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Newborn HAL User`s Guide

1. Ventilate and perform chest compressions Wait indefinitely for actions Newborn HAL User Guide 131 owed Newborn HAL Simulators for Health Care Education Beth s Donna s Baby Baby is born with a mild asphyxia that needs attention Once ventilations are started the baby s vitals go to a healthy state Begin PPV Wait Indefinitely for action 132 User Guide Newborn HAL NET Newborn HAL9 Simulator for Health Care Education Cynthia s Baby Male infant with central cyanosis limp flaccid and requires immediate resuscitation No spontaneous movement of right arm is noted Stat CXR reveals a fractured right clavicle and right pneumothorax Perform ventilations and needle decompression Wait Indefinitely for actions Perform fluid resuscitation Wait Indefinitely for action Newborn HAL User Guide 133 i Newborn HAL Gaumard Ae Simutators for lealth Care Education Elaine S Baby This baby is born with moderate asphyxia and will require CPR and oxygen to bring the vitals to a healthy state Administer 10096 O2 with bagging Wait Indefinitely for actions 134 User Guide Newborn HAL G Newborn HAL aumard i Simulators for Health Care Education Francines s Baby This ba
2. Providers nurse or doctor suggest moving to OR www lilz l k Provider allows breech to deliver to umbilicus with maternal pushing and does not pull e Several preprogrammed evaluation templates included in the GIGA software Each template includes a set of multiple choice questions fill in the blank and true or false questions for a variety of scenarios Select an evaluation template from the Load template drop down to begin ass Evaluation Form Load template gt Breech Vaginal Delivery Evaluation Nai Forceps Delivery 1 Postpartum Hemorrhage On Site Revie shoulder Dystocia Umbilical Cord Prolapse Vacuum Delivery Enter the name of the facilitator administering the evaluation in On Site Reviewer field as Evaluation Form Load template Eclamptic Seizure Print Evaluation Name Eclamptic Seizure On Site Reviewer Date 0 i Newborn HAL User Guide 91 Complete the form by answering each question Evaluation Name Edlampuc seizure On Site Reviewer Date 01 20 2013 None m Yes No N A Calls for additional help Nursing or Physician e Calls for anesthesia 0 Providers turn or assist in turning patient to side during seizure e Inserts tongue blade into mouth e Click Print at the top right corner of th
3. 4 Adjust the Max Alpha to modify the type of interactivity effect Monitor the graph for a visual model of the plasma concentration e Alpha 1 Additive e Alpha lt 1 Synergistic Induction e Alpha gt 1 Antagonistic Inhibition Cance DEE Max Ata 0 75 L 30 a e ug Isobologram plasma concentrat ___ move i gmove 3 Os move All TEST EXNEL MEM 9 Use the test panel to simulate the interaction between the drugs based on dosage and time of administration Test Panel Test object weight 68 kg Time Effect Graph Apply Naloxone Narcan E ES E Dose 1 lug Attime 0 4 0 o Apply Captopril Capoten Dose 2 mg Attime 9 OF 0 M Update Graph z Results At time 01 45 00 Max Interaction Effect 3 88 Alpha 0 93 Compared to Additive individual drug effect increased by 6 87 Newborn HAL User Guide 81 To simulate the medications interactivity using the test panel 1 Enterthe patient s weight and the dose for each drug Test Panel Test object weight kg Apply Naloxone Narcan a E Dose 2 lug Attime 05 0 oF Apply Captopril Capoten Dose 25 mg At time of ogj E oi m ssa 10 Update Graph z Results Attime 01 45 00 Max Interaction Effect 3 88 Alpha 0 93 2 Compared to Additive individual drug effect o increased by 6 87 2 En
4. 5 Half Life hr min sec 6 Peak Time hr min sec Precise IL Pinar ail AAA Y i 6 Enter half maximal effective concentration EC50 0001 mg dl m Concentration that produces 50 of the maximum effect Available Palettes Apply Items Threshold ug X ge P 7 Select the standard dose SD effect palette created earlier and then click the applicable dosage button to assign it to the threshold Repeat this step to assign the over dose OD effect palette to the Over Dose threshold EC50 0001 mg dl Concentration that produces 50 of the maximum effect Available Palettes Apply tems Threshold an meme d Froes j rem pend 8 Select the threshold unit and set the dosage amount that will trigger the programmed palette effect bduces 50 of the maximum effect F Apply Items Threshold mg ones iom erepertes i Eat p clear 4 Betame Newborn HAL User Guide 77 9 Click Add to save the new medication to the Medication List library READ mM aie eee Sains 7 hr min sec very quick 5m After configuring the drug properties using the Add New Medication menu click the Update Graph button to generate the effect plasma
5. 53010 Gaumard Simulators for Health Care Education Newborn HAL is an interactive educational system developed to assist a certified instructor It is not a substitute for a comprehensive understanding of the subject matter and not intended for clinical decision making Newborn HAL User Guide G13 8 1 Gaumard Scientific Company 2013 All Rights Reserved www Gaumard com 2 User Guide Newborn HAL Contents CONLE S sein nor En CES ra PU EE ANIMS rac mM PSOE 3 End User License Agreement 6 Care and Cautlolis soes pucr eure VE TE DRE EK REMIT PER ERR NEUES 8 OVE Fal VV ARMING S eoi secures iude oi Og UU tb Doku iO n ue cn peto tl OR bedeutet 0 ete eoe ees 9 Electrical THEa tee TTE PET 9 Getting Stated s cossebria Fuck da eR TaEPIE QUENDAM REM PU ESAE Pd 10 97 7 11 TEMNO y pepe eder TT 12 Equipment Sep suc duuorue aeu eRpei Fund a i 13 Control Fable PO sssrin Rub quee bed Debe ie ands Urb e ud bee de rebate eiua 14 Newborn HAL Baley sete m UN 14 VUORO deen ean E T 15 Working with GIGA serere suere 17 otartibdg Ie NTU AON secet edite meae Inti aat evasa ai eei deua que eI o lsu stu c t atus 18 Profiles and Operating MOGOS sciet meteo ptio ote tau ona Seta eoe to meta enc 18 Manual ModE PEE TT 19 AULOITiate Mode seinri eut e Loads tat ot ust eod en teste Lotus eot issus 19 IGA NIG HACE RETI Em MTM 20 SOMIMC
6. BP 60 35mmHg i Temperature 37 5 C 1 4 Land LS 22 User Guide Newborn HAL In the List View the vital signs controls are divided into separate categories Click through the categories to view the controls available for the current simulator configuration Lung Sounds vol Right Left Enable the instant apply option and click the control to change the vital sign to a new value Vital signs undergoing change blink yellow CEPHALIC Ei oec Newborn HAL User Guide 23 The Body View mode displays an interactive model of the simulator The model is a representation of the simulator and its internal organs The floating control boxes are used to monitor and change the vital signs just like in the List View mode Cyanosis Muscle Tone limp q CIRCULATION BP 60 35mmHg Temperature 37 5 C x List View Use the Body View controls to rotate zoom and re center the model Click the transparency button to view the model s internal organs STATUS DETAILS none 3 Musce Tone limp x Crying Off x 24 User Guide Newborn HAL The floating controls are used to monitor and change the vital signs The default layout displays commonly used vital signs controls Click the button to add controls to the floating window STATUS DETAILS x A CEPHALIC Cyanosis 0 x LINE KO 1 AIRWAY Upper Airway Sound vol Cry
7. to accept the incoming connection Diagnostics On the menu bard click Helo gt Diagnostics to open the module diagnostics window The diagnostics window is used to test the status of each of the modules equipped in the simulator during troubleshooting Click Check All Modules to perform a full status test Active modules report light blue and inactive modules report black If there is a specific module that fails to respond please contact customer support Modules for features not installed on the simulator will report inactive Audio Theos voce Vv 5 M 5 R 0 Hest v 5 M 5 8 0 Lung Front Upper Right Vol NA Lung Front Upper Left V 1 M 5 R 0 ht v 5 M5 8 0 KK Left v 5 M 5 8 0 Q Bowel Upper Right Val NA To perform an individual module check first select the module and click Check Single Module Notice that the name of the module is displayed on the right column when it is selected Newborn HAL User Guide 149 Consumables Replacements and Optional Parts Contact Gaumard Scientific for a complete list of consumables and replacement parts and their prices C Consumables R Replacements A Accessories U Upgrades M Factory Repair ONLY Item ID Name Type Description 3010 001 A C Virtual Monitor A 17 Touch Screen monitor and desktop 3010 002 D C Virtual Monitor A D C Powered 12 Touch Screen Mobile Monitor with stylus 3010 010 Battery C Rech
8. 40 100 100 100 Shocks Socks Shocks Convert to NSR convert to NSR degrade to yo bpm OP EO oo bpm BP P enoi 120 80 120 80 fibrilation OK l a Cancel The behavior of each auto response option is explained below e Off The software does not respond to the electric therapy e Prompt The software detects the electrical therapy and prompts the facilitator before applying the changes configured in the Settings section e Auto The software automatically detects the electrical therapy and compares it to a threshold selected by the provider If the threshold is met the vitals will automatically change to the parameters specified on the Settings section Each type of electrical therapy has a unique set of default parameters For example the default response to a defibrillation Shock applies the following vital sign parameter changes NSH 75 bpm BP 120 80 Click the palette button to program a specific palette item as an auto response Defibrillation Shock Prompt e Auto NN e at Joules 200 l 7 Shocks ag convert to NSR lt el 70 bpm BP 120 80 Select the desired palette from the Load Palette Item window and click Load Load Palette Item Palette Healthy vitals Q francine02 c gloria01 gloria02 Healthy Vital Signs The defibrillation shock auto response is now configured apply the Healthy Resting palette if a virtual
9. An exclamation sign is shown when there is no communication with the simulator and battery information cannot be retrieved Cw EI E The simulator is set to STAND BY mode automatically when the battery is depleted The simulator will not initialize until the battery is recharged using the battery charger Recall that the battery can only recharges when the simulator is powered off Internal Battery Approx 3 hours 20 User Guide Newborn HAL Session clock The session timer displays the duration of the current session Click the timer to reset the clock or to start a new session Event entries in the text log are synchronized with the session timer ction Duration 40 x d Body view 00 12 15 Reset Session Clock Power Stand by The power button is located at the bottom right corner of the GIGA software Toggle the power button to set the simulator to stand by mode and then again to resume Newborn HAL User Guide 21 UI Panels and Tabs The GIGA user interface UI is divided into several panels and tabs The following sections outline the function and use of each of the controls on the screen aa GIGA Newborn HAL B8505004 QUICK START NEWBORN B CEPHALIC 2 AIRWAY EE Cyanosis 0 Upper Airway Sound vol none 3 Muscle Tone limp Crying Off x A BREATHING A CARDIAC RR 40bpm gt EKG Sinus OS oj
10. Manage Drug List button to open the Add New Medication manager MeDoseand orRste Rate 80 Hp ml min Start W Do Rate un Lmin Start 024 RANCH LABOR AB vo FROVIDE aam d a nr gym Poa Use the Add New Medication manager to add new medications edit medication properties update existing items and program medication interactions ass Add New Medication 1 New Medication 7 Medication Response Medication List EC50 mg dl 2 Description Concentration that produces 50 of the maximum effect Available Palettes v Apply Items Properties 4 Properties 4 Edit Clear 4 8 Drug Effect Tester lug C ug kg mg C mg kg C g C g kg Test object weight 85 00 kg F Update Graph r E N Push WV Infusion 7 IM E subQ Topical Per Oral Inhalation hr min sec Precise og o amp oF Approximate very quick 5m hr min X sec Precise of off oF Approximate very quick lt 5m Edit Med Delete Med Select a medication from the Medication List and click edit to view the medication s properties 74 User Guide Newborn HAL Each medication is programmed with two palette items One palette item is programmed with the vital signs adjustments to simulate the effects of a standard dose S
11. e CPR Ratio Average compression to ventilation ratio e Evaluation Mode It displays the evaluation mode selected e No Flow Time Arrest time without chest compressions e No Flow Fraction Fraction of arrest time without chest compressions EVALUATION MODE TEST NO FLOW TIME 00 21 min sec NO FLOW FRACTION 0 39 COMPRESSION DEPT e 68 User Guide Newborn HAL Print save the report data by pressing the print save buttons located on the right top of the window Soe rte quete Luc 90 Os Casts ratio Save Data R epth ENSE have 199 mmHn f comn Facilitator can load a saved report using the Load Report button Open Report Goad Report CPR Settings VENTILATIONS Medication Auto Mode The Medication tab is exclusive to the automatic operating mode Use the medication controls to simulate the physiological effects and reactions of medications administered to the patient model To simulate the effects of a medication the GIGA software processes the drug s properties dosage and interactions and then adjusts the patient vital signs accordingly The Meds Profile includes a library of preprogrammed drugs The built in drug editor allows facilitators to stay current with new medications or make changes to the properties of the existing drugs All of the preprogrammed drugs included in the Med Profile library are found in the 2008 Handbook of Emergency Cardiovascula
12. of 1584 30 8 Approximate very quick lt 5m Clear All In the example below two drugs preprogrammed to interact have been administered The interaction information is listed in the Interaction Status panel wr b ui Naloxone Narcan 0 ug IV Push 4 29ug kg 98 63 sd 00 10 17 Captopril Capoten 0 mg Per Oral 6 20ug kg 3 36 sd 00 09 57 More Potent Eff Change Less Potent Eff Change Max Alpha Current Alpha Newborn HAL User Guide 83 Event Log The event log records a time stamped entry of events that occur during the simulation session It addition every individual entry records a snapshot of the vital signs parameters at the time the event occurred The text log records the following events e Vital sign changes applied manually or made by scenario e Events detected by onboard sensors e g intubation sensor defibrillation sites e Preprogrammed speech phrases e Satisfactory or unsatisfactory evaluation e Facilitator notes 01 24 33 APPLIED TO NOELLE Reset the Model 01 24 33 APPLIED TO NOELLE Reset the Model MODEL TO NOELLE 00 00 01 24 36 MODEL TO NOELLE 00 00 EtCO2 33 FHRAccel t dramatic 00 03 12 00 03 15 APPLIED 00 00 alice01 HR 75 RR 21 Temp 00 04 36 APPLIED 00 00 alice02 ContractionFreq 4 00 04 59 APPLIED 00 00 alice03 RR 23 OSat 97 Select patient vital signs options to view a snapshot of
13. recording to stop at the end of the scenario automatically Click Stop A V from the menu to end the recording Fetal Neo Link Auto Mode The Fetal Neo Link transfers the fetal vital signs to the Newborn Premie Software at end of the delivery The feature allows the providers to continue simulation using the full featured neonate without interruptions To configure the fetal link communication between the Noelle and Newborn Premie computers 1 Click F N Link Setup FN open the Fetal Neo Link connection menu File Setup Monitors Auto Mode View 2 Set the adapter to Wireless network connection 3 Enter a port number for the connection and click Connect If the port number is busy click Find Available to scan for an open port Newborn HAL Preemie Fetal Neo Link Setup 4 Open the Setup F N menu on Newborn HAL Premie HAL tablet 5 Enter the NOELLE controller IP and the matching port number and then click Connect The Fetal Neo Link is now connected For information on how to troubleshoot connectivity issues please reference the appendix Newborn HAL User Guide 115 The fetus vital signs information is transferred at the end of the delivery automatically Aternatively click Transfer current fetal data to send the information manually File Setup Monitors Auto Mode A prompt is displayed on the Newborn HAL Premie software to
14. x ri gt 9Sat 98 ka 1 HR 140bpm 10 25 56 ay 02 18 2013 2 CIRCULATION T PALETTE SCENARIO i BRANCH SCENARIO HYPOXIA LAB PROVIDER ACTIONS BP 60 35mmHg K Sounds R 2 L 2 Temperature 37 59C x l olo dil E 00 00 15 b Status Details The Status Details panel is used to monitor and control the simulator s vital signs The individual parameter controls displayed on the details tab provide the simplest method for controlling the simulator s vital signs sounds and features There are two viewing modes for controlling the simulator The List view displays the vital signs controls in a list format while the Body view displays the interactive patient model with floating control boxes Toggle the view buttons to switch between the two modes CEPHALIC ex Cyanosis Q9 Muscle Tone limp 7 CEPHALIC 7 AIRWAY AIRWAY E Cyanosis 095 Upper Airway S Upper Airway Sound vol e GIGA Newborn HAL B8505004 QUICK START NE ound vol none 3 none 3 Muscle Tone limp Crying Off Crying off BREATHING SO RR 40bpm f OSat 98 CARDIAC e 7 ae EKG Sinus x HR 140bpm 1 BREATHING p nj A CARDIAC CIRCULATION v F RR 40bpm EKG Sinus BP 60 35mmHg 98 HR 140bpm Temperature 37 5 C gt sowe mg ay Bowel Sounds none D CIRCULATION
15. 2012 11 2 3 Select the item to export from the list and click Export Export File Type Last Modified as 08 31 2012 11 28 36 E 08 31 2012 11 28 36 08 31 2012 11 28 36 08 31 2012 11 28 36 08 31 2012 11 28 36 08 31 2012 11 28 36 08 31 2012 11 28 36 08 31 2012 11 28 36 Description A 0 P 1 G 0 A 0 R 0 The Save As window is displayed ey Documents GIGA Backup Search GIGA Backup p File name helen04 plt Save as type Palette Items plt Browse Folders Newborn HAL User Guide 99 4 Browse to the location where the file will be saved and click Save gt m Documents GIGA Backup X Search GIGA Backup ys File name helen04 plt Save as type Palette Items plt Click File Exit to close the GIGA software and turn the simulator off Alternatively click the power bottom and click the X icon near the top corner of the screen Setup Calibration Options Monitors Remote Access Via Network odes Help Auto Response Set Med Id Scan RF Channels Use the Calibration menu to calibrate the simulator s features and to reset the sensors back to default settings Calibration Calibration Wizard Welcome to the Manikin s calibration wizard Proceed only after you have reviewed the calibration section in the user manual Please select the function you would like to calibrate Chest Compressions Artificial ventilation Blood Pre
16. A 4 6 Enter the name of the test the unit and decimal precision f Add Insert Entry Name HDL Cholesterol Unit mg dL Precision 8 NORMAL RANGE 1 im BS ETT TT 7 Enter a Normal Range the provider to reference The normal range is visible on the lab report The Allowed Range restricts the minimum and maximum value that can be entered a test result Click OK to add the new test j Add Insert Entry Name HDL Cholesterol Unit mg dL Precision NORMAL RANGE Minimum 35 00 Maximum 85 00 ALLOWED RANGE Minimum Maximum Newborn HAL User Guide 63 8 Repeat the process to add more tests and categories Click Save to create the new lab template e Edit Lab Results Template Name Lipid Panel Description Cholesterol HDL LDL Triglycerides lp Add 9 remove ERename d et d E A il v i _ 1 Delete T Edit T Insert T A T v Lipid Panel Female Variable Normal Range HDL Cholesterol mg dL 35 00 85 00 4L Cholesterold HDL Ratio 0 00 4 40 Lipid Panel Male Variable Normal Range HDL Cholesterol mg dL 29 00 71 00 Cholesterol HDL Ratio Ratio 0 00 4 90 Lipid Panel Both Variable Normal Range Cholesterol mg dL 0 00 199 00 LDL Cholesterol mg dL 0 00 129 00 Triglycerides mg dL 30 00 200 00 Allowed value range
