Remove tram list Change Dose and or Rate Warp Fatol gt Manage Drug List Fluids amp Gas Concentration EE Rate umi Start 02 Use this menu to Unselect a highlighted drug View the effect the drug is currently having on the vitals of the patient View any of the dose effects for that drug Turn the drug effect off At the bottom of the Drugs page controls for fluids and gas administration are found Fluids amp Gas Concentration 960 Rate umin Start 02 Copyright 2010 by Gaumard Scientific All rights reserved 901 Instruction Manual Pediatric HAL S3004 S3005 Two fluids can be administered saline or blood Fluids amp Gas Fluids amp Gas Saline Ww Oxygen To apply any of these options including oxygen select t
134. lect SigmaTel Audio The Advanced Controls for Alt Mic dialog box is displayed Select Microphone boost under the Other Controls section Click Close Advanced Controls for Alt Mic These settings can be used to make fine adjustments to your audio Tone Controls These settings cantrol how the tone of your audio sounds Bass Low fee Treble Other Controls These settings make other changes to how your audio sounds See your hardware documentation for details Close This should improve the volume of the microphone used for streaming audio Copyright 2010 by Gaumard Scientific All rights reserved 23 Instruction Manual Pediatric HAL S3004 S3005 4 Connecting to the Gaumard Monitors To connect the virtual monitor to the GaumardUl you must have both computers joined to the same network and you must properly configure their IP addresses Make sure that the Monitors menu is visible by enabling it from the Options dialog box The section below describes in detail how to do both of these things First create a computer to computer wireless network connection Note that the wireless connections between the computers are programmed at Gaumard if the simulators are shipped with a virtual monitor In case a customer decides to buy the virtual monitors at a later date the wireless network has to be set either by the user or a Gaumard representative onsite There may also be cases when for vari
135. locking MOST not ALL incoming light then click Set Dilation Light button e Increase Decrease use these controls to increase or decrease the sensitivity to light e Reset to Default Use this button to reset the pupil s sensitivity to the factory settings 136 Copyright 2010 by Gaumard Scientific All rights reserved iil Pediatric HAL Add Ons Options Environment General CPR Options Pacing Shack Tolerances Other One Yearold Features OneYearGld HAL s Add Ons add even more fidelity to your simulation Sine YearOld HAL Virtual Monitor se OneYearOld Virtual Vital Signs Monitor Cancel Instruction Manual Pediatric HAL S3004 S3005 Options Environment General CPR Options Pacing Shack Tolerances Other Pediatric Features PEDIATRIC HAL s Add Ons add even more fidelity to your simulation EELIATRIC HAL Virtual Monitor se Pediatric Virtual vital Signs Monitor Bawiatric Kits s Right Index Bleeding Kit Cancel This tab allows you to select any of the additional packages that you may have installed in your manikin Make sure you select only the Add Ons that are currently being used on your manikin otherwise the software might not control the manikin properly The Vital Signs Monitor simulates a vital signs monitor attached to the patient The vital signs are synchronized through a wireless network between the facilitators tablet and the computer running the mo
136. log entry is created it will have the name of the provider added to it as follows 00 07 41 Charles Parker Action Check for pulses brachial To deactivate deselect the active provider and return to general logging click the Team button and the vertical bars will return to neutral color All provider buttons can be edited or deleted by right clicking them and selecting an option from the menu d Session info The session info area contains the Session Title and Facilitator fields at the top of the page These fields are included when a report is saved or printed Details Palette Lab Scenario Model Log Gaumard Providers Team Emergency Reported Airway Breathing Circulation Assess responsiveness Determine patency Assess breathing vagal maneuver 4 Call For assishance nen Aira lal OF device AFFach elartrndaec dis Copyright 2010 by Gaumard Scientific All rights reserved 115 Instruction Manual Pediatric HAL S3004 S3005 9 Evaluation The Evaluation panel always visible at the bottom of the software window allows the facilitator to insert standard evaluations or arbitrary notes into the log The stylus device and hand writing recognition technology makes annotating in real time very fast and convenient Evaluation Care Provided Linsatisfacbory Satisfactory Standard evaluations are given context by their position in the log relative to detected and o
137. lus is held near but without touching the screen Tapping the screen with the stylus tip is like clicking the primary usually left mouse button Holding the stylus button while tapping the screen Is like clicking the secondary usually right mouse button Calibrating the stylus For working with the Pediatric HAL software and many other applications the stylus input is far superior to a mouse in both speed and comfort An additional advantage Is it can be easily calibrated for your personal comfort On the desktop is a shortcut to the Pen Calibration program which can also be found in the Windows Control Panel The calibration program will present the user with crosshair targets at each of the four corners of the screen Position yourself and the tablet as if you are working and carefully touch the exact center of each of the targets After calibration the pointer should be displayed directly beneath the stylus tip Significant changes to viewing angle should be followed by calibration for best performance Rotating the display One of the buttons along the right edge of the screen rotates the display The display orientation is set at the factory for optimal comfort while using Newborn HAL If you accidentally rotate the QJ screen press the button repeatedly until the original orientation is restored 14 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 3 Charge the Battery
138. mard Scientific All rights reserved 55 Instruction Manual Pediatric HAL S3004 S3005 Many of the functions related to Palette Items are also available by clicking the second mouse button usually the right button while the pointer is positioned over an Item Note when using the tablet computer this is best done by holding the stylus button while tapping the screen For more information on customizing the Palette see the Tips on Palette Item and Scenario Creation section of the Appendix at the end of this guide 56 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 4 Lab Laboratory tests are helpful tools for evaluating the health of a patient To simulate this process the Lab Tab allows the facilitator to create laboratory tests and results Any number of custom templates can be created for use in scenarios In addition the facilitator is in control of the results of each test This gives the facilitator the ability to create reports where results are above or below normal ranges Once a laboratory test is prepared the facilitator can display the results on the Virtual Monitors window for the provider to utilize Details Palette Lab Scenario Model Speech Log Gaumard Lab Reports E Template Description Sent Create New Lab Report Lab Template X Template Description New Template Ig Hematology Blood Test Male red blood cel
139. me New Medication Generic Brand Name Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 4 Under the Description field type the condition this medication treats You can add a Note at the end of your description stating specific explanations about the dosage Description Used to show how to set up a new drug in the software 5 Select the units and the administration route nit n Unit Other Other lug ugkg O mg maka Og O gkg 6 Specify the HALf Life and Peak time If these numbers are unknown use the approximate option to estimate these times It is required that a HALf life and peak time are specified for each drug Halt Life Peak Time min min SEL omues CASALE ome EIEI Approximate Approximate quick 5 20m v 1 Findalist of the available palettes in the bottom left side of the page To add the palettes you created to the drug profile highlight the desired palette and click on the matching button Medication Response Apnlv Items P Threshold Milrinone UD ay r MB Adenosine UD MB Adenosine OD a 1d MB Adenosine 5D E Standard Dose D n E Adenosine UC NB Adenosine UD High Dose HD MB Alprostadil QD cx UC NAE ab Over Dose ob MB Alprostadil 5D Froperties In the example above select NB Adenosine UD and click on the Under Dose button that is indicated by the pointer Once added i
140. muscular Injection Sites IM sites on both deltoids and quadriceps are also available Intraosseous Access Intraosseous access used for the infusion of fluids blood and or drugs directly into the bone marrow of the tibia or other large bone It is a quick way to find venous access when alternate peripheral veins are not visible or palpable Setting up an intraosseous access line Is an invasive procedure that can be simulated with Pediatric HAL 28 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 E Cephalic Reactive Eyes Pediatric HAL has blinking eyes with photosensitive pupils The dilatation state of the pupils the blinking rate and light reactivity are easily manipulated from the tablet PC giving the user total control Central Cyanosis User may choose from various intensities healthy mild severe and use the physiological modeling to trend improvement or degradation of condition For more information about how to use this feature go to Section III A 6 Seizures The seizures mechanism can be used in conjunction with scenarios and can also be set up and saved as a custom Palette Item Choose between mild and severe seizures Copyright 2010 by Gaumard Scientific All rights reserved 29 Instruction Manual Pediatric HAL S3004 S3005 This control will only appear and enable when the tablet is correctly connected to the manikin
