NOELLE® S550 User Guide
Contents
1. For example if the Assess responsiveness button is clicked when the session clock reads 00 03 36 the following entry is automatically generated 00 03 36 Action Assess Responsiveness 00 03 36 Action Assess responsiveness Special Button The special button add additional functionality to the provider actions section The button allows the facilitator to be more specific on the provider action he she wishes to log For example if the button Ventilate is clicked the following entry is created 00 02 24 Action Ventilate 31 NOELLE S550 User Guide 00 02 24 Action Ventilate On the other hand if the button next to Ventilate is clicked a list of additional options appears Options EVM transport ventilator mechanical ventilator Use correct hand CPAP BIPAP The facilitator can be more specific and choose for example transport ventilator and the following entry is added 00 01 28 Action Ventilate transport ventilator 32 Options mechanical ventilator Use correct hand CPAP gt EIPAP _ A Text Log This is the large panel at the bottom of the Log Page containing all the time stamped text entries Every event on a session is reflected as an entry in the Text Log Open the Text Log by clicking on the shortcut icon located on the upper right side of the application2. Gaumard Leadership Through Innovation Simulators for Health Care Education NOELLE 550 User Guide Maternal and Neonatal Birthing Simulator User Guide NOELLE is an interactive educational system developed to assist a certified instructor It is not a sub 2012 Gaumard Scientific Company stitute for a comprehensive understanding of the subject matter and not intended for clinical decision All Rights Reserved making www Gaumard com Gaumard Simulators for Health Care Education NOELLE 550 user Guide Maternal and Neonatal Birthing Simulator NOELLE is an interactive educational system developed to assist User Guide N 3 1 12 a certified instructor lt is not a substitute for a comprehensive Gaumard Scientific Company 2012 understanding of the subject matter and not intended for clinical All Rights Reserved decision making www Gaumard com NOELLE S550 User Guide NOELLE 550 User Guide Contents END USER LICENSE AGREEMENT a ts 4 GAR ANDA TON Sar dt dora lic daciocntods 6 UTE o O r aa ahae ed ia een t le tide sada bees Sared ie Seiearie 6 ETS A ata O A ah ae ee ee O a A aie a aR Ae an 7 OD OY O tessa sonia setais outraged erate ones on aa 7 TEN UNI ree a E io es eae O ON 7 The Binning Fackage contains the TONO MIA a SATE TEARRE 7 EQUIPMENT SET Ub anita aa wt ated eee a cn Sse a to 8 Leg ASS II a a dc a clea AR o ele A 8 Fetal Heart Rate SO CACM aces A A oa ita 8 FOWE IOI a o ie oe eta 8 OMIT C
3. The default value for the compression rate is 100 compressions per minute Adjust rate using the and buttons Press OK to save the changes and return to previous screen CALIB calibration Calibrate the sensors inside the simulator using the calibration menu CALIB to set the standard against which compression and ventilation will be evaluated during the exercise Choose which function you would like to calibrate between chest compressions C CAL and artificial ventilations V CAL The chest compression and artificial ventilation calibration procedures follow similar steps 25 NOELLE S550 User Guide Calibrating chest compressions 1 2 3 26 Press MORE from the main screen Select CALIB to enter the calibration menu For this example select C CAL Press START to begin with the calibration Omni will ask you to perform a number of correct chest compressions The facilitator should follow the text cue on the screen to perform just one compression at a time until finished COMPRESSION CALIGRATION When Omni is ready to calibrate it will display COMPRESS Perform a correct compression Follow the text cue on the screen to perform the remaining four compressions When the calibration is complete Omni will display DONE Press SAVE Select V CAL and repeat steps 3 5 to calibrate ventilations Resetting Omni s Pressure Sensor It is recommended that the Omn
4. Place birthing fetus in the vertex breech or transverse position onto the elevating pillow and lift fetus anteriorly using squeeze bulb NOELLE 550 User Guide a fi Snap abdominal cover into place O 6 Lift fetus anteriorly using squeeze bulb 7 Conduct the four Leopold Maneuvers Dilating Cervix As the fetus proceeds down the birth canal it pushes against a simulated uterus cervix The simulated cervix is designed to permit considerable distension During delivery the cervix dilates as the fetus moves down the birth canal At crowning the head passes through the cervix and through the vulval insert Students can measure birth descent and cervical dilation which may be used to plot the progress of labor 15 NOELLE S550 User Guide Normal Labor and Delivery To complete a normal delivery follow the instructions below 1 e 16 Remove the abdominal cover Lubricate the head and shoulders of the articulating birthing fetus pr y Lubricate the vulva and cervix internally and externally using silicone lubricant Warning Always lubricate the baby and the birth canal prior to every delivery Poor lubrication may damage the birth canal fetus and the birth mechanism Attach the umbilical cord to the baby Warning Route the cord so it does not bind in the mechanism The umbilical cord can be wrapped once around the fetal neck a tin Ni A
5. Place the lubricated fetus onto the lubricated inflatable cushion and snap the lubricated abdominal cover into place 7 Inflate the cushion lifting the fetus anteriorly 8 Inflate the cushion at the base of the pelvic cavity to position fetus 9 Confirm the breech position and attempt to manually turn the fetus within the uterus by transabdominal manipulation Breech Birth 1 To simulate breech presentations with the NOELLE fully retract the birthing mechanism 2 Remove the soft scalp from the fetal head 21 NOELLE S550 User Guide Information The fetus has a receptacle at the rectum and frontal fontanelle location into which the matching pin located on the birthing mechanism is inserted Information Removing plug reveals aperture for birthing mechanism Insert the plug into the rectum of birthing fetus during delivery 3 Insert the birthing mechanism into the fetal head using one or two adapters gp 4 Place the fetal legs in either an extended position to simulate footling delivery or retract the legs for a frank delivery A Warning Lubricate the lower torso and legs of the fetus The Pinard or Leg Flip maneuver frees one leg then another The fetal arms may also require a similar maneuver during delivery The fetal arms are delivered and the fetus rotated anteriorly to birth the head 22 Delivery of the Placenta The placenta supplied with NOELLE may be
6. 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 GIVEN BY GAUMARD ITS DEALERS DISTRIBUTORS AGENTS OR EMPLOYEES SHALL CREATE A WARRANTY OR IN ANY WAY INCREASE THE SCOPE OF THIS WARRANTY AND YOU MAY NOT RELY ON ANY SUCH INFORMATION OR ADVICE GAUMARD DOES NOT WARRANT GUARANTEE OR MAKE ANY REPRESENTATIONS REGARDING THE USE OR THE RESULTS OF USE OF THE SOFTWARE OR WRITTEN MATERIALS IN TERMS OF CORRECTNESS ACCURACY RELIABILITY CURRENTNESS OR OTHERWISE AND THE ENTIRE RISK AS TO THE RESULTS AND PERFORMANCE OF THE SOFTWARE IS ASSUMED BY YOU IF THE SOFTWARE OR WRITTEN MATERIALS ARE DEFECTIVE YOU AND NOT GAUMARD OR ITS DEALERS DISTRIBUTORS AGENTS OR EMPLOYEES ASSUME THE ENTIRE COST
