NP 081-07 Geri/Keri Manikins.indd
Contents
1. Male Catheterization Prostate Examination Ostomy Care Surgical Bandaging Enema Administration Pediatric Injectable Arm Intramuscular Injection Breast Examination Arterial Puncture Arm Adult Injectable Arm Black Pediatric Injectable Head Intradermal Injection Arm Heart Catheterization TPN Ear Examination Peritoneal Dialysis Suture Practice Arm Suture Practice Leg Spinal Injection Hemodialysis Arm Episiotomy Suturing Suture Kit Pelvic Normal amp Abnormal Stump Bandaging Upper Stump Bandaging Lower Cervical Effacement Birthing Station Cricothyrotomy Tracheostomy Care Sigmoidoscopic Examination Central Venous Cannulation Blood Pressure Arm Intant Intraosseous Infusion Simulator Advanced IV Arm Venipuncture and Injection Arm Advanced IV Hand Auscultation Trainer Testicular Exam Male amp Female Catheter CPR Dog LFO1162U LFO1174U LFO1184U LFO1193U LFO3000U 36020 036090 1 0361 6 70 036200 LFO03632U LFO3633U LFO03699U LFO3709U 720 50 7600 770 LFO3953U LFO3955U LFO3965U LFO04200U LFO6001U LFO06012U 0 LFO06204U Venatech IV Trainer NG Tube amp Track Skills Venatech IM amp Sub Q Special Needs Baby CPARLENE Series Adult Airway Management Trainer with Stand Adult Airway Management on Manikin Child Airway Management Trainer with Stand Child CRiSis Manikin Deluxe Child CRISis Manikin with Arrhythmia Tutor PALS Update Kit I2. by suctioning the contents water The stomach can be removed by rotat ing the head 180 backward to align the key holes in the neck and then pull ing up The stomach reservoir will come through the neck opening only if less than 250 cc of water is contained in the stomach 6 When administering water to the internal stomach reservoirs and when the stomach reservoir contains water the head and upper torso should be at least slightly elevated to prevent backflow into the head of the manikin See figure 6 INTRAMUSCULAR INJECTIONS Intramuscular injections may be per formed in inserts at the left hip right thigh and at both shoulders Inject air only as these inserts cannot be drained To remove the injection inserts compress them sideways and pull out INJECTABLE TRAINING ARM Figure 7 ABOUT THE IV ARM A removable right arm has been includ ed for IV training The arm rotates at the elbow for easy accessibility to the ante cubital tossa along the torearm and at the back of the hand A bony landmark at the shoulder identities soft tissue for intramuscular injections See figure 7 Although this arm will provide years of trouble tree usage the skin and veins can be readily replaced when needed The outer skin is easily peeled oft revealing the core and veins liter ally providing a brand new arm The lite of the replaceable skin and veins will be prolonged by utilizing smaller needle size
3. opening the clamp Allow infusion water to pass through the system until air bubbles are eliminated Shut off the flow with a pinch clamp The venous system is now full and pressurized Insert an IV needle or butterfly in the vein Flashback will indicate proper insertion Close the clamp on IV bag A tube and remove pinch clamp from shoulder tubing 8 Attach latex needle adapter to IV needle and IV tubing See figure 10 Proof of proper procedure will then be evidenced by the flow of infusion fluid trom IV bag B Control flow rate with clamp on IV set B This fluid can be used over If more realistic experience is desired with blood flashback instead of water when inserting buttertly into lumen of vein use next procedure C C Recommended Procedure for Simultaneous IV Infusions and Drawing Blood Using two IV bag kits hook up and install with IV bag A and IV bag B See figure 11 Remove air vent trom bag B 1 Begin with synthetic blood in IV bag 2 Open clamps on both A and B to pressurize system Flush system by allowing blood to flow into container B until bubbles in tubing disappear then regulate blood flow from bag A using clamp System is now full of blood and pressurized Blood can now be drawn anywhere along the path way of the vein 3 Intravenous intusion insert but tertly into lumen of vein Proof of correct insertion is evi
4. top of the unit Once all of the necessary connections have been properly made go to the section titled Calibration Procedures and calibrate the unit When the calibration proce dures have been completed the simula tor is ready for use SUPPLIES REPLACEMENT PARTS FOR BLOOD PRESSURE SIMULATOR LFO1096U Electronic Control Unit with Sphygmomanometer B20146U Blood Pressure Speaker System THE AUSCULTATION SIMULATOR The Auscultation Manikin duplicates heart and lung conditions selected by the instructor by wireless remote control The student should palpate to identity the correct auscultation sites and will hear different heart and lung sounds as the SmartScope is moved from site to site The simulator has six heart sites seven lung sound sites on the anterior surtace with 10 locations on the posterior sur face and midaxillary sites The remote control can select from 12 different heart conditions as well as 16 lung conditions The instructor can select any condition easily so the student can compare sounds and make a diagnosis The remote control does not have to be pointed directly at the manikin or stethoscope to operate One remote control will operate multiple sets of SmartScopes and manikins simultane ously Great for group instruction The range of the remote control is up to 100 feet GENERAL INSTRUCTIONS FOR USE To begin using the Auscultation Trainer press the red power button This tu