17. Breathing ec Details gt Vital Controls Sound Controls ES Respiration rate 30 bpm jo Respiratory Pattern 4 OSat 96 Currently on sim no EtCO2 39 mmHg nn Inspiration Percentage Currently on sim 3 1 0 0 1 lo OSat 4 Currently on sim Change To jo EtCO2 E Currently on sim Change To 39 fo 5 bL 3 fQ Click the sound controls tab to change the sound types for audible features e g heart rate and volume level as Details Breathing Respiration rate 30 bpm Sync ALL Lung Sounds OSat 96 le Lung Sounds Right 4 EtCO2 39 mmHg rmal Lung Sounds right Lung sounds volume right Lung sounds left Lung sounds volume left wheezing insp squeaks Newborn HAL User Guide 27 After the list of changes is created click NOW to update the vital signs instantly Alternatively click a trending timer to update numerical vital sign parameters e g heart rate blood pressure gradually ec Details Vital Controls Breathing Respiration rate Sync ALL Lung Sounds Osat e Lung Sounds Right EtCO2 Currently on sim Change To Lung Sounds ight normal wheezing Lung sounds volume right Vol 2 Vol 3 Lung sounds left Lung sounds volume left bv NE NE 10sec 30sec 1min 2min 5 min 10 min On Apply Clear and Close Details Window A palette item stores one or more vi
18. ECG waveform The options available are 5 seconds 10 seconds 15 seconds and 20 seconds e Display Open the waveform properties menu Edit the waveform color amplitude intensity and scroll direction To change the type of waveform displayed click the waveform menu and select close Click the empty waveform menu and select the new waveform type While operating on the Automatic mode the ECG option displays a sub menu for 12 individual leads Capnography 36 User Guide Newborn HAL The new waveform type is now displayed Click the numeric menu to access the numerical parameter options To change the type of numerical parameter displayed click the numeric menu and select close Click the empty numerical menu and select the new parameter type Numerical parameters can be adjusted directly from the virtual monitor tab Double click the numerical parameter to open the floating control window Adjust the parameter to the new value and submit the changes using the Apply NOW or trending options Newborn HAL User Guide 37 By default the NIBP parameter does not update automatically Click the NIBP menu and select Stat to refresh the reading Alternatively set a refresh interval to automate the stat process periodically pi jranch 5 38 User Guide Newborn HAL Palette Use the Palette tab to sort manage and edit the palette items in the current profile Each profile s
19. Mild Cyanosis I Severe Cyanosis Ren Dee tem o a H ORUM i MO EE VENTILATION oa LOW Approx VIRTUAL MONITOR PALETTE SCENARIO BRANCH SCENARIO LOG 01 30 20 HYPOXIA MODEL Oxygen turned off Temperature 37 5 C 01 30 20 HYPOXIA MODEL Oxygen 1 L min 01 30 22 HYPOXIA MODEL Oxygen 2 L min 01 30 22 HYPOXIA MODEL Oxygen 3 L min 3 CIRCULATION gt BP 45 25mmHg The hypoxia model options improve or deteriorate the cardiac and respiratory vital signs gradually e Pause Model will pause at the current state e Improve Trend the vital signs to a healthy state e Deteriorate Trend the vital signs to a severe cyanotic state Ventilations are detected when the respiratory rate is at 0 Select the cyanosis level to move to any of the following states immediately e Healthy Pedi is pink with adequate oxygenation e Mild Cyanosis Pedi is slightly blue and the vital signs are starting to deteriorate e Severe Cyanosis Pedi is blue apneic and vital signs are rapidly worsening The modeled therapy menu provides additional intervention options e Improve Gain Adjust the slider to increase or decrease the cyanotic response to ventilations e Oxygen Adjust the slider to administer oxygen to the fetus in liters per minute e Epinephrine Administer epinephrine to the model Set the epinephrine dose and then click
20. Shock 100 joules Shocks External Pacing 40 mA i Add Go to End i OK I i 1 Start Bradycardia 2 Deteriorate 3 Interventions 4 Atropine 5 Epinephrine n 6 Dopamine mun Pace N Previous End The key event is now programmed to move the scenario to node 8 if pacing is detected wei OSat 5 Epinephrine Newborn HAL User Guide 53 The Linked Action model medication tab is exclusive to the automatic mode Program the medication linked action to trigger an alternate path when the system detects that the specific medication has been administered to the simulator Linked Action Miu ney Drug Recognition Medication Atropine 54 User Guide Newborn HAL FACTORY PRESET SCENARIOS MANUAL MODE These scenarios in the manual mode are found in the Quick Start Newborn profile There are eleven linear scenarios and no branching scenarios Detailed flowcharts for each scenario are included in the appendix Alice s Baby Healthy baby Baby has an asphyxia attack and the providers need to give ventilations to help bring ASPAYAA SeN back the vitals to a healthy state Baby is born with a mild asphyxia that needs attention Once ventilations is started the Beth s Donna s Baby baby s vitals go to a healthy state Male infant with central cyanosis
21. Use the vital sign parameter controls to change between the available sound types Volume controls for the lung sounds are located on the status panel Enable or disable the right or left lung independently Ventilate using a BVM or a mechanical ventilator To display chest rise during ventilation and receive feedback on the CPR window set the lungs to the Enabled state and the respiratory rate to 0 For more information on the CPR trainer go to page Error Bookmark not defined Cardiac Auscultate realistic heart sounds synchronized to the heart rate and heart rhythms CHEST COMPRESSIONS During cardiac arrest chest compressions are measured and logged Use the CPR window to assess CPR technique and effectiveness by monitoring cadence and depth in real time For more information on the CPR trainer go to page Error Bookmark not defined ECG MONITORING AND ELECTRICAL THERAPY The conductive skin sites allow the use of real EKG electrodes Track the cardiac rhythm with real equipment just like with a human patient Warning Do not pace or defibrillate the simulator Doing so will result in damage to the simulator Use the virtual shock panel to simulate the administration of electrical therapy via software To enable the virtual shock panel feature go to page 103 Circulation Palpable pulses are dependent on blood pressure Use the software controls to disable distal pulses and simulate severe hypo
22. accept the incoming neonatal vital information Click Yes to load the vital signs information PGAR Data Received Newborn Initial data received from Noelle model Do you wish to use this data to reinitiate Newborn model Now 116 User Guide Newborn HAL 2 Copy the setup file to the simulator s Help control computer 3 Run the GIGA update file to update the software File Setup Monitors Do not change the wireless network Auto Mode l settings Doing so will disconnect the n virtual monitor computer and the AN F M Link Gaumard Monitors vital signs software ILLE 2 To update the GIGA software using an Check for Updates Ethernet connection HTT 4 Connect an Ethernet cable to the laptop Create Ad Hoc Network PC Click Check for Updates Click Install to begin the update The download progress bar begins to auto Click the Instruction Manual option to open a fill as the setup file is downloaded digital copy of the latest User Guide information After the download is complete the update setup wizard is launched automatically ABOUT GUI 7 Click Next and follow the wizard to Sethe ee complete the software download Click About GUI to view the software version a Ay EERE The diagnostics menu is used to test the status of electronic and mechanical components in the simulator Click Check all Modules to run a full systems check Active modules repor
23. add Administering epinephrine increases the heart rate e Reset Click Reset to clear the oxygen flow and the epinephrine dose onboard Newborn HAL User Guide 65 Session Time 00 00 08 Session RD Facilitator 2 CPR EVALUATOR CPR GIGA features a CPR performance evaluator and trainer Click the CPR icon on the vertical menu bar to open the CPR window e Lung and heart 3D view organs compromised during CPR are responsive to provider actions Use the 3D view controls to rotate zoom and re center the model 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 This tool allows the instructor to get real time feedback on the current compressions and ventilations being done by the providers Also it will register real or virtual electrical therapy a Ll e Graphical representation of Nm D B compressions and ventilations the ventilations are represented by the blue segment and the compressions by the maroon Segmen COMPRESSIONS No TEN time 00 07 mu sec ENENN LENIN TN B a i LO Open this window when your students or providers are ready to start performing M compressions and or ventilations e Electrical therapy representation Real ne or virtual defibrillation pacing is represented by the y
24. auto configure the port used for this connection 11 Write down the controller IP and port number then click Connect 12 Navigate to the V menu on the virtual monitor computer and select Remote access Via Network 13 Please wait 30 seconds for the feature to initialize 14 Enter the controller IP and port number as shown on step 7 and click connect The Non Scenario Automatic Response feature allows the facilitator to set preprogrammed responses to electrical therapy events When the electrical therapy is detected auto responses can automatically load a specific palette item or prompt the facilitator before making preprogrammed changes to the simulator s vital signs Warning Do not defibrilate or pace Newborn HAL Preemie with real medical equipment Doing so will result in damage to the simulator s internal components 106 User Guide Newborn HAL Non scenario response settings detect electrical therapy administered when a scenario is not in progress For information on how to configure auto responses for use during a scenario go to page 46 To activate the virtual shock panel for administering electrical therapy virtually go to page 115 omatic responses settings All Off IEAI Prompt ji Display warning when non shockable All Auto EKG is shocked a o MEN o oo Prompt Prompt Frompt Prompt ORN Q Auto 4 Auto 9 Auto Auto Jodes Jodes Joules
25. dL 30 00 200 00 100 00 e 40 E 140 ii Send the completed lab report to the virtual monitor screen to assist the care provider To transfer the lab report to the virtual monitor screen 1 First select the report from the lab reports list LAB Lab Report W Name Template Description Sent Create New Lab Report View ECCEN Selected Item Edit 2 Click Send to Monitor button to transfer the lab report to the virtual monitor send to monitor 60 User Guide Newborn HAL 3 An exclamation icon notifies the provider a file is ready for access on the Gaumard Monitors Instruct the participant to click the patient menu drop down and select the lab report Noelle Ask for 4 The lab report opens using the system s default application Home View Lab 01 Report Time Description Above normal range Cholesterol LDL Cholesterol Lipid Panel Female Variable Normal Range Comment HDL Cholesterol mg dL 35 00 85 00 85 00 Cholesterold HDL Ratio 0 00 4 40 5 10 Care required Lipid Panel Male Variable Normal Range Comment HDL Cholesterol mg dL 29 00 71 00 35 00 Cholesterol HDL Ratio Ratio 0 00 4 90 Lipid Panel Both Variable Normal Range Cholesterol mg dL 0 00 199 00 LDL Cholesterol mg dL 0 00 129 00 Triglycerides mg dL 30 00 200 00 5 The letter Y represents a shared document Click the Stop
26. defibrillation shock of 200 Joules or greater is detected The programmed response palette is listed in the settings panel Defibrillation Shock off of Prompt amp Pri Auto Au at Joules Shocks AUTOMATIC MODE NON SCENARIO AUTOMATIC RESPONSES The Automatic Mode non scenario Automatic Responses are unique to the automatic mode Link All Auto Response to Cardiac Irritability Auto responses will work only if the cardiac irritability option on the details page matches the selection on this window Pnario automatic responses settings Link All Auto Response to Cardiac Irritability Modeling m of none a pt On if Cardiac Irritability is s g Bg Defibrillation Shock Cardioversion Shock An event prompt is displayed if electrical therapy is detected and the cardiac irritability set does not match the selection on the responses window Drug Model Effect Configure the auto response behavior for drug administration e Auto Apply the drug effects based on medication s programmed properties and dosage Prompt Display a confirm prompt before applying the drug s effects Newborn HAL User Guide 107 Use the Scan RF Channel tool to search for the strongest RF communication channel available Click the Scan RF Channels option in the setup menu to start the scan Please wait while the system completes the process Communication
27. flexion disables chest rise Seizures Intraosseous access O IK K K aie nie ae ne ne ne ee ee le ee ne ne nee ne Min Physiologic Model n Instructor control data change 300 feet Oth Audio Video recording and ena debriefing O Gaumard Virtual Monitor O Newborn HAL User Guide 119 Newborn HAL s airway can be intubated orally using LMA or endotracheal tubes and nasally using a nasogastric tube Recommended Device Size Procedure Intubation Miller O Blade size LMA Size 1 Nasal Intubation 5 Fr catheter ETT 3 0 no cuff 6 Fr suction catheter Oral Intubation Once intubated sensors detect the depth of the intubation tube Should the tube be inserted too deep the left lung is automatically disabled realistically demonstrating right mainstem intubation Correcting the tube position re enables the left lung 120 User Guide Newborn HAL Warning Always lubricate tubing airway and nasal opening prior to performing any nasal or oral intubation Failure to do so will make intubation very difficult and is likely to result in damage Do not insert liquids or spray silicone oil into the mouth and airway HAL has multiple upper airway sounds synchronized with his breathing Breathing Control rate and depth of respiration and choose independent quadrant lung sounds synchronized with the available breathing patterns Listen to the lung sounds using a stethoscope
28. hold Provider is to intervene again 3 Intervention Atropine Epinephrine Dopamine Node 4 Node 5 Node 6 Airone Node vital signs palettes simulate the response to atropine P Time limit Go to node 3 after 1 minute 5 Node vital signs palettes simulate the response to Epic pine epinephrine Time limit Go to node 3 after 1 minute Domus Node vital signs palettes simulate the response to dopamine P Time limit Go to node 3 after 1 minute Vital signs simulate the effect of pacing Scenario ends 52 User Guide Newborn HAL A Linked Action key event triggers an alternate path when electrical therapy is detected Click the Linked Action radio button and select the available actions Then set the electrical therapy thresholds or number of shocks require to trigger the action Click add to create the key event Add Linked Action Drug Recogniton Defibrillation Shock 3 Shocks Cardioversion Shock E Joules Shocks Non Sync Shock Joules Shocks External Pacing mA EET Set the Go to node from the drop down and click OK to save the changes Edit Path Key events r amp Move re W Rename l j Delete l ne Action Linked Action Electrical Therapy Drug Recognition Defibrillation Shock 200 gt Joules Shocks Cardioversion Shock 100 Gjoules Shocks Non Sync
29. holding the pen in a natural writing software panel after the connection with the position for greater accuracy during normal simulator is established For more USE information about the battery indicator refer to page 20 The battery charge is displayed on the WIRELESS COMMUNICATION USB MODULE The controlling computer transmits the startup and control commands to simulator through the USB RF communication module WARNING Do not store the simulator with a discharged battery It is good practice to re charge the battery at the end of every simulation session Connect the RF communication module to an available USB port on the tablet If the simulator will not be used for an extended period re charge the battery at least once every 30 days Doing so will prevent a reduction of the battery s total charge capacity to self discharge The simulator s battery can only be recharged using the battery charger In addition the simulator must be off or in standby The battery charger does not recharge the battery while the simulator is in use nor does it keep the battery from discharging 14 User Guide Newborn HAL To operate the simulator from wall power using the power adapter Turn the simulator off and connect the battery charger to recharge the battery 1 Fully recharge the simulator s battery To charge the battery 1 Close the GIGA software to turn the simulator off Connect
30. infa The tallest bar represents the strongest channel Double click the bar to connect to the simulator ada a Leo DN the channel selected 108 User Guide Newborn HAL Auto Mode Upgrade The Modeling drop down menu in the top left corner of the GIGA contains four options Modeling Patient Reset Model Import Between Patients and Auto Log Setting Use the modeling patients menu create new patients and to copy items from one patient to another File Setup Monitors New Patient Import Between Patients Noelle Auto Log Settings Recent Patients gt Reset Model To create a new auto mode patient go to Modeling gt Modeling Patient gt New Patient The new patient window is displayed LIS Mew Patient New Patient Term weeks e MIUCIF Height 1 cm Weight kg Other Enter the name of the patient age gender height weight and or additional notes Then click Save To load an already existing patient go to Modeling Modeling Patient Load Patient Load Model Patient Select Last Modified 08 31 2012 11 28 40 Alyssa is a 23 year old female Her height is 08 31 2012 11 28 40 172 7 cm Her weight is 93 0 kg 08 31 2012 11 28 40 Her companion s name is Bill husband Her OB 08 31 2012 11 28 40 history shows a gravida of 0 a term of 0 a ucc E preterm of 0 and that she is currently 40 08 22012 1120 40 weeks pregnant she has had 0 spontaneous 08
31. limp flaccid and requires immediate resuscitation No Cynthia s Baby spontaneous movement of right arm is noted Stat CXR reveals a fractured right clavicle and right pneumothorax NOD This baby is born with moderate asphyxia and will require CPR and oxygen to bring the Bane s Baby vitals to a healthy state This baby was born through a C Section and is responsive but need some attention after a while all vitals go to a healthy state Francine s Baby GlonauBab This baby is born with mild asphyxia but no matter how good the interventions are this y disastrous intrapartum complication results in neonatal death This baby is born with a severe asphyxia that has to be treated emmidiately after ventilations and EPI have been given the baby s vitals go towards a good outcome Meconium aspiration syndrome Newborn with mild Respiratory Distress Transient Tachypnea of the Newborn Helen s Irene s Baby Newborn HAL User Guide 55 These scenarios in the Automatic mode are found in the Meds profile There are three linear scenarios and no branching scenarios All shown are for a premature infant patient Scenario Name Linear Scenario Description Adenosine OD Asystole gt severe AVB asthma exited Adenosine SD Asystole gt Sinus Adenosine UD Asystole gt previous rhythm The scenarios in the Automatic mode are found in the Quick Start Newborn Modeling profile There are eight linear scenarios and one branchin