7. OF ALL NECESSARY SERVICING REPAIR OR CORRECTION OTHER THAN EXPRESSLY DESCRIBED ABOVE NOELLE 550 User Guide 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 ADVISED OF THE POSSIBILITY OF SUCH DAMAGES IN NO EVENT SHALL GAUMARD S LIABILITY HERE UNDER IF ANY EXCEED THE PURCHASE PRICE PAID BY YOU FOR THE SOFTWARE ALL RIGHTS NOT EXPRESSLY GRANTED IN THIS LICENSE AGREEMENT ARE RESERVED BY GAUMARD ACKNOWLEDGMENT BY INSTALLATION OF THIS SOFTWARE YOU ACKNOWLEDGE THAT YOU HAVE READ AND UNDERSTAND THE FOREGOING 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 T
8. ROA position a yo El Cao e n 2 Locate a small squeeze bulb on the left side of NOELLE The bulb is attached to an inflatable bag near the dilating cervix 3 Inflate the bag using the manual squeeze bulb The fetal head and shoulders will rise toward the maternal symphysis pubis simulating locking the shoulder behind pubic bone Note that the fetal head is palpable beneath the stomach cover 4 Connect the Omni to NOELLE using the communication cable 5 Select SPEED of delivery set the labor duration by pressing the or sign 6 Press OK to save the changes and to return to the main screen 7 Activate DYSTOCIA by turning ON the feature from Omni main screen Dystocia enables the turtle signs 20 Information Activate or deactivate dystocia at any time during the delivery Students must use various maneuvers to deliver the baby 8 Ifthe fetus cannot be delivered the Instructor can press the RESUME key which will cause the fetus to resume the movement down the birth canal Warning Do not place the fetus in the LOA position as it will attempt to birth with its shoulders at right angles to the axis of the vulva causing undo stress on the delivery mechanism At any time the Instructor may completely retract the delivery mechanism by selecting RESET in the Omni controller Cesarean Delivery Demonstrate a C section using NOELLE Remove the metal snaps just above
9. 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 that you have read and understand this license agreement and agree to be bound by its terms and conditions 5 Term of Agreement The term of this Agreement and the license granted to you pursuant hereto shall commence upon installation of this Software This Agreement and the license granted herein may otherwise be terminated by Gaumard in the event that you are in breach of any provision of this Agreement In the event of termination you agree to immediately return this Software accompanying items and any copies thereof to Gaumard 6 LIMITED WARRANTY A THE CD ROM MEDIA THE MEDIA WHICH CONTAINS THIS SOFTWARE IS WARRANTED
10. The different types of entries are classified as Actions Detected Events Evaluations and Notes Text Log is subdivided in four different functions Actions Actions refer to those performed by one of the providers in the session The facilitator can quickly log actions from the Provider Actions section and make the entry more specific using the Team Logging feature The following is an example of an Action entry 00 07 24 Action Assess responsiveness Detected Events Each time one of the various sensors in the simulator detects a provider action it is automatically logged as a Detected entry These actions include intubation BP cuff placement artificial ventilations and chest compressions The following example shows an entry after a provider administrates a chest compression 00 05 36 Detected chest compression too weak Evaluations The facilitator adds evaluations by clicking on the Satisfactory or Unsatisfactory buttons next to Text Log The facilitator can evaluate individual providers with a single click For example if provider Steve Parker did a correct procedure the Evaluation entry would be 00 36 01 Steve Parker Evaluation Care Provided Satisfactory 00 36 01 Steve Parker Evaluation Care Provided Satisfactor Notes Notes can be entered directly in the Text Log The following is an example of a Note entry 00 51 09 Steve Parker Note provider took too long
11. repair modules 24 CPR Tools CODE Blue Code Blue is a CPR training tool incorporated in the Omni controller It was designed to help teach CPR by monitoring cadence and depth of cardiac compressions and airway ventilations in real time A Warning Do not perform mouth to mouth ventilation since the simulator airway can be difficult to clean afterwards Code Blue Components Code Blue consists of the Feedback Graphics and specialized menus to control e CPR Operational mode TEST or COACH mode e C V Ratio customize the compression to ventilation ratio e Compression Ventilation Rate customize the compressions per minute Furthermore Code Blue can be calibrated to a specific standard to assess compressions and ventilations Code Blue Menus Press MORE from Omni Main Screen to access Code Blue MODE Toggle between COACH and TEST mode The COACH mode generates audible tones to coach CPR ratio A high pitched beep signals the care provider to perform a compression and a low pitched beep signals a ventilation Toggle to the TEST mode to perform CPR without the audible cues NOELLE 550 User Guide C V RATIO Compression to ventilation ratio Adjust the compression to ventilation ratio using the and buttons Press OK to save the changes and return to previous screen The default value for the C V Ratio is 30 compressions to 2 ventilations CMP VNT RATE Compression or Ventilation rate
12. the pubic bone and birth the baby between the stomach cover and the pubic bone To complete this procedure follow the steps below 1 Retract delivery mechanism 2 Insert inflatable cushion 3 Attach abdominal cover using the metal snaps except for snaps above the pubic bone 4 Birth the neonate between the stomach cover and pubic bone Information To demonstrate midline or bikini incisions with NOELLE utilize an optional abdominal cover The optional C section cover is available as P N 560 029 Prolapse of the Umbilical Cord Simulate prolapse of the umbilical cord by positioning cord on a critical position and decreasing the fetal heart rate from Omni Placenta Previa To simulate placenta previa with NOELLE place the placenta in the desired position to simulate the condition with the maternal side against the uterine wall or the cervical os Then place the fetus within the uterine cavity with the presenting part closest to the placenta External Version Version may be attempted to rotate the fetus from a breech position into one permitting normal vertex presentation 1 To practice external version remove the abdominal cover and the fetus 2 Retract the delivery mechanism Insert the inflatable cushion 4 Remove the foam in the abdominal cover NOELLE S550 User Guide gi Thoroughly lubricate the inside surface of the abdominal cover the fetus and the inflatable cushion 6