141. n Apply NOW 10 sec 30 sec 1 min 2min 5 min 10 00 min s Copyright 2010 by Gaumard Scientific All rights reserved 45 Instruction Manual Pediatric HAL S3004 S3005 Automatic Mode Details Palette Lab Drugs Scenario Speech Log Gaumard ae Airway Appearance Tongue Edema Patient s Info Cyanosis Level Eyes Pupils CEN _ _ 9 L Enable Rxn Time sec Gender IV Eyes State R Enable Rxn Age b y E Height 108 0 cm Breath ng Respiratory Pattern Lung Condition Weight 18 3 kg Respiration Pattern O2 Saturation End Tidal CO2 Pediatric is a o bpm 9 95 mmHg Resp Rate Auto e pee mpm u P change n OSat change EJ coe change bod Een Dco via TotalO2 level w via TotalCO2 level w Tidal volume amp uto ml u Left Lung Right Lung Chest Rise Chest Rise Sounds Sounds rum Note Auto means this vital is auto controled by model Click H button to hold this vital to Current Apply Approximate Time wow 10see aneee rmn 2ein smin 10 00 min 8 Details Palette Lab Drugs Scenario Speech Log Gaumard Legend Qo eo Circulation Patient Status EN Heart Sound Cres EN Patient s Info ECG Name Pediatric Rhythm m r im Gender M Heart Rate Blood Pressure Age 5 y beats min mmHg 5 Height 108 0 cm change n BP i O change Y Vascular
142. n Manual Pediatric HAL S3004 S3005 V Appendix Copyright 2010 by Gaumard Scientific All rights reserved 18 Instruction Manual Pediatric HAL S3004 S3005 A More About Scenarios Pediatric HAL comes with three factory preset profiles designed in conjunction with healthcare professionals Two are in Manual Mode one uses the physiological modeling in Automatic Mode The contents of each are described below In Manual Mode Quick Start Scenarios a variety of complete scenarios and the palette items they comprise Default only a simple Palette filled with common conditions no scenarios When creating a new profile it is often useful to include the Default profile contents and begin customization from that foundation In Automatic Mode Default Modelling only a simple palette filled with common conditions no scenarios When creating a new profile it is often useful to include the Default profile contents and begin customization from that foundation Meds three scenarios demonstrating a sample set of medication reactions Following the list of scenarios are flowcharts displaying specific Details settings actions and health status for each step 188 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 1 Quick Start Pediatric 5 S3005 Factory Preset Scenarios 4 Epiglottitis 1 Chest Injury 1 Soccer boy with SVT 5 Supraventr
143. n wetting the bed He appears pale with sunken eyes and breathing very rapialy Perform Actions Excessive fluids Perform actions Copyright 2010 by Gaumard Scientific All rights reserved 209 Instruction Manual Pediatric HAL S3004 S3005 2 Quick Start Pediatric 1 S3004 Factory Preset Scenarios 1 Shaken Baby Syndrome 2 Drowning Boy 1 Second Degree Block 2 Sinus Tachycardia and Hypertension 3 Congenital Heart Failure 1 Bee Sting 2 Hypovolemic Shock 210 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 iati Laser Pediatric HAL One Year i Respiratory Scenario Simulators for Health Care Education Bronchiolitis NG Y A one year old child is brought to your ER with a one day history of a clear runny nose low grade temperature and a wet cough His mother states today that he is refusing to drink and appears to be breathing fast She claims his immunizations are up to date and he has been in good health Wait indefinitely for suction of nasal secretions and supplemental O2 E Nebulized albuterol Yes treatment successful 2 min timeout Wait indefinitely for racemic epinephrine via nebulizer every four hours Wait next day Copyright 2010 by Gaumard Scient
144. nder e Resistance v v Resistance v v Age l y O Contractility Contractility Height 80 0 cm E omaso RA 5 RV ETS toot CAL LM eight 10 0 kg Infant is a Circulatory Blood volume ml Cardiac Irritability v healthy 1 year ascular Properties ald Vessel Diameter v Vessel Stiffness v Respiratory Shunt flow 96 Dead Space qmi PH Environment Ambient Pressure ATM Inspired Air Mix O2 CO2 96 New Load Note Auto means this vital is auto controled by model Click H button to hold this vital to Current Apply Approximate Time m NOW 10sec 30sec imin 2min 5min 10 00min S3005 Pediatric HAL Five Year Old Manual Mode Details Palette I Lab I Model I Scenario I Speech I Log Gaumard E A SDCGAAELILLZIAIUUULULL LLL Legend Clear Settings Load Palette Item Save as Palette Item Qo of Airway Upper Airway Sound Tongue Edema Breathing Resp Pattern OSat amp Left Lung Right Lung Respiratory Rate chance 3 Chest Rise 3 Chest Rise 9 breaths min Inspiratory Time 08 EtCO Sounds Sounds a ERE men change Circulation Rhythm iv 3 Sinus Arrhythmia Blood Pressure Absent Pulses Y PERRA E Heart Sound Systolic Diastolic Radial Left Radial Right 9 beats min Y 9 mmHg O cana Osee Level Bowel Sounds Pupils w i Be O Enable Ryn Time sec Temperature oC mi Right Index Bleeding O Enable Rx
145. nection on the A V System side please consult your A V System s documentation GaumardUl also permits automatic sending of a Start Record message to the A V Unit NOTE Because It is possible to extend a simulation session beyond the last step in a scenario the Stop Recording message does not have an automatically stop option Copyright 2010 by Gaumard Scientific All rights reserved 173 Instruction Manual Pediatric HAL S3004 S3005 7 Help The help menu has four options GUI Help About GUI Check for Updates and Diagnostics GUI Help About SUI Check For Updates Diagnostics a GUI Help GUT Help About SLI Check For Updates Diagnostics GUI Help allows you to view a soft copy of the entire Pediatric HAL help manual b About GUI GUI Help About aUI Check For Updates Diagnostics 1 4 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 Clicking on About GUI displays the following dialog box Gaumard Simulators for Haalth Care Educatian Gaumaral_l Yersian 1 19 5 0 Firmware 1 19 Copyright 6 2010 Gallmard Scientific Co waw Gaumard cam Le This dialog box gives you the version of the software you are currently using c Check for Updates GUI Help Abaut GUI Check Far Updates Diagnostics Use this feature to check for software updates To check and install software upgrades follow
146. ng A shared folder will be marked as seen below t3aumarcd Ll Add to this folder any kind of files that you wish to share with students or providers Then access the File Sharing Setup window from the GaumardUl Monitors menu Custom numbers Configuration The File Sharing Setup menu Is used to manage shared files File Sharing Setup The files on this list will be accessible from the patient menu on the vital sign monitor The Context Name will be the name displayed Shared Files Available Files File Context Name Quiz rtf Quiz X ray bmp X Ray Chest Hematology rtf Blood Test 160 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 Files in the Gaumard UI folder will be listed on the Available Files panel located on the left To share a file click on the Add button in the middle of the screen Enter a context name on the pop up menu and click OK The shared file will appear on the right list box Remove individual files by using the Remove button on the right A yellow icon will be shown on the top left of the screen once a file is shared This will inform the provider that a file is available for viewing Pediatric f Ask for Click on the Infant or Pediatric buttons to bring down the selection of available files Once a file is selected it will automatically open on the Gaumard Monitor screen Copyright 2010 by Gaumard Sc
147. ng data swe Cancel Navigate to the bottom of the page to save the new category Cancel Once a new template is created it will be listed on the Lab Template section at the bottom of the Lab tab Lab Template Template Description New Template in Neonate Blood test For newborn and premie See ee OB Blood test For Noelle Edit Delete Ea bi Use the buttons on the left panel to edit or delete lab formats 60 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 b Creating a Lab Report To begin click on Create a New Lab Report from the right panel Lab Reports Name Healthy Sortby Name Sortby Color Selected Item E M Lab Format Format Neonate Blood test OB Blood test Edit Lab Report Lab Format Neonate Blood test Format Description For newborn and premie Report Name Description 1 CBC with differential Variable WBC K uL 9 00 30 00 NormalRange normal values are for term neonates Hgb g dL Hct 96 13 50 16 50 42 00 51 00 normal values are for term neonates normal values are for term neonates PLTS K uL Neutrophils 96 242 000 00 378 000 00 59 00 59 00 T normal values are for term neonates normal values are for term neonates Bands 96 Metamyelocytes 96 Lymphs 0 00
148. nitor Vital Signs Monitor allows the user to customize each trace independently of each other users can set alarms time scales boundaries and grid options The HALO Virtual Monitor checkbox allows you to enable or disable the Monitors menu option in the upper left corner of the user interface Once the Vital Signs Monitor option is enabled the menu will appear Copyright 2010 by Gaumard Scientific All rights reserved 13 iv General Environment General Nave able Log Auto Save Save Auto save every 10 4 pss maj Timer D eset session timer once scenario is started amp ical therapy Panel how defibrillation cardioversion panel Stand bv warning Narn the first time trying to apply settings L when system is on Stand By mode Units International System SD Imperial OK Cancel This tab allows you to n Enable auto saving of the log Save your current log report An automatic timer reset option Is in stand by Instruction Manual Pediatric HAL S3004 S3005 Enable message box that will warn you If you are trying to apply changes while the manikin Display shock panel for electrical therapy The shock panel is displayed in the upper right corner of the interface Shack Panel Select units SI or English 138 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 v Pediatric Features labeled a
149. ns and pharmacologic intervention The model used in this operating mode was developed based on physiologic principles Features unique to this mode include a comprehensive list of drugs for easy administration a drug profile editor for adding new drugs or editing existing ones among other things Facilitator the person conducting the simulation an instructor or lab staff member GUI the Gaumard User Interface is the software application used to control the manikin and evaluate care providers Palette a collection of Palette Items Each profile has its own palette Palette Item any full or partial set of physiological parameters that have been grouped and saved together under a single name Profile a unique Premie HAL software configuration including custom Palette Scenarios and options Each Profile acts as a separate program in that changes made to one profile have no effect on the others Provider a person participating in the simulation as a healthcare provider Scenario a saved sequence of physiological states like a playlist Scenarios provide a level of automation that unburdens the facilitator and allows standardized presentation of symptoms Scenario Item a Palette Item that is part of a scenario Scenario Items may also represent a fixed delay period Wait or a pause Wait Indefinitely Stylus a special pointing device for the tablet computer The stylus is the fastest and easiest means