32. menu option to open the Profiles menu To switch to a different profile select the operating mode and the new profile and click Load Clicking New Session in the file menu will e Clear any loaded playing scenario e Clear any loaded playing palette e Reset vital signs to normal values e Clear out log page e Restart the session clock The session clock is located at the bottom of the dialog box St View The shortcut key for staring a new session is Ctrl N 98 User Guide Newborn HAL Clicking on Reset Session Clock resets the clock back to zero It does not have any effect on the transition time remaining ona scenario it does not reset the vital signs or clear out loaded scenarios The facilitator can also reset the session clock by clicking on the Session button next to the session time List View This option allows you to save all the information recorded in the log page as a text file Clicking on it brings up the Save As dialog box r Save As gO d Reports X m Search Reports p Organize v New folder a v gt Yr Favorites Name Date modified Type E No items match your search gt ag Libraries gt dj Homegroup b jE Computer D Network 4 m r Filename Report1 Save as type Text files txt a Hide Folders Select the desired name and path and click Save The shortcut key for saving a report is Ctrl S For a s
33. the vital signs values when the event occurred L WE EWE CEE UU Fiircinady ec Properties 00 03 12 Cephalic Seizures none Eye state closed Pupil dilation time 0 5 sec Right pupil reaction On Left pupil reaction On Right pupil dilation 5 Left pupil dilation 5 Airway Tongue Edema Off Pharyngeal Swelling Off Upper Airway Sound normal Upper Airway Sound volume 2 Breathing Right chest rise Left chest rise Pneumothorax Pneumo Right Pneumo Left Lunn Carmninnena nnm E 15 mir o co SSSSS 84 User Guide Newborn HAL Enter notes into the add to log field to record notes manually The information is categorized in the log as NOTE GRIP e aro eee Oe M Ege oio M eue zi o ME e ME cuzze ME PROVIDER ACTIONS Log 00 01 01 NOTE The team is ready to start Additional providers joined Ld Team amp S x The log event time stamps reference the GIGA session clock At the start of a new simulation exercise click File gt New Session to reset the session clock 00 00 00 reset any vital parameters settings and clear all the event entries Profile Ld Reset Session Clock Monitors Save Report View k Print Report Help Import Export Exit The log information is recorded in a rich text format Export the log information to save a detailed history of the events that occurred during t
34. this manikin Also you can name each monitor with an appropiate description O All sensors always ON except tor Swan Ganz Adapter Controler IP 10 0 1 1 Port 8001 Connected to 10 0 1 2 114 User Guide Newborn HAL ANN Audio amp Video GIGA is capable of interfacing with a number of third party A V recording systems Generally A V solutions capture footage of the simulation and interlace it with the event information generated by the simulator control software To enable the fetal Neo link menu option go to Set Up Options Other and checkmark Use AV System 7 File Setup Monitors b Auto Mode y Stop AV Click Setup AV to configure the software connection to the AV system Enter a port number for the connection and click Connect to establish a link Please contact the AV administrator for information on how to accept incoming connections from the GIGA software A V Link Information x refresh Ip Adapter Local Area Connection Controller IP 192 168 50 123 Port 8001 p lt find avail 24 Connected to Return to the A V menu and click Start AV to initialize the recorder Some third party A N solutions may not recognize the Start command generated by the log event If the recorder does not start remotely please start the new video manually using the third party controls The log event does not command the
35. to zero none will be Sounds are synchronized to the breathing cycle What you are really setting here when you choose a lung sound is the condition of the lungs given respiratory drive That is 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 It is 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 do not 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 h
36. virtual monitor main screen such as a glucose levels or a platelet count Click on the empty scalar menu and select l Other from the list of available scalar On the GIGA menu bar click parameters Select the name of the custom Monitors gt Custom Numbers to open the parameter Custom Numerical Parameters on Monitor menu Click the Add button to create a new parameter NIBP FtCO Custom Numerical Parameters on Type the name and units of the new parameter and then click OK G u c a x E Custom Numerical Parameters on Monitor s Name Hematocrit The scalar parameter is now created Enter a value for the parameter and click Update Remove Hematocrit 52 Yo update Glucose 83 mg dl update Newborn HAL User Guide 113 The figure below shows two new values Glucose level and hematocrit levels Return to the custom parameter menu on the GIGA software to update the values when necessary On the GIGA menu bar click Monitors Configuration to open the virtual monitor setup window Use the virtual monitor setup window to verify the connection between the GIGA software and the Gaumard Monitors vital signs software re configure the communication ports and view the controller IP address To troubleshoot connectivity issues go to page 141 d Newborn HAL Virtual Monitor Setup Select the number of monitors that wil be used with
37. 00 00 100 o 58 User Guide Newborn HAL 9 Click Save to create the lab report The newly created lab report is now listed in the Lab Reports section Sort lab reports by name template description or color tag W Name Template Description Sent Create Bow Lab Report oer RN Ea KITE View Sort by Color Selected Item 10 Click Preview to review the final lab report sent Create New Lab Report Sort by Color Selected Item Newborn HAL User Guide 59 The preview window displays the test results how the provider will see them on the virtual monitor screen If the computer is connected to a printer click PRINT to create a hard copy DEFA T DD AETI E Enr nca anh in Marth Couth Amarica Lab Preview X Print Lab 01 w Report Time rt Description Above normal range Cholesterol LDL Cholesterol a nnn nnn nnn nnn Lipid Panel Female wa Variable Normal Range Value Comment gem b HDL Cholesterol mg dL 35 00 85 00 85 00 m Cholesterold HDL Ratio 0 00 4 40 5 10 Care required mm T gj Lipid Panel Male 9 l variable Normal Range Value Comment HDL Cholesterol mg dL 29 00 71 00 35 00 3 Cholesterol HDL Ratio Ratio 0 00 4 90 4 00 Lipid Panel Both m P Variable Normal Range Value Comment E Cholesterol mg dL 0 00 199 00 190 00 LDL Cholesterol mg dL 0 00 129 00 135 00 40 Triglycerides mg
38. 31 2012 11 28 42 abortions 0 elective abortions and 0 living 08 31 2012 11 28 42 children 08 31 2012 11 28 42 08 31 2012 11 28 42 08 31 2012 11 28 42 08 31 2012 11 28 42 08 31 2012 11 28 42 08 31 2012 11 28 42 Select the desired patient and click on Load Notice that the factory pre set patient cannot be deleted as opposed to any of the patients that you create yourself which can be deleted Patient information is displayed on the right side and near the top of the Details tab 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 is currently on Ventricular Fibrillation clicking on reset model changes the ECG rhythm back to sinus Use the Import between patients menu to import palettes scenarios and branching scenarios from other patient profiles into the current active one To import an item another patient in to the active patient 1 Click Auto Mode Import Patient to open the Import menu 2 Select the item category to import Import Between Patients Palettes Scenarios Branching Scenarios N A Preeclampsia Newborn HAL User Guide 109 3 Select the patient name that contains the items to be imported into the active patient Import Between Patients Importing Palettes Preeclampsia NENNEN 4 Select the items to import from
39. AUS 120 ICI OI SOHO acuti dace reenter cet et reenter Rent ee centr tn eet eee rte etn be EM DE reda 120 Bilateral Chest ao eee ee m im ee tee de im EM EM 120 Pulmonary VerlatolixsstunevissooeidetbsievdeRuidePdetbniev de Buioe Pdetbdiev de uide aN 120 We 121 Heart Sounds NI m 121 GhesEeompressioOElS 1565291 2 029 RER 121 ECG Monitoring and Electrical Therapy eeeeseeeeeeeeeee 121 CSIC UO ania letarastieduta ite idet duet iotoo Sub A debuts 121 Papale dicm EO TODOS 121 Programmable Blood Pressure us cett eruca trt rete etn eruere ptus 121 Connecting thie MOditled Ul asiciiuet tence tet eee nat dO bet cabe cheat atout een 121 4 User Guide Newborn HAL Intravenous Extremllles ses iei ed e e ee vai e Cu e eu etin d de p IE 121 IMG TEIN Ico WII ceia A A E 122 Intramuscular Injection Sites sce tide bna iste tds fuer itus lacs iuam eee tds heu uae 123 Intraosseous ACCES Stead rete adeblte cua e Moti asd uto ud eet ade lato eode Ud eet ed 124 CEDNA epee ener UEM 124 RY NNO oa ad cence at EU DE M e I IL ADEM E 124 Muscle Tone and S6elzul 65 ccu eooeeiicdosie Queso eeb o tole Queste io dosi e Ole wecpe dio Drei ub igo 124 VEMO a5 oc eet see reece see aceasta oe emce ce ee ome Dit pica 124 oathi terzallobuos sitire asin ee rtt aie tt 124 Umbilical Cord System S N B0906424 or higher 125 Bowel Sounds Systems S N B0906424 or highe
40. Automatic mode or manually by the Instructor e Training Guide with both basic and advanced interactive scenarios e Use pre programmed scenarios modify them or create your own quickly and easily e Installation and training worldwide e Simulation Made Easy AIRWAY e Calibrate head flexion to obstruct airflow and chest rise e Oral and nasal intubation e Use an ET tube or LMA e Sensors detect depth of intubation e Unilateral chest rise with right main stem intubation e Multiple upper airway sounds synchronized with breathing APPEARANCE e Color responds to hypoxic events and interventions healthy mild cyanosis severe cyanosis e Forearms movements reveal muscle tone active medium limp BREATHING e Control rate and depth of respiration and observe chest rise e Ventilation is measured and logged e Select independent left and right lung sounds e Chest rise and lung sounds are synchronized with selectable breathing patterns e Accommodates assisted ventilation including BVM and mechanical support e Unilateral chest rise Conductive skin regions allow for ECG monitoring with real equipment 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 bilaterally using a cuff palpation or auscultation Blood pressure sounds audible between systolic and diastolic
41. C OM sla Ss nac satay iatea hae iota att eaten aoe SNP LOOPS URN C SLE E SORTE ION 20 Battery INGIC ALON RIOT 20 SESSION ClO C EE T at tee etna 21 OWOSI Oland Dys ost catty tee Senet ected cee ead n Eon pat tent te pt bites Costa 21 UlPanels and TADS RE 22 SIUS DEAS suo iEI EMI neo eee enone ee ot 22 Vinul MOMO Sessie eae neo sup on ne M eaaa A p dc erc AT LE MD ee rire 36 mici TR KK Ex RM XEM 39 lei E 40 Branching o cenaho S sissies EE ELEM 47 Newborn HAL User Guide 3 MOGEIING NEWOOM PICMG en ink beo o A S 65 Sixt 66 ug EU 66 Sole CUR 67 ODO aaa rp ER REOR 68 Medication AUTO MOOG PRENNE RR IRI COURIR P PRORNOREOU ENCOUNTER NIU 67 zac C senieteenleameenatens 84 Provider ACTIONS MM E 86 e U Fe 10 al ie MEE SEE 91 MIS SIE TNR EPNEECNR 98 mtem T e E 98 a E E A A E A E E EE eee E 100 Fetal Neo Link Auto Mode n nnannnannennnannennnannnnnnnnnnnnnnnrernnnereresnerereenene 105 Auto Moder Uporade Jernia E E A EA 109 MONIO S arena a a A a 111 PIN Audio amp VIDEO semi nienn MIRI UNS EE NER AE eA Tirar 115 Fetal Neg JEn AIO MOdE Vaiten a Aon a SERICO 115 mill RM cece ne ces mie ae AN AAE A eu acu E E 117 Working with Newborn HAL 118 his c eC 120 MUDUR MR 120 AWAY OUINOS M PLN 120 SUI esee aa a Em 120 Breathing alleles bes eut x eU Ed ERAT rue Ee RV V R
42. D and the other palette item is programmed with the effects of an over dose OD Additional information such as half life peak time and route is also programmed into the medication properties When the medication is administered to the patient the software applies the palette item associated with the dose threshold The Auto Mode adjusts the vital signs changed by the palette item gradually to simulate the medication s effect on the patient To create a new medication 1 Create a palette item using details page for the effects of a standard dose SD Then repeat the process to create a palette item for the effects of an over dose OD For general information on creating a palette items please go to page 39 Descpription ast Details Clear E Save l 3 Load Naloxone SD Breathing Respiration rate Auto Inspiration Percentage Auto B Tidal volume Cardiac Cardiac irritability slight improve J Circulation Blood pressure Hold to change 25 25 API via Vascular_ Properties F UA FHR Operating mode M J FHR Baseline B Variability Accel Decel Intensity at Fetal Movement in 10min m Fetal O2 Level h gr D0 Duelo deed 2 After dose effect palettes are created using the Details controls go to the drug tab and click the Manage Drug List button r Rate Rate z ml min Start IV l min Start 024 Newborn HAL User G
43. Guide Newborn HAL The File Sharing Setup menu is used to manage files shared with the virtual monitor software The list of files stored on the Gaumard Ul folder available for sharing is displayed on the left panel To share a file first select the file from the left panel and click the Add button File Sharing Setup The files on this list will be accessible from the patient me Name will be the name displayed Available Files Shared Files Enter a context name on the pop up menu and click OK to share Enter Context Name X ray Chest Files currently shared are listed on the Shared Files list Shared Files File Context Name X ray 1 bmp X ray Chest Once a file is added to the Shared Files list a yellow notification icon is shown on the patient menu at the top left of the virtual monitor screen The icon notifies the provider that a file is available for viewing Click on the patient name button to bring down the selection of available files and select the context name to open Newborn On the virtual monitor screen click ona scalars menu and select Close to make the entry available for the custom parameter X Ray Chest The x ray file is now open The scalar entry is now a blank field To troubleshoot file sharing access errors go refer to the Gaumard Monitors Guide CUSTOM NUMBERS Use the custom numbers menu to add custom numerical parameters to the
44. N 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 6 User Guide Newborn HAL 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 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 AD
45. Sharing button on the right panel to remove the lab report items from the Gaumard Monitors menu Create New L An editable copy of the lab report is stored inside the Gaumard UI folder on the computer s home screen Go to page 111 for information on how to access other files from the Gaumard Monitor screen Newborn HAL User Guide 61 Build new lab templates to supplement new scenarios To create a new laboratory test template 1 Navigate to the bottom of the tab and click New Template New Template B 15 ood cell coagulation as im Choride The Edit Lab Results Template window is displayed w Edit Lab Results Template name Category C LL ry ee een CY 2 Enter a name for the new template followed by a description e Edit Lab Results Template Name lipid Panel Description Cholesterol HDL LDL ETC preme enm nA e v enn Delete 3 Create categories to group a series of tests in a lab report Click Add to create a new category Description Cholesterol HDL LDL Triglycerides Category a pow 4 Enter the name of the category and click OK a Category Name Lipid Panel Female 62 User Guide Newborn HAL 5 Click add on the Single Entry menu to create a new test under the current category Single Entry i posee e te eel
46. TAILS Lung Sounds vol Right Left Each cardiac rhythm has a specific effect on the blood pressure waveforms The pressure waveforms include ABP CVP PAWP and Pulse The blood pressure values are affected when any of the following parameters are changed e Vascular profiles vessel diameter and vessel stiffness e Heart Rate e LV Contractility e Total Blood Volume Newborn HAL User Guide 33 Set the patient status to Excited after exercise to increases heart rate temperature respiratory rate tidal volume O2 CO2 diffusion capacity metabolic rate and CO2 formation rate Set the status to resting for a normal state STATUS DETAILS HK Sounds Pulse Radial Temperature Patient State Vessel Diameter Vessel Stiffness Blood Volume PH Level The Bleed and Wound size options simulate blood loss virtually To start the virtual bleeding click the Bleed button and then adjust the bleeding rate using the Wound Size control Once the bleeding function is activated the Auto Mode will adjust the vital signs in response to the blood loss If the provider does not intervene the vital signs will deteriorate and myocardial ischemia will occur For information on how to infuse blood to the model virtually go to page 73 34 User Guide Newborn HAL The Cardiac irritability control adjusts the cardiac rhythms indirectly Set the Cardiac Irritability to improve to move the curren
47. VISED 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 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 Newborn HAL User Guide 7 Care and Cautions 8 User Guide Newborn HAL Overall Warnings Hemember that damage caused by misuse is not covered by your warranty It is critical to understand and comply with the following guidelines Additional warnings are found throughout the documentation If the simulator will not be used for an extended period re charge the battery at least once every 30 days to prevent damage to the battery Do not attempt to intubate without lubricating the airway adjunct with a silicone oil lubricant provided Failure to do so will make intubation very difficult and is likely to result in damage NEVER disconnect the communications module while the GIGA software is running The software will halt and the module may be damaged When simul
48. a realistic response to the event and adjust the blood pressure values automatically To enable the Automatic Mode option in the profiles menu go to page 103 Click Auto Mode to pause the automatic changes To return the patient to the initial state click Reset P PH Level 7 40 UTERUS HEM A Body view Q 00 00 08 all m Auto Mode On Pause 30 User Guide Newborn HAL Patient files store general information such as weight height and age The automatic mode factors the patient s weight as it adjusts related physiological parameters GIGA includes several preprogrammed patients in the Quick Start Modeling profile For more information on how to edit a patient profile go to page 65 Newborn is the default patient loaded when the Quick Start Modeling Profile is selected and it is an ideal candidate for most simulations Click the patient information bar to view the patient s profile aa GIGA Newborn HAL B8505004 QUICK START NEWBORN MODELING Patient Newborn M 34w 35 0 cm 3 0 kg Patient s Info Name Newborn i Gender M Terr 34 weeks i Height 35 0 cm Weight 3 0 kg a a a F In the automatic mode the Details panel includes additional vital sign parameters and control options not available in the Manual mode STATUS DETAILS x Heart Sound vol Regurgitation tricuspid pulmonary mitral aortic Valve Resistance tricuspid pulmonary m
49. a specific condition or effect Click the Add node button to create a new node for the first set of vital signs BRANCH SCENARIO x cor tet te TENES ADD NODE i 1 Node Name 1 Palette Scenario To 00 10 HD End Newborn HAL User Guide 47 Click the node s identifier number to edit the node properties aene Sane Click to Change Node Properties Enter a name for the node and description and then click Save Mode Properties Unique Identifier 1 Mame Start Bradycardia Description Bradycardia Click Add Item to add palette items or Add Scenario to add full scenarios to the node 1 Start Bradycardia M ET Scenario Path gt N 48 User Guide Newborn HAL Add more nodes each with palette items to simulate every stage in the scenario In this example several nodes simulate the effects of medications that maybe administered to the patient by the provider The first two nodes simulate the complication 1 Start Bradycardia 2 Deteriorate The following nodes 3 Interventions 4 Atropine 5 Epinephrine 6 Dopamine and 7 Pace are activated only when the provider administers the applicable medication or electrical therapy Each node is programmed with palettes that simulate the effect described Clear Load Bradycardia 1 Start Bradycardia e w Palette Scenario Pa