13. to assess patient 00 51 09 Steve Parker Note provider took too long to assess patie CPRLink Menus File ne Gaumard Scientific OMNI File Setup Help New Session Reset Session Clock Save Report Print Report Exit NOELLE S550 User Guide New Session Clicking New Session in the file menu will e Start a new simulation session Clear out log page e Restart the session clock h Do you want to save this session report E The session clock is located at the bottom of the Log box Session Time 00 31 19 You can also start a new session by clicking on the session clock drop down menu located at the bottom of the Log box and selecting New Session New Session Reset Session ck Reset Session Clock Clicking on Reset Session Clock resets the clock back to zero Reset the session Clock by clicking on the session clock drop down menu located at the bottom of the Log box and selecting Reset Session Clock New Session Reset Session Clock Save Report 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 33 NOELLE S550 User Guide Search Reports Organize v New folder gt J Favorites gt J Libraries gt e Homegroup gt 1 Computer D Gu Network Date modified No items match your search Filename Reportl Type Save as type T
14. when performing nasal and oral intubation Doing so can permanently damage the system Always lubricate tubing airway and nasal opening prior to performing any nasal or oral intubation Resuscitation Ventilation and manual chest compressions are measured and logged showing the instructor exactly how students are performing Teeth and tongue NOELLE is supplied with fixed upper and lower dentures The tongue may be moved gently from side to side 14 Obstetrics The NOELLE birthing mechanism offers the ability to demonstrate a variety of obstetric techniques including e Fetal palpation e Vaginal delivery e Shoulder dystocia e Cesarean delivery e Complete frank and footling breech deliveries e External version e Cord prolapse e Placenta previa e Vacuum or forceps delivery Automatic Birthing Mechanism and the Omni NOELLE is supplied with an electromechanical system to automatically deliver the fetus using the Omni controller The system configured with the Omni provides internal rotation linear motion to crowning and a second rotation to present the fetal shoulders parallel to the longitudinal axis of the vulva Leopold Maneuvers Practice Leopold Maneuvers with NOELLE 1 Retract the birthing mechanism and remove the articulating birthing baby 2 Place elevating pillow within simulator 3 Route the inflation bulb outside NOELLE through any space provided on the left side 4
15. A SR 37 AWAY Manage meN e lr e dl e co le 37 Mi A a IN a E 37 Umbilical Catheterization sec eins seht root ADAE ans Seo ote ed rd es 37 CONSUMABLES AND REPLACEMENTS eat a ta epee ceded tontos 38 0 1d oe AA II A A A A A I 38 CONTACT US tana il dao loe AEE 39 WARRANT stas dada tl e lil rd ai ei id 40 EXCLUSIVE ONE YEAR CMTE O VMA RPAN TY a a cs 40 NOELLE S550 User Guide 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 CPRLink the Software media you agree to be bound by the terms of this agreement lf you do not agree to the terms of this agreement promptly return the uninstalled media and accompanying items to Gaumard at the address indicated below 1 Grant of License Gaumard hereby grants to you an individual or institution the right to install and activate the Software on one computer for use with one Interactive patient simulator system The software may also be installed on any number of other computers at the same institution so that students may access the learning resources One copy of the software may be made for backup purposes You may not network this Software or allow multiple users unless you purchased a multi user workstation license Sharing this Software with other individuals or allowing other individuals to view the contents of this
16. HE LICENSE DESCRIBED HEREIN NOELLE S550 User Guide Care and Cautions Overall Warnings Remember that damage caused by misuse is not covered by your warranty It is critical to understand and comply with the following guidelines Procedures Do not attempt to intubate without lubricating the airway adjunct with silicone lubricant provided Failure to do so will make intubation very difficult and is likely to result in damage When simulating drug administration via endotracheal tube providers must use an empty syringe Passing liquids into the trachea or esophagus may cause internal damage Mouth to mouth resuscitation without a barrier device is not recommended as it will contaminate the airway Treat NOELLE with the same precautions that would be used with a real patient Always keep clear of the birthing mechanism while the system is on Never operate the birthing mechanism without the tummy cover in place Storage Store NOELLE 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 NOELLE at an ambient temperature of 95 degrees Fahrenheit 35 Celsius Cleaning NOELLE should be cleaned with a cloth dampened with diluted liquid dishwashing soap Remove all traces of any lubricant Do not clean with harsh abrasives Dry thoroughly NOELLE is splash proof but not water proof Do not submerge or al
17. ONEOUER sitaducrse se sala A A A Sai oia 9 SUING S a O Mane alana ihe O II ou dort car akan is 10 ES AAA Mace Rah eM i ala le ti te ln st Wheat nts ta AA Mls 10 NAM AVIONES A li odo lean 10 WORRINS WITH eMac iat ae cra ec ds rd loro de ol tel leo ts ed arado e e 13 lo A e A ICP an Ce 13 Eds A A A AAA AR AAA A AAA a 13 EYES ODIA ADO EXC a 13 E AAA A A A ERTS aT PORES ee ewe 13 Range ol Movemnen LA Ad 13 A a a aa a a head uh ond inal 13 Ss ha sesh ee ose th case eee tle gh bul yc ek pect ded etna Pas Aarons a ata eateee 13 A A he ee a E 13 A A A A 15 Automatic Birthing Mechanism and A die a ele th 15 Leopold MIANCUIVECIS ti A Ai TIO hae 15 Baun O TX nn oi A 15 POTTED OFA DEV dd de 16 Vacunas SS CO DOI o cocos pas 19 y RI A he ee Seo a a eh ale ie Geet het eat oe 20 Cesarean PICU CIY aac lin a a ll ates 20 Prolapse othe UMDINCaNG O sisne ts ed nu cid testes tt tanta 21 PACT A AI A oe SG cago eh asc cp De ake ba hal ede etd co etiees eS ee 21 DN a a a ciao esas sae a eet ee 21 Si EAEI VEIE PES ENEE AEE A EO E E ATE EES FET SEEE EE ATE OE TETE EE EA E 21 Devar YOR TIC IAC CIA sisia alse a a ats hase a E el E Mans albeit ch i a a a 22 NOELEEGRPOSTPARTUMACTIeissotesionsosantatera intra wacint ne aa aaa a aaa ea ea ENa 23 FUundal Massage and POS DANUBIO CQINO sesasi a a A T 23 EPSOM RODAIN en a a el 24 OPR TOOL anana A A a Ere OCT EOD 25 COD AAA AAA AAN AN NA 25 el AAA e A A A A Mee 27 NOELLE NEONATAL CARE nn 37 CASES O R ARA A A a a a a a a a a a
18. Parker A colored button is inserted on the Team Logging region for the provider just added There can be up to six different providers each with a corresponding button Every time one of the provider buttons is clicked that person becomes the active provider To indicate the active provider the vertical bars on each side of the Log page will match the color chosen for that person Team On the Log Page image for example the provider Steve is the active provider so the vertical bars are teal colored While there is an active provider every time a Provider Action or Evaluation log entry is created it will have the name of the provider as follows 00 07 41 Steve Parker Action Ventilate BVM To deselect the active provider and return to general logging click the Team button and the vertical bars will return to neutral color Providers All provider buttons can be edited or deleted by right clicking them and selecting an option from the menu Provider Actions This section refers to the collection of buttons in the middle of the page It allows the facilitator to accurately keep track of provider actions The buttons are grouped into 6 groups Basic Airway Breathing Circulation and Trauma Care Anytime the facilitator clicks one of the buttons a time stamped log entry is generated with that particular action NOELLE S550 User Guide Breathing Circulation Trauma Care onde onson je