150. ns monitor defaults to All On 158 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 Another way to control the sensors Is to go to Monitors gt Sensors gt Window CPR AN Help ECG Leads File sharing SpO2 Probe Custom numbers NIBP Cuff Thermometer Configuration Resp Monitor EO Capnography ABP cannula B CY catheter SWAN Cane All ON All OFF This option brings up a floating dialog box that can be viewed from any of the tabs in GUI It can also remain opened as the users work in different scenarios The Sensors dialog box looks like the one below Sensors ECG Leads Spo Probe MIBP Cuff Thermometer Resp Monitor Capnography ABP cannula CV catheter SWAN Ganz All ON DFF Light blue radio buttons indicate that a particular sensor is turned on and dark blue radio buttons indicate that a sensor Is turned off In the example above all the sensors are turned on except the Thermometer and the ABP cannula Instruction Manual Pediatric HAL S3004 S3005 b File Sharing File sharing is only available when using the Gaumard Vital Signs monitor To use this tool you must first locate the GaumardUIl folder on the desktop of the tablet The folder must be shared for access by the monitor software This can be done by right clicking over the folder selecting Properties and then Enable Shari
151. nual Pediatric HAL S3004 S3005 ii Automatic Mode These scenarios in the automatic mode are found in the Pediatric 5 s Meds profile There are three linear scenarios and no branching scenarios All shown are for a five year old patient Scenario Name Scenario Description Linear Adenosine OD Asystole gt severe AVB asthma exited Adenosine SD Asystole gt Sinus Adenosine UD Asystole gt previous rhythm These scenarios in the automatic mode are found in the Pediatric 1s Meds profile There are three linear scenarios and no branching scenarios All shown are for a one year old infant patient Scenario Name Scenario Description Linear Adenosine OD Asystole gt severe AVB asthma exited Adenosine SD Asystole gt Sinus Adenosine UD Asystole gt previous rhythm Flowcharts for these scenarios can be found in Section V A of this manual Copyright 2010 by Gaumard Scientific All rights reserved 81 Instruction Manual Pediatric HAL S3004 S3005 e Using Factory Preset Scenarios A powerful way to teach Emergency Care is to use the factory preset scenarios To locate and load any of them follow these three easy steps 1 Goto the Scenario page Details Palette Lab Model Scenario Speech Log Gaumard Go to Branching Load Scenario wee 1 Scenario Add to scenario Name Transition Description A gt m ELE
152. of controlling the Premie HAL software See the Equipment Set up section of this guide for more information on working with the stylus 12 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 C Equipment Set up 1 Connecting the Communication Module The communications module is a USB device and a short USB cable is included The module s USB cable can be connected whether the computer is on or off The affixed patches of Velcro can be used to physically secure the module to the back of the computer When the computer is on the green indicator light on the communications module confirms that it has been correctly installed When the manikin establishes communication with the tablet computer the communication indicator in the status viewer in the GUI will blink green For more information about the communication indicator refer to Section B 1 b A warning Never disconnect the communications module while the Pediatric HAL software Is running Doing so can seriously damage the module Copyright 2010 by Gaumard Scientific All rights reserved 13 Instruction Manual Pediatric HAL S3004 S3005 2 Configure Tablet Computer You should familiarize yourself with the tablet computer instruction manual The following issues are of special importance Using the stylus The stylus operates very much like a mouse You will notice that the pointer moves when the sty
153. on Mild Cyanosis Pedi is bluish and vital signs are starting to deteriorate Severe Cyanosis Pedi is blue apneic and vital signs are rapidly worsening Modeled Therapy Improve Gain Moving this slider will help increase or decrease the cyanotic response to ventilations Oxygen By selecting an oxygen rate the baby will improve faster with proper ventilation Flow On must be selected to activate the oxygen response Epinephrine Select the desired epinephrine dose and then select Administer Immediately the heart rate of the Pediatric HAL should rise and the dose on board should start diminishing over time The dose should be enough to increase the heart rate a small percentage in order to help the oxygen delivery in the system therefore helping improve the neonate with proper ventilation Reset By selecting Reset the oxygen flow and the epinephrine dose onboard will be eliminated CPR Monitor The CPR monitor has two bar graphs and a real time display that gives the user feedback on the CPR given to Pediatric HAL Both bar graphs have a label on the left that change color representing low yellow correct green and high red levels of treatment At the same time the real time graphs also show each compression and ventilation Copyright 2010 by Gaumard Scientific All rights reserved 103 Instruction Manual Pediatric HAL S3004 S3005 8 Speech a Prerecorded Sounds Pediatric HAL has many pre recorded
154. on Manual Pediatric HAL 83004 S3005 179 Instruction Manual Pediatric HAL S3004 S3005 For more information go to the Appendix Section V C 2 180 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 IV Care and Cautions Copyright 2010 by Gaumard Scientific All rights reserved 181 Instruction Manual Pediatric HAL S3004 S3005 A Overall Warnings Remember that damage caused by misuse Is not covered by your warranty It is critical to understand and comply with the following guidelines There are inherent dangers in the use of some medical devices For simulations that incorporate electrical therapy of any kind always know your equipment and follow the device manufacturers safety guidelines Defibrillation is only allowed on the large sternum and apex sites marked green below NEVER deliver a shock to ECG electrode targets on the shoulders or waist marked red below Doing so will not create a fire hazard nor is there risk of shock to the provider but internal damage in HAL may result This situation is considered improper use and is NOT covered by the HALO warranty The system will require repair at our facility Electrode gel on the skin between any two electrode paddle targets can become a pathway for electrical current just as in real life If this occurs HAL s skin can be burned Only deliver electrical therapy when the simulator is intac
155. one or both of the lungs is disabled for chest rise If both lungs are inflating then the pneumothorax function Is not activated Recall that the model is based on accurate physiologic principles and by definition pneumothorax occurs only when one or both of the lungs collapse Copyright 2010 by Gaumard Scientific All rights reserved 8 Instruction Manual Pediatric HAL S3004 S3005 6 Drugs Automatic Mode only The Drugs page is unique to the automatic mode This operating mode contains numerous drugs that are frequently used during cardiovascular care All of these drugs are found in the 2008 Handbook of Emergency Cardiovascular Care published by the American Heart Association To get started select a desired drug from the list Details Palette Lab Drugs Scenario Log Gaumard Drug Dose Units Rate Route E onboard Warp rator Manage Drug List Fluids amp Gas Concentration o Rate uUmin Start 02 After making your selection a brief description is displayed at the top of the window The HALf life and peak time are also indicated as well as the under standard high and over dose effects see figure below 88 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 Drug Dose Units Route Rate Dose men ainephrine Primatene Adrenalin Onboard OCS Drug Properties Description Half Life 00 02 00 Peak Time
156. ound is the condition of the lungs given respiratory drive Thatis if the patient s respiratory rate were changed from zero what sound would be heard Assuming that the lungs themselves are normal in this scenario you would choose normal for the lung sound setting Then as the scenario progresses if the patient starts breathing there will be no need to set the lung sound again It will already be set The same principle applies to the heart sound and other settings 2 Include notes to guide the facilitator during the simulation Itis common for scenario designers especially those who act as facilitators to neglect the importance of notes in the scenario They think that they will remember the learning objectives patient history and other details at the time they are ready to conduct the simulation They usually don t especially when revisiting a scenario months after creating It When you add Wait and Wait Indefinitely steps to a scenario you have an opportunity to edit the item description Use this description field to hold notes to the facilitator Typically scenario designers write notes in that space to indicate what the provider s or facilitator should be doing at that point Further when saving the scenario you may edit the scenario description This is the best place to put patient history and any other longer notes and instructions 3 Assume that providers will do the right thing Usually you should create
157. ous reasons the wireless network needs to be reconfigured This tutorial is specific for Windows XP 1 Locate the wireless connection icon on the bottom right corner of your desktop ec me i odo AM WIRELESS CONNECTION 2 Right click over the icon Asmall menu appears Select View Available Wireless Networks from the options on the menu Disable Status Repair View Available Wireless Networks Change Windows Firewall settings Open Network Connections wr sa7am 3 The Wireless Network Connection dialog box opens Select the link that says Change advanced settings located on the bottom left of this window This will open a new 238 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 dialog box Wireless Network Connection 4 When the Wireless Network Connection Properties dialog box is displayed select the Wireless Networks tab Locate the Advanced button located on the lower right Click on it A Wireless Network Connection Properties BE 74 xj Mawe Up Move dowr Taperties setting up wireless network confiquration Copyright 2010 by Gaumard Scientific All rights reserved 239 240 D Instruction Manual Pediatric HAL S3004 S3005 In the Advanced dialog box select Computer to computer ad hoc networks only Make sure the check box on the bottom