50. actory preset scenarios S T A B L E Newborn COO OMAMA O Rename Delete New Profile p cancel The GIGA control software has two modes of operation Manual and Automatic Each mode includes a Quick Start profile with preprogrammed scenarios exercises created in conjunction with experienced healthcare instructors and working medical professionals Continue to the next section to learn more about the each operating mode and the profiles included After selecting an operating mode and profile click Load to continue Manual Mode In the Manual operating mode the facilitator fully controls the vital signs and physiologic responses Newborn HAL Profiles OPERATING MODE PROFILES DESCRIPTION Default Modeling Newborn Modeling Scenarios Meds Profile EE EN Rename Delete as New Profile 9 oem p cone The Manual mode includes the following profiles Default Profile includes one preprogrammed palette with healthy vital signs Quick Start Newborn includes eleven scenarios Automatic Mode The Automatic mode assists the facilitator by automatically adjusting vital signs in response to caregiver participation pharmacologic intervention and manual input For example when facilitator increases the heart rate the Auto mode will calculate the response and adjust the blood pressure automatically To activate the operating mode as an upgrade option go to page 103 For more informat
51. ample report look at the figure below BE Home View Gaumard Scientific GaumardUI 01 17 2013 08 37 25 Session Facilitator Providers Team 00 04 17 Action Sharing File Added Chloe Lab 1 rtf displayed as Chloe Lab 1 00 04 54 Provider File accessed Chloe Lab 00 10 32 Action Sharing File Removed Chloe oe 1 rtf displayed as Chloe Lab 1 00 11 16 Applied 00 00 Palette Anaphylaxix 1 Details HR 74 BP 122 64 RR 0 EtCO2 30 Temp 37 6 Arterial Bleed ON Venous Bleed 00 11 18 Key Event Checked Competently incise and open abdominal wall 00 11 18 Key Event Checked Competently initiate removal of ovarian teratoma 00 11 18 Key Event Checked Identify anaphylaxis as threat to patient s life 00 11 19 Key Event Checked Callfor help 00 11 19 Key Event Checked Identify and remove potential causative agents 00 11 19 Key Event Checked Increase FIO2 00 11 20 Key Event Checked Give epinephrine 00 11 20 Key Event Checked Terminate the procedure to focus on resuscitation 00 11 21 Applied 02 00 Palette Anaphylaxix 4 Details HR 108 BP 105 65 RR 0 Inspire 0 OSat 91 9 o EtCO2 30 Temp 37 6 Arterial Bleed OFF Venous Bleed OFF H 00 11 20 Key Event Checked Provide supportive measures including increased IV fluids This option allows you to print a text file containing all the information in the log for the latest session Clicking on Print Rep
52. argeable battery 3010 011 Battery Charger R 100 240 V AC external battery charger 3010 013 Power Cord R S 3010 020 Umbilical Cord Kit C S3010 023L L Lower Left Arm C Lower left arm assembly S3010 023R L Lower Right Arm C Lower right arm assembly a 027L R Lower Left Leg Includes knee plastic connectors S3010 029R L I O Leg Skin Cover C Light color skin cover for right leg tibia bone 3010 031 I O Tibia bones C I O leg tibia reservoir bones S3010 060 Simulator Transport Case R Soft storage and transport case S 3010 061 Simulator Transport Case A Hard storage and transport case S3010 080 Simulated Blood Concentrate C S3010 081 Silicone Oil C Oil based Silicone lubricant 3010 085 Modified Neonatal Blood Pressure R BP Cuff for Newborn Hal S3010 Cuff 3010 EXW Two Year Extended Warranty A Extended warranty for years Two AND Three S3010 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 150 User Guide Newborn HAL Warranty Gaumard warrants that if the accompanying Gaumard product proves to be 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 Damage resulting from acci
53. ating drug administration via endotracheal tube providers must use an empty syringe Passing liquids into the trachea or esophagus may cause internal damage Newborn 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 simulator Store Newborn HAL in a cool dry place Extended storage above 85 degrees Fahrenheit 29 Celsius will cause the simulator to soften and slowly warp It is acceptable to operate Newborn HAL at an ambient temperature of 95 degrees Fahrenheit 35 Celsius Newborn HAL is splash proof but not water proof Do not submerge or allow a large volume of fluid to enter the interior of the simulator 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 Newborn 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 When the arm veins require replacement contact Gaumard to arrange for a lower arm exchange Refer to the Consumables and Replacement Parts section of this guide and contact customer servi
54. by was born through a C Section and is responsive but needs some attention after a while all vitals go to a healthy state Warm baby apply suction and administer O2 Wait Indefinitely for actions Newborn HAL User Guide 135 onec Newborn HAL Simulators for Health Care ducatior Gloria s Baby This baby is born with mild asphyxia but no matter how good the interventions are this disastrous intrapartum complication results in neonatal death Begin PPV Wait Indefinitely for action Begin PPV and chest compressions Wait Indefinitely for action Administer Epinephrine Wait Indefinitely for action 136 User Guide Newborn HAL Newborn HAL timudaion for Veal Gee duceilon Helen s Irene s Baby This baby is born with a severe asphyxia that has to be treated immediately After ventilations and EPI have been given the baby s vitals go towards a good outcome Begin PPV Compressions and Epinephrine Wait Indefinitely for actions Newborn HAL User Guide 137 Newborn HAL Gaumard Simulators for Health Care Education MAS Meconium Aspiration Syndrome Apply suction intubate and supply 10096 O2 Wait Indefinitely for actions 138 User Guide Newborn HAL Newborn HAL Gaumard Simulator
55. cagen Heparin LMW Enoxaparin Lovenox Heparin UFH Hydralazine Apresaline m Change Dose and or Rate A brief description is displayed at the top of the window The half life peak time and drug concentration values are listed in addition to the standard and over dose dosage MEDICATION Furosemide Lasix iz mg Push Administer Drug Properties Description Half Life 00 30 00 Peak Time 00 45 00 C50 2 64mg dl Diuretic drug used to treat hypertension a Standard Dose Furosemide SD 40mg Over Dose Furosemide OD 120mg 1 Enter the dose units route and rate if applicable and click Administer MEDICATION Drug Dose Units Route Furosemide Lasix Y 50 mg IV Push X Drug Properties Description Half Life 00 30 00 Peak Time 00 45 00 EC50 2 64mg dl Diuretic drug used to treat hypertension a Standard Dose Furosemide SD 40mg Pene Naren D iicncnanaida OM 19a 70 User Guide Newborn HAL 2 The Proceed Drug window prompts to confirm the dosage effects before applying them Adjust the peak effect percentage and or the dosage effect and then click Yes to apply the effects Proceed Drug 50 0mg of Furosemide Lasix through IV Push has just been Administered This dose will be treated as Dose Do you want this drug to take the following peak effect View Effect 3 Reverse effect when the drug s level begins to drop No Eff
56. ccession No changes are made to manikin 04 00 wheezing difficulty exhaling tongue edema respiratory allergy Closed airway 00 00 all difficult airway actuators on Wait Indefinitely SR drug therapy expected Healthy Resting 02 00 normal vitals Wait Progress palette indicator items During the scenario each vital signs palette updates the patient s vital signs The palette s transition time trends the increase or decrease of numerical parameters e g Heart rate blood pressure over seconds or minutes In the figure below for example the vital signs palette Healthy Resting is programmed with a transition time of 2 minutes When the scenario reaches Healthy Resting it will take 2 minutes for the vital signs to trend from the previous state to the values programmed within the palette Name Transition Description Wait 00 20 No changes are made to manikin respiratory allergy 04 00 wheezing difficulty exhaling tongue edema Closed airway 00 00 all difficult airway actuators on Wait Indefinitely ees drug therapy expected Healthy Resting 02 00 normal vitals Wait palettes do not update or change vital signs Instead wait palettes give the participant time to perform an action this may be treatment in response to a complication or performing a standard assessment 40 User Guide Newborn HAL Scenarios are controlled using the playback buttons at the bottom of the tab Intuit
57. ce for more information Do not inject fluids into the intramuscular sites Intramuscular sites are for placement exercises only Do not remove or replace the umbilical cord while Newborn HAL is in operation Doing so will cause damage to the system Do not pull or carry the simulator by the limbs Handle Newborn HAL with the same care as a human patient Electrical Therapy One of Newborn 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 Newborn HAL s conductive skin sites allow the attachment of real EKG electrodes This feature permits the user to track cardiac rhythms with their own equipment just like with a human patient A few special concerns are described below Newborn HAL does not accept real electrical therapy Do not pace or defibrillate Newborn HAL with real electrical equipment The Gaumard User Interface features a virtual electrical therapy function to simulate defibrillation or pacing Newborn HAL User Guide 9 Getting Started 10 User Guide Newborn HAL Overview Tetherless and fully responsive even while being transported e Powered from an internal rechargeable battery or wall outlet e Battery capable of 300 recharges e Simulator receives commands from a wireless tablet PC and operate at distances up to 300 feet e Option to operate automatically using
58. concentration results Continue to the next section to program interactors for this drug Properties Properties Edit Clear in T 8 Drug Effect Tester g C g kg Effect Plasma Concentration log Graph SubQ 107 107 10 Plasma Concentration mg dL Drug Interactions i j 78 User Guide Newborn HAL Use the Interaction Editor window to program drug interactions When two or more medications preprogrammed to interact are administered the physiologic model will adjust vital signs to simulate interaction effect Interaction Editor Naloxone Narcan Current Drug Data T Half Life 01 00 00 Peak Time 00 01 30 SD 400ug OD 2000ug EC50 0 0001mg dL Isobologram plasma concentration Captopril Capoten Drug List 6 74 9 111 Interactor Data Half Life 01 54 00 Peak Time 01 00 00 SD 25mg OD 75mg 100 150 200 EC50 0 0240mg dL Naloxone Narcan mg dL 10 6 Test Panel Test object weight kg Apply Naloxone Narcan Dose 400 ug At time Apply Captopril Capoten Dose 25 mg At time Results Attime 00 46 51 Max Interaction Effect 82 39 Alpha 1 05 Compared to Additive individual drug effect reduced by 0 90 Effect editor Newbo
59. d complete the next steps using the Create an ad hoc network tool included in Gaumard Monitors software 1 On the virtual monitor computer click the Gaumard Monitors icon to start the vital signs software Newborn HAL User Guide 147 2 Click the V menu near the top left corner and select Create Ad Hoc Network Monitor Selection Comm setup Performance Keyboard Toggle Cursor Remote Access Via Network Check for Updates Help About mii The Virtual Monitor Create ad hoc Wireless Network window is displayed 3 Select Wireless Network Adapter If the wireless adapter is not listed first enable the adapter using the Windows network menu and then return to this window Create Ad Hoc Wireless Network 1 Select Wireless Network Adapter p Wireless Network Adapter 1 2 Wireless Network Name GaumardNet i 3 Monitor IP 10 1 JJ 1 11220 Y Y Apply Wireless Network Settings 4 Enter a wireless network name case sensitive Use the same name entered in the controller computer GaumardNet is the required name for Windows 7 computers 2 Wireless Network Name GaumardNet 3 Monitor IP b Setthe Monitor IP 148 User Guide Newborn HAL 17 On each control PC and virtual monitor PC enter the same values for the first three IP fields and a set unique value for the last field The suggested address is fo
60. d in the position shown hyper the Korotkoff sounds do not match the extended or hyper flexed with the desired systolic and diastolic values set using the level and click the OK button GIGA controls i E A green filled oval indicates the value was Before starting the calibration process place successfully set the blood pressure cuff on the simulator as it would be placed on a real human patient ENTE Head Position Calibration Connect the blood pressure cuff s N Hold Newborn Hal in the positon shown and click Sy OK a ea Luer lock connector to the simulator s shoulder To calibrate the blood pressure feature 1 Click Setup gt Calibration gt Blood pressure and click Next Hyper Flexed 2 Verify which arm will be calibrate and click Next 3 Set the pressure on the BP cuff to 0 i e cuff valve open as prompted by the calibration wizard 4 Click the OK button to record the current cuff pressure for the interval A green filled oval indicates the pressure Hold Newborn Hal in the position shown and click interval was recorded successfully 5 Set the pressure on the BP cuff to 20 mmHg as prompted by the wizard Click OK to record Hyper Extended 6 Continue increasing the BP cuff pressure as indicated by the prompt and recording the pressure intervals Calibration Head Position Calibration 7 Atthe end of the calibration wizard click Finish to close the cal
61. ddress 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 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 tha
62. defined below e Off The scenario does not respond to the electric therapy e Prompt The software detects the electrical therapy and prompts the user for approval before advancing to the next palette e Auto Advances to the next palette automatically only if the electrical therapy meets the threshold specified 46 User Guide Newborn HAL Branching Scenarios Unlike linear scenarios which move from one palette to the next the trajectory of a branching scenario can change in response to the participant s actions Click the Branching scenario tab to access the branching scenario window BRANCH SCENARIO Auto Responses n ADD NODE Ste Le raro Mu ee ete 0 71 28 cei eM BRANCH SCENARIO ME e ME ON On M lop zT pio Uis S Use the panel buttons to clear load and save new scenarios or to switch from branching to linear scenarios Click Load Scenario to access the preprogrammed branched scenarios in the current profile BRANCH SCENARIO Auto Responses E e ADD NODE The process of creating a new branching scenario is the following e Add nodes e Add palettes or scenarios to each node e Add paths to nodes that require provider action e Create key events to alter the progress and trajectory of the nodes within the scenario A branching scenario consists of several Nodes Each node is preconfigured to run a normal scenario or a series of palettes simulating
63. dent misuse abuse neglect or unintended use of the Gaumard product 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 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 disclaimers 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
64. dia 00 00 RR 10 HR 45 2nd deg AVB Type II i Speechi 00 01 complaint Feel dizzy 2 Deteriorate w Palette Scenario Path v 00 01 3 Wait 02 00 No changes are made to manikin Speechi 00 01 confusion What happened Cardio Drop 01 00 HR 15 BP 10 OSat 5 Key events activate alternate paths in a node The alternate paths are used to change the trajectory of the scenario depending the participant s actions To add a key event to a node first add the additional paths 2 Deteriorate M Palette Scenario Path b 00 01 gt 3 C gt wait 02 00 No changes are made to manikin x E Speechi 00 01 confusion What happened Exp End Cardio Drop 01 00 HR 15 BP 10 OSat 5 3 x BH End x BH End Click the Edit path icon to program key events for the node 50 User Guide Newborn HAL A key event is the action expected by the participant Type a name for the action and then click Add Edit Path Key events f Rename l Delete Action Linked Action After the action is added to the Key Events list assign the node that this action will move the scenario to using the Go to menu Click OK to save changes Edit Path Le ses Key events Selected Atropine A l jo Move be V 4 L
65. disconnect the RF module for at least five seconds then plug it back in and restart the software RF module not connected RF module not identified by the computer Is the communication indi cator panel consistently yellow See solution above in section making reference to blinking communication indicator is consistently yellow Is the respiratory rate set to 0 min Chest com pressions are only detected when the respiratory rate is set to 0 per minute 0 min Otherwise they are ignored Set respiration rate to zero Neck is hyper flexed Return the head to a normal position Recalibrate the Head Position sensor All others See Calibration Wizard section inside User s Manual Is the communication indi cator panel consistently yellow See solution above in section making reference to blinking communication indicator is consistently yellow All others See Calibration Wizard section inside User s Manual In some simulators the trachea is disconnected from the lungs when they are not on Simulator not running Newborn HAL User Guide 145 Low chest rise or no Wrong settings or disabled chest rise at all while breathing Loss of brachial Brachial pulses disabled pulse Pre built scenarios don t show up A sound is absent or Volume not set to user s is not heard at criterion desired volume level 146 User Guide Newborn HAL Enable the lungs from Deta
66. e 1 From the menu bar go to Help Create ad hoc Wireless Network 15 The Controller Create Ad hoc Wireless Network window is displayed 2 Select the Wireless Network Adapter If the wireless adapter is not listed first enable the adapter using the Windows network menu and then return to this window Description Controller Create Ad Hoc Wireless Network x Create Ad Hoc Wireless Network 1 Select Wireless Network Adapter p gt Wireless Network Adapter 2 Wireless Network Name b24 GaumardNet 3 Controller IP p gt 10 200 Apply Wireless Network Settings 1 Enter a wireless network name case sensitive Use the same wireless network name to configure the Gaumard Monitors PC GaumardNet is the required name for Windows 7 computers 2 Wireless Network Name b GaumardNet gy 3 Controller IP m Set the Controller IP 16 On each control PC and virtual monitor PC enter the same values for the first three IP fields and a set unique value for the last field The suggested address is for the Controller IP is 10 1 1 200 odua umet 3 Controller IP E24 10 1 1 iE 1 1200 App ly Wireless Network Settings 5 Click Apply Wireless Network Settings to save the settings 6 Restart the computer GAUMARD MONITORS NETWORK CONFIGURATION After the GIGA control computer is configure
67. e charger when the charger s LED turns green indicating that the simulator is completely charged Do not turn on the GIGA software until the charging process is complete On the menu bar go to Setup gt Options gt Environment and select FIXED Then enter the simulator s serial number in the text box Finally restart the software Get simulator closer to computer or move away from obstructions tently yellow GIGA has set the power mode to STAND BY automatically RF module not found message is displayed when GIGA is started Chest compressions are not properly detected or not detected at all Artificial ventilations are not properly detected or not detected at all Simulator s chest does not rise with artificial ventilation e g BVM There s too much RF in terference either from another Gaumard tetherless simulator in the vicinity or an RF radiator Try changing the RF channel by going to the menu for Setup Options gt Environment Select Auto change to channel number from 1 11 The battery on the simulator is depleted Turn off the software and plug charger adapter to the simulator The charger s LED will turn green when the simulator is completely charged Do not turn on the GIGA software until the charging process is complete The adapter labeled Power Supply does not recharge the battery Connect the RF module to any USB port Close the software and