19. age resulting from failure to properly maintain the Gaumard product in accordance with Gaumard product instructions including failure to property clean the Gaumard product and 3 Damage resulting from a repair or attempted repair of the Gaumard product by anyone other than Gaumard or a Gaumard representative This one year limited warranty is the sole and exclusive warranty provided by Gaumard for the accompanying Gaumard product and Gaumard hereby explicitly disclaims the implied warranties of merchantability satisfactory quality and fitness for a particular purpose Except for the limited obligations specifically set forth in this one year limited warranty Gaumard will not be liable for any direct indirect special incidental or consequential damages whether based on contract tort or any other legal theory regardless of whether Gaumard has been advised of the possibilities of such damages Some jurisdictions do not allow disclaimers of implied warranties or the exclusion or limitation of consequential damages so the above 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 the products manufactured and produced by Gaumard This limited warrant
20. arge postpartum uterine assembly to the distal end of the vagina using the locking ring assembly The postpartum uterine assembly consists of a thin outer uterine skin and a smaller harder inner uterus It also contains a filling tube to stream the simulated blood through the assembly and out the vulva 4 Use the squeeze bulb attached to the postpartum uterine assembly to inflate the space between the two uteri expanding the soft external skin sufficient to simulate a boggy uterine condition 5 Use the syringe to insert simulated blood to the postpartum uterine assembly 6 Lift the uterus anteriorly using the inflatable cushion The picture below shows the inflatable cushion fully inflated 23 NOELLE S550 User Guide The white Velcro patch on the fundus may be used to position the uterus at various orientations within the abdominal cavity Bimanual massage will cause air to leak from the thumb screw in the squeeze bulb causing the outer skin to contract When sufficient air is released the student will begin to feel the harder inner uterus which simulates the contracted postpartum state Episiotomy Repair Remove the fully dilated vulva used during delivery and select one of the three episiotomy repair modules Snap a repair module into place Use a 000 size suture and small curved needle to repair the surgical incision or repair 000 sized sutures are recommended to extend the life of the
21. ations are too strong Waveform peaks exceed the green zone Ventilation was performed correctly Waveform peak is inside the green zone Provider Actions Screen The provider actions screen allows the facilitator to keep track of every event during a session lt automatically creates an entry whenever a detected event occurs Also the facilitator can log provider actions with a simple click Open the provider actions screen by clicking on the shortcut icon located on the upper right side of the application 30 The Provider Actions screen consists of four different areas from top to bottom session info team logging buttons provider action buttons and text log Session Info The header section consists of the Session Title and Facilitator fields at the top of the Team Logging section Type the session title and facilitator name directly into the note field It serves as assisting with record keeping purposes when a report is saved or printed Team Logging The Team Logging feature allows the facilitator to designate which member of the team performed a particular action The Team Logging section is right above the Provider Actions section First the facilitator should add all providers in the team one by one by clicking the Add button and filling out the Add Provider dialog box Session Title Providers Prone E E r Add Provider Steve
22. ations to your specific criteria That is you will be telling the system what a correct chest compression is and or what a correct artificial ventilation is Providers will be evaluated by the system based on this criteria The chest compressions and ventilations are calibrated in the same way After making a selection this dialog box is displayed NOELLE S550 User Guide Calibration Calibration Wizard Welcome to the calibration wizard Proceed only after you have reviewed the calibration section in the user manual Please select the function you would like to calibrate x Chest Compressions pa Artificial Ventilation Click next to proceed with the calibration The application will now ask you to perform a number of correct chest compressions or artificial ventilations depending on which was selected Calibration Chest Compressions The values from the last compressions user calibration are shown below Press START and do 5 correct chest compressions one at a time following the text cue Never Calibrated lt Back al Finish Calibration Chest Compressions The values from the last compressions user calibration are shown below Press START and do 5 correct chest compressions one at a time following the text cue 1 Dom lt Back Finish NOELLE S550 User Guide The facilitator should follow the text cue on the screen to perform just ONE compression or ventilation at a
23. ble deviation from the compressions or ventilations entered during the calibration procedure otherwise the program uses default sensor values Rate Tolerances the rate tolerance parameter sets the permissible deviation from the selected compression set For example if the user sets the Compression Rate at 100 compressions minute and the Compression Rate Tolerance at 10 any compression frequency between 90 and 110 compressions per minute will be considered correct Options CPR Options Tolerances o CPR Intensity Tolerances Artificial ventilation intensity evaluation tolerance 10 Chest compression intensity evaluation tolerance T 10 o CPR Rate Tolerances Artificial ventilation rate evaluation tolerance MM MN S 4 10 Chest compression rate evaluation tolerance yA 10 Cancel Calibration This tool allows you to easily calibrate the sensors inside the simulator First choose which function you would like to calibrate chest compressions or artificial ventilations Calibration Calibration Wizard Welcome to the calibration wizard Proceed only after you have reviewed the calibration section in the user manual Please select the function you would like to calibrate The procedures for each specific calibration are described in the sections below Chest Compressions Artificial Ventilations This tool allows you to calibrate the chest compressions and the artificial ventil