5. will also turn off the sounds in the arm The pulse will always be on unless the pulseless feature is activated or if the systolic or heart rate levels are set to zero To do this press the Menu key tour times The down arrow key will set the pulse to pulseless Press the arrow up key to turn the pulse back on See figure 21 Located to the right of the Menu key is the auscula tory Gap key See figure 22 This key is included to simulate the ausculatory gap that is sometimes present between phase 1 and phase 2 sounds in which no audible sound is noted during this portion of ausculation This control func tion is included so that the trainee can become familiar with this phenomenon Pulse Location Pressing the Gap key simply turns the gap function off or on When the key is pressed a message will briefly appear that the ausculatory gap is enabled or disabled Also the main display will show at the bottom right of the display Ne AGap Y for on or AGap N for off BA ALD APP MENU Gar asco Bicod Pressure S nutatar ARGO Sori Alen 1 Figure 21 k MEHU Gap TALBRATE e A Wisco Hlk Presi AACD Pie A Figure 22 The arrow up and down keys also control the volume of the sounds that are present in the arm From the main menu press the up arrow key to increase the volume press the down arrow key to decrease the volume The volume levels can be
6. Mas CO Life form GERi KERIi THE NURSING SKILL MANIKINS The ideal manikin for all OBRA required training GERi LF04040U LF04001U LFO4030U LF04003U KERi LF04021U LF04020U LF04022U LFO4023U INSTRUCTION MANUAL Lifeform Products by Nasco Advanced GERi m Congratulations for choosing a GERi KERi nursing skills manikin This realistic fully functional lightweight nursing manikin comes with a superior range of motion and allows you to simulate over 35 nurs ing and medical procedures The quality and simple design makes this manikin easy to use and care for while teaching your students basic patient care techniques so please familiarize yourself with this manual before using the manikin for student training Three year warranty In the Basic GERi KERi manikins the internal fluid reservoirs have been eliminated for greater economy Ostomy care oral and nasal lavage gavage and suctioning procedures cannot be per formed but can be simulated Urinary catheterization and enema administration cannot be simulated Basic GERi LFO04040U Basic KERi LF04021U LIST OF COMPONENTS Complete GERi LFO4001U Complete KERi LF04020U LIST OF COMPONENTS Male genitalia Female genitalia Wig Dentures Hearing Aid 12 cc syringe REN cleaner Lubricant spray Serial number located under the skin at the back of the neck Male genitalia Female genitalia Wig Dentures Heari
7. Toothbrushing should be preformed without water or any cleaning agents to avoid leaking into the head of the mani kin and to simplify cleanup Denture removal is accomplished by grasping the dentures pulling forward and then down for the upper plate or forward and then up for the lower plate EYE IRRIGATION Both eyes may be irrigated using water only To drain tilt the head sideways and empty into a basin or onto an absorbent cloth Cotton swabs should be used carefully and only on the outer ear EAR CARE Both ears may be irrigated using water only To drain tilt the head sideways and empty into a basin or onto an absorbent cloth Cotton swabs should be used carefully and only on the outer BED BATHS AND HAIR WASHING To simplity cleanup dry bed baths and shampoos are recommended to elimi nate the chance of water entering the inside of the manikin However a soft cloth and water can be used for bath ing exercises and a mild shampoo and cool water can be used for hair wash ing Avoid scrubbing any painted areas of the manikin To dry the wig blot with a soft towel and air dry Do not brush the hair when wet and never use a hair dryer or blow dryer on the wig MALE CATHETERIZATION Not Available on Basic Note To avoid the possibility of leakage make sure you use the 16 French Foley catheter supplied with the simulator The male genital insert represents an uncircumcised adult male To prepare for cathe
8. ach is distinctly different and present for only a portion of the mea surement sequence LOW BATTERY INDICATOR When the battery supply diminishes to a level near the point that the unit will no longer function properly the low batt segment of the systolic pressure display will activate when the pressure in the sohygmomanometer cuff reaches above 20 mmHg At this point the batter ies should be replaced as soon as pos sible in order to insure proper operation of the unit Refer to the section titled Installing the Batteries CALIBRATION PROCEDURES To calibrate the simulator set the unit up as described in the section titled Using The Blood Pressure Simulator Apply the cuff to the simulated arm Set the control box systolic pressure to 150 mmHg and set the diastolic pres sure to 70 mmHg Proceed with a simulated blood pressure measurement Note the discrepancy in the readings between the gauge and the control box Set the systolic offset Example If the blood pressure reading was taken and the sounds started at 148 mmHg then the offset is 2 If the sounds started at 152 mmHg the offset is 2 For this example assume that the sounds started at 148 mmHg Press and hold the Calibration key until the systolic cor rection window appears See figure 23 Using the arrow up key set the cor rection to 2 Set the diastolic offset Example f the blood pressure read ing was taken and the sounds st