68. e screen once the evaluation is completed tic Seizure cl Seizure amd Dat 01 30 2013 EE Select the Microsoft XPS Document writer to save the finished evaluation as digital document Click Print to save the digital copy in the system Microsoft XPS Document Writer Status Print to file Location Comment Find Printer Page Range Al Number of copies 1 H Selection Curent Page Fages Collate 92 User Guide Newborn HAL Enter a name for the evaluation and click Save gt Documents Evaluations v Search Evaluations p Organize v New folder yi Favorites Documents library Evaluations oy Libraries ES Documents RU Music lee Pictures B Videos LI Computer vr x Al a2 a Eclamptic Seizure Session 3 xps Filename Eclamptic Seizure Session 3 xps Arrange by Folder bd If the PC is connected to a printer select and open the evaluation document saved in the previous step c gt gt Libraries Documents Evaluations Organize v Open v Favorites 53 Libraries Documents 2 Music i Pictures B Videos Share with Print E mail Burn Documents library Evaluations t Eclamptic Seizure Session 3 xps ma XPS Document 4 150KB Newborn HAL User Guide 93 Navigate to the XPS Viewer file menu and select Print Mlt Enter Alt F4 nic Pregna
69. e vital signs monitor Select the waveform and click eee ON to display the readings on the virtual FILE SHARING montara TO MISSILE DSIMINEIS reading click OFF The vital signs monitor sensors defaults to All On The file sharing menu allows the facilitator to send images audio and text files to the virtual monitor screen Use the file sharing feature to fulfill file requests by the provider SpO2Probe p Sensor ra during simulation ECG Leads File sharing Resp Monitor Custom numbers The files on this list will be accessible from the patient menu on the vital sign monitor The Context Thermometer Configuration Name will be the name displayed Available Files Sar bm 1 w Layout ABP cannula Capnography CV catheter IIA Some sensors such as NIBP and Thermometer are equipped with a STAT control that will allow the facilitator to activate readings on the virtual monitors from the controller software Newborn HAL User Guide 111 The files used for sharing are stored in the control PC Before the simulation begins add mock image jpg bmp or text files txt into the Gaumard UI folder located on the home screen of the control computer Cei mtd Uttar Ui Open the File Sharing from the menu Also clicking on the file sharing icon will open this window Sensors Auto Mode Custom numbers View Configuration Help 112 User
70. ect to the dose that is stil on board To turn off the Proceed Drug prompt click Setup Auto Responses and change the Drug Model Effect settings to Auto The administered drug panel displays information on dosage rate does administered and total time of administration Administer Newborn HAL User Guide 71 The Auto mode adjusts the patient s vital signs to simulate the effects of the drug automatically Temperature 37 0 C x Vessel Stiffness 103 x PH Level 7 40 x UTERUS HEM B e Es eeM The blood pressure continues to decrease in response to the medication s properties S0 Cardiac Irritability CIRCULATION 0r SSG UTERUS HEM 3 Increase the Rate factor to speed up the effect of a medication on the patient model and or Rate Rate k ml min t Start IV 1 z L min t Start 024 Administer Oug kg 0 009esd 1 01 36 24 Unselect Current Effect ELCHENSENCTTUTEN Effect Off Over Dose Select from the following options e Unselect Unselect a highlighted drug e Current Effects View the effect on the patient s vital signs e All effects View all the available programmed drug effects for this medication e Drug effect toggle Turn the drug effects on the patient model on or off 72 User Guide Newborn HAL Dru
71. ellow shock pace TESTING MEN icon The test mode provides compression and RCM EU ventilation feedback in real time without audible n EMEN EN To begin press the Start button Perform Wi i TE Tail qn compressions and ventilations to obtain 66 User Guide Newborn HAL e Compression and ventilation depth indicators The depth indicators are located to the right of the CPR graph The indicators fil color changes between the following states VENTILATIONS Grey no intervention was detected 2 Yellow compression was too shallow Ventilation was too weak 3 Green compression ventilation was performed correctly 4 Red compression was too deep Ventilation was too strong e Average of compression depth e Average of ventilation PIP The averages of compression depth and ventilation PIP are located to the left of the depth indicators If the simulator has installed the new chest compression sensor the average of compression depth will be measured in inches cm instead of mmHg e Compression Rate number of compressions per minute e Ventilation Rate number of ventilations per minute The compression and ventilation rate controls are located below the CPR graph A VENTILATION RATE 28 COMPRESSION RATE EN The coach mode is enabled when the Coach button is pressed f No flow time 00 05 min sec The coach mode generates visual and audible cu
72. environment tab is used to configure the connectivity options Select the GENERIC option to scan and connect to the nearest e Virtual Monitor Enable the Monitors menu option to configure the virtual monitor connection To verify the connection status between GIGA and the Gaumard Monitors go to page 114 simulator Alternatively select the FIXED option and enter the simulator s serial number to connect to a specific simulator only The FIXED mode is required to enter activation code for upgrade features e S T A B L E Activate the S T A B L E scenarios e Automatic Mode Activate the Automatic mode and the physiologic s model Options Noelle Features CPR Options Pacing shock Tolerances Loq Other General Noelle Add Ons GENERIC Find and establish a connection with C Noelle Please switch un EIXED once connected NEWBORN HAL s Add Ons add even more fidelity to your simulation NEWBORN HAL Virtual Monitor FIXED The software will enable controls for z 3 E Use Newborn Hal Virtual Vital Signs Monitor features available on your simulator FIXED Noelle Setup Enter the Serial Number from the Noelle simulator that THIS computer will control SN on RF Module S T A B L E Q 0000001 Can t find Serial Number Automatic Channel Change x P indgErc Check noise in channel This tab allows the facilitator to Manually assign a unique channel for e E
73. er vIalnreecenmrannr Add Provider 3 The provider is now added to the log tab Repeat the steps to add up to six different providers Session Title Simulation 1 Facilitator c X Newborn HAL User Guide 87 Provider actions can be tracked as a team or individually Click the provider s name to set the provider as active and track the actions individually Session Title Simulation 1 rar Emergency meer Click the appropriate option to track the action For example if the provider assesses the patient s responsiveness by requesting them to open their eyes click the Assess responsiveness button and select Open your eyes E Options responsiveness DC open your eyes N open your eyes if you can feel me touching you U v WU Log Evaluation of Lisa ACTION Intubation Check ACTION Intubation Check ACTION Extubate ACTION Extubate Lisa ACTION Assess responsiveness open your eyes 00 54 57 Lisa ACTION Assess responsiveness open your eyes if you can feel me touching you ADD TO LOG Click the Team button to deactivate the active provider and return to general logging Right click the provider button to delete or rename a provider Session Title Simulation 1 PROVIDERS 88 User Guide Newborn HAL Create new clickable provider action buttons to expand the library of actions To add a new action to an existing category 1 Click the button on the ca
74. es of the compression to ventilation ratio programmed in the Options menu A high pitched beep signals the care provider to perform compressions A low pitched beep signals the provider to perform ventilations If the provider performs CPR at a correct rate the beep signals volume will decrease If the rate is out of range the beep signals volume increase again In addition to providing training on the CPH rate the coach mode also enables audible commands when the compression meets the following criteria the compressions per minute are below the programmed settings the audible command FASTER is played the compressions per minute are above the programmed settings the audible command SLOWER is played the compressions depth is below the programmed settings the audible command HARDER is played the compressions depth is above the programmed settings the audible command TOO DEEP is played the compressions recoil is not complete the audible command RELEASE is played Compression and ventilation data is displayed in the log window as CPH is performed by the provider EKG Ventricular fibrillation 3 orH20 0 crH20 Ventilation rate count was correct 2 ventiations detected Y Low 0 OK 0 Hig Compression rate count was high 35 detected Low 14 OK 13g Ventilation rate count was correct 2 ventistions detected Low 0 OK 1 Hig Shock 1 150 Joules Compression rate count was high 19 compressions detec
75. ession recording and simulator control solution for facilitators in a lab or mobile environment The built in GIGA software allows the facilitator to control Newborn HAL while recording care provider interaction and event logs The upgrade replaces the standard tablet with a convertible touchscreen laptop loaded with the Pro environment and GIGA 2 WI FI enabled cameras 1 motorized 180 view USB camera and carrying case ncn ALLT wee ese Lg um CU For more information on using the Pro system refer to the documentation included with the upgrade option 126 User Guide Newborn HAL Appendix Newborn HAL User Guide 127 More about Scenarios Factory Preset Scenarios DINEM 9 MAS 10 RDS 11 TTN 128 User Guide Newborn HAL Mote ots C Meme T C Preeclampsia A ES emmys RE Quick Start Newborn Modeling Automatic Branching Newborn HAL User Guide 129 OMEN Newborn HAL9 Simulators for Health Care Education Alice s Baby Healthy baby Apply suction and O2 Wait Indefinitely for actions 130 User Guide Newborn HAL Gaurd Newborn HAL Sdalors lor Hash Cine Ecni Asphyxia Baby has an asphyxia attack and the providers need to give ventilations to help bring back the vitals to a healthy state Apply suction and O2 Wait indefinitely for actions
76. ette Item Transition min sec o oF 59 59 Max Item Description Initial condition all vital signs are specifi 2 dy View The first palette is now added Click Add Palette to Scenario button again to add more vital sign palettes and wait palette items Print Add Iten Scenari 1 to 10 Newborn HAL User Guide 43 A Wait item maintains vital signs values steady for the transition time allotted Insert a wait item to give the provider time to perform an action or an assessment For example auscultating blood pressure or gathering general information about the patient Alternatively add Wait Indefinitely to hold the vital signs until the next item button is clicked from the playback controls Transition min sec n OI CES 08 y 59 59 Max No changes are made to manikin The wait palette item is now added Add I Sce Name Transition Description SELE initial state 00 00 Initial condition all vital signs are specified Wait 01 00 No changes are made to manikin Deteriorating 00 30 Vital signs deteriorate 20 over 30 seconds Edit T Add more palette items and then use the Selected Item menu to make any changes SCENARIO x ow a O e Z nma m Add Item to Scenario Name Transition Descri
77. fferential Glasgow Coma Scale Hematology Lipid Panel Metabolic Panel Neonate Blood test OB Blood test Report Hame Template Description Description 7 Enter a report name a report time and a description In addition select a color tag for the lab report on the right panel Color tags aid the sorting of lab reports on the report list window Edit Lab Report Lab Template Cholesterol HDL LDL Triglycerides Report Name ab 01 Description Above normal range Cholesterol LDL Cholesterol Lipid Panel Female Variable 8 Enterthe test results in the Value column Include any comments associated with the test performed Lab result values for each of the preprogrammed scenarios in the Quick Start NEWBORN HAL profile are included in the NEWBORN HAL Workbook STS u up Description Above normal range Cholesterol LDL Cholesterol Lipid Panel Female Variable Normal Range Value Comment HDL Cholesterol mg dL 35 00 85 00 O Cholesterold HDL Ratio 0 00 4 40 arereqired Lipid Panel Male Variable Normal Range Value Comment HDL Cholesterol mg dL 29 00 71 00 35 Cholesterol HDL Ratio Ratio 0 00 4 90 4 lil Lipid Panel Both Variable Normal Range Value Comment Cholesterol mg dL 0 00 199 00 190 00 I LDL Cholesterol mg dL 0 00 129 00 135 Triglycerides mg dL 30 00 2
78. fluid runs from the drain 122 User Guide Newborn HAL Warning Fill the IV vasculature with diluted Gaumard simulated blood only Any other simulated blood brand containing sugar or additives may cause blockage and or interruption of the vasculature system Do not fill IV systems without the drain connector in place Doing so could result in damage to the self healing ports When finished with the IV simulations flush and drain the IV vasculature and leave the stoppers connected to avoid leakage of any residual fluids During infusion exercises always connect the stopper to one port and leave the drain tube attached to the other port Direct the outflow into a collection container IM sites are located on both deltoids and quadriceps for placement and technique exercises Warning Do not inject fluids into the intramuscular sites Use flashlight to detect dorsal pedal injection site on the left foot veins simulators with serial number B0906424 or higher ONLY Newborn HAL User Guide 123 The intraosseous access allows for infusing fluids blood and or drugs directly into the bone marrow of the tibia Remove the skin and the bone inserts to drain the fluid infused during an exercise To get more uses from every bone insert reseal the needle holes using cement glue Recommended Device Size IO Access 18 gauge Procedure Control and program the cyanosis visible on the si
79. g scenario All shown are for a premature infant patient Scenario Name Linear Scenario Description Variations A Uterine Rupture A Preeclampsia A Healthy Baby B Baby was delivered SVD and is fairly vigorous Healthy Baby A Baby is vigorous and earns good APGARS 56 User Guide Newborn HAL Lab Use the Lab tab to create mock laboratory tests results to aid the participants during simulation In addition create new laboratory templates to supplement different types of scenarios Once a laboratory report is created send the file to the virtual monitor screen for the provider access during the exercise LAB Lab Report Edit Delete Preview Send to monitor Lab Template Platelets Differential assessment of patient s conscious state 3 15 Blood Test Male red blood cell white blood cell coagulation Cholesterol HDL LDL Triglycerides Anion Gap Albumin Alkaline Phos Calcium Choride To create a new lab report with mock test results 5 Click Create a New Lab Report on the right panel Create New Lab Report Sort by Color The Edit Lab Report window is displayed Edit Lab Report Lab Template CBC Differential 7 Clear Save Cancel Newborn HAL User Guide 57 6 Select a Lab Template from the drop down menu Edit Lab Report Lab Template CBC Differential CBC Di
80. gs cannot be removed from the list during the administration process with the exception of IV infusions To stop an IV infusion before it is finished highlight the medication from the list and click stop Change Dose and or Ri Remove from list aaa Fluids amp Ga Saline Volume ml Rate After the dose administration is complete select the drug and click Remove from list Restart Change Dose and or Rate Rate 80 B Fluids amp Gas Saline Volume ml Rate H ml min To remove all the medications from the list and reset the effects on the patient model click File gt New Session Reset Session Clock Monitors Auto Mode Save Report View Print Report Help Import Export Exit FLUID amp GAS The automatic mode can process the administration of gas and or fluids to the patient model ee Fluids amp Gas Mal Saline Volume ml Rate ml min Start IV 4 Blood Cannula Concentratian B5 Rate L min Start 02 VIRTUAL FETALM PALETTE SCEMARIO BRANCH LABOR LAB SPEECH JE Low Select from saline blood or oxygen and the volume concentration and rate Click on Start to administer m mE oU o n Fluids amp Gas Saline Volume ml Rate ml min Start IV Oxygen Cannula Concentration 100 Rate 5 L min start 02 Newborn HAL User Guide 73 Click the
81. he session To save the session log report as a text file 1 Click FILE gt Save report 2 Entera name for the report 3 Select the desired name and path and click Save Newborn HAL User Guide 85 Provider Actions Use the Provider Actions tab to track actions performed by the provider manually Each option on the Provider menu generates a time stamped entry in the text log below PROVIDER ACTIONS VIRTUAL FETALM PALETTE SCENARIO BRANCH MEDICAT LABOR AB SPEECH LOG 01 24 33 APPLIED TO NOELLE Reset the Model 01 24 33 APPLIED TO NOELLE Reset the Model 01 24 34 MODEL TO NOELLE 00 00 HR 85 BP 105 70 RR 19 EtCO2 40 FHRVariability moderate FHRSpo 01 24 35 MODEL TO NOELLE 00 00 EtCO2 33 FHRAccel DecelInt dramatic Lat Ml ADD TO LOG Enter the session tile information and the name of the facilitator at the start of the session The information is included in the final log report PROVIDER ACTIONS Simulation 1 B PROVIDERS 86 User Guide Newborn HAL The team logging feature is used to track the individual actions of up to six providers manually The feature records the name of the provider with the action as an event entry in the log To add a new provider to the Provider Actions window 1 Click Add button to add a new provider Session Title Simulation 1 Breathing 2 Enter the provider s name and select a color tag Click OK to save the provid
82. ibrate the ventilation performance benchmark 1 Click Setup gt Calibration gt Ventilations and click Next The wizard prompts to perform ventilation H1 5 2 Perform one ventilation correctly A green filled oval indicates that the chest ventilation was recorded successfully 3 Perform ventilation 2 as prompted by HEAD POSITION the wizard A green filled oval indicates that the ventilation was recorded Head position calibration allows the facilitator successfully to show the system at what point to obstruct air flow through the airway when the neck is 4 Continue the calibration process to hyper extended or hyper flexed record a total of 5 ventilations as prompted by the wizard Calibration Calibration Wizard At the end of the calibration process the POM CU PNE Welcome to the Manikin s calibration wizard Proceed only after wizard re ports the ave rage peak pressure you have reviewed the calibration section in the user manual and duration values for the procedure Click Please select the function you would like to calibrate Save to store the settings r O Chest Compressions Please test the ventilation calibration Artificial ventilation using the CPR trainer Go to page 66 learn more about the CPR trainer and the feedback graphic Q Blood Pressure Cuff Head Position Calibrate the Blood pressure cuff feature if Hold the hea