24. cord system e Tube 2 drain the umbilical cord system e Tube 3 drain gastric contents introduced orally 3 NOELLE S550 User Guide Consumables and Replacements Selected Parts List Contact Gaumard Scientific for a complete list of consumables and replacement parts and their prices ene een 38 ME IM A S550 INST In Service Training Contact Us E mail Technical Support support gqaumard com Before contacting Tech Support you must 1 Have Omni simulator s Serial Number 2 Benext to Omni simulator if troubleshooting is needed E mail Sales and Customer Service sales gaumard com Phone Toll free in the USA 800 882 6655 Worldwide 01 305 971 3790 Post Gaumard Scientific 14700 SW 136 Street Miami FL 33196 5691 USA Office hours Monday Friday 8 30 am 4 30 pm EST GMT 5 4 Summer Time NOELLE 550 User Guide 39 NOELLE S550 User Guide Warranty EXCLUSIVE ONE YEAR LIMITED 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 1 Damage resulting from accident misuse abuse neglect or unintended use of the Gaumard product 2 Dam
25. deactivated Resume Menu Toggle between PAUSE and RESUME The RESUME option will start the automatic birthing mechanism PAUSE will stop the delivering mechanism Reset Menu When selecting RESET the automated birthing mechanism will move to its initial position A message on the Main Screen will confirm the command 11 NOELLE S550 User Guide More Press MORE to access the CPR tools navigation menus 12 Working with NOELLE Bandaging The fingers and toes of NOELLE are separated to permit bandaging exercises The surface of the simulator is smooth and resistant to water oil and liniments Ear The ear cavity may be filled with about 10 mL of fluid Eyes Ophthalmologic Exercises The head has separately inset and removable eyes permitting e Administration of orbital medicines including drops ointments into the conjunctival sac e Removal of foreign bodies e Eye irrigation Hygienic Care NOELLE s hair can be shampooed bathing exercises and head draping may also be practiced Range of Movement NOELLE s head and jaw articulate The legs and arm articulate in a normal fashion Breathing Chest Rise Lungs expand normally permitting realistic chest rise Chest compressions are measured and logged CPR Use a normal size adult BVM which will seal around the mouth and nose The ribs have normal anatomical landmarks and the lungs permit an adequate chest rise A Warnin
26. eard by placing the bell of a conventional stethoscope on to the abdomen Move the bell of the stethoscope around until the heart tones are clearly heard Change the fetal heart rate using Omni by accessing the FHR menu The cervix dilates as the fetal head moves down the birth canal Crowning of the fetal head can be seen 18 Mouth and nose suctioning can be simulated External fetal rotation aligns shoulders with the longitudinal axis of the vulva Vacuum assisted Delivery Vacuum assisted delivery may be practiced with the NOELLE simulator using a vacuum cup 1 Begin the vacuum assisted delivery by inserting the soft scalp over the skull of the birthing fetus Information Placing the soft scalp over the skull improves the vacuum seal between the fetal head and the vacuum 2 Lubricate the fetus supplied with NOELLE and place it onto the delivery system in the normal ROA position 3 Connect the Omni to NOELLE using the communication cable 4 Select RESUME from Omni Information Omni will load with predetermined settings Fetal heart rate of 140 BPM delivery speed of 2 minutes and the dystocia feature OFF Activating the delivery mechanism will move the fetus down the birth canal 5 Select PAUSE as soon as the cervix is fully dilated NOELLE S550 User Guide 6 Insert a lubricated vacuum cup into the vagina and place the cup onto the flexion point of the skull located be
27. ext files txt y se caes a Hide Folders Select the desired name and path and click Save A sample report is below Gaumard Scientific Gaumard CPR 3 13 2012 10 40 27 AM Team Detected chest compression Detected chest compression Detected chest compression Detected chest compression Detected chest compression Detected chest compression Detected chest compression Detected chest compression Detected chest compression Detected chest compression Detected chest compression Detected chest compression Detected chest compression Detected chest compression Detected chest compression Detected chest compression Detected chest compression Detected chest compression Detected chest compression peak 44 mmHg duration 0 4 seconds peak 39 mmHg duration 0 1 seconds peak 48 mmHg duration 0 3 seconds peak 52 mmHg duration 0 2 seconds peak 39 mmHg duration 0 1 seconds peak 53 mmHg duration 0 1 seconds peak 10 mmHg duration 0 1 seconds peak 48 mmHg duration 0 2 seconds peak 43 mmHg duration 0 2 seconds peak 25 mmHg duration 0 1 seconds peak 22 mmHg duration 0 2 seconds peak 21 mmHg duration 0 1 seconds peak 54 mmHg duration 0 3 seconds peak 68 mmHg duration 0 6 seconds peak 58 mmHg duration 0 3 seconds peak 24 mmHa duration 0 1 seconds peak 42 mmHg du
28. g Do not perform mouth to mouth ventilation since NOELLE S airway can be difficult to clean afterwards NOELLE S550 User Guide Circulation Bilateral Pulses NOELLE s palpable pulses carotid brachial radial femoral can be simulated by pumping the squeeze bulb located beneath NOELLE lower left arm Injection Sites Sites on the upper left and right arms and legs permit IM injections An IV training arm provides an extensive venous network to start IVs or infuse fluids Injection Training Arm and Hand IV IM or SubQ exercises can be performed Always use needle sets sized 22 or thinner to extend the life of the veins and skin Always use clean water in the veins and drain after use Airway Nasal and Oral Intubation The nose is patent permitting feeding exercises or passage of a nasal 13 NOELLE S550 User Guide Airway management techniques can be practiced on NOELLE including BVM nasal oral intubation and suctioning Endotracheal tubes NG tubes and LMAs can be used Use the Sellick maneuver if needed to bring the vocal folds into view eee l a E E o a R pa wa va a a a au a 8 z2 23 a a a 3 z A agi En o La s 155 ES 2 ga a 83 a S Sa 3 qe 5 ae ee _ A Recommended Device Procedure Size Intubation Blade size Miller 4 or MAC 3 5 Nasal Intubation 8 mm outer diameter max Oral Intubation ETT Fr 7 or 7 5 A Warning Do not introduce liquids
29. i s pressure sensor is reset at altitudes greater than 1000 ft to avoid inaccurate compressions and ventilations readings Perform the sensor reset procedure only as part of the initial calibration process 1 Select RESET within the compression ventilation calibration menu COMPRESSION CALIBRATION After resetting the sensor Omni will display DONE 2 Select SAVE to finish HELP Every screen on the Omni controller has a HELP menu The help window provides access to global settings such as delivery mechanism reset backlight time and Omni Simulator serial number OMNI Y Serial Number 5550 serial Number BACKLIGH BUTTONS Noelle 550 ay a is INIT MTR Resets the delivery mechanism BACKLIGHT Back light timer SERIAL View Omni and simulator serial number Scroll help text down Delivery Mechanism Reset The INIT MTR button can be used to help the delivery mechanism find its initial position after an abnormal shutdown such as a power outage during a delivery Use only during troubleshooting Backlight The default value for Omni s backlight timer is 10 minutes After 10 minutes the backlight will turn off To increase the backlight duration adjust the backlight timer with the plus or minus sign Press OK to accept the changes Serial View Omni and simulator serial number Press OK to return to the HELP menu NOELLE 550 User Guide CPRLink CRPLink is an applicat