9. adjusted from level 1 the lowest volume to level 7 the highest volume USING THE BLOOD PRESSURE SIMULATOR First verify that the pressure line tubing from the sohygmomanometer and the audio line coming from the simulated arm assembly are properly connected to the blood pressure simulator unit as previously described in the set up pro cedures Apply the sohygmomanometer cuff and gauge to the simulated arm assembly in the usual manner Apply the stethoscope to the simulated arm also in the usual manner Set the systolic and diastolic controls to the desired levels Select the auscultatory gap if desired Finally adjust the pulse rate control to the desired setting To proceed with the simulated blood pressure measurement first close the valve on the sohygmomanometer bulb tightly and begin pumping air into the cuff until the gauge reads higher than the preset systolic level chosen Once this point is reached loosen the valve on the bulb slightly to allow the gauge pressure reading to decrease slowly While monitoring the arm assembly with the stethoscope note the point on the sphygmomanometer gauge when the first Korotkoff sound is heard This will be the systolic blood pressure Allow the pressure in the cuff to continue to decrease until the point at which the last pulse is heard noting the reading on the gauge This is the diastolic blood pressure Compare the results of reading the systolic and diastolic blood pres
10. ay result in damage to the simulator ENEMA ADMINISTRATION Enema administration can be practiced on the female genital insert only To pre pare the manikin for enema exercises be sure the enema reservoir is securely attached to the inside of the rectum Position the manikin on its left side in the Simm s Position Lubricate the appli cator liberally and gently insert through the anus Administer water only into the rectum To simplity cleanup you may choose to leave the applicator in place while positioning the manikin over a drainage basin The rectum will drain via gravity as soon as the manikin leaves the lett Simm s position Be sure to have a basin under the manikin Rinse the anus and internal rectal reser voir to remove any residual lubricant DOUCHING PAP SMEARS AND VAGINAL INSPECTION The temale genitalia also allows for douching but extreme care should be taken to lubricate the applicator thor oughly Only water should be used as a douching agent Pap Smear procedures and visual inspection of the vagina and cervix may be demonstrated on GERiI KERi but again extreme care should be taken to thoroughly lubricate any instrument of insertion Use the smallest possible soeculum and avoid exerting too much pressure on the vaginal walls Overexertion will damage the simulator just as it would cause tissue damage in an actual patient The soeculum must be thoroughly lubricated prior to inser tion The
11. beats per minute See figure 19 The palpation can be set to either on or pulseless When the pulseless set ting is used the diastolic and systolic pressures will automatically be set to 0 11 KET Au ada WENU GAP CALIBRATE p anien ikri Siriatik Se Alice Jaco Boni Passu RACO Mpi 2 PALPABLE PULSE FEATURE The Nasco Life form Blood Pressure Simulator also incorporates a palpable pulse at the radial location See figure 20 Palpations can be felt upon start up of the unit or after blood pressure set tings have been made Press the Menu key repeatedly until Set PALPATION menu appears Pulse ON is defaulted and enables the palpation feature Palpations continue during inflation until the cuff pressure reaches the systolic set point and resumes when the cuff pres sure reaches the systolic set point during the deflation of the cuff A pulseless condition can be simulated by switching your unit to the pulseless mode Press the Menu key repeatedly until Set PALPATION menu appears By pressing the down arrow at this point palpations can be disabled causing the 12 MEHL TALIBARAT 5 Airo ii Figure 19 simulator to be pulseless When in the oulseless mode all settings are auto matically reset to O and all blood pres sure sounds are disabled The pulseless setting