83. ibration wizard Newborn HAL User Guide 101 MEME E EN Calibration Head Position Calibration Hold Newborn Hal in the position shown and click w Reset Left BP Sensor y Reset Right BP Sensor i a 4 l Reset Compressions Sensor l Reset Ventilations Sensor I Reset ET Tube Sensor We Reset Force Sensc i l Reset Right OSat Sensor l Reset Contractions Sensor Reset Left OSat Sensor I Reset Labor Motor Remove User Calibration EN Back l Finish l Cancel Once the prompt reads Done the facilitator can go back and calibrate another function or click the Finish button to close the OPTIONS calibration wizard and go back to normal Dm M operation Navigate through the Options menu to o configure software settings and enable FACTORY SETTINGS additional features Use the Factory Settings menu to restore sensors settings back to the factory default values Resetting the sensors deletes all current calibration settings Calibration Monitors gt z View gt Remote Access Via Network Help gt Auto Response Set Med Id Scan RF Channels Remove all adjuncts or peripherals that may alter the neutral state of a sensor prior to resetting it Click the sensor button to reset it to the factory setting Please reference the directions for use guide for troubleshooting information 102 User Guide Newborn HAL The
84. il page on the GIGA software Make sure lungs are enabled and both respiration rate and inspiration percent are different than 0 Try changing the respiration rate to a different value and if still nothing happens try turning the restart the simulator 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 Wireless ad hoc network GIGA generates the vital signs information displayed on the virtual monitor PC The information is transmitted through a wireless ad hoc connection between the two computers in real time The wireless settings are configured at the factory so no additional configuration is required Please reference the troubleshooting information included on page 143 to resolve common connectivity issue before attempting to reconfigure the network Use the Create an ad hoc Wireless network tool to configure the wireless ad hoc link between the two computers Then configure the connection between GIGA and the Gaumard Monitors software Complete the next steps using the Controller Create Ad Hoc Wireless Network tool built in to GIGA softwar
85. ilitator to initialize the simulator and control the vital signs Before turning on the computer for the first time please review the documentation included with the product for important care and warning information The tablet s stylus is a pen shaped input used to interact with files and programs e Left click tap the screen with the pointer Tap twice rapidly to double click e Right click tap and hold a highlighted item or hold the button near the pointer Secure the RF communication module to the tablet or PRO computer using the Velcro patch The tablet is now ready to communicate with the simulator wirelessly For information about the signal strength indicator go to page 25 WARNING Never disconnect the communications module while the Newborn HAL software is running Doing so can seriously damage the module Newborn HAL Battery Newborn HAL S N B1010788 or higher includes two separate power adapters labeled Newborn HAL Charger and Newborn HAL Power Supply Please review the use for each adapter before using the simulator for the first time and tap the item or text Newborn HAL has a maximum battery runtime of approximately 3 hrs Total runtime is dependent on the breathing rate volumes seizures and muscle tone As part of the initial setup process calibrate the stylus using the Tablet and Pen calibration tool in the Windows control panel Complete the calibration process while
86. ing Off x 28 show all clear all Chest Rise Respiratory Pattern Inspire EtCO2 Enable the instant apply option and click the control to change the vital sign to a new value Vital signs undergoing change blink yellow STATUS DETAILS x KO z 1 AIRWAY Upper Airway Sound vol none 3 M CEPHALIC Newborn HAL User Guide 25 The expanded details view is used to tabulate a list of vital sign changes before applying them all at once In addition the Details list is used for creating palette items a set of vital signs parameters stored in a single loadable item Click the edit button to open the expanded Details list Lung Sounds vol Right normal 2 Left normal 2 x The vital signs controls are divided into categories Click through the categories to view the controls available for the current simulator configuration ec Details Vital Controls Sound C oun M go to Cardiac e Respiratory Pattern Currently on sim normal e Respiration Rate Currently on sim 10 e Inspiration Percentage Currently on sim ie e OSat Currently on sim ss 5 5 EtCO2 Currently on sim ace a NOW 10sec 30sec 1min 2min 5min 10 min llOn Apply Clear and Close Details Window 26 User Guide Newborn HAL Change vital sign value or state to add it to the Details list EH
87. ing 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 of 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 available setting on the Details page Remember that only the settings you specify will cause a change in the simulator and all other settings will remain constant Therefore by starting with a complete state the simulator s condition will always be the same when the scenario starts regardless of what she 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 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
88. ion on how to operate the simulator using the Auto mode go to page 30 Noelle 574 575 576 Profiles PROFILES DESCRIPTION Default Modeling Noelle Modeling Scenarios Meds Profile EE E Rename Delete New Profile rene i a on nace EISE The Automatic mode includes the following built in profiles Default Modeling includes one preprogrammed palette with healthy vital signs Meds Profile includes a library of pre programmed medications Quick Start Newborn Modeling This profile contains eight linear scenarios and one branching scenario allowing instant simulation of a wide range of conditions Profiles store palette scenario and option settings independently changes made to one profile have no effect on the others Below are some examples on how profiles are used e Assign one profile to each user of your Gaumard simulator system e Use profiles to organize and protect palettes and scenarios e Create a profile dedicated to a specific academic course taught by multiple instructors e Devote an entire profile to one particular subject area or even one particular scenario To create a new profile click New Profile l MEET HENENER Rename Delete O Enter a name for the new profile followed by a description Create New Profile Profile Name Winter Session Profile Description Ej OR j Copy current profile Inc
89. is displayed in Value column It won t be visible when entering data The new template is listed on the Lab Template section at the bottom of the Lab tab Use the buttons on the left panel to edit or delete lab templates Lab Template a CBC Differential Platelets Differential Glasgow Coma Scale assessment of patient s conscious state 3 15 E Hematology Blood Test Male red blood cell white blood cell coagulation Et Lipid Panel Cholesterol HDL LDL Ti rye Metabolic Panel Anion Gap Albumin Alkaline Phos Calcium Choride X 64 User Guide Newborn HAL Modeling Newborn Premie Use the Hypoxia tab to evaluate the effectiveness of a provider s intervention on an apneic patient The model adjusts the cardiac oxygen saturation and cyanosis dynamically in response to effective ventilations The model also responds to the administration of epinephrine and oxygen ass GIGA Newborn HAL B8505004 S T A B L E NEWBORN STATUS DETAILS x HYPOXIA I CEPHALIC 2 AIRWAY MR PAUSE hypoxia modeling Improve Gain eo H e6 IMPROVE adequate oxygen perfusion breathi Upper war Sond vol Minis 2 Oxygen 1H 6 3 ymin none 3 x DETERIORATE compromised oxygen perfusion apnea Muscle Tone limp x Epinephrine 0 1 mg r Add Crying off x dose onboard 0 mg kg Model rate 3 x l Healthy l
90. istory and any other longer notes and instructions Newborn HAL User Guide 141 3 Assume that providers will do the right thing Usually a scenario should be created with the assumption that the providers will perform correctly As long as they do the scenario can be allowed to continue Naturally preparation must be made for what might happen to the simulator 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 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 exercise
91. itral aortic Contractility RA 100 Auto RV 100 Auto LA 100 Auto LV 100 Auto Cardiac Irritability Newborn HAL User Guide 31 The Hold and Auto options are unique to the automatic mode The Auto Mode adjusts vital sign controls with an auto suffix automatically Checkmark Hold to prevent the Auto Mode from adjusting the value Then change the vital sign to the new static value The automatic mode will not change values set to hold The Auto Mode will adjust all other controls set to auto STATUS DETAILS MEDICATION Heart Sound vol T Regurgitation tricuspid Off pulmonary Off mitral aortic Valve Resistance tricuspid 135 pulmonary 135 mitral 135 Some changes are gradual and even if submitted for immediate change 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 The lung condition parameter adjusts the shunt flow dead space airway resistance and respiratory pattern automatically Shunt Flow Ah Dead Space 155ml 32 User Guide Newborn HAL In the automatic mode a tidal volume of 450 m L to 500 m L is considered the normal level for an adult of average build The auto mode does not restore the respiratory rate if it is set to zero Always remember to specify a new respiratory rate STATUS DE
92. ively the click play stop pause or next as necessary during the scenario Click next to proceed to the next palette from a wait indefinitely palette Next palette Previous palette Use the scenario Quick Launch tab to start a scenario with a single click The Quick Launch tab displays all the scenarios saved in the active profile Scenario Scenario 1 Scenario 2 Scenario 3 Branch Scenario Branching Branching Scenario 1 Scenario 2 Build new scenarios to expand the number of exercises available in a training program The general process of creating a new linear scenario is the following e Create a vital sign palette item for each state in the scenario e Add the vital signs palettes and wait times to the scenario e Play the scenario e Modify and edit palettes e Save the scenario The first step is to create several vital sign palette items using the Details tab Each palette item represents a physiological state during the scenario Program the first palette item to be used as the scenario s starting point Set values for all the physiological parameters sound types and volumes This ensures that when the scenario begins no vital signs from a previous state will inadvertently carry into the scenario exercise Newborn HAL User Guide 41 Using the list view controls select the vital signs parameters for the starting physiological state in the scenario Click
93. let and not battery reserve Use the power supply for simulation sessions lasting 2 hours or more If simulation sessions are shorter than 2 hours use the simulator s battery reserve The power supply adapter will NOT re charge the battery Avoid using the power supply adapter when the simulator s battery is completely depleted Newborn HAL User Guide 15 Refer to the manufacturer s documentation included with the virtual monitor system components for important safety installation and start up information before turning on the computer for the first time To setup the virtual monitor PC 1 Place the all in one PC within line of sight of the controlling computer 2 Connect the power supply 3 Connect the USB keyboard and mouse receiver 4 Turn on the computer VIRTUAL MONITOR WIRELESS CONNECTIVITY The control PC and the all in one virtual monitor PC automatically establish a wireless link at startup The wireless connection allows the Gaumard control software to transmit the vital signs information to the Gaumard Monitors software To verify the wireless link between the two computers click the wireless icon located on the task tray The wireless network name is configured at the factory and may differ from the one seen below To troubleshoot connection issues between the virtual monitor computer and the controlling tablet please go to page 143 Currently connected to See Unidentified ne
94. lude contents of Default Include contents of Quick Start Noelle Lastly click Create to save the new profile Newborn HAL User Guide 19 GIGA Interface The GIGA software is used control the simulator monitor the vital signs and evaluate the provider s performance The simulation technician or instructor carrying out the simulation operates the GIGA software The GIGA control elements and scenario programming procedures are consistent throughout the Gaumard family of high fidelity simulators Some software controls and features covered in this guide may be hidden depending on the simulator s hardware configuration and optional upgrades aa GIGA Newborn HAL B8505004 QUICK START NEWBORN ate 2 2 CEPHALIC 2 AIRWAY Oed 0 x Upper Airway Sound vol none 3 Crying off gt Muscle Tone limp 2 BREATHING E 3 CARDIAC RR 40bpm EKG Sinus 3 98 E 23 HR 140bpm X 10 25 56 ay 02 18 2013 i Gace oe VIRTUAL MONITOR PAETE SCENARIO BRANCH SCENARIO HYPOXIA LAB PROVIDER ACTIONS BP 60 35mmHg K Sounds R 2 L 2 X Temperature 37 5 C x j a ER Qo 06 Connection status The communication indicator displays the status of the radio link between the tablets USB RF module and the simulator Full bars indicate excellent communication i e normal operation Battery indicator The battery indicator displays the battery charge information
95. mulator Use the Model tab to automate the change in cyanosis as the provider performs CPR intervention For more information on the Model feature go to page Error Bookmark not defined 124 User Guide Newborn HAL Control the movement of the simulator s arms by enabling any of the available muscle tone settings limp reduced active left arm only right arm only jittery or seizures For a more pronounced movement effect lay the simulator on a flat surface with the arms parallel to the ground Systemic Perform catheterization exercises via exchangeable male and female genitalia To fill the urine reservoir remove the white cap and use the modified syringe to fill the bladder reservoir Recommended Device Size Procedure Urinary Lubricated 5 to 8 catheterization Fr Infusion 4 ml UMBILICAL CORD SYSTEM S N B0906424 OR HIGHER Catheterize or inject the umbilical cord To fill the umbilical cord with fluid inject any of the three blood vessels with 2 mL of water using the syringe For catheterization exercises use a 6 Fr urethral round tip catheter lubricated with silicon oil Recommended Device Size Procedure Lubricated 6 Fr urethral round tip Umbilical Vein Catheterization Infusion 2ml The replaceable umbilical cord can be trimmed or cut Before removing or replacing the umbilical cord after an exercise turn off the simulator by exiting the software File2 Exit or set the sim
96. nable auto saving of the log each simulator to prevent crosstalk when operating multiple Gaumard e Save your current log report simulators in close proximity For best results leave one channel open between the channels in use e Select units SI or English e Enable stand by warning e Enable electrical therapy virtual shock panel Use the Tolerances to adjust the maximum cyanosis level Enter the activation code to enable upgrade features Activation codes are unique to the simulator s serial number Before entering a code go to the Environment tab and set the connection mode to FIXED then enter the simulator s serial number Newborn HAL User Guide 103 Options NEONATE FEATURES I Ico Ot eee Customize the following simulator specific cr miss m features Tolerances Log Environment Noelle Add Ons e Fine tune the pulse intensity for normal blood pressure Enable Log Auto Save e Synchronize the leg blood pressure to Auto save every 10 E ES the arm blood pressure when the values are not specified Session Timer ate een ar EE e Synchronize post ductal and pre ductal oxygen saturation parameters when values are not specified Show defibrillation cardioversion pacer panel e Use temperature sensor Stand by warning Warn the first time trying to apply settings when system is on Stand By mode International System ST Imperial Options Envir
97. ncy On Site Reviewer Jane Date 01 18 2013 1 History Select the printer device from the list box and click print Page Range All Selection Curent Page Pages 13 Enter either a single page number or a single page range For example 5 12 It is recommended that documents be first saved as XPS files before being printed into hard Copies 94 User Guide Newborn HAL Create new evaluation templates for new scenarios using the edit mode To enter the edit mode toggle the Go To button located on the top right of the evaluation form window Enter a name for the new evaluation template in the Evaluation Name field a Evaluation Form Loadtemplate Save Clear Delete Evaluation Name Shoulder Dystocial I OnSiteReviewer O F Add al bremoveail le mnsert il le A LW J li Add al kepelet liethser Click Add on the Category menu Evaluation Name Shoulder Dystocial On 5ite Reviewer Select the category type and enter the category title Click OK to save Category Options 1 Select Category Type Question with answer region Multiple choice Yes No Multiple choice Disagree Neither Agree or Disagree Agree Multiple choice Unacceptable Poor Average Good Perfect The new category is now created Un Site Reviewer Multiple Choice Entry 1 Yes No N A Newborn HAL User Guide 95 Highlight the
98. new category and then click Add on the Multiple Choice Entry menu Yes No N A Type the evaluation statement in the new multiple choice field LVaiuduui males On Site Reviewer Multiple Choice Entry 1 gt EEN Ee deeem dem a ET Yes No N A Repeat the previous steps to add more categories questions and multiple choice options Evaluation Name Shoulder Dystocia On Site Reviewer Category Multiple Choice Entry 1 pre pend enn A e posee prm A d Ee 1 Provider Tasks and Performance 0000 00 00 04 Yes No N A Calls for additional help Nursing or Physician Calls for pediatrics Applies gentle traction to attempt delivery Utilizes McRobert s maneuver Utilizes Suprapubic pressure Attempts oblique maneuver Woodscrew or Rubin Performs Episiotomy After the evaluation template design is complete click Save at the top of the window ass Evaluation Form loadtemplate si Evaluation Name Shoulder Dystocia OnsiteReviewe OOOO O O 96 User Guide Newborn HAL The evaluation form is now available for use Load template l Clear Print Go To Edit Mode Yes No N A Calls for additional help Nursing or Physician CUT Newborn HAL User Guide 97 Mew Session Reset Session Clock Save Report Print Report Import Export Exit Click the Profile
99. off the simulator and connect the battery charger If the battery charger indicator light goes to green immediately reset the charger using the steps below Turn off the simulator Disconnect the charger from the wall and the simulator Please wait 60 seconds while the charger resets Reconnect the charger to the wall only Please wait approximately 30 seconds for the charger to initialize Reconnect the charger to the simulator Keep the simulator off until the battery is fully recharged Check the charger connector that goes into the simulator The charger should have 3 pins If any pins are bent or broken please contact Gaumard for a replacement Turn off the software and plug charger adapter to the simulator The charger s LED will turn green when the simulator is completely charged Do not turn on the GIGA software until the charging process is complete The adapter labeled Power Supply does not recharge the battery Disconnect the Power Supply and follow the charging procedure explained above Newborn HAL User Guide 143 Simulator doesn t run for the time specified on the manual Simulator doesn t respond to any com mand even that blin king communication indicator is consis tently green Commands are taking longer than usual to take effect or simulator is not reporting every action blinking communication indicator is consis with a different simulator Multiple simula