30. ion e Ventilation is measured and logged Circulation e Bilateral carotid radial and brachial pulses e Chest compressions are measured and logged Venous Access o Bilateral arm with venous network in forearms e Bilateral quadriceps and deltoid intramuscular injection sites Other e Powerful yet intuitive user controller and interface software e One year limited warranty available extended warranty to three years e Technical support NOELLE 550 User Guide Terminology Facilitator the person conducting the simulation an instructor or lab staff member Provider a person participating in the simulation as a healthcare provider Code Blue feature of Omni to monitor train and evaluate CPR CPRLink the application to monitor train and evaluate CPR The Birthing Package contains the following Check List e 48 hour postpartum uterine assembly e Abdomen cover with speaker attached e Articulating birthing fetus e Automatic birthing mechanism e Carrying bag for neonate e Cervix Holder e Inflatable cushion for Leopold Maneuvers e Instructional demo on CD ROM e Neonate with intubation capabilities airway and umbilical cord e NOELLE head and torso assembly with IV arm e NOELLE Training Guide with basic and advanced scenarios e Omni Code Blue Pack e Postpartum hemorrhage kit e Postpartum perineum insert e Power supply e Silicone lubricant e Talcum powder e Three vulva in
31. ion that enables monitoring and logging of compressions and ventilations performed in real time by the user on a PC Ventiation Data Rate PIP Ti IE PEEP LV 24 42 This software aims to provide additional testing and teaching tools for CPR using an interface to display a waveform graph of the compressions and ventilations CPRLink Minimum System Requirements e Operating System Windows XP or Windows 7 e Computer and processor 1 gigahertz GHz or faster 32 bit x86 or 64 bit x64 processor e Memory 1 gigabyte GB RAM 32 bit or 2 GB RAM 64 bit e Hard disk 4 gigabyte GB available disk space e Install media CD DVD Drive e 1 O Ports USB port Setup CPRLink Software Installation If installing the CPRLink software for the first time follow the instructions listed below 1 Insert the CPRLink installation CD in your PC 2 Double click the installation file on the enclosed media In case the auto run is disabled open My Computer In the My Computer window open the drive that contains the CPRLink CD Double click on CPRLink and locate setup Double click on setup to start the installation 3 Follow the instructions on your screen 2l NOELLE S550 User Guide Equipment Set Up 1 Connect the power supply to the power input on the simulator and then connect the power supply to the wall outlet 2 Connect the communication cable to the simulator and to Omni 3 Connect the USB cable to O
32. l or nasal intubation plus suctioning Cricoid prominence permits the Sellick s maneuver Bilateral lung expansion is perceived with realistic chest rise Airway Management Practice BVM techniques using an infant sized mask having a thick seal When intubating use a Miller 1 blade and an uncuffed 2 5 mm endotracheal tube ETT with appropriate stylet A Warning Before inserting ET NP or OP tubes always lubricate the distal end of the tube Failure to do so will damage the tiny airway Umbilical Cord The umbilical cord remains patent for several hours after birth and may be used to infuse medications in a critically ill neonate The neonate supplied with NOELLE has a patent umbilicus for use in such training Generate palpable umbilical pulses using the squeeze bulb NOELLE S550 User Guide Umbilical Catheterization At birth and for only a few hours thereafter the umbilicus can be used for intravenous access and for measuring arterial blood gasses pressure The umbilical cord is connected to an internal reservoir that can be filled with 2 3 cc of water using the syringe provided Students can insert a lubricated umbilical catheter Information For catheterization use an umbilical catheter AN Warning Lubricate the distal tip before inserting an umbilical catheter The filling and drainage tubes of PEDI Blue are located on the right side of the neonate e Tube 1 fill the umbilical
33. le Omni is detecting the simulator features After the start up screen Omni will automatically proceed to the main screen Do not connect NOELLE or Omni to a computer LAN network or unauthorized diagnostic equipment Doing so will cause serious damage to the equipment NOELLE S550 User Guide NOELLE S550 User Guide Navigation Menus Edit NOELLE settings using the navigation menus Using Omni Select a menu item by pressing the soft key buttons Main Screen located on the right side of the controller Each menu has additional submenus or toggle selection Use the submenus to decrease increase accept or cancel The Omni main screen is divided in three sections the values Feedback Graphics Current Settings and Navigation Menus Pressing each button will display each menu item in detail 140 BPM FAR A 2MIN SPEED OFF BYSTOCIA os SPEED Set labor duration Enable disable turtle oes Feedback Graphics PAUSE RESUME Stop continue delivery Monitor and evaluate depth and cadence of compressions and ventilations in real time l RESET Return delivery motor to Start position MORE Access Code Blue navigation menus Fetal Heart Rate Menu To change the vital signs parameters press the and buttons Pressing and holding this button will continuously increase or decrease the parameter value Current Settings Pressing OK accepts the changes and returns to the Current settings i
34. low water to enter the interior of the simulator Set Up NOELLE will only power on when connected to the AC power supply Birth Canal Maintenance Ball point pens ink and markers permanently stain the birth canal insert Do not wrap this or any other Gaumard product in newsprint The birth canal insert can be cleaning by wiping with a mild solution of soap and water After cleaning dust with talcum powder Store the unit in a cool dry place After exercise is completed DO NOT leave birthing baby in contact with the birth canal Post partum Hemorrhage Warnings Use only Gaumard s provided simulated blood Any other simulated blood brand containing sugar or any additive may cause blockage and or interruption of the vasculature system At the end of every simulation always flush the system with distilled water to prevent clogging Getting Started Overview The NOELLE S550 Maternal and Neonatal teaching system permits students to appreciate the complete birthing experience from the onset of labor to delivery and treatment of the mother and neonate after delivery It provides capabilities in ALS obstetrics and neonatal resuscitation protocols Airway e Oral and nasal intubation e Usean ET tube or LMA Accessories e Postpartum hemorrhage kit Simulator e Delivering mechanism e Articulating body Breathing e Bilateral lung expansion with realistic chest rise e Accommodates assisted ventilat