158. pecial needs He wears braces to walk and has speech and language delays He has been vomiting for three days and has been refusing to eat He has also been crying a lot He has no medications His foster father says he has to leave because his wife needs the car to go to work A five year old boy wandered away from his parent s farm house in freezing temperatures He was found by a passing motorist curled in a snow drift He was dressed only in pajamas and his exposure time was at least four hours The motorist wrapped him up and drove him to the hospital A five year old immigrant boy wandered in a field that was recently sprayed with pesticides Organophosphate His parents took off his clothes and washed him off with water but a few minutes later he began vomiting and became limp They drove him to the ED that was thirty minutes away A five year old boy presents to the ED with some tiny red dots on his arms and legs and his mother says he hasn t peed since yesterday Last week he had some bloody diarrhea and has been vomiting for two days but they were on vacation so they didn t see a doctor Copyright 2010 by Gaumard Scientific All rights reserved Scenario Name Soccer Boy with SVT Status epilepticus Supra ventricular Tach Toy Balloon byr 18 Scenario Type E Instruction Manual Pediatric HAL S3004 S3005 Scenario Description A previously healthy boy is brought to the ED because his mo
159. pressions 1 eee Okr Sa Hea EE a e D The waveform peaks either do not reach or exceed the green Good zone Copyright 2010 by Gaumard Scientific All rights reserved 169 Instruction Manual Pediatric HAL S3004 S3005 EE Gaumard Scientific CPR Evaluator Ventlation Data Compression Data 43 Rate 39 min Low Vent tme sec Comp time 0 5 sec Last Vent 00 05 07 Last Comp 00 00 00 dE Here the waveform peak is entering the green Good zone If the compression was as forceful as the preceding compressions the green label will change to red Gaumard Scientiic CPR Evaluator Trainer Ventilation Data 115 Compression Data Rate rin Vent time 0 2 sec Comp time 0 2 sec Last Vent 00 00 00 Comp 00 03 05 Ventilation Count Correct 2 Mot Enough Compressions 1 2 Ok Gare a ete ala B 1 0 Copyright 2010 by Gaumard Scientific All rights reserved EE Gaumard Scientific CPR Evaluator COMPRESSION Trainer Ventilation Data 93 Vent me 0 5 sec ast Vent 00 00 00 ventilation Count Correct z 2 Ok i Ae Instruction Manual Pediatric HAL S3004 S3005 Compression Data Rate min Comp time 0 2 sec Last Comp 00 02 26 Mat Enough Compressions 1 eae eal ee Oy Again the waveform peaks miss the green Good zone for ventilations EE Gaumard Scientific CPR Evaluator COMPRESSION Trainer Ventlaton Data 52 vent time 0 3 sec as
160. ption allows you to change your current profile The profile Profile window is displayed Mew Session Reset Session Clack Save Report Print Report Import Export ExiE Pediatric HAL One Tear Profiles Pediatric H amp L Five Year Profiles Select Operating Mode Select Operating Mode Manual Automatic O Manual Automatic Profiles Profiles Profile Description Profile Description Default Profile Default Default Modeling Default Modeling Scenarios Quick Start Pediatric 1 Meds Profile Quick Start Pediatric 5 7 Quick Start Pediatric 1 Modeling Manage Manage Quick Start Pediatric 5 Modeling Rename Delete Rename Delete Mew Profile Mew Profile Cancel Cancel Copyright 2010 by Gaumard Scientific All rights reserved 117 Instruction Manual Pediatric HAL S3004 S3005 b New Session Clicking New Session in the file menu will v Clear any loaded playing scenario v Clear any loaded playing palette v Resets vital signs to normal values v Clears out log page Restarts the session clock The session clock is located at the bottom of the window Clocks Transition remaining 00 00 00 Session 00 00 01 The shortcut key for staring a new session is Ctrl N Setup Monitors CPR Profile Mew Session Reset Session Clack Save Report Print Report Import Export ExiE 118 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual
161. r Systemic Scenario Gaumard id uu Simulators for Health Care Education Bee Sti ng h T NG SA A You are called to a home where a one year old boy was bitten multiple times by angry Yellow Jackets thirty minutes ago When you arrive you see areas of hives around the bites his lips and eyes are swollen and he has audible stridor Wait indefinitely for Oxygen Epinephrine Nebulized Albuterol Wait indefinitely for Additional Epinephrine IV Favorable response No gt Steroids Benadryl Wait indefinitely for anti hypertensive infusion Copyright 2010 by Gaumard Scientific All rights reserved 221 Instruction Manual Pediatric HAL S3004 S3005 Pediatric HAL One Year Systemic Scenario Gaumard Hypovolemic Shock mE I Hyponatremic Seizures A one year old boy presents to the ED with a three day history of vomiting and watery diarrhea with out blood or mucous He attends daycare and a note was sent home about two other children with rotovirus diarrhea He was given Pedialyte the first day and his vomiting and diarrhea decreased on the second day Today however his diarrhea is constant and he has refused to drink His urine output is unclear because of the diarrhea in the diapers During your assessment he has a thirty second period of tremors Wait indefinitely for two boluses of Ringer s Lactate
162. report look at the figure below Report 1 txt Notepad TE mil Fie Edt Format ew Helo 10 14 2008 12 16 22 model to Brent 00 00 Details EtCO2 14 Model to Brent 00 00 Details EtCO2 9 Model to Brent 00 00 Details EtCO2 4 Apoliec Sag eh Oetails Bleeding OFF Apoliec tc anthony 00 00 oetails Rhythm Sinus D applied to anthony perali s Reset rhe Model model to Anthony 00 005 Detaiis RR 12 EtCO2 40 Info 00 000 Start scenario Apoliecd tc Anthony 00 00 Palette Start State Details Ahythm Asystole AR Ins Model to Anthony tog be 3 Heer site RR 12 Inspire 33 model ro anthony 00 00 Detalls RR O ErCO2 0 l applied to Anthony 00 00 Palette vfib coarse ipetails Rhythm ventricular fibril Apolied to Anthony 00 10 Palette v Tach stable Details Rhythm Ventricular tach Model to Anthony 00 100 Detaiis FR 120 RR 10 Inspire 37 Model to Anthony E oranes HR 120 Model to Brent 3903008 perans ErCO2 19 Li d Model to anthony 00 07 Detalls HR 120 model ro Anthony 09 06 Session Resetting cloc Session CLOCK RESET Model to Anthony 00 05 Model to Anthony 09 04 model ro Anthony Model to Anthony Model to Anthony Model to Anthony 00 00 Model to Anthony model ro anthony petaiis KR 120 uam cm rw t d nit t Details HR 120 RR 16 EtCO 2 38 betalis HR 120 Details BR 120 Details EtCO2 30 Details EtCO2 2
163. right 2010 by Gaumard Scientific All rights reserved 89 Instruction Manual Pediatric HAL S3004 S3005 After highlighting the desired drug that is being applied via IV infusion click on Stop A stopped drug is highlighted red as shown in the figure below Details Palette Lab Drugs Scenario Log Gaumard Drug Dose Units Route Rate Dose Administered Onboard Sweets Sample IM Demonstration mg kg IM 661 3283 uglkg 00 08 16 Sample Inhalation Demonstration 0 mg kg Inhalation 666 509 uglkg 00 08 08 Sample Iv Push Demonstration 0 mgka Iv Push 674 1314 ug lkg 00 07 54 Sample Per Oral Demonstration oO mg kg Per Oral 116 7638 ug lkg 00 07 45 Sample SubO Demonstration mg kg Sub 686 0375 uglkg 00 07 33 Sample Topical Demonstration mg kg Topical 690 0527 uglkg 00 07 25 Restart Infusion Remove from list Change Dose and or Rate Warp rator 7 Manage Drug List Fluids amp Gas Concentratian o Rate umin Start 7 You can restart the infusion of a stopped drug at any time You can also change the dose and rate of drugs that are applied via IV infusion Change drug dose rate Note Leave blank if you don t want to change a parameter Dose Rate Sample IV Infusion maka makg min Cancel 90 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 Right clicking on a drug that is being administered disp
164. rights reserved Instruction Manual Pediatric HAL S3004 S3005 3 Microphone Boost for Streaming Audio Use the instructions below to increase the streaming audio volume Double click on the speaker icon found in the tablets task bar in the lower right corner The Volume Control dialog box is displayed Click on the Option menu and select Properties ii Volume Control Options Properties antral Wave SW Synth CD Player w Advanced Controls Balance Balance Balance mn Je en Je I i B Volume Volume Volume Volume T SER Mute all L Mute Mute Mute SigmaTel Audio The Properties dialog box is displayed Under Adjust volume for select the Recording option and click OK Copyright 2010 by Gaumard Scientific All rights reserved 235 Instruction Manual Pediatric HAL S3004 S3005 Mixer device SigmaTel Audio Properties E Ed volume for v Alt Mic The Recording Control dialog box is now displayed Make sure that the Advanced Controls option is checked in the Options menu i Recording Control iS 21 2 Help Properties w Advanced Controls ES 236 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 Click on the Advanced button under the Alt Mic volume control 31 Recording Control mE Options Help Microphone Alt Mic Balance Balance b 4 b 4 Volume Volume Se
165. rio Scenario Auto Responses Go to Branching Branching Scenario screen Details Palette Scenario Lab Drugs Log Gaumard Clear Save Scenario Load Scenario Go to Normal Scenario 1 Initial Assessment 00 00 ee Reset Model 00 01 Reset physiology model to def o2 supplied by blo by E 5 i TE opoo HR 140 EP 50 30 RR 50 O2 Wait Indefinitely us Wait For actions to be performed E C Prolonged suctioning of posterior pharynx E Iren B Ten Add Item Add Scenario Copy Remove Add path ES rat 2 Correct Action 00 10 d F Give Oxygen 00 00 100 exe yt ait 01 00 No changes are made to manikin LS annes Add Item Add Scenario Copy Remove Add path E 3 Incorrect Action 00 10 E Normal 2 00 30 HR 80 wait 00 20 Transfering to MICLI d Moral ooo HR 140 RR 80 BP 40 35 Tem z Addnode M a D Go to the linear scenario page by clicking on the Go to Normal Scenario button Copyright 2010 by Gaumard Scientific All rights reserved 69 Instruction Manual Pediatric HAL S3004 S3005 Adding Nodes A branching scenario will consist of several Nodes added by the facilitator Each node Is preconfigured to run a normal scenario or a series of palettes The facilitator will then activate key events that will alter the trajectory of the nodes To add a node
166. rm exchange For a small fee we will deliver reconditioned and warrantied lower arm assemblies to your facility After receiving the replacement arms use the same box and the enclosed shipping label to return the old arms to Gaumard For international and express service additional fees may be charged Refer to the Consumables and Replacement Parts section of this guide and contact Customer Service for more information 184 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 B Electrical Therapy One of Pediatric HAL s most exciting features is the accommodation of real monitoring and electrical therapy devices In most cases no special instruction is necessary to use such devices Electrodes of your choice are applied directly to the flexible conductive targets on the chest A few special concerns are described below Warnings ECG lead Il the monitoring lead is the only ECG signal produced on the manikin HAL has sites on his chest for up to 4 ECG electrodes to accommodate today s most common monitors marked red below These sites are electrically tied together by an appropriate impedance preventing lead off alarms from the monitor And as stated previously in Care and Cautions here are inherent dangers in the use of some medical devices For simulations that incorporate electrical therapy of any kind always know your equipment and follow the device manufa
167. roled by model Click H button to hold this vital to Current Apply Approximate Time R m NOW 10 sec 30 sec 1 min 2 min 5 min 10 00 min Choose the settings you wish to change from the available fields and click one of the Apply buttons below New settings will be applied over the time period indicated by the button s label Click the NOW button to change Pediatric HALO condition instantly or click one of the other Apply buttons to create a trend Some settings always get applied immediately such as cardiac rhythm and breathing pattern while numerical settings such as heart rate and respiratory rate can be easily made to transition gradually linearly from their current values to any target you specify The right most button can be customized to any transition time you require by clicking the part of the button labeled Edit As transitions are applied the time remaining in the transition is displayed in the Clocks panel at the bottom of the program window It is very important to note that those settings that you do not specify will remain unchanged If there is already an ongoing transition at the moment you click an Apply button it will stop and a new transition will begin from the current physiological state A Ventricular Tachycardia Warning If the cardiac rhythm is maintained at Ventricular Tachycardia for one minute the following prompt window will be displayed Copyright 2
168. rt Scenarios Palette Items Saved as plt files palette items in each profile are located at the top level of each profile folder To copy palette items from one profile to another copy the plt file found in the source profile folder Scenarios Scenarios are stored as sub folders within profile directories Scenarios can also be transferred between profiles by copying the scenario folder and its contents 226 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 A NEVER B Modify files in the resources directory or those at the top level of the Gaumard User Interface directory Manipulate files or folders while the GaumardUI software is running B Modify or delete dll scn or sys files Copyright 2010 by Gaumard Scientific All rights reserved 2217 C Troubleshooting 1 General Troubleshooting Guide Instruction Manual Pediatric HAL S3004 S3005 Use the following table to find causes and solutions to a number of possible problems Symptom Possible Cause Communication Battery connectors in the never gets manikin are reversed established or is lost mE blinking communi Battery is discharged cation indicator is Computer is too far away consistently red from simulator Trying to communicate with a different simulator Starting more than one simulator with its own tablet Solution Make sure to connec
169. ruction Manual Pediatric HAL S3004 S3005 BUSINESS PROFITS BUSINESS INTERRUPTION LOSS OF BUSINESS INFORMATION AND THE LIKE ARISING OUT OF THE USE OR INABILITY TO USE SUCH PRODUCT OR RELATED TO THIS AGREEMENT EVEN IF GAUMARD HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES GAUMARD SHALL NOT BE LIABLE TO YOU FOR ANY INDIRECT SPECIAL INCIDENTAL OR CONSEQUENTIAL DAMAGES OR LOST PROFITS ARISING OUT OF OR RELATED TO THIS AGREEMENT OR YOUR USE OF THE SOFTWARE AND OR THE RELATED DOCUMENTATION EVEN IF GAUMARD HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES IN NO EVENT SHALL GAUMARD S LIABILITY HERE UNDER IF ANY EXCEED THE PURCHASE PRICE PAID BY YOU FOR THE SOFTWARE ALL RIGHTS NOT EXPRESSLY GRANTED IN THIS LICENSE AGREEMENT ARE RESERVED BY GAUMARD ACKNOWLEDGMENT BY INSTALLATION OF THIS SOFTWARE YOU ACKNOWLEDGE THAT YOU HAVE READ AND UNDERSTAND THE FORE GOING AND THAT YOU AGREE TO BE BOUND BY ITS TERMS AND CONDITIONS YOU ALSO AGREE THAT THIS AGREEMENT IS THE COMPLETE AND EXCLUSIVE STATEMENT OF AGREEMENT BETWEEN THE PARTIES AND SUPERSEDES ALL PROPOSED OR PRIOR AGREEMENTS ORAL OR WRITTEN AND ANY OTHER COMMUNICATIONS BETWEEN THE PARTIES RELATING TO THE LICENSE DESCRIBED HEREIN 8 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 l Getting Started Copyright 2010 by Gaumard Scientific All rights reserved 9 Instruction Manual Pediatric HAL S3004 S3005 A Overvi
170. s Apneustic apnea and normal Lung Sounds Multiple lung sounds are available normal wheezing inspiratory squeaks crackles and rales Bilateral Chest Rise Right or left lung can be disabled individually Pulmonary Ventilation HAL can be ventilated with a BVM or mechanical ventilator 24 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 C Cardiac Heart Sounds HAL is equipped with several realistic heart sounds normal distant systolic murmur S3 and 54 which are tied to a user defined heart rate and selectable rhythms ECG Monitoring and Electrical Therapy HALG s conductive skin sites allow the attachment of real electrodes and defibrillator pads This feature permits the user to track cardiac rhythms and events with their own equipment just like with a human patient Copyright 2010 by Gaumard Scientific All rights reserved 25 Instruction Manual Pediatric HAL S3004 S3005 D Circulation Bilateral Pulses HAL s palpable pulses carotid brachial radial femoral and pedal are dependent on blood pressure Users can also disable distal pulses to simulate severe hypotension Programmable Blood Pressure Programmable blood pressure can be read using a sohygmomanometer and users can auscultate the Korotkoff sounds When care providers use the blood pressure cuff to take a measurement by auscultation a modified cuff must be used wit
171. s OneYearOldFeatures on the S3004 j Pediatric Hal Add ons ediatric Features Cyanosis ET Tube Sensor Set pulse If the system gives strenghts Sat May false ET tube for normal cyanosis readings it needs to BP wel be reset Simply 100 705 remove the ET tube from the baby and 1 0 30 click on the button below Reset ET Tube L Sensor Default Default OK Cancel Fine tune the pulse intensity Fine tune the Maximum cyanosis intensity In case the ET Sensor is not responding properly to the intubation remove everything from the airway and click on the Reset ET Tube Sensor button Copyright 2010 by Gaumard Scientific All rights reserved 139 vi Pacing BM Pacingishock Pacing Reporting Heart Rate J Change za fel Current J D Change Shack Threshald Detect Shack Jg 5 Joules Threshold OK Cancel vii CPR Options Pacing Shock ventilations and Compressions compressions per minute Compression Ventilation Ratia Only ventilations ua ventilations per minute OK Cancel 140 Instruction Manual Pediatric HAL S3004 S3005 When HAL is being paced the pacers oscillate by a minimum fraction both on the heart rate and the current This oscillation can make the software fire an event each time these small changes are captured In this tab you can set a threshold for each parameter so that only changes great
172. s currently on Ventricular Fibrillation clicking on reset model changes the ECG rhythm back to sinus After clicking this menu option the following dialog box is displayed A Ore vau sure you Wank bo reset the model Click Yes to proceed with the reset c Import between Patients Modeling Monitors CPR AJV Modeling Patients Reset Model Import Between Patients Auto Log Settings This menu option allows you to import palettes scenarios and branching scenarios from one patient to another To do so select what you will like to import highlight the patient you would like to import items from and then select the specific item and click on import After importing an item it appears under the patient to whom it was imported 154 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 The following figure illustrates how to import palettes from patient Hal to Mark Import Between Patients Importing Select Dylan CO Poisoning Initial STEMI HR 150 RR 30 BP CO Poisoning Recover NSR HR 100 BP 105 72 CO Poisoning Worsens HR 60 BP 140 90 Cheyne Healthy Pedi all vitals are set to a health Properties Importing cenarios Branching Scenarios Select Pediatric Properties Close Copyright 2010 by Gaumard Scientific All rights reserved 155 Instruction Manual Pediatric HAL S300
173. s section allows for easy and fast logging of drugs administration including dose and route The software comes preloaded with a set of commonly used drugs Each of these Copyright 2010 by Gaumard Scientific All rights reserved 113 Instruction Manual Pediatric HAL S3004 S3005 drugs has a default dose unit and a default route for administration which can be overwritten by just typing over For example for Epinephrine the default dose unit is ml kg and the default route is IVP intravenous push In order to enter for example that a provider administered 1 ml kg of epinephrine via IVP the facilitator just has to enter the text e the software automatically searches the drug list and displays the best match if any Low Heart Rate Details Palette Lab Model Scenario Log Gaumard Providers EUM Team Emergency Reported Airway Breathing Circulation Callfor assistance Open airway O2 device A Attach electrodes Manage bleeding Airway management o2fow_ ual Cyanosis E imm Wheezing Rales m Establish IV Gasping ventilate i Pallor Interpret rhythm Not Breathing Extubate gt Medication Blood loss Drug Dose Units Route Du ia a fe Log CPR NENNEN After a drug has been selected just clicking on the dose text field automatically fills the units and route fields with the default values for that particular drug Medication
174. saline 206 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 Copyright 2010 by Gaumard Scientific All rights reserved 207 Instruction Manual Pediatric HAL S3004 S3005 Pediatric HAL Five Year Systemic Scenario Gaumard k n NE ez Simulators for Health Care Education Septic Distri butive Shock ne Ag gt 7f AE Ves A five year old boy with Sickle Cell Anemia is brought to the ED with what the mother thought were infected mosquito bites She treated them with antibiotic ointment Most of them improved except for one large area on his abdomen that now measures 3X4 cm with a localized abscess formation He developed fever yesterday of 40 Deg C Today he has developed chills and his temperature is still 40 Deg C despite fever reducers He takes folic acid and penicillin daily His immunizations are up to date 208 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 Pediatric HAL Five Year Systemic Scenario Gaumard Simulators for Health Care Education Diabetic Ketoacidosis A five year old boy presents to the ED with a history of vomiting for one day His mother says he has vomited at least ten times since the night before and he can t keep anything down He has a low grade fever and has not had diarrhea but he has bee
175. scultation Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 e Blood pressure sounds audible between systolic and diastolic pressures e Pulse strengths vary with blood pressure and pulses are synchronized with ECG Simulator e Physical size is 50th percentile of 5 year old 83005 1 year old S3004 e Interchangeable genitalia e Internal rechargeable NiMH battery Venous access e lV training arm right only Control e Wireless tablet PC with stylus control e Communication modules are FCC and CE Compliant e Communications module can be used simultaneously with the tablet computer s integrated wireless IEEE 802 11b networking device e Bluetooth R technology in the tablet computer allows wireless printing to compatible printer and quick connections to other devices Accessories e 100 240 VAC charger e Blood pressure cuff e Instructions e Carrying case Other e One year limited warranty extended warranty to three years e Installation and training services available Copyright 2010 by Gaumard Scientific All rights reserved 11 Instruction Manual Pediatric HAL S3004 S3005 B Terminology It is wise to spend a moment familiarizing yourself with some of the terminology that will be used to discuss simulation with the Pediatric HAL system Automatic Mode In this mode vital signs respond automatically to caregiver participation instructor specificatio
176. se has become more filled with yellow mucous and he has had little to drink He is not taking any antibiotics You are called to a home where a one year old child is gasping for breath His mother says he has had wheezing before and is being treated for baby asthma He saw his doctor last week and has been receiving nebulized Albuterol three times a day for one week Over the past few days his fever has increased to 39 Deg C his nose has become more filled with yellow mucous and he has had little to drink He is not taking any antibiotics Copyright 2010 by Gaumard Scientific All rights reserved 9 Instruction Manual Pediatric HAL S3004 S3005 Scenario Scenario mE Scenario Description Name Type c Branching You are called to a home where a one year old boy was bitten multiple times by angry Yellow Jackets thirty minutes ago When you arrive Bee sting Trauma m you see areas of hives around the bites his lips and eyes are swollen and he has audible stridor A one year old child is brought to your ER with a one day history of a clear runny nose low grade temperature and a wet cough His mother Bronchiolitis Respiratory states today that he is refusing to drink and appears to be breathing fast She claims his immunizations are up to date and he has been in good health A one year old boy is transferred to your facility with a history of Cong Heart Fai Cardiac weakness and seizures despite therapeutic
177. spite fever reducers He takes folic acid and penicillin daily His immunizations are up to date Branching A five year old boy wakes up early and is thirsty His parents had a AVR party the night before and left glasses half full of mixed alcoholic ingestion Trauma drinks around the living room When the parents get up two hours later they find him asleep on the floor and smelling of alcohol They cannot wake him up so they call 911 While watching a baseball game a five year old boy was hit by a high cardat velocity foul ball in the chest He immediately falls to the ground and Ares Cardiac cries I m hurt As you approach he becomes unresponsive You access the ABC s and find him to be pulseless and not breathing You call for an EMT and report a cardiac arrest During the ride home from a family camping trip a five year old boy falls asleep in the back of his parents truck camper The night was Cardiac Cards cold so the heater in the cab was turned on When they returned Ischemia home he seemed confused couldn t walk and complained of a headache and vomited His parents bring him to the ED and are worried about meningitis A five year old boy was racing his BMX bike over a dirt hill in his back yard He had his helmet on but not his chest protector His mother was watching and said he became airborne and the handle bar of the Chest Injury Trauma bike landed on his chest when he hit the ground He is crying my chest h
178. t Vent 00 00 00 Compression Data Rate imin Comp tme 0 5 sec Last Comp 00 02 11 Too Many Compressions 67 L 22 OK 16 H 28 Here the ventilation peaks reach the green zone fairly consistently Copyright 2010 by Gaumard Scientific All rights reserved 1 1 Instruction Manual Pediatric HAL S3004 S3005 Trainer This feature can be used to help the students or providers create the correct rhythm of compressions to ventilation ratio Trainer Ventlat On Ven Last Ven eot Turning the Trainer on will enable frames to flash around the Compression and Ventilation labels prompting the provider to administer each procedure when the red or blue frame appears The instructor can change the CPR ratio on the trainer by going to CPR Options b Options AW Help Evaluator Clicking on Options under the CPR menu will take to the CPR tab of the Options window Pacing Shack ventilations and Compressions compressions per minute Compression ventilation R atia Only ventilations s ventilations per minute OK Cancel 172 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 6 A V Enabling the AV Link displays the following A V menu Connected to This menu permits sending Start and Stop messages to the recorder as well as displaying the connection status In order to set up the con
179. t and fully assembled NEVER attempt to service or modify any of the electrical connections especially those between conductive skin sites and the internal electronics Discontinue use if any wires are found exposed with damaged insulation 182 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 HAL should be cleaned with a cloth dampened with diluted liquid dishwashing soap If medical adhesives remain on the skin clean with alcohol wipes DO NOT USE GOO GONE as the citric acid in the formula will cause pitting of the various materials comprising your manikin When connecting the battery to the manikin make sure to match the two color coded connectors to the corresponding color coded battery terminals Do not attempt to intubate without lubricating the airway adjunct with silicone oil lubricant provided Failure to do so will make Intubation very difficult and is likely to result in damage Always lubricate tubing airway and nasal opening prior to performing any nasal or oral exercises NEVER disconnect the communications module while the HAL UI software is running The software will halt and the module may be damaged When simulating drug administration via endotracheal tube providers must use an empty syringe Passing liquids into the trachea or esophagus may cause internal damage The provided baby powder should be used sparingly on top of the lungs and ribs to elim
180. t how to use this feature go to Section III B 7 Vital Signs Monitor The Vital Signs Monitor simulates a vital signs monitor attached to the simulated patient The vital signs are synchronized through a wireless network between the facilitator s tablet and the computer running the monitor Each trace can be customized independently of each other users can set alarms time scales boundaries and grid options For information on how to setup Gaumard Monitors with GUI please refer to the Appendix section V C 4 Copyright 2010 by Gaumard Scientific All rights reserved 33 34 Instruction Manual Pediatric HAL S3004 S3005 IIl Working with the GaumardUI Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 A Profiles A profile is a unique configuration of customized Palettes Scenarios and options Each Profile acts as a separate program in that changes made to one profile have no effect on the others When starting the GaumardUl you are prompted to select an operating mode and then a profile Manual Mode In this mode vital signs and other responses are changed according to the specifications given by the instructor Pediatric HAUG One Year Profiles Select Operating Mode Manual Automatic Profiles Profile Description Default Profile s Default Quick Start Pediatric 1 Quick Start Pediatric 5 Manage Rename Mew Profile Cancel
181. t red wire to red terminal and black to black Make sure battery is charged Get simulator closer to computer Make sure to select the right simulator when opening the software In a multiple simulator environment make sure to enter the right Serial Number Select different channels for each of the simulators and then turn them on one at a time meaning Wait until a link has been established between the tablet and the simulator the yellow window goes away Only after that start running the GaumardUl software in the second tablet and so on for the rest of the simulators To do so go to menu Setup Options gt Environment gt Select Auto change to channel number from 1 11 228 Copyright 2010 by Gaumard Scientific All rights reserved Symptom Possible Cause All others Simulator doesnt run Battery not charged for the time specified properly on the manual Simulator doesn t The computer is properly respond to any com communicating with a mand even that blin simulator but not king communication necessarily the one you indicator is consis Intend to control tently green Instruction Manual Pediatric HAL S3004 S3005 Solution Close the GaumardUI software and unplug the RF module for at least 5 seconds then plug it back in Disconnect one terminal from the battery and reconnect after 5 seconds Restart the software and wait for initialization Make sure that LED in
182. the bottom left of the screen notifying the user of the status of the reset OK or TRY AGAIN Should the sensor not respond please refer to the troubleshooting guide or contact Customer Support Calibration Factory Default Settings Reset Left BP Sensor Reset Right BP Sensor Reset compressions Sensor Reset ventilations Sensor Reset ET Tube Sensor Remove User Calibration Finish At the end of calibrating a function the Calibration Wizard resets the manikin for the changes to take effect and displays the message Done If the wizard displays the message Can t reset it means that the new calibration values will take effect next time you start the software If the changes need to take immediate effect close the GaumardUI software wait about one minute for the manikin to turn off then start the GaumardUl software again Copyright 2010 by Gaumard Scientific All rights reserved 133 Instruction Manual Pediatric HAL S3004 S3005 b Options The GaumardUl has several options that can be preset by the instructor neu oes c gie me mel CLEE NEL Rr Lonel Auto Responses Scan RF Channels The Options dialog box contains eight tabs Environment Tolerances Pediatric HAL ada ons General Pediatric Features Pacing CPR Options and Other Options OPTIONS ineYearold Hal Add Ons OneYearold Features Pediatric Hal Add Ons Pediatric Features CPR Options Pa
183. ther says he has been acting tired and passed out while playing soccer today He said his chest hurts and his heart jumps Mom calls 911 because as her son was falling asleep she noticed seizure activity of his arms and legs He had had short seizures with high fever when he was one and two This time he had no fever and was well the entire day There has been no history of trauma He has been seizing for at least fifteen minutes when you arrive You correctly assess he may develop status epilepticus A previously healthy boy is brought to the ED According to his dad he has been acting tired and passed out today He said he feels dizzy and his heart jumps You are at a birthday party where you see a five year old trying to blow up a balloon Instead of blowing out he sucks the balloon in and begins gasping for breath He is turning cyanotic and cannot cry You assess his airway is obstructed and the obstruction must be removed You try simple measures as back blows and chest thrusts and activate EMS Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 These scenarios in the manual mode are found in the Quick Start Pediatric 1 profile Five of these scenarios are linear and seven are branching All shown are for a one year old patient Scenario Scenario Name Type 9M Trauma Boy Hypovole Systemic mic Shock B Pneumonia Respiratory and Septic Scenar
184. ther ran into the room and his older brother explained he had choked on a peanut His grandmother saw he was turning blue She told her grandson to call 911 Wait indefinitely for five abdominal thrusts c e Wait indefinitely for intubation e Copyright 2010 by Gaumard Scientific All rights reserved 191 Instruction Manual Pediatric HAL S3004 S3005 Pediatric HAL Five Year Respiratory Scenario Gaumard Upper Airway Obstruction EE Toy Balloon 5yr UN You are at a birthday party where you see a five year old trying to blow up a balloon Instead of blowing out he sucks the balloon in and begins gasping for breath He is turning cyanotic and cannot cry You assess his airway is obstructed and the obstruction must be removed You try simple measures as back blows and chest thrusts and activate EMS Unsuccessful or 1 min timeout Airway cleared successfully Yes Holding state for secondary treatment options No changes to vitals 2 min timeout Secondary Treatment Options Racemic Epi IV or IO Epi O2 delivery Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 m i Gaumard Pediatric HAL Five Year Respiratory Scenario Spese f atta Epiglottitis Ve A f
185. tini 4 ifsome tone R 1 APGAR O 4 0 P 0 G 0 4 0 R 0 Other APGAR 1 A 0 P 1G 0 4 0 R 0 APGAR 2 4 0 P 1 6 0 A D R ligasping APGAR 3 0 P 1 G 1lfrespond to patini 2 0 R 1 Apply Approximate Time Now 10 sec 30 sec 1 min 2 min 5 min 10 00 min If any changes are made to any of the palettes UD SD HD or OD from the Drugs page a prompt to decide if you want those changes to apply to the original palette item as well will display Click OK to make those changes take place Compare the properties of the original palette versus the properties of the palettes selected for each drug To do that click on the buttons labeled properties shown in the figure below Copyright 2010 by Gaumard Scientific All rights reserved 99 100 Add New Medication Mew Medication Generic Brand Names Description Used to show how to set up a new drug in the software Unit uaimaja Unit Other ug Llugkg O mg M mokg Og O gkg F oute C Iv Push Topical I Infusion IM SubQ Per Oral Inhalation Half Life Peak Time min Sec hr Precise Approximate Threshold hr min sec very quick 5m 9 Precise Approximate Medication Response Milrinone UD IP Adanaci Under Dose MB Adenosine UD T IB AI a lenasin NB Adenosine 5D Standard Dose NB Adenosine SD NB Adenosine UD NB Alprostadil OD High Dose M
186. tions most facilitators choose Auto mode for the auto response settings The key issue Is standardized timing of symptom presentation A consistent repeatable simulation is essential for fair assessment of that care provider in relation to others and for the broader interpretation of results in the context of training validation studies When in doubt it is best to choose Prompt mode in which the facilitator will be given direct control of the responses as events are detected Copyright 2010 by Gaumard Scientific All rights reserved 225 Instruction Manual Pediatric HAL S3004 S3005 B File Structure Advanced users may find it helpful to understand the GaumardUI directory structure With direct file manipulation one can easily move palette items and scenarios between profiles as well as move entire profiles from one computer to another Folders E Desktop E iE My Documents Y My Computer S Local Disk C Program Files 3 2 Gaumard Scientific 3 iE Gaumard User Interface Lj manikins 3 profiles Default Profile Quick Stark Scenarios c resnurces Profiles In the GUI program folder is the profiles sub folder e g C Program Files Gaumard Scientific Gaumard User InterfaceNprofilesV All user information is saved there and it is the only folder that should be modified manually In the example shown notice that there are 2 profiles in this installation Default Profile and Quick Sta
187. ts name will appear between the dose buttons and the Copyright 2010 by Gaumard Scientific All rights reserved O5 96 Instruction Manual Pediatric HAL S3004 S3005 threshold numbers Medication Response Apnlv Items Threshold Milrinone UD gmemeeeemeeUUUUUUHENES Under Dose i ME Adenosine UD MB Adenosine ob SCS co COSoo nono a a a NE Adenosine SD E Standard Dose sb 18 NB Adenosine UD a DEG NB Adenosine UD High HD MB Alprostadil QD i E alb Over Dose op MB Alprostadil 5D v Froperties Do the same for the other three palettes and enter the threshold value for each You may use the same palette for more than one dose Such is the case for Adenosine for example Medication Response Analy Items Milinone UC E Under Dose MB Adenosine UD Threshald MB Adenosine OD NB AdenosinesD Standard Dose NB Adenosine SD deletes High Dose NB Adenosine SD MB Alprostadil Ob Cad mI xr 42 d gt NB Alprostadil SD Over Dose E Properties Notice that in the case of Adenosine there are only three pallets NB Adenosine UD NB Adenosine SD and NB Adenosine OD The standard dose is used in this drug profile twice once each for the standard and high dosages Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 Medication Response Threshald Apply Items Milrinone UD A Under Dose
188. tus oE Status 11 ABC Airwa in Tongue Edema Throat Sound a Rate 35 bpm In 34 o Q Right Lung Breathing Resp Pattern snd Q Left Lung snd Oz2 5at 98 o ELCOZ 40 mmHg Circulation Bae Cardiac Rhythm Heart Rate 140 bpm Q Sinus arrhythmia Heart Sound Blood Pressure _ R 92 67 mmHg Absent Pulses Radial L r More lt Temperature 37 0 Cj nd Skin Color elzures Eves State Pupils State LEE Q Enabled Rxn d Q Enabled Rn Ren Time 0 5 sec Bowel Sound UL De a Our LLO or AB Airwa Tongue Edema Throat Sound Lung Condition Resp Pattern Rate 33 bpm In 40 ie Tidal volume 41 ml Q Right Lung FE end Q Left Lung FE snd lf Pneumotharax Orz Sat 92 Ho ERCOZ 40 mmHg E n Circulation Patient State Heart Sound Cardiac Rhythm Heart Rate 140 bpm Q Sinus arrhythmia Blood Pressure Lg Rg 85 b2 mmHg Absent Pulses Radial L Other Temperature 37 0 C Convulsions Eves State Pupils Skate LEE Enabled Rxn ao Q Enabled Ren Rn Time 0 5 sec Cyanosis r Copyright 2010 by Gaumard Scientific All rights reserved Adv E Cardiac Tricuspid valve Regurgitation Resistance Pulmonary Valve Regurgitation Resistance Mitral Yalve Regurgitation Resistance Aortic Valve Regurgitation Res
189. u would like to calibrate Q Chest Compressions Factory Settings The procedures for each specific calibration are described in the sections below Copyright 2010 by Gaumard Scientific All rights reserved 127 Instruction Manual Pediatric HAL S3004 S3005 i Chest Compressions Artificial Ventilations This tool helps calibrate the chest compressions and the artificial ventilations to specific criteria That is the calibrator will be telling the system what a correct chest compression is and or what a correct artificial ventilation is Providers will be evaluated by the system based on this criteria The chest compressions and ventilations are calibrated the same way After making a selection this window is displayed The software will now ask for a number of correct chest compressions or artificial ventilations to be performed depending on which being calibrating Calibration Chest Compressions Please select the type of calibration you would like to do Normal Calibration You wil be asked to perform based on your criteria Providers wil be evaluated based on that criteria Never calibrated Back Factory settings 128 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 Calibration Chest Compressions The values from tne last compressions user calibration are shown below Press START and do 5 correct chest compressions one at
190. umard User Interface Welcome to the Gaumard User Interface Setup Wizard Gaumard srusio ror neait cre The installer will guide you through the steps required to install Gaumard User Interface on your computer WARNING This computer program is protected by copyright law and international treaties Unauthorized duplication or distribution of this program ar any portion of it may result in severe civil ar criminal penalties and will be prosecuted to the maximum extent possible under the law Click Next and follow the wizard instructions to complete the software download If updates are not available the Install button is disabled and the following dialog box is displayed Copyright 2010 by Gaumard Scientific All rights reserved 177 Instruction Manual Pediatric HAL S3004 S3005 GaumardUr Update Please wait while we check for new updates Current Version 1 19 9 0 Latest Version There are no current updates for your software please try again in a couple of days Thank vou Install Download Progress Cancel d Diagnostics GUI Help Abaut GUI Check For Updates Use this feature as a troubleshooting tool 178 Copyright 2010 by Gaumard Scientific All rights reserved S3004 MS Diagnostics Info Ado Throat voice Throat Streaming Heart Lung Front Upper Right Lung Front Upper Left KK Right KK Left Bowel Upper
191. urts and I can t breathe He was not unconscious and his extremities and abdomen appear normal You suspect fractured ribs a lung contusion or a tension pneumothorax 16 Copyright 2010 by Gaumard Scientific All rights reserved Scenario Name Diabetic Ketoacidosis Epiglottitis Gram Negative Sepsis Hypothermia OP Poisoning Renal Failure Scenario Type Trauma Trauma Instruction Manual Pediatric HAL S3004 S3005 Scenario Description A five year old boy presents to the ED with a history of vomiting for one day His mother says he has vomited at least ten times since the night before and he can t keep anything down He has a low grade fever and has not had diarrhea but he has been wetting the bed He appears pale with sunken eyes and breathing very rapidly A five year old girl was recently adopted from another country Her immunization status Is in question and her parents had planned to have her immunized soon Two weeks after her arrival in the United States she developed a high fever of 40 Deg C and has difficulty in swallowing Her voice became weak and she had coarse stridor with every breath Her parents tried treating her for croup with some cool mist as they had their other children but she showed no improvement Her parents then brought her to the E D A five year old boy with cerebral palsy is carried in to the ED by his foster father He is one of five foster children all with s
192. ve been performed correctly click the Save button Otherwise press the Back button to repeat the calibration Calibration Chest Compressions Press SAVE if you are satisfied with these values or BACK to re do calibration Sum 972 Peak 278 Duration 0 5 Back Finish Factory settings Notice that the user can go back a step abort or cancel at any time during the procedure 130 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 ii Blood Pressure Cuff Blood pressure cuff calibration should be performed only when the Korotkoff sounds do not match the systolic and diastolic values set from the computer Calibration Calibration Vizard Welcome to the Manikin s calibration wizard Proceed only after WoL have reviewed the calibration section in the user manual Please select the function you would like to calibrate Chest Compressions Artificial ventilation Blood Pressure Cuff Head Position Factory m re a Settings z Back Cancel To calibrate place the blood pressure cuff on the manikin s left arm Remember to connect the cuffs luer lock connector to the manikin s shoulder The blood pressure enabled arm will display when the software checks the manikin s settings Copyright 2010 by Gaumard Scientific All rights reserved 131 Instruction Manual Pediatric HAL S3004 S3005 Calibration Blood Pressure Cuff Ple
193. xity to a scenario or if you need to superimpose special conditions Note that e All the controls in this page are unique to the modeling mode e Cardiac irritability can be used to modify cardiac rhythms indirectly You can improve move towards normal sinus rhythm or deteriorate move towards ventricular fibrillation and asystole any of the rhythms Cardiac Irritability none slightirandoam qreatirandom slightiimprove qreat imprave slightideter ior ate greatideter iorate Copyright 2010 by Gaumard Scientific All rights reserved 53 The progression of rhythms generally follows the pattern displayed in the figure to the right where X represents e normal sinus rhythm e multifocal atrial tachycardia e atrial flutter e atrial fibrillation e junctional rhythm e left or right bundle branch block e or atrio ventricular block Instruction Manual Pediatric HAL S3004 S3005 F X rhythm X with PACs X with unifocal VC s X with multifocal PVC s Unifocal V tach Multifocal V tach Ventricular Fibrillation Asystole The Hold H and Auto buttons on the Details page are unique to the automatic mode These controls add a new level of regulation that allows higher physiologic accuracy Amongst the vitals that can be placed on hold or auto are respiratory rate inspiration time tidal volume oxygen saturation and end tidal CO from the A B tab and blood pressure from the C O tab Thes
194. y Gaumard Scientific All rights reserved 135 Instruction Manual Pediatric HAL S3004 S3005 il Tolerances Tolerances Others CPR Intensity Tolerances Artificial ventilation intensity evaluation tolerance J 10 96 Chest compression intensity evaluation tolerance y 10 96 CFR Rate Talerances Artificial ventilation rate evaluation tolerance J 10 36 Chest compression rate evaluation tolerance J 10 95 Pupil Sensitivity Set En Ambient Set Dilation saat Increase Reset to Light Hg Decrease Defaut Default OK Cancel This tab is used to select the tolerance and intensity of both chest compressions and ventilations At the bottom of the tab you can find controls related to pupil sensitivity If the Blinking Eyes kit is installed you can recalibrate the pupil sensitivity using these controls The five buttons are described below e Setto Ambient Light If the pupils are constantly closing with the current ambient light you can disable the pupil reactivity and open the pupils to the desired diameter Then use the Set to Ambient Light button to recalibrate the sensitivity to the current environment and then enable the reactivity on each pupil e Set Dilation Light The pupils should react to low ambient light by increasing their diameter To set pupils to react to proper low ambient light intensity cover both eyes b
195. y can only be assessed by a provider using Gaumard s Vital Signs Monitor available separately Circulation The Circulation section displays Pediatric HAL cardiac parameters b Communication Indicator Communication mi mii eii ac The communication indicator shows the status of the radio link between the computer and the manikin The bars are unfilled with blue when there is no attempt to communicate for example when the module is not connected to the computer or the system is in STAND BY mode The number of blue bars filled indicates the strength of the signal Copyright 2010 by Gaumard Scientific All rights reserved Al Instruction Manual Pediatric HAL S3004 S3005 Status Ac Wi The warning icon indicates a signal conflict with another manikin Clicking the icon produces the following message RF Communication AUS There is currently another Gaumard Simulator on the same channel For optimal communication performance switch to another channel Note Use Setup gt Scan RF Channels for a recommended channel c Battery Indicator The battery status indicator progresses as the battery in the manikin is used The exclamation mark indicator is shown when there is no communication with the manikin and the program cannot get the battery information d Sound Volumes Throat Sound Throat Sound normal normal f Breathing MA Resp Pattern p Resp Pattern normal noma ipid T
196. y using LMA or endotracheal tubes as shown in the figures below NOTE Always lubricate tubing airway and nasal opening prior to performing any nasal or oral exercises Intubation Blade Miller 2 or MAC 3 Miller 1 size Size 2 2 5 Size 1 5 2 Nasal Intubation 12 Fr catheter 10 Fr catheter ETT 5 0 or 5 5 no cuff 10 Fr EIT 3 5 no cuff 8 Fr suction suction catheter catheter Nasogastric Tube 12 Fr catheter 10 Fr catheter Intubation can be made more difficult by turning on tongue edema Oral Intubation 22 Copyright 2010 by Gaumard Scientific All rights reserved Instruction Manual Pediatric HAL S3004 S3005 Once intubated sensors detect the depth of the intubation tube Should the tube be inserted too deeply the left lung is automatically disabled realistically demonstrating right mainstem Intubation Correcting the tube position enables the left lung Tracheostomy Users can perform tracheostomy Airway Sounds HAL has multiple upper airway sounds synchronized with his breathing normal stridor Inspiratory stridor expiratory and stridor biphasic Copyright 2010 by Gaumard Scientific All rights reserved 23 Instruction Manual Pediatric HAL S3004 S3005 B Breathing Breathing Pattern Users can easily control rate and depth of respiration and choose independent left right upper and lower lung sounds which are synchronized with selectable breathing patterns Kussmaul s Cheyne Stokes Biot
197. you to change shunt flow dead space alrway resistance and respiratory pattern indirectly You can choose one of four options as shown in the figure below Lung Condition amp Emphysema Fibrosis Asthma 2 Tidal Volume Tidal volume is the amount of air breathed in or out during normal respiration Tidal volume for a normal adult is 500 mL for a pediatric patient it would be between 10 20 mL between 6 8 mL Kg E Tide Volume Aw mi If the respiratory rate goes to zero the model does not restore it automatically Always remember to specify a new respiratory rate b Circulation and Other The Details side tab C O see One Year Old Five Year Old includes circulation and other controls Note that e Each cardiac rhythm has a specific effect on the blood pressure wave forms The pressure wave forms include ABP CVP PAWP and Pulse e Similar to OSat and EtCO blood pressure can be changed indirectly when using the modeling mode You can do so by selecting one of four options Arterial properties vascular diameter and stiffness Heart Rate LV Contractility Total Blood Volume Copyright 2010 by Gaumard Scientific All rights reserved 51 Instruction Manual Pediatric HAL S3004 S3005 Click on the question mark to view a Summary of these options Model is going to auko adjust Following parameters according to your BP input Option 1 Vascular Profiles vessel Diameter and vessel

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