100. onment General CPR Options Tolerances Log Other Newborn Hal Add Ons Head Position Use HP sensor a ibri j i Sync Vitals when left blank Checkmark the Defibrillation Cardioversion Panel to show the virtual Shock Panel W Lep EP ta Ann shortcut on the main screen Sync Postductal OSat to Preductal The shock panel is a floating control used by the facilitator to administer electrical therapy to the patient via software For more information on working with the shock panel during a scenario go to page 103 asx Shock Pace Panel Use the controls in this window to adjust error margin allowed by the CPR intensity and rate e Compression to ventilation ratio e Compression rate per minute e Ventilation rate per minute e Average of compression depth e Average of PIP peak inspiratory pressure 104 User Guide Newborn HAL OTHER The Fetal Neo Link is now connected For BENDUM information on how to troubleshoot Checkmark Once a Palette is applied load connectivity issues please reference the to Details Tab to show the value of each of appendix the palette s vital signs parameters on th Detail s tab control entries USING THE NEO LINK AV SYSTEM The fetus vital signs information is Ta EE transferred at the end of the delivery GIGA is capable of interfacing with a number automatically Aternatively click T
101. oo i Rename Delete j 9 Action Linked Action Electrical Therapy Drug Recognition Defibrillation Shock Joules Shocks Cardioversion Shock Joules Shocks Non Sync Shock Joules Shocks an External Pacing 1 mA Add j J Goto End f ok 4 cer NR 1 Start Bradycardia 2 Deteriorate 3 Interventions 4 Atropine 5 Epinephrine As 6 Dopamine I 8 Pace Previous c End Newborn HAL User Guide 51 In the figure below node 2 is configured with four alternate paths Once the provider performs any one of the actions listed as key events checkmark the key event to activate the alternate path 2 Deteriorate w Palette Scenario Path v 00 01 m E Wait 02 00 No changes are made to manikin E Atropine x Speechi 00 01 confusion What happened Rm v Cardio Drop 01 00 HR 15 BP 10 OSat 5 9 Epinephrine x on A Dopamine x O PA x c Node T Node Description Name 7 1 Start Node vital signs palettes simulate bradycardia Go to node 2 bradycardia Vital signs palettes deteriorate the patient s condition by 15 Care provider has 4 options Each option key event moves the scenario to the node specified If no action is taken the 2 Deteriorate Scenario will move to node 3 at the end of the time limit Atropine Epinephrine Dopamine Node 4 Node 5 Node 6 Wait indefinitely vital signs are on
102. ort brings up the Print dialog box The shortcut key for this option is Ctrl P Use the Import menu to import palettes scenarios and modeling patients created on another PC or stored in a backup location To import an item into GIGA 1 Click File gt Import on the menu to access the Open menu 2 Setthe type of file to import WU Program ries m Program Files x86 ProgramData 4 rr II Z ZUIZ 3S1U FW T 1 7 2013 8 51 AM F 1 14 2013 2 43 PM Scenario Files scz Branched Scenarios bsz Palette Items plt Profiles pz 3 Browse to the location where the item is saved and click Open to import e Open QU gt Fh Flash Drive v Beard Flash Drive Organize v New folder IT e i gt Wir Favorites Same Type L Chris scz SCZ File gt GJ Libraries gt e Homegroup gt MS Computer gt Git Network I i i a File name The scenario file is copied to the GIGA scenario library automatically Use the Export feature to backup palettes scenarios branched or linear and model patients files To export an item and save it to a location on the computer 1 Click File gt Export to open the Export menu 2 Select the file type from the Export File Type drop down menu Last Modified 08 31 2012 11 2 08 31 2012 11 2 Alice 4 08 31 2012 11 2 alice01 08 31 2012 11 2 alice02 08 31
103. owever 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 In addition to the standard one year of coverage the following support plans are available Two Year Extension covers second and third years Call for pricing USA only Newborn HAL User Guide 151 Gaumard Simulators for Health Care Education Contact 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 Fax 305 667 6085 Before contacting Tech Support you must 1 Have the simulator s Serial Number located in the left leg under the IM site 2 Access to the simulator and the control computer if troubleshooting is needed Post Gaumard Scientific 14700 SW 136 Street Miami FL 33196 5691 USA Office hours Monday Friday 8 30am 4 30pm EST GMT 4 Summer Time Gaumard NOELLE GIGA and HALO are trademarks of Gaumard Scientific Company Inc Gaumard Scientific Company 2013 All rights reserved All rights reserved C 152 User Guide Newborn HAL
104. pressures Umbilical pulse and bilateral brachial pulses operate continuously Pulse strengths vary with blood pressure and pulses are synchronized with ECG Physical size is 50th percentile at 40 weeks gestational age Interchangeable genitalia Internal rechargeable NiMH battery Venous access Bilateral IV training arms Patent umbilicus Intraosseous access at tibia Wireless tablet PC with stylus control Communication modules are FCC and CE Compliant Communications module can be used simultaneously with the tablet computer s integrated wireless IEEE 802 11b networking device 100 240 VAC Charger Power supply Battery Charger Blood pressure cuff Instructions Carrying case One year limited warranty extended warranty to three years Installation and training services available Newborn HAL User Guide 11 Terminology It is wise to spend a moment familiarizing yourself with some of the terminology that will be used to discuss simulation with the Newborn HAL system 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 Facilitator the person conduc
105. pter to Wireless network connection Calibration 3 Enter a port number for the connection m aan 11 ons and click Connect If the port number E a is busy click Find Available to scan for Remote Access Via Network w an open port Auto Response Newborn HAL Preemie Fetal Neo Link ee Setup Scan RF Channels 4 Open the Setup F N menu on Newborn HAL Premie HAL tablet The USB RF module drivers must be 5 Enter the NEWBORN HAL controller IP installed on the virtual monitor PC and the matching port number and then before the Remote Access via click Connect Network feature can be configured Newborn HAL User Guide 105 Go to www Gaumard com to download the latest USB RF module drivers using PC with internet access Do not connect the Virtual Monitor PC to the internet Transfer the USB RF module setup file to the virtual monitor PC using a USB drive and complete the installation To configure the Remote Access via Network connection 5 Connect the simulators USB RF module an available USB port on the virtual monitor PC 6 Verify that both computers are connected to the ad hoc network e g GaumardNet 7 Initialize GIGA on the tablet PC open the Remote Access via Network menu from the Setup menu 8 Select the Remote access via network radio button 9 Verify that Wireless Network Connection is selected from the adapter list 10 Click Find available to
106. ption SELECTED ITEM ow Initial state 00 00 Initial condition all vital signs are specified Wait 01 00 No changes are made to manikin Q Send Lab Lab 1 00 00 Move Deteriorating 00 30 Vital signs deteriorate 20 over 30 seconds Wait Indefinitely E Hold vital signs Click Next Palette to continue Improvement 00 45 Vital signs improve 30 percent over 45 seconds Edit Transition Healthy Restng 510200 momavtis Insert Remove Duplicate Properties Edit Palette VIRTUAL MONITOR PALETTE BRANCH SCENARIO LAB SPEECH PROVIDER ACTIONS 44 User Guide Newborn HAL Click Save Scenario to store the scenario in the current profile for later use Add Item to Name Transition Description gt initial state 00 00 Initial condition all vital signs are specified Wait 01 00 No changes are made to manikin Send Lab Lab 1 00 00 Move Deteriorating 00 30 Vital signs deteriorate 20 over 30 seconds A Type in a name and a description for the new scenario and click Save Save Scenario Scenario Name Allergic Reaction Scenario Description Simulation Session 1 Incorporate the following features into a scenario for added realism e Auto responses move onto the next palette item automatically when virtual electric therapy is detected e File sharing and lab reports Send lab reports to the virtual monitor computer e Speech add phrases or c
107. r 125 Oin E EX 125 Temperature Probe Placement Detection 125 Milla SIONS IVIODIEO o ceni oerte oer c pedea tl tenebre pni Ue eurn peut D esos deu abonos 126 PIOS ODIO sudes titestetnes eati es ettet ate Tct teach uae nee A Tener 126 PAD DCO RR M PQC 127 More about Scenarios ariere ERGEBEN EA AE AAAA ENEA PANAT ATRE 128 Factor Preset ScenarloS soenan aa a a D Ede 128 More about scenarios sessesssessssssesseeeneen nennen nnn nnne nnn rs 141 TEtOUDIOSDOOUlIS ossucasanio on Aas dre c E doa i oO doe ut Ego eas 143 Wireless ad hoc He WODK s o oca Senco etae ch Saws ooh orden eee 147 DAGNO eT 149 Consumables Replacements and Optional Parts 150 MAE AMY ccedasdu uia acai tessa toanlies dct neladiiuc la ania lanminh i lar 151 Sondeos 152 Newborn HAL User Guide 5 End User License Agreement This is a legal agreement between you the end user and Gaumard Scientific Company Inc Gaumard This software is protected by copyright laws and remains the sole property of Gaumard By installing the GIGA 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 a
108. r the Monitor IP is 10 1 1 220 3 Monitor IP 2 10 21 1 z 1 5 Y 6 Click Apply Wireless Network Settings to save the settings 7 Restart the computer 3 Monitor IP 1 l1 i 220 10 l CONFIGURE THE VITAL SIGNS BROADCAST After the wireless ad hoc link is established between both computers complete next steps to configure the transmission of the vital signs information 1 Verify that both computers are connected to the GaumardNet network using Windows wireless connection menu If the computers are not connected select the GaumardNet network and click Connect manually Curemiy connected tc To Unidentified network No Interet acces Start the GIGA control software On the GIGA menu bar click Monitors Configuration 18 The NEWBORN HAL Virtual Monitor Check Modules Setup window is displayed Check Single 4 Set the adapter to Wireless network connection and click Connect to begin transmitting the vital signs information Write down the controller IP and Port number Q Cyanosis 5 Start the Gaumard Monitors software on the virtual monitor PC 6 Click the V menu near the top left corner and then select Comm Setup 19 The TCP Comm Setup window is displayed 7 Enter the Controller IP and Port number displayed on the GIGA Virtual Monitor Setup window 8 Click Connect
109. r Care published by the American Heart Association MEDICATION Dug Dose Unis Route Rate mg Alteplase Activase tPA mg IVInfusion gera Drug Properties Description Half Life 00 25 00 Peak Time 00 08 00 EC50 0 031mg dl Manages acute coronary syndrome and reduces the incidence Standard Dose Alteplase 5D 40mg of congestive heart failure It can also be used to treat massive _ Over Dose Alteplase OD 150mg Stop Infusion Remove from list Change Dose and or Ratel Rate Fluids amp Gas Saline Volume ml Rate ml min Start IV Oxygen Cannula Concentratian Rate L min Start 02 5 VIRTUAL FETALM PALETTE SCENARIO BRANCH LABOR AB B PROVIDE Newborn HAL User Guide 69 Follow this guide to administer a medication directly from the medication tab To administer a medication from the Medication tab 9 Select the medication from the Drug drop down menu MEDICATION Drug Calcium Gluconate Captopril Capoten Carboprost hemabate Clopidogrel Plavix Dexamethasone Decadron Diazepam Valium Digoxin Lanoxin Digitek Digoxin ImmuneFab Digibind Diltiazem Cardizem Dinoprostone Prostaglandin E2 PGE Dobutamine Dobutrex Dopamine Intropin Enalapril Enalaprilat Enalapril Vasotec Ephedrine Epinephrine Primatene Adrenalin Eptifibatide Integrilin Esmolol Brevibloc Flumazenil i Furosemide Lasix Glucagon Glu
110. ransfer of third party A V recording systems current fetal data to send the information Checkmark the Use AV System to enable manually the AV setup option on the menu bar For oe more information about the A V menu go to page 115 Monitors Fetal Neo Link Auto Md Mode The Fetal Neo Link transfers the fetal vital signs to the Newborn Premie Software at end of the delivery The feature allows the providers to continue simulation using the full featured neonate without interruptions A prompt is displayed on the Newborn HAL MEN Premie software to accept the incoming NEWBORN HAL FETAL NEO LINK neonatal vital information Click Yes to load SETUP the vital signs information To configure the fetal link communication PGA Data Received b etwe e n th e N ewb O rn H A L a n d Newborn Initial data received from Noelle model Do you wish to use this data to reinitiate Newborn model Now Newborn Premie computers EN 1 Click F N Link Setup FN open the Fetal Neo Link connection menu ie The Remote Access via Network feature allows GIGA to communicate with the simulator remotely using the virtual monitor PC as the RF transmitter The alternate configuration may provide better connectivity in environments with numerous walls or obstructions between the simulator and the control PC ses Print Setup gt Monitors Auto Mode View Transfer current fetal data 2 Setthe ada
111. rn HAL User Guide 79 To program one or more medications to interact with the current drug 1 Select the interactor from the drug list click Add Interaction Editor Naloxone Narcan Current Drug Data Half Life 01 00 00 Peak Time 00 01 30 SD 400ug OD 2000ug EC50 0 0001mg dL Fx mE Interactors Remnove 1 Edit 4 Remove All Drug List a W Calcium Chloride Calcium Gluconate wa Wg Clopidogrel Plavix Dexamethasone Decadron Cog N Dinoxi nin k Information about the interactor drug is displayed in the Interactor Data window Naloxone Narcan Half Life 01 00 00 Peak Time 00 01 30 SD 400ug OD 2000ug EC50 0 0001mg dL om F ETT Remove 0 05 a S 2 E c a 003 G o a o a L o Remove All Edit Drug List Captopril Capoten Interactor Data Half Life 01 54 00 Peak Time 01 00 00 SD 25mg OD 75mg 001 EC50 0 0240mg dL 2 The drug is included into the interactors list Repeat the process to add more drugs to the interactors list if necessary SD 400ug OD Z7UUUug EC50 0 0001mg dL Interactors Nitroprusside Nitropress 80 User Guide Newborn HAL 3 Select the interactor and click Edit Cow a tru Captopril Capoten Drug List dd
112. s for Health Care Educatior RDS Newborn with mild Respiratory Distress Syndrome gets a pneumothorax after oxygen is given Administer Oxygen Wait indefinitely for action Apply needle aspiration Wait Indefinitely for action Newborn HAL User Guide 139 4 N rn HAL Gaumard ewbo Simulators for Health Care Education TIN Transient Tachypnea of the Newborn Apply suction and deliver O2 Wait Indefinitely for action 140 User Guide Newborn HAL More about scenarios As described previously palette items represent complete or partial groups of settings that have been stored as a single item 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 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 therefore be applied to a wide range of scenarios The key is to include only in your palette items the settings that are directly related to the physiological event represented by that palette item 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 build
113. s require a higher degree of automation For such applications 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 142 User Guide Newborn HAL Troubleshooting Use the following table to find causes and solutions to a number of possible problems Battery does not Attempting to recharge recharge Simulator simulator using the turns off even after a power supply full charge Simulator is on The battery charger is stuck on the charged Green state charger requires reset Charger is broken Communication Battery is discharged never gets established or is lost blinking communi cation indicator is consistently red Computer is too far away Get simulator closer to computer from simulator RF module is not Close the GIGA software and connect the connected USB RF module to the tablet computer After clicking the GIGA icon select the Turn off the simulator and connect the battery charger Reset the charger if necessary see below The simulator does not charge while it is powered on Turn
114. ssure Cuff Head Position The procedures for each specific calibration are described in the sections below 100 User Guide Newborn HAL The chest compression calibration wizard records the average depth as pressure of 5 chest compressions GIGA evaluates provider performance using the information recorded during the calibration as the correct benchmark To calibrate the compression performance benchmark 1 Click Setup gt Calibration gt Chest Compressions and click Next The wizard prompts to perform compression 1 2 Perform one chest compression correctly A green filled oval indicates that the chest compression was recorded successfully 3 Perform chest compression 2 as prompted by the wizard A green filled oval indicates that the chest compression was recorded successfully 4 Continue the calibration process to record a total of 5 compressions as prompted by the wizard At the end of the calibrating session the wizard reports the average peak pressure and duration values for the procedure Click Save to store the settings Please test the compressions calibration using the CPR trainer Go to page 66 learn more about the CPR trainer and the feedback graphic The ventilation calibration wizard records the average pressure of 5 ventilations GIGA evaluates provider performance using the information recorded during the calibration as the correct benchmark To cal
115. t blue Modules that are inactive or not installed GIGA report black Version 2 12 16 0 Firmware 33 33 DIAGNOSTICS Copyright 2013 Use this feature as a troubleshooting tool to Gaumard Scientific Co verify the status of the simulator s features eee oer perc For more information on using the Enel diagnostics screen for troubleshooting go to OK page 147 Hedistributable GIGA installer files are available for download at http www gaumard com software updates To update the GIGA software using a flash drive 1 Download the update file to a flash drive using a computer with internet access Newborn HAL User Guide 117 Working with Newborn HAL 118 User Guide Newborn HAL Disclaimer The section below describes all possible features in the Newborn HAL simulator The content of this table are subject to change without prior notice Please contact Gaumard Scientific for the most current information Legend Y Yes N No O Optional Category Simulator Feature Nasal Intubation Airway Oral Intubation Breathing Airway Sounds Independent Chest Rise Breathing Lung Sounds Heart Sounds Cardiac Chest Compressions ECG generated in real time 4 patches Bilateral IV Bilateral virtual BP Circulation Pulses Fontanel Brachial Umbilical Cyanosis Disable Pulses Brachial Bowel Sounds Starting with SN B0906425 Male Female Catheterization Systemic Head Position Sensor Hyper
116. t heart rhythm to normal sinus gradually Alternatively set the cardiac irritability to deteriorate to move the heart rhythm to ventricular fibrillation and eventually asystole pulmonary 135 mitral 135 aortic Contractility RA 100 o Auto 10095 Auto 100925 Auto 10095 Auto none slight random great random slight improve great improve Bleeding rate 584 DEPTH great deteriorate The progression of rhythms generally follows the pattern displayed in the figure below where X represents normal sinus rhythm multifocal atrial tachycardia atrial flutter atrial fibrillation junctional rhythm left or right bundle branch block or atrio ventricular block X rhythm p X with PACs X with unifocal PvC s X with multifocal PVC s Unifocal V tach Multifocal V tach Ventricular Fibrillation Asystole Newborn HAL User Guide 35 Virtual Monitors The interactive virtual monitor tab VM displays the patient s vital signs information The waveform and numerical parameters are interactive and the layout is fully customizable If the VM tab is not available go to page 103 to activate the virtual monitor add on 12 10 04 ay 02 13 2013 VIRTUAL MONITOR faak NITO Click the waveform name to access the waveform options e Freeze Pause the waveform reading To unfreeze the selection click the waveform menu and select Go e ime Set length of the