35. mni and to the USB port of your PC Omni will display a heart icon on the lower left side of the screen when a connection with the PC has been established A Warning Do not start the CPRLink application until Omni is connected to the PC Starting CPRLink Double click on the CPRLink icon on the desktop of your PC CPR Screen The CPRLink main screen contains the drop down menus used to save and clear session logs change the application options and access the program s help The main screen also contains the controls used to evaluate compressions and ventilations 28 Open the CPR evaluator by clicking on the shortcut icon located on the upper right side of the application The provider performance indicator boxes are located on the right The V ventilation and C compression box fill color changes between the following states e Grey No intervention was detected e Yellow Compression was too shallow Ventilation was too weak e Green Compression ventilation was performed correctly e Red Compression was too deep Ventilation was too strong Compression and ventilation data is displayed at the bottom of the window as CPR is performed by the provider Compression Data Ventilation Data 2 Rate ct LC Rate PIP Ti 0 0 1 00 33 0 I E PEEP LV 00 29 L 17 OK 0 H 0 L 8 OK 0 H 0 Not Enough Co
36. mpressions 17 Too Many Ventilations 8 Compression Data e Rate Rate of compressions in real time e Ct Compression time Average length of each compression in seconds e LC Last Compression Time elapsed since the last compression performed Ventilation Data e Rate Ventilation rate in real time e PIP approx Peak Inspiratory Pressure e Ti Time inspiration e LE Inspiratory Expiratory ratio e PEEP approx Positive End Expiratory Pressure e LV Last Ventilation Time elapsed since the last ventilation performed Trainer The CPRLink application generates visual and audible cues of the compression to ventilation ratio programmed in the CPR Options menu When the Trainer button is clicked the V ventilations and C compressions box borders blink to indicate the correct reference CPR rate A high pitched beep signals the care provider to perform a compression and a low pitched beep signals a ventilation NOELLE 550 User Guide Performance Examples Compressions are too shallow Most waveform peaks do not reach the green zone Compression indicator is yellow Compressions are too deep Waveforms peaks mostly exceed the green zone Compression indicator is red Compressions are performed correctly Waveform peaks are mostly inside the green zone Ventilations are too shallow Waveform peaks do not reach the green zone 29 NOELLE S550 User Guide Ventil
37. nformation is listed at the center of the previous screen Pressing CANCEL returns to the screen previous screen with no changes applied 140 EPM 2 MIN OFF ee FHR CN 140BPM Come Yan HELP 10 Fetal Heart Rate Submenus Accept the value and OK return to main screen Returns to previous CANCEL screen with no changes applied Decrease the current FHR Reset delivery mechanism set backlight time and view Omni and Simulator serial number Increase the current FHR Delivery Speed Menu Changes to the delivery speed can be made by increasing or decreasing minutes with the and buttons The speed ranges from 1 to 30 minutes Pressing and holding a button will continuously increase or decrease the parameter value Pressing OK accepts the changes and returns to the previous screen Pressing CANCEL returns to the previous screen with no changes applied Increase the current labor duration OK Accept the value and return to main screen CANCEL Returns to previous screen with no changes applied NOELLE 550 User Guide Decrease current labor duration Reset delivery mechanism set backlight time and view Omni and Simulator serial number Increase the current labor duration Dystocia Menu Enable or disable turtle signs during delivery Toggle between DYSTOCIA ON and DYSTOCIA OFF When Omni displays ON the dystocia feature is activated Similarly when it displays OFF the dystocia feature is
38. positioned so that it births spontaneously or requires either modest cord traction or manual removal In addition the placenta is designed with two removable placental fragments These fragments are attached to the body of the placenta with Velcro You may reverse one or both fragments causing one or both to birth with the placenta or remain affixed to the uterine wall Students must carefully inspect the birthed placenta to make sure it is complete and that no fragments remain internally If retained fragments are noted the student must retrieve them using a gloved hand under appropriate aseptic conditions NOELLE Postpartum Activity After delivery the uterus normally contracts reducing postpartum bleeding Under certain conditions contraction does not occur and extensive bleeding may continue If this condition is not recognized and treated in a timely manner the new mother may go into shock and die Inadequate uterine contraction may present as a boggy or soft uterus assessed through abdominal palpation Uterine contraction may be augmented using certain drugs and or uterine massage Information Simulate pharmacologic interventions with NOELLE s bilateral injection sites Fundal Massage and Postpartum Bleeding 1 To practice uterine massage remove NOELLE s fully dilated vulval insert NOELLE S550 User Guide 2 Snap the postpartum perineum insert into place L y ET 3 Attach the l
39. ration 0 3 seconds peak 25 mmHg duration 0 2 seconds peak 46 mmHg duration 0 2 seconds peak 49 mmHg duration 0 1 seconds Print Report This option allows you to print a text file containing all the information in the log for the latest session Clicking on Print Report brings up the Print dialog box Exit You can exit the application at any time by going to File Exit or by clicking on the red x button at the top right corner of the CPRLink Set up iumard Scientific OMNI Setup Help Options Calibration Options The Options window contains the accessible to the user for configuration parameters 34 CPR Options e Select the number of desired compressions per minute e Specify the compression ventilation ratio e Select number of ventilations per minute if the Only Ventilations option is selected CPRLink will retain the options tolerances and calibration data last entered Options Ventilations and Compressions 100 Compressions per minute Compression Ventilation Ratio 30 2 Only Ventilations 112 Ventilations per minute Compression Tolerances Select the tolerance and intensity of both chest compressions and ventilations These parameters change the percentage deviation permitted while evaluating a compression or ventilation Intensity Tolerances if the user has calibrated the software these tolerances represent permissi
40. sert for episiotomy repair e Two dilating cervices e Two fully dilated vulva e Two mechanical adaptors e Two placentas with fragments e Two umbilical cords e Umbilical clamp e User Guide NOELLE S550 User Guide Equipment Set Up NOELLE is shipped partially assembled The birthing fetus and neonate are fully assembled Perform the following steps as part of the first install process Leg Assembly 1 Place NOELLE on a flat surface 2 Remove the abdominal cover and other materials packed within the abdomen 3 Remove the wing nuts washers and springs from bolts on hips 4 Remove IM site from each leg and slide bolt through hole 5 Reach through the IM site and attach to the bolt the washer spring second washer and lastly the wing nut 6 Tighten the wing nut until the spring is compressed slightly Fetal Heart Rate Speaker Connect the speaker cable exiting NOELLE s belly cover to the left side of the birthing mechanism ppe A 5 i i y x _ os a a Y 1 e e r 5 2 Power Supply Connect the power supply to the power input located on NOELLE s right side and then connect the power supply to the wall outlet Information Always operate NOELLE with the power supply connected Omni Controller Omni controls NOELLE responses with the touch of button Connect the communication cable to NOELLE and to Omni Gaumarad A startup screen is shown whi
41. t the communication cable to NOELLE and to Omni 11 Select desired fetal heart rate using the Omni controller by pressing the or button and press OK to accept the value You may adjust the heart rate at any time during delivery to simulate episodes of bradycardia or tachycardia 12 Now select the speed of the delivery by accessing the SPEED menu and increasing or decreasing minutes Press OK to accept the changes 17 NOELLE S550 User Guide 13 After confirming the settings for the labor press the RESUME button to begin the delivery ae 10 The birthing cycle can be paused at any point and then resumed To return the birthing mechanism to its initial position press RESET Note that the fetus rotates internally as it moves forward after the head is delivered and before the shoulders are delivered The student or instructor may help the fetal head and shoulders through the vulva as in real life Once the shoulders are delivered the student can complete delivery of the baby and placenta A Information In the event the birthing baby binds in the birth canal the mechanism will pause and back up It will automatically try a second time If this occurs remove the abdominal cover PAUSE the birthing mechanism from the Omni and determine the cause In most cases binding can be prevented by thoroughly lubricating the fetus the dilating cervix and the vulva During delivery fetal heart tones can be h
42. time until prompted for successive compressions ventilations For example if calibrating chest compressions The wizard prompts you with a 1 1 Perform one correct chest compression A green filled oval indicates that the chest compression was successfully recorded The wizard prompts you with 2 2 Perform a second correct chest compression A green filled oval indicates that the chest compression was successfully recorded 3 Continue the process At the end of the calibrating session the wizard shows the average peak depth and duration values for the procedure Calibration Chest Compressions ee a ed ae Sum 56 Peak 34 Duration 0 2 lt Back Finish 36 Help Scientific OMNI Help Instruction Manual About Real Time Data Instructional Manual Open the instructional manual About Click to view the version of the software About y Gaumard ulators for Health Care Education Gaumard CPR Version 2 0 0 0 Copyright 2012 Gaumard Scientific Co Www qaumard Com OK NOELLE Neonatal Care The full size neonate supplied with the S550 NOELLE is a resuscitation baby with e Patent umbilical cord e Realistic airway with tongue vocal folds trachea and esophagus e Articulated head neck jaw arms and legs e Heart lungs ribs stomach and liver e Bilateral lung expansion with realistic chest rise Perform BVM or CPR Conduct ora
43. ttach the placenta to the abdominal wall using the Velcro fastener The abdominal wall has three placement sites to attach the placenta Information Orienting the Velcro patches in parallel causes the placenta to be retained orienting them at right angles causes the placenta to release with modest traction D Information Ensure the marker of the automatic birthing mechanism aligns with the markers of the mechanical adapters and the birthing fetus Connect the cylindrical adapters with blue markers aligned to automatic birthing mechanism Attach fetus to birthing mechanism Position the baby so that its head faces toward the left side of the simulator This is the ROA or right occipital anterior position NOELLE S550 User Guide Information Placing the fetus in the right occipital anterior ROA position at the beginning of the simulation will result in a nose down crowning followed by shoulder rotation Placing the fetus in the left occipital posterior LOP position will result in a nose up presentation which may require some assistance on the part of the student or Instructor Breech deliveries may also be performed as detailed later Information Any other delivery position may be chosen however take care that the fetal shoulders are aligned with the long axis of the vulva insert A Warning If the fetal shoulders are NOT aligned with the vulva binding may occur 10 Connec
44. tween the fontanelles Use the manual vacuum pump supplied with such devices to cause the attachment of the cup to the skull Wait a few minutes for the chignon to form Uy 7 Await the next contraction that may be simulated by asking NOELLE to bear down 8 Have the student apply a steady traction perpendicular to the plane of the cup 9 Select the RESUME key then the PAUSE key again to move the fetus slightly down the birth canal Some vacuum assisted delivery devices are equipped with a means for measuring the amount of traction which may be on the order of about 15 pounds The student must stop traction when the simulated contraction ceases Repeat this procedure of waiting for the simulated contraction and providing traction during the contraction if and only if the fetus is moving down the birth canal with each contraction The student may also assess the potential need for an episiotomy to facilitate delivery In the event delivery progress is not being made NOELLE must be immediately referred as a potential C section candidate 19 NOELLE S550 User Guide Shoulder Dystocia During dystocia the fetal shoulders become wedged behind the pubic bone NOELLE may be used to practice the resolution of dystocia using episiotomy techniques the McRoberts maneuver suprapubic pressure posterior arm sweep or elbow knee delivery 1 To demonstrate shoulder dystocia place the fetal baby in the
45. ty then the first purchaser will be liable for all repair costs in addition to costs of shipping and handling Extended Warranty In addition to the standard one year of coverage the following support plans are available e Two Year Extension covers second and third years e Call for pricing USA only 40 2012 Gaumard Scientific Company Inc All rights reserved Gaumard CODE BLUE NOELLE are trademarks of Gaumard Scientific Company Inc Patented other patents pending Always dispose of this product and its components in compliance with local laws and regulations
46. y 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 1 Contact Gaumard and request authorization to return the Gaumard product Do NOT return the Gaumard product to Gaumard without prior authorization 2 Upon receiving authorization from Gaumard send the Gaumard product along 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 3 Ifthe necessary repairs to the Gaumard product are covered by this limited warranty then the first purchaser will pay only the incidental expenses associated with the repair including any shipping handling and related costs for sending the product to Gaumard and for sending the product back to the first purchaser However if the repairs are not covered by this limited warran
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