12. bing 5 If none of these measures work peel back the skin soap up arm and skin generously with lvory liquid detergent of the arm to the knuck les do not remove trom fingers and examine all tubing for possible kinks Soap up arm and skin gener ously with lvory liquid detergent and return skin over arm CARE OF SIMULATOR After each class use disconnect blood and flush the venous system Return synthetic blood to the storage bottle Remove pinch clamps and IV sets from arm Use tap water to flush the venous system and wash the outside of the arm with lvory liquid detergent and water Excess water may be removed from the arm by raising the hand lowering the shoulder and draining it into a sink or basin Always remove the pinch clamps from shoulder tubing and drain excess water trom veins betore storing CAUTIONS 1 This synthetic blood is specially for mulated to be compatible with the selt sealing veins and plastics used in manutacturing the arm 2 NEVER use synthetic blood for intra muscular injection 3 DO NOT use dull or burred needles as these will cause leaks in the system Burred needles will cause permanent damage Use smaller needles 20 to 25 gauge 4 DO NOT allow blood to dry on the simulator it may stain the skin 5 Use only 500 cc of infusion fluid as a larger amount will also increase the pressure of the venous system resulting in leaks 6 DO NOT clean the sim
13. denced by flashback of blood Insert end of IV tubing into butterfly Adjust flow to desirable rate with clamp With this arrangement the IV bag B when full may be easily switched with A Note Always regulate flow of blood from the raised bag and open the other clamp D Intramuscular Injections The procedure tor administering intra muscular injections can be practiced in the area of the deltoid Prep the site with distilled water only These injections can be done utilizing the appropriate needle and syringe 1 2 cc of distilled water may be injected however we recommend utilizing air as injectant since the dis tilled water cannot be drained but must evaporate from the arm Synthetic blood must NEVER be used for injections TROUBLESHOOTING blood cannot be aspirated during the blood drawing procedure 1 The clamp is not opened 2 There are kinks in the tubing of IV sets 3 Tubing has been pinched shut by constant pressure of pinch clamps Lumen remains pinched occasion ally even if pinch clamps are loos ened Slide clamp to new position and with fingers manipulate tubing at pinched site to restore lumen In heavy use slide clamp to new position on tubing from time to time to prevent the permanent pinch caused by constant clamp pressure Replace IV kit 4 If these measures do not unclog the venous system try using a large 50 cc syringe to force fluid through the tu
14. er and Lower Enema Administration Female Eye Irrigation Gastrostomy Care Lavage Gavage Only on Complete Advanced and Auscultation Hair Care Washing Combing Hearing Aid Removal and Insertion Techniques Injection Sites 4 Intramuscular Intramuscular Injection Sites Arms Thigh and Buttock IV Arm Attachment Optional on Basic Complete and Auscultation Oral Hygiene Ostomy Care lleostomy and Colostomy Lavage and Suctioning Pap Smears and Douching Patient Positioning Superior Range of Motion Patient Transter Techniques Prostate Exam Stage B Male Tracheostomy Care Lavage and Suctioning Urinary Catheterization Female and Male Uncircumcised SUPERIOR RANGE OF MOTION GERi KERI manikins offer the most complete and realistic range of motion with no pinch points This allows for correct patient positioning The manikin s articulation includes Trunk rotation hyperextension Shoulder abduction adduction rotation hyperextension Elbow extension flexion pronation supination Wrist flexion hyperextension radial flexion ulnar flexion Fingers abduction adduction flexion soft lifelike material Neck rotation hyperextension lateral flexion Hip abduction adduction rotation hyperextension Knee extension flexion Ankle eversion inversion dorsiflexion plantartlexion Toes abduction adduction flexio
15. in or sink gradually flush the vascular system with synthetic blood by slowly opening the clamp Allow some blood to pass through the system until the air bubbles have been eliminated 6 Once the system is tilled use one of the pinch clamps to close off the blood outlet tubing The venous system is now full of blood and pressurized Be sure to leave the clamp on the IV tubing open 7 Atter tilling the venous system according to instructions the arm is now ready for you to practice drawing blood Blood can be drawn anywhere along the pathway of the vein Distilled water rather than alcohol should be used to prepare the sites Synthetic blood will actually be aspirated once the vein is prop erly punctured 8 Small diameter needles 20 to 25 gauge should be used B Preparing the Arm for Intravenous Infusions Close the clamp at the end of IV bag A tube then fill with water distilled water is recommended and hang not more than 18 above the arm See figure 9 Appropriate intravenous infusion needles or butterflies should be used distilled water is recom mended as an infusion IVs can be started anywhere along the pathway of the simulated vein Cleanse the sites with distilled water only Attach the adapter end of the IV tubing into one of the shoulder tubing ends Place the other shoulder tub ing end in a basin or jar and flush the vascular system by
16. male luer fitting attached to it Attach this to the male luer fitting at the top of the unit marked CUFF See figure 14 Atter the pressure line fitting has been properly installed locate the plug that is at the end of the wire which extends trom the simulated arm assembly Insert the plug from the arm into the jack at the top of the unit marked ARM See figure 15 At this point the Blood Pressure Simulator is ready for use The unit has been facto ry calibrated tor use with the accessories included in the kit No further calibra tion adjustments should be necessary at this time If the unit is to be used with a sohygmomanomebter other than that supplied with the unit or if recalibration is necessary at a later date then see the section titled Calibration Procedures Figure 5 FAMILIARIZING YOURSELF WITH THE NASCO Life form BLOOD PRESSURE SIMULATOR CONTROL PANEL Under the display window are three buttons Menu Gap and Calibrate See figure 16 The systolic pressure is set by pressing the Menu key once The pressure is adjusted up or down using the up or down arrow keys See figure 17 The diastolic pressure is set by pressing the Menu key a second time Adjust the set ting up and down with the arrow up or down keys See figure 18 The heart rate is set by pressing the Menu key a third time and adjusting the rate with the arrow up and down keys The pulse rate can be set trom O beats per minute to 300
17. n soft lifelike material ARMS Arms can be removed by bending the elbows backward approximately 90 to align the keyholes at the shoulders pull outward away from shoulder of the manikin Reverse this procedure to reas semble See figure 1 LEGS The legs detach from the body at the hips by bending the legs backward approximately 150 so that the feet are near the shoulders and the keyholes are aligned The legs can now be pulled outward away from the body Reverse these procedures to reassemble See figure 2 HEAD The head may be removed by rotating it 180 backwards to align with the key holes and pull up Reverse this proce dure to reassemble JOINTS All other joints may be disassembled with a flat head screwdriver Hold the opposite end of the connector pin to prevent unproductive rotation EYES The eyes may be removed by creasing the skin at the outside of each eye and rolling the eye up See figure 3 GENERAL INSTRUCTION FOR CARE GERi KERi comes completely assembled and is simple to take apart it needed Most cleaning can by done with a soft cloth and warm water Avoid washing the painted areas on the mani kin Stubborn stains can be treated by using REN cleaner and a soft rag Stains caused by makeup ink and newsprint are indelible and cannot be removed Avoid contact with these substances Do not apply cosmetics or betadine solution to the manikin ORAL HYGIENE
18. n tubes should be well lubri cated prior to insertion and the stomas should be rinsed with warm water after completion of the exercise to remove any residual lubricant The fluid capacity of the stoma reservoirs is 20 cc Removal of the internal stoma reservoirs can be achieved by removing the genitalia and reaching through the genital cavity The reservoir bags are attached directly to the underside of the stomas To remove pull the reservoir fittings down and disconnect from the stomas Then pull the reservoir bags from the Velcro attachments Rinse with water to clean Reverse the procedure to reattach the internal stoma reservoirs See figure 5 TRACHEOSTOMY CARE The tracheostomy canal is not remov able from the body so any water administered to this site must be suc tioned out after completion of the exercise Suctioning dressing changes tracheostomy tube placement and cuff inflation may be practiced on the manikin The tracheostomy canal is not connected to the oronasal system and access is provided only through the stoma site ORAL AND NASAL LAVAGE GAVAGE AND SUCTIONING Not Available on Basic Access to the stomach is provided through the mouth and both nostrils The insertion of any type of tube or instrument requires generous lubrication prior to insertion Only water should be used in tube feeding exercises The internal stomach reservoir has a capaci ty of 375 cc The stomach may be emp tied
19. nfant Airway Management Trainer with stand Child Intraosseous Intusion Femoral Access Leg on a Stand Child Airway Management Trainer with Torso Basic Buddy CPR Manikin Airway Larry Airway Management Trainer Infant CRISis Manikin Baby Buddy Infant CPR Manikin Fat Old Fred Airway Management Cricoid Pressure Trainer Chest Tube CRISis Manikin complete Deluxe CRISis Manikin Deluxe Plus CRISis Manikin Adult Sternal Intraosseous Infusion CPR Prompt Adult Child Manikin CPR Prompt Infant Manikin CPR Prompt Keychain Rescue Aid CPR Prompt Rescue and Practice Aid Masco Fort Atkinson 901 Janesville Avenue P O Box 901 Fort Atkinson Wisconsin 53538 0901 1 800 558 9595 www eNasco com E mail lifeform eNasco com COPYRIGHT NASCO 2007 PRINTED IN U S A NP 081 07
20. ng Aid 12 cc syringe REN cleaner Lubricant spray Fluid drainage basin Catheter bag with fitting and pres sure sleeve Serial number located under the skin at the back of the neck Auscultation GERi LFO4003U Auscultation KERi LFO04024U LIST OF COMPONENTS Male genitalia Female genitalia Advanced GERi LFO04030U Advanced KERi LF04022U LIST OF COMPONENTS Male genitalia Wig Female genitalia Wi Hearing Aid J 12 cc syringe Dentures REN cleaner Hearing Aid 12 cc syringe REN cleaner Lubricant spray Fluid drainage basin Catheter bag with fitting and pres sure sleeve Right IV Training Arm Left Blood Pressure Training Arm Serial number located under the skin at the back of the neck VISUAL INSPECTION FEATURES Cancerous Mole Comparison Decubitus Sacral Ulcer Stage 1 Dilated Pupil Comparison Skin Wrinkles and Folds Elderly Appearance GERiI only Lubricant spray Fluid drainage basin Catheter bag with fitting and pres sure sleeve Smart Scope with single and dual headpieces Remote Control with LCD display Two AA and two AAA batteries Serial number located under the skin at the back of the neck PATIENT CARE SIMULATION Bandaging Finger and Toe Flexible and Individually Molded Bandaging and Wound Dressing Bed Baths Blood Pressure Arm Attachment Optional on Basic Complete and Auscultation Clothing Changes Denture Removal Upp
21. on The final restriction represents the sphincter muscle where the urethra joins the bladder Gently advance the cath eter past this point until you feel a pop as you enter the bladder Water will now flow through the catheter into an exter nal drainage basin Note Special care should be taken when using a Foley catheter Cuff infla tion should only be attempted when it is in the proper position inside the blad der Just as in a real patient the cuff must be completely deflated before the catheter is removed Improper use of a Foley catheter can result in damage to the simulator Leaving a catheter in the simulator may result in damage to the simulator A Atter completion of the exercise remove the male genital insert by reversing the assembly instructions page 3 Disconnect the catheter bag and fitting from the insert piece Drain the bag thoroughly Rinse bag and the outside of the penis to remove any residual lubricant PROSTATE EXAMINATION Not Available on Basic The male genitalia also includes the capability tor digital rectal prostate pal pation The prostate gland represents stage B progression of prostatic cancer A discrete hard nodule is palpable in the upper right quadrant simulating a begin ning stage of carcinoma The student must fully lubricate his or her finger prior to insertion into the rectum The rectum should be rinsed with warm water after completion of the exercise The male rect
22. opped at 72 mmHg the oftset is 2 or if the sounds stopped at 68 mmHg the offset is 2 14 aca iload Proniwe hamata ALS Fiet Me Figure 23 5 3 AUT GAP CALIBRATE 1 2 Tipin Figure 24 i _ re a ej For this example assume that the sounds stopped at 72 mmHg From the systolic window press the Menu key to change the diastolic window See figure 24 With the arrow down key set the correction to 2 Press the Menu key again and the message CALIBRATION COMPLETE will appear The main menu window will be displayed PREPARING YOUR EQUIPMENT FOR USE WITH THE NASCO Life form BLOOD PRESSURE SIMULATOR To adapt your sphygmomanometer for use with the simulator it is first necessary to obtain the luer fitting and the T fit ting included with the simulator which is also available through your Nasco catalog sales office Using a wire cutting pliers or similar instrument carefully cut the pressure line of the sohygmoma nometer about 2 trom the gauge See figure 25 Figure 28 Take the T titting and insert it between the two ends of tubing that were previ ously cut See figure 26 Assemble the portion of pressure line tubing over the remaining barbed end on the T fitting See figure 27 Lastly take the loose end of the tubing and push the female luer fitting into it See figure 28 Attach the female luer fitting to the fitting marked CUFF at the
23. rns on the remote control and sends a sig nal to activate the stethoscope as well Atter the unit is activated the display will be in the status mode displaying the current menu settings for the heart and lung conditions To select a new condition press either the heart or lung button This will put the display into the menu mode The user can select a condition by either using the number buttons or by viewing the conditions in sequence using the scroll button After the condition is selected press the enter button to activate 15 THE REMOTE CONTROL CAN BE PROGRAMMED TO THESE HEART CONDITIONS 01 Normal 02 Aortic regurgitation 03 Pulmonary stenosis 04 Mitral stenosis 05 Holosystolic 06 Mid systolic 07 S3 Gallop 08 S4 Gallop 09 Systolic click 10 Atrial septal detect 11 PDA 12 VSD THE REMOTE CONTROL CAN BE PROGRAMMED TO THESE LUNG CONDITIONS 01 Normal lung 02 Normal Vesicular 03 Wheezes 04 Mono wheeze 05 Fine crackle 06 Coarse crackle O7 Ronchi crackle 08 Stridor 09 Cavernous 10 Bronchovesicular 11 Bronchial 12 Pulmonary edema 13 Infant 14 Friction rub 15 Egophony 16 Pectoriloquy CONSULT THE ENCLOSED LAMINATED CARD FOR LUNG AND HEART SOUND SITE LOCATIONS To listen to the selected sounds place the earpieces in ears angled in a for ward position Place the diaphragm of the SmartScope over one of the appropriate sites on the manikin see diagram on back As an alterna
24. rol Unit from the box and turn it over placing it face down onto a pad ded work surface Locate the Open compartment on the back of the panel where the batteries are to be installed See figure 12 Place your thumb or index finger on the Open compar ment and push up This will open the battery compartment The compartment is marked as to the and positions of the batteries The battery bracket is now accessible to the user ON OFF SWITCH Figure 13 Install 6 AA batteries as indicated by the orientation diagram embossed in the bottom of the bracket It is recommend ed that alkaline batteries be used for increased battery lite After the batteries have been properly installed reassemble the Blood Pressure Simulator by simply reversing the disassembly procedures Place the unit face up on the work sur face and turn it on by pressing the on off switch on the top right of the unit See figure 13 Observe the display and verity that a readable display is present indicat ing proper battery installation Note The control box has a battery saving feature which will turn the unit off atter about 8 10 minutes if no keys are used within that period of time The next step is to connect the simu lated arm and speaker assembly along with the sohygmomanometer cuff and gauge assembly included with the unit First locate the end of the pressure line attached to the sohygmomanometer that has the fe
25. s such as 20 to 25 gauge However if instruction with larger needle sizes is required this can be done the skin and veins will merely need to be replaced sooner The Skin and Vein Kits are available through Nasco INTERNAL STRUCTURE Internally the vascular structure rubber tubing begins at the shoulder and con tinues under the arm crosses the ante cubital fossa forearm makes a loop in the back of the hand and then returns to the underarm This venous system See figure 8 is constructed of special plastic tubing with the lumen being the Life form Blood Anterior Posterior a a Pinch Wonks System Clamp f Posterior lezen ma NIG Kaye a6 oe i Inlet Tubing Outlet Tubing approximate size of a human vein This vascular structure has an inlet tubing and an outlet tubing at the shoulder It is via these tubes that synthetic blood is injected and removed allowing practice in the techniques of blood drawing and starting intravenous infusions GENERAL INSTRUCTIONS FOR USE A Preparing the Synthetic Blood 1 Fill the pint bottle containing synthetic blood concentrate with distilled water 2 Pour the synthetic blood into one of the bags 3 Be sure the clamp on the IV tubing is closed and hang the bag no more than 18 above the level of the arm 4 Attach the end of the IV tubing to one of the shoulder tubings 5 With the other shoulder tub ing in a bas
26. sures on the gauge with the respective set tings on the simulator If the readings were accurate they should compare favorably with the preset values If the auscultatory gap had been selected then an absence of an audible pulse would have been noticed during what would have been the phase 2 Korotkott sound It is this lack of an audible pulse that is considered an auscultatory gap Note that in reality the auscultatory gap can be present in either the phase 1 or phase 2 Korotkoft sounds It it is desired to demonstrate the sounds heard while measuring a subject s blood pressure to the trainee or group of trainees an auxiliary blood pressure speaker amplifier system is available SB20146U If the auxiliary speaker is used the speaker is plugged into the EXT AUDIO AMP jack located next to the ARM output jack at the top of the unit Adjust the volume control to increase the output of the auxiliary speaker amplifier and proceed with the blood pressure measurement sequence as it would normally be per formed except that the stethoscope need not be used Instead listen to the sounds as they emanate from the speak er amplifier noting the differences in the Korotkott phases being presented 13 The Nasco Life form Blood Pressure Simulator is programmed to demon strate the five Korotkott phases includ ing an auscultatory gap which can be heard during auscultation of a subject while measuring the subject s blood pressure E
27. terization exercises fill the 140 cc syringe supplied with water Lubricate the end of the administration tube and insert through the urethra at least 7 8 Be sure the catheter bag and fitting are attached to the urethra behind the genital insert The Velcro on the catheter bag should be secured to the Velcro on the genital track Depress the plunger of the syringe to fill the catheter bag The catheter bag has a capacity of approximately 375 cc Place the track on the track mount located at the underside of the abdomen Gently slide the genital insert back to the body Litt and push the bottom of the genital insert into the genital opening in the body Push the top of the genital insert down and in to secure the system The natural restrictions of the male urinary tract have been designed into the male genital insert so proper manipulation of the penis is required to achieve cath eterization Thoroughly lubricate the 16 French Foley catheter supplied with your simulator prior to insertion Insert the catheter about 2 into the urethra until the restriction of the mucosal fold is encountered Withdraw the catheter slightly stretch the penis slightly and then advance the catheter past the first restric tion See figure 4 Advance the catheter approximately 2 additional inches until you feel the restriction of the bulbous urethra Elevate the penis to about 60 and advance the catheter past the second restricti
28. tive an amplitied speaker SB20146U can be used allowing an entire classroom to hear at the same time To connect the speaker plug the speaker cord into the speaker jack on the top of the SmartScope box When a speaker is connected to the SmartScope the ear pieces will not work Place the diaphragm of the SmartScope over the appropriate sites on the manikin Note The remote has a battery saver that shuts the unit down atter eight min utes if the remote is left on the same setting To prevent if from shutting down select a different heart or lung sound within the eight minute period of time AVAILABLE SUPPLIES LFO1144U Additional SmartScope LFO1148U Replacement Remote Control B20146U Amplified Speaker 04070 Keri Upper Torso LF04047 N U Geri Upper Torso LF04073 N U Keri Lower Torso LF04048 N U Geri Lower GerRI KERI THE NURSING SKILLS MANIKIN Component Replacement Parts Other Available Life form Simulators LF00698U LF00856U LF00885U LF00901U LF00906U LF00929U LF00957U LF00958U LF00961U LF00984U LF00995U LF00997U LF00999U LF01008U LF01012U LF01019U LF01027U LF01028U LF01034U LF01036U LF01037U LF01038U LF01042U LF01062U LF01063U LF01064U LF01069U LF01070U LF01082U LF01083U LF01084U LF01087U LF01095U LFO1108U LFO1121U LFO1131U LFO1139U LFO1142U LFO1143U LFO1152U LFO1155U Adult Injectable Arm White Female Catheterization
29. ulator with solvents or corrosive material as they will damage it 7 DO NOT use for subcutaneous injection Nasco s Intradermal Injection Simulator LFO1008U is specially designed for intradermal injection training and practice 8 Nasco Vein Tubing Sealant Kit LFO1O099U will extend the life of the tubing SUPPLIES REPLACEMENT PARTS FOR INJECTABLE TRAINING ARM LF00845U Life form Venous Blood quart LF00846U Life form Venous Blood 1 gallon LFO1099U Vein Tubing Sealant Kit LFO3215U Skin and Vein Replacement Kit W09199U REN Cleaner 10 BLOOD PRESSURE SIMULATOR The Nasco Life form Blood Pressure Simulator is designed for years of main tenance free operation as a training tool for not only the nurse doctor or pre hospital healthcare provider but also for anyone involved in the training of health care professionals The Nasco Life form Blood Pressure Simulator has digitally recorded blood pressure sounds that can be varied by pulse rate and volume The different Korotkott phases can be identified and an optional auscultatory gap can be selected A palpable radial pulse is present in the wrist For additional uses purchase the Blood Pressure Speaker System SB20146U for group demon strations or review LIST OF COMPONENTS 1 Case 2 Arm with speaker wire 3 Electronic control unit 4 6 AA batteries 5 Sphygmomanometer GENERAL INSTRUCTIONS FOR USE Take the Blood Pressure Electronic Cont
30. um does not have the capacity for enema administration FEMALE CATHETERIZATION Not Available on Basic Note To avoid the possibility of leakage make sure you use the 16 French Foley catheter supplied with the simulator To prepare for female catheterization fill the 140 cc syringe supplied with water Lubricate the end of the administration tube and insert through the urethra at least 7 8 Be sure the catheter bag and fitting are attached to the urethra behind the genital insert The Velcro on the catheter bag should be secured to the Velcro on the genital track Depress the plunger of the syringe to fill the catheter bag The catheter bag has a capacity of approximately 375 cc Place the track on the track mount located at the underside of the abdomen Gently slide the genital insert back to the body Litt and push the bottom of the genital insert into the genital opening in the body Push the top of the genital insert down and in to secure the system Thoroughly lubricate the 16 French Foley catheter supplied with your simulator prior to Insertion Note Special care should be taken when using a Foley catheter Cuff infla tion should only be attempted when it is in the proper position inside the blad der Just as in a real patient the cuff must be completely deflated before the catheter is removed Improper use of a Foley catheter can result in damage to the simulator Leaving a catheter in the simulator m
31. vagina should be rinsed with warm water after completion of the exer cise to remove any residual lubricant GASTROSTOMY CARE LAVAGE AND GAVAGE A flanged hole simulating an abdominal incision for the insertion of a feeding tube is included on the upper torso for performing lavage and gavage Inside the upper torso is a reservoir bag with a maximum capacity of 500 66 which is attached to the gastrostomy open ing with a two part coupler The bag is removed by pushing in on the clear L shaped button and pulling it straight away To attach simply push the coupler body with bag attached onto the cou pler insert part with a black O ring that is protruding from inside the torso You will hear a slight snap when the con nection is complete With extensive use these two coupler parts may no longer snap so the clear L shaped button will have to be manually pulled all the way out after connecting the two parts Test the connection by pulling on the cou pler body to ensure that it is locked This gastrostomy feature is designed for use with a 16 French feeding tube It is recommended that the tip of the feed ing tube be lubricated before inserting Make sure the reservoir is straight and flat before attempting to simulate actual feeding with a liquid OSTOMY CARE Colostomy and ileostomy care can be practiced on GERi KERiI includ ing stoma dilation irrigation cleaning and ostomy bag changing procedures Irrigatio
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