117. t 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 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 DEFECT 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 GIVE
118. tal sign settings into a single loadable object Use a palette item to update a set of vital signs quickly For example one palette item can be created to update all the cardiac parameters to a healthy state To create a new palette item set the values for the desired vital signs parameters and click Save 8 EKG Sinus Heart rate 74 bpm Heart Sound normal Heart sound volume 3 28 User Guide Newborn HAL Enter a name for the palette a description and choose color code Click Save to create the new palette Item Palette items are stored in the active profile Save as Palette Item Palette Item Name Color e Healthy Q Care Required Select the palette item from the Load Palette Item menu and click Load A PALCI IC Load Palette Item Sinus 74 bpm Heart Sound Normal Newborn HAL User Guide 29 Click the apply option to submit the changes r we ree ast Details X Healthy Heart Sinus 74 bpm Heart Sound Normal Cardiac EKG Sinus Heart rate 74 bpm Heart Sound normal Heart sound volume 3 Md Fon pply Clear and Close Details Window While operating in the Automatic Mode GIGA adjusts the patient s vital signs automatically in response to caregiver participation instructor input and pharmacologic intervention For example if the heart rate is increased GIGA will calculate
119. ted Low 14 OK 2 Ventilation rate count was high 4 ventilations detected Low 0 OK 1 High Shock 2 200 Joules Compression rate count was high 33 compressions detected Low 11 OK 1C Shock 3 200 Joules Ventilation rate count was high 6 ventiations detected Low 0 OK 0 High E ve 00 00 DETECTED Ventilator PEEP C REMOVED Ventilator PEEP CP EVALUATION Ventiations EVALUATION Cormpressions EVALUATION Ventfations DETECTED defibritation EVALUATION Compressions DETECTED defibrifation EVALUATION Ventfations w Newborn HAL User Guide 67 To access the report window after completing a CPH session press the Open Report button Note that this button is disabled until the Stop button has been pressed CPR Settings a Open Report Load Report 3 VENTILATIONS fF ON This window displays a summary of the most important parameters during CPR training Depth IM Above 100 mmi 6 comp INN Inrange 41 mmHg comp 90 I Below 51 mmHg 2 comp Average depth mmHg VENTILATION PIP VENTE ATION RATE COMPRESSION RATE ti ov 285 1 vet Rate 20 vpm 2 vent I Above 110 cpm 8 comp meo Overt I In range EL and 86 0 vent i Below 90 vent Average PIP 0 Average rate vpm Average rate cpm The top bar of the report window displays e Session Time Total time of the CPR activity e Total Inactivity Time Total time without CPR activity
120. tegory 2 The category menu is displayed Breall 1 LirCulatio a Circulation Custom Log nim 2 Action type 9 Descriptive Action Responsive Action 3 Descriptive Actions v OK feCancel m 3 Enter the name of the action and select the type of action aa Airway Custom Log Button 1 Action Ventilate 2 Action type Descriptive Action Responsive Action 3 Descriptive Actions Newborn HAL User Guide 89 4 Enter a description for the possible action and click to add Repeat the process to add several actions as Airway Custom Log Button 1 Action Ventilate 2 Action type Descriptive Action 5 Click OK to save The new action is listed in the airway category Breathing Circulati transport ventilator mechanical ventilator Use correct hand CPAP BIPAP 90 User Guide Newborn HAL Evaluation Form The evaluation tool assists facilitators in reporting and assessing provider interaction using a questionnaire form A completed evaluation form can then be stored as a digital document or printed for distribution ass Evaluation Form Load template Breech vaginal Delivery Clear Print Go To Edit Mode Evaluation Name Breech Vaginal Delivery On site Reviewer James Date 01 30 2013 6 Providers nurse or doctor request pediatrics
121. tension PROGRAMMABLE BLOOD PRESSURE Use the modified sohygmomanometer included with the system to get blood pressure readings controlled by GIGA In addition auscultate the Korotkoff sounds using a stethoscope Connect the Luer Lok fitting on the end of the extra branch to the Luer Lok port on the simulator s left shoulder Bilateral IV training arms allow intravenous infusions as well as drawing fluids Recommended Device Size Procedure IV Access 23 gauge needle Newborn HAL User Guide 121 Follow the steps below to fill the IV vasculature for drawing fluids 1 First locate the fill syringe with fill tubing the drain tube with pinch clamp the luer connectors and stoppers included in your simulator packaging Warning Do not over tighten the luer connectors into the newborn s ports 4 Connect the drain tube with clamp Luer to one of the connectors and the Connectors fill tubing with syringe to the other connector Stoppers The threaded ports located on both lower arms and left lower leg of the newborn are used for filling and draining the IV system 2 Fill the modified syringe and the fill tubing with water or diluted Gaumard simulated blood 3 Connect the fill and drain luer connectors to lower arm leg threaded ports as shown below 5 Leave the drain tube s clamp open and depress the syringe until air has been purged from the IV system and
122. ter the time of administration for each drug and click Update Graph Test object weight 75 kg Time Effect Graph p GSS eS Z maaan Narcan ony Dose 400 jug Attime 07 108j o6 Captopril Capoten on Apply Captopril Capoten Dose 25 mg Attime 054 455 05 Update Graph Results Attime 00 46 51 Max Interaction Effect 82 39 Alpha 1 05 Compared to Additive individual drug effect reduced by 0 90 Effect oas8 88 BBA Bw BBs The results indicate that the maximum interaction effect 82 39 occurs at 00 46 51 The alpha at that point is 1 01 and the drug effect for each drug is reduced by 0 90 Fine tune the Max Alpha control and retest if the drug interaction effect is not realistic i Update Graph j Results At time 00 46 51 Max Interaction Effect 82 39 Alpha 1 05 l Compared to Additive ees drug effect reduced by 0 90 A time effect graph is generated from the test results Tap and hold to draw a zoom area Time Effect Graph 82 User Guide Newborn HAL 3 Right click anywhere on the graph access the zoon and print options Time Effect Graph Page Setup Print Show Point Values Un Zoom Isobologram plasma concentration 5 Review all the properties of the new medication in the Add New Medication window and click Add to save the new changes hr min sec Precise
123. th i O gt Bradycardia 00 00 RR 10 HR 45 2nd deg AVB Type II Speechi 00 01 complaint Feel dizzy 2 Deteriorate e Palette Scenario Path wait 02 00 No changes are made to manikin Speechi 00 01 confusion What happened Cardio Drop 01 00 HR 15 BP 10 OSat 5 3 Interventions o Palette Scenario Path wait Indefinitely Wait for intervention 4 Atropine Qo Palette Scenario Path gt Atropine 01 00 HR 10 BP 7 5 Epinephrine o v Palette Scenario Path gt Epi infusion 01 00 HR 4596 BP 8 A path refers to the trajectory from one node to another after the last palette in the node expires The scenario will move on to the node indicated by the arrow Click on the Time Limit icon to modify the Go To point for the default path H Scenario Path Newborn HAL User Guide 49 In this example the first node must move to Node 2 Deteriorate after the time limit expires Click OK to save the changes F r FalzLLE r SLEIT ITU F Fau Set Time Limit min Sec 59 59 Max Go to Deteriorate bp Cancel Fl Epinephrine Node 1 is now configured to proceed to Node 2 as indicated by the arrow Bradycardia Note for this scenario to function as intended the E 2 Start Bradycardia o w Palette Scenario Path 00 01 2 gt Bradycar
124. the Save as Palette Item button to create the new palette STATUS DETAILS ec Details AIRWAY B Tongue Edema off x Pharyngeal Swelling Off x Airway Tongue Edema Off normal 3 Pharyngeal Swelling Off Laryngospasm Off Upper Airway Sound stridor inspiratory Upper Airway Sound vol The Save as Palette Item dialog box is displayed Type in the palette item name and a brief description assign a color tag and click Save Save as Palette Item Palette Item Name Initial State Palette Item Description Patient s initial state Color Healthy Care Required Create the next palette item with only those vital sign parameters that are relevant to the second stage in the patient s condition Repeat this process to create palettes for the third and final stage in the scenario Remember to program only the values that require change After all the individual vital sign palettes are created go to the Scenario tab and click Add to Scenario x i o Add Item to Scenario b D ipti Move Edit Transition 42 User Guide Newborn HAL The Add Palette item menu displayed Select the vital sign palette programmed to be first state in the scenario Enter 0 min O sec for the transition time so the initial vital signs are applied immediately Click Add to add the palette to the scenario AGES Add Pal
125. the adapter labeled Newborn Premie HAL Charger to the battery port located on the simulator s using the Battery Charger adapter 2 Disconnect the Charger and connect the Power Supply adapter Activate the GIGA software 4 The GIGA battery icon will display a lightning icon when the power supply is connected right side Please contact Gaumard for information on the power supply 3 Allow the simulator to charge for 2 3 hours or until the charger displays a green light The charger indicator light will show red during the charge period and green once the process is complete upgrade for earlier Newborn HAL models Virtual Monitor The Gaumard Monitors software displays NEWBORN HAL s simulated vital signs in real time The interactive monitoring software is preloaded in to the virtual monitors PC The virtual monitor PC also allows the facilitator to play back the session recordings stored in the PRO PC for debriefing 4 After the charger indicator light turns green disconnect the charger The simulator is ready for use Avoid using the simulator while the battery charger is connected Please reference the troubleshooting guide for information on how to resolve battery issues USING THE POWER SUPPLY SYSTEM S N B1010788 OR HIGHER The power supply adapter allows the simulator to operate through long simulations sessions by drawing power from the wall out
126. the list and click Import Faye baby 8181818 I E RR 0808 i Properties P9 The palettes are now copied into the active patient Newborn A 2 P 2 G 2 ga A 0 P 1 G 0 A A 0 P 1 G res A 0 P 2 G ifres A 0 P 2 G I res A 1 P 2 G ifres A 1 P 2 G 1 co A 1 P 2 G ifco A 2 P 2 G 110 User Guide Newborn HAL Monitors S Yv vM The sensor control window is a floating panel with on off toggle controls Click Monitors sensors Window to open the floating sensor control panel Use the Monitors drop down menu to enable disable sensors on the virtual monitor screen share files program custom scalars and verify the connection between the GIGA and Gaumard Virtual Monitor software Sensors rica term of 0 a preterm of 0 and that she is currently File Setup Sensors File sharing Auto Mode Custom numbers View Configuration Layout If the Monitors drop down is not showing go to Setup Options Add ons and checkmark Use Virtual Vital Signs Monitor Single click the circular icon to enable or disable the sensors displayed on the virtual monitor screen Click the circle dark to disable the sensor and light blue to re enable it In the example above all the sensors are on except the thermometer Use the sensors option to enable or disable any of the waveforms displayed in th
127. 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 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 Contact Gaumard and request authorization to return the Gaumard product Do NOT return the Gaumard product to Gaumard without prior authorization Upon receiving authorization from Gaumard send the Gaumard product along with copies of 1 the original bill of sale or receipt and 2 this limited warranty document to Gaumard at 14700 SW 136 Street Miami FL 33196 5691 USA If the 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 H
128. ting the simulation an instructor or lab staff member GUI the Gaumard User Interface is the software application used to control the simulator 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 Newborn 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 of controlling the Newborn HAL software See the Equipment Set up section of this guide for more information on working with the stylus 12 User Guide Newborn HAL Equipment Set up Newborn HAL User Guide 13 Control Table PC The tablet PC is preloaded with the GIGA control software used by the fac
129. tores an independent library of palette items To modify the vital sign parameters programmed into a palette select a palette and click the Edit button After the changes are made using the Details tab click the Save as Palette Item button See the Tips on Palette Item and Scenario Creation section of the appendix for more information on customizing palettes Select a palette item from the list and click Now button to update the vital signs to the values stored in the palette item Descpription Wr Edit ug Delete Fi Properties VIRTUAL MONITOR FETAL MONITOR ME PALETTE Rxezi tiom EOT O LABOR LAB SPEECH PROVIDER ACTIONS Newborn HAL User Guide 39 Scenarios GIGA includes several preprogrammed scenarios to simulate a variety of complications All preprogrammed scenarios are included in the Quick Start Profile Click File gt Profile to switch to switch to a different profile without exiting the software To use a preprogrammed scenario go to the Scenario tab and click Load Scenario Auto Responses Add Item to i E o The Load Scenario dialog box appears Select a scenario and click Load For a list of all the scenarios available go to page 55 Scenarios automate changes to the patient s condition to simulate an entire exercise without the need for manual input A linear scenario is simply a playlist of vital signs palette items and wait palette items played back in su
130. tors are on at the same time All others Battery not charged properly The computer is properly communicating with a different simulator Distance between computer and simulator is reaching its limit Or there are too many ob structions between walls etc 144 User Guide Newborn HAL name of the applicable simulator and click Start On the menu bar go to Setup Options Environment and select FIXED Then enter the simulator s serial number in the text box Finally restart the software 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 GIGA software 1n 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 Close the GIGA software and unplug the RF module for at least 5 seconds then plug it back in Restart the software and wait for initialization On the menu bar go to Setup gt Options gt Environment and select FIXED Then enter the simulator s serial number in the text box Finally restart the software Turn off the software and unplug charger adapter from the wall and the simulator for 1 minute Reconnect the charger to the wall and the simulator Unplug th
131. twork No Internet access Wireless Network Connection 2 GaumardNet Connected gaumard Other Network Open Network and Sharing Center eto fo uy 2 54PM i 16 User Guide Newborn HAL After the wireless connection is established double click or tap the Gaumard Monitors icon to start the vital signs software The Gaumard Monitors software is now ready to receive the vital signs information generated by the GIGA control software 12 10 29 For more information about the Gaumard Monitors software please refer to the Gaumard Monitors user guide Working with GIGA Newborn HAL User Guide 17 Starting the Simulator After reading the manufacturer s care and caution information press the power button to turn on the Tablet PC The GIGA software initializes the simulator Double click the GIGA icon on the tablet s home screen to start The simulator selection menu is shown Select NEWBORN HAL and click Start as GIGA 2 14 16 0 Gaumard Simulators for Health Care Education Please select one simulator The wireless link between GIGA and the simulator is established within 1 minute 18 User Guide Newborn HAL Profiles and Operating Modes After the startup screen the profile and operating mode selection menu is displayed Newborn HAL Profiles OPERATING MODE PROFILES DESCRIPTION Default Profile f
132. uide 75 The Add New Medication window is displayed aa Add New Medication I EC50 mg dl mil Concentration that produces 50 ofthe maximum effect E Available Palettes Apply Items Threshold M SD 15 n F Over Dose 4 oD 36 Properties Properties 4 Edit F Ciear j M valngls Flug C ug kg mg C mg kg 1g E g kg Test object weight 85 00 kg Update Graph Mg 4 Route i El N Push E Vinfusion 7 IM El SubQ El Topical Per Oral V Inhalation A hr min sec Precise o amp of of Approximate very quick lt 5m 3 Type the name of the new medication e g Generic Name Brand Name and enter the medication s description and the dosage information as Add New Medication 1 New Medication Naloxone Narcan 2 Description Used as a narcotic antagonist for opioid effect reversal Note Second dose may be administered 5 minutes later 4 Select the units and the administration route W ug ug kg C mg kg C g C g kg 4 Route IV Push IV Infusion IM SubQ Topical Per Oral Inhalation 5 Half Life hr sec 76 User Guide Newborn HAL 5 Enter the drug s Half Life and Peak time Ixus LJ Te Tar OI IH TETCILTUTT
133. ulator on STAND BY mode After the simulator is powered down the umbilical cord can be safely unplugged For information about ordering replacement umbilical cords go to page 150 Warning Do not remove umbilical cord while Newborn HAL is in operation Doing so will cause damage to the system BOWEL SOUNDS SYSTEMS S N B0906424 OR HIGHER Auscultate the abdomen for normal and hyperactive bowel sounds BOWEL o Bowel Sounds normal Enable Sound vol Center On 2 x Enable Volume TEMPERATURE PROBE PLACEMENT DETECTION The temperature reading on the vital signs monitor is displayed when a temperature probe is placed on the lower right quadrant of the abdominal area To enable the temperature sensor detection feature go to Setup Options Neonate features Tab Checkmark Use temp sensor and click OK to save The log panel detects the placement of the sensor Newborn HAL User Guide 125 The virtual monitor touchscreen display simulates the functionality of a patient vital signs monitor Users can customize the type of waveforms and scalars displayed set alarms and display lab reports x rays and other files for the provider to access during simulation 17 03 57 For information on how to setup Gaumard Monitors with GUI please refer to the help File included with the Gaumard Monitors software The Pro system is an all in one s
134. ustom speech Newborn HAL User Guide 45 The scenario can also automate the distribution of shared files and labs Click Add to scenario and then use the File and Lab tabs to select from available documents For more information making files available for file sharing go to page 111 To create a new lab report go to page 57 Add Palette Item ratte re on Transition min sec mn OK eee eel min sec of shims 59 59 Max 59 59 Max Item Description Item Description The scenario auto response settings move the scenario to the next palette when electrical therapy is detected Electrical therapy can be applied by the facilitator via Virtual Shock panel or by the care provider using real medical equipment if the simulator supports it Auto responses advance to the next palette if the virtual shock is applied while a wait indefinitely palette is playing and the heart rhythm is shockable s Scenario automatic responses settings All Off All Prompt A Display warning when non shockable pr All Auto EKG is shocked Off off mm Prompt i Prompt e Auto Auto ES T 8 Joules 100 5 SER Io EE Umm advance to next advance to next advance to next sonar p scenario item only scenario item only scenario item only when at WAIT when at WAIT when at WAIT Eoo E 9 The three response options